The use of immunosuppressive biologics, non-steroidal drugs (NSAIDs) and corticosteroids, all known as Anti-Inflammaties, has been rebuked by many. But there are still, a good majority of Doctors, pain-management specialists, and orthopedic surgeons who prescribe them for arthritis, tendonitis, and bursitis because apparently, they think there is no better alternative or it may just be the case of being unaware of positive alternatives. This is evident in the ballooning anti-inflammatory therapeutics market which is projected to reach a valuation of £100 Billion by 2020. But according to researchers, there already exists a better alternative and that is Platelet-Rich Plasm a.
Why Anti-Inflammatories? One of the reasons why these are so popular is the belief that most musculoskeletal diseases are due to inflammation. It is believed that inflammation is the main cause of injuries and pain. But numerous studies have shown that inflammation is a signaling process used by the body to recruit growth factors and cytokines to the tissue microenvironment. While suppressing the inflammation with drugs interrupts this natural process and provides short term relief to the symptoms, in the long run, it prevents structural healing.
But the argument among pro-anti-inflammatory Doctors is that they provide the best short term relief. They claim that a short or two of Anti-inflammatories keeps the situation under control and is not a big deal in the larger scheme of things. Not true! They have pain-relieving properties but not as dramatic as we may think. First, corticosteroids are not as the ultimate pain-killers. Second, neither can NSAIDs be considered the most effective pain-killers and that’s a fact. Third, the immunosuppressive biologics like DMARDS, cytokine-blockers and TNF-blockers are not effective pain-killers anyway. But they all have one thing in common. And that is, a long-list of side effects!
The Effects of anti-inflammatories:
Studies show that even a single dose of these anti-inflammatories can lead to unwanted complications. Let’s take a deeper look. 1. Steroids Steroids are evidently the most destructive ones. But the problem is once they work, patients may prefer them again and again. Especially athletes. But the long term effects are disastrous. Not only are they hard to get off of, the steroids have the ability to kill mesenchymal stem cells, lead to cartilage loss, and are one of the most common causes of secondary osteoporosis. 2. NSAIDS
Medscape reports that more than 70 million of them are prescribed to patients each year in the United States alone. This is in spite of the warning issued by the Arthritis, Rheumatism, and Aging Medical Information System (ARAMIS) against NSAID use. This isn’t even mentioning the harmful effects to the stomach lining. To the patient, it sounds like a decent proposal – use non-steroidal drug to temporarily alleviate pain. However, are are consequences. In this comprehensively researched article on the Journal of Prolotherapy, the writer calls for a total ban on the use of NSAIDs for joints owing to its potential for degenerating cartilage. This is alarming considering that majority of the NSAIDs are prescribed for joint conditions like arthritis. In another study, use of NSAIDs was shown to have tripled the progression of Knee Osteoarthritis.
3. Biologics Anti-inflammatory biologics include drugs that block pro-inflammatory cytokines like tumor necrosis factor alpha (TNF) and interlukin-6 (IL-6) as well as conventional disease-modifying antirheumatic drugs (DMARDs). The problem with these drugs is that they suppress the biologic entities responsible for the natural immunity of the body. Applying them to a joint for example, doesn’t limit its effect to that area. Instead, it suppresses these biologic entities THROUGHOUT the body including liver, colon, small intestine, bones, skin and even neurons. Blocking pro-inflammatory cytokines are definitely a bad idea. For example, the cytokine IL-6, one of the main cytokines targeted by the new generation of Arthritis drugs is a major component of the central nervous system. So is anti-TNF drugs. Blocking these can only lead to adverse events in the long term elsewhere in the body.
Can PRP Disrupt The Anti-Inflammatory Therapeutics Market? Although not immediately evident, the trend for these Anti-inflammatories are actually going down. As researchers discover more serious side effects, the market will start shifting to more natural solutions like Platelet-Rich Plasma . In fact, it’s already happening as we speak. Even without the support of insurance companies, more and more people are opting for PRP. That means people are willing to pay out-of-pocket for PRP instead of accepting drugs. Patients and physicians are learning the hard way that SUPPRESSION OF INFLAMMATION DOES NOT EQUAL TO HEALING
Independent research is also catching up with Platelet-Rich Plasma . It has proved so far that PRP is far superior for: 1. Chronic low back pain The study shows that sacroiliac joint (SIJ) injection of Platelet-Rich Plasma has a longer-lasting effect on pain than steroids. And the difference is HUGE. While efficacy of steroids was only 25% at 3 months, it was 90% for PRP. 2. Tennis Elbow In this study, the steroids were only able to suppress symptoms for lateral epicondylitis, while PRP was able to biologically heal and repair. Furthermore, the steroids caused further tendon degeneration. Another study proved that patients who had PRP shows better pain and functional improvements than patients who had corticosteroid injection. 3. Plantar fasciitis This randomised, blinded study concluded that PRP delivered at least the same pain-relief results as steroids. Other researchers have concluded that PRP is actually more effective than steroid injection in terms of pain and functional results. Another study also proved that PRP was more effective and durable than cortisone for plantar fasciitis. Yet another British study also pointed out that PRP injections are superior to corticosteroid injections.
4. Knee Osteoarthritis A recent study shows that intra-articular PRP injections are better than HA, ozone, and corticosteroids. Another study recently proved that PRP injections are better than Hyaluronic Acid for knee osteoarthritis. 5. Rotator Cuff Tears This study proved that Platelet-Rich Plasma injections show benefit earlier than cortisone injections for rotator cuff tears. Another similar study also found that a single dose of PRP is better than steroid for Shoulder impingement syndrome.
Why PRP Is Actually Good For Both Patient And Doctors As you can see, the reason why more and more physicians and patients favor Platelet-Rich Plasma over Anti-inflammatories is that PRP not only reduces pain and restores function but it actually also biologically promote healing. Yes, of course, the manufacturers of the conventional drugs would love you to believe that their billion-dollar-research-backed miracle drug is VASTLY superior to the autologous Platelet-Rich Plasma that can be produced within 10-20 minutes in a small clinic. But what we’ve seen is quite the opposite.
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