BPC 157? Prolotherapy? PRP? Others? Best Injections for Healing?
John Paul Catanzaro BSc Kin, CSEP-CEP has written a great summary of a variety of different injections one might consider at least once in their athletic careers or lifetimes to prevent having surgery and/or to improve function and to get out of pain. If you do want to maybe take one of these injections, remember that each treats injuries different and with varying successes. Here's our quick rundown on each injection in the article below keeping in mind that injections have the best success to with minor issues and/or injury prevention.
Vitamin B12 and traumeel isn't going to "fix" something broken, but it could provide some temporary pain relief, especially for joint treatments.
PRP is not a magic cure for torn ligaments and tendons, and for grade 2 or 3 injuries, you may not see success. Recovery is long, and treatment not cheap.
Prolotherapy is essentially a sugar water injection which makes it the most cost effective solution for generally loose (but not torn) ligaments. A highly underrated option for chronic pain and dysfunction in combination with target physical therapy.
Hyaluronic Acid can be helpful for joint pain and irritation but don't expect full recovery from this treatment with serious degenerative issues. As always, the question is: how bad is it? Ask your doctor.
BPC 157 could be considered a combination of the above therapies as it works in a variety of different healing ways together. If prolotherapy or Vit B12 doesn't work, this may be something you can consider as a follow up. If PRP didn't work for your ligament or tendon issue, this may not work either.
Intra-Muscular and Intra-Articular Botox is not something we've heard about or ever head of anyone getting. Consult an expert. It's something potentially to consider for chronic joint and muscle pains.
Intra-Articular Growth Hormone is a potentially stronger and more effective option than Hyaluronic Acid for joint related pains and degenerative conditions.
Stem cells? Sure, but they are really expensive and sometimes difficult to find treatment faculties. The best bet here according to research is for joint healing and repair.
Cortisone should be avoided at all costs. Research suggests you get no more than 3 injections into the same body area, for life! Not a sustainable long term solution to pain or inflammation. And does not "fix" the cause of the pain, really.
*If you are simply looking for more basic joint and or muscle pain relief: dry needling, physical therapy, massage, acupuncture, magnesium baths, arnica, menthol, ice, heat, and NSAIDS are other things to consider.
When you think of getting an injection to deal with an injury, what’s the first thing that comes to mind? Most likely, it’s a cortisone injection. Most of us have had one at some point, and most of us know how much it tickles. We’ve learned over the years that cortisone injections are not always effective, they can lead to more harm than good down the road, and they hurt like hell! Well, today we have many more options available to us.
Here are eight injection methods to help speed up the healing of injuries:
Vitamin B12 and Traumeel injected into trigger points provide a very potent anti-inflammatory effect without hindering the body’s healing mechanism. For example, if you inject this blend into the infraspinatus muscle (a common trigger point for shoulder pain) and then use laser to heat it up, it will spread into the shoulder joint capsule and work its magic.
This one feels and acts like a cortisone injection initially, except that it does not have the potential harmful side effects of a cortisone injection such as tendon rupture and scar tissue formation. I had the B12/Traumeel procedure done many years ago by Dr. Anthony Galea and it certainly provides an anti-inflammatory effect, but it feels like Mike Tyson punched you in the shoulder before that happens!
Platelet-Rich Plasma Therapy (PRP), a method known as PRP, involves injecting some of your own blood after it’s been removed and been centrifuged down to isolate the platelets – the part of the blood that contains all the healing factors. The therapy appears to help repair muscle, bone, and other tissues. It also appears to help regenerate ligament and tendon fibers, which could shorten rehab time and possibly eliminate the need for surgery.
To say the method is revolutionary would be an understatement! It’s so crude and simple, yet highly effective. I had a colleague who was scheduled for rotator cuff surgery but decided to give PRP a shot before going under the knife. The procedure was guided under ultrasound to inject the platelets right into the tear and after three treatments, it was completely healed!
A few years ago, I suffered from medial epicondylitis (golfer’s elbow), which can be a debilitating condition. It was so bad that I had trouble holding a fork! I had PRP done on the common flexor tendon of both arms. What a difference! Gripping anything heavy, like doing max deadlifts or fat-grip chin-ups, was no longer a problem. The results were like night and day!
There are many physicians around the world that perform this procedure now. Make sure that you find a skilled one to do it. If you inject the wrong tissue (e.g., a bursa sac), you’ll cause more harm than good.
Prolotherapy is an injection method used to initially irritate and then stimulate healing of injured and painful joints and connective tissue. Some refer to it as “nonsurgical ligament reconstruction” because it’s often used to address ligament laxity (weak or damaged ligaments).
What happens when you irritate an injured ligament that’s been dormant for a while? It starts to heal. Ligaments don’t have a great blood supply, so bringing any sort of “attention” to the area is a good thing. Injecting an irritant, like a dextrose solution, into a ligament will cause your body to mount an attack against it, which causes inflammation, the first stage of healing. Without inflammation, you don’t have repair or remodeling. In other words, you don’t heal.
Prolotherapy may be just what the doctor ordered to heal a ligament… that is, before the doctor orders surgery. It’s worth the irritation.
Hyaluronic Acid is a key player when it comes to joint health. Think of cells in the body as bricks of a house. Hyaluronic acid keeps the mortar between the bricks (collagen) from drying out and cracking. It’s basically the “glue” that keeps your cells together. We’ve all heard of stories where the foundation of a house was weak and brittle because the mortar was falling apart. The same sort of thing can happen in your body as you age and tissue starts to dry out.
Hyaluronic acid can help lubricate and cushion joints and reduce pain. This stuff is so versatile. It’s used to regenerate eyes, skin, hair, lips, and – you guessed it – joints, specifically the hyaline cartilage that lines movable joints. Hyaluronic acid will attract moisture to the joint, almost like an oasis in a desert, and it will help to fill in the cracks in the foundation.
You can take hyaluronic acid orally or apply it topically, but if you want the greatest injury-healing impact without worrying about any absorption issues, inject that sucker straight into the joint.
Peptide BPC-157 is an underground remedy for injured tendons, ligaments, and muscles. This particular peptide has the ability to heal tissue big-time, and it’s quickly becoming a very popular “behind the scenes” treatment for many guys in the iron game.
I took notice after a colleague of mine, Mike Demeter, mentioned his experience with this stuff. Mike used 250mcg of peptide BPC-157 twice a day. Within 10 days, his range of motion improved considerably and there was a significant reduction in pain. You can read all about it HERE.
The bottom line is that this peptide can work pretty fast to get the job done and it appears to be free of side effects. If you’re thinking about giving it a shot, check out How To Use BPC-157 by Ben Greenfield. You’ll learn everything you need to know from that article.
Intra-Muscular and Intra-Articular Botox can provide some serious relief for joint pain. You can either shut off overactive muscles that may be causing pain in a joint, or shut off the pain nerves in the joint itself.
Lateral patellofemoral overload syndrome, for instance, is a painful knee condition that typically affects runners and cyclists, but it can hit anyone that’s active and that includes the average gym rat who does high-rep squats and lunges and throws some cardio in the mix. Research has found that injecting a Botox-like substance into the tensor fascia latae (a muscle that runs along the front and side of the hip) followed by a few months of physiotherapy can wipe out knee pain in a majority of subjects.
Botox can even be used to treat chronic arthritis when injected right into the joint. Research has shown a significant decrease in joint pain in ankles, knees, and shoulders. It does so in two ways: it targets pain nerves within the joint and can reduce nerve-related inflammation of the muscles surrounding the joint without compromising strength and function of adjacent muscles. Diminished wrinkles around the area are just an added bonus!
Intra-Articular Growth Hormone (GH) has the unique ability to regenerate cartilage. If you’re a “bone on bone” case, you may be a perfect candidate for this procedure. I heard an interview on the subject with Dr. Allan Dunn, the pioneer of the procedure, and found it quite intriguing. You can listen to that interview HERE (forward it to around the 1:07:19 mark).
Get this, intra-articular GH can actually promote the development of fetal cartilage. Yes, the same stuff that grew in your body when you were in your mother’s womb! To understand how the process works, read Developmental Healing of Cartilage and then find a physician in your area that can perform the procedure. Granted, you need to use a high dose of GH (around 15-30 IUs depending on the size of the joint), and it’s expensive. It also requires a bit of time and some physio (the joint must remain unloaded throughout the process), but with a success rate of 95% for ankles, elbows, and wrists in particular, I’d say the potential to regenerate cartilage is well worth it.
Stem Cells are the new kids on the block for treatment of skeletal muscle injuries. Think of stem cells as the “repairmen” of the body. These guys go to work to heal all sorts of joint, muscle, tendon, ligament, disc, and bone injuries, and the word on the street is that they really work!
Joe Rogan of UFC fame has talked quite a bit about the effectiveness of stem cell treatments. He had it done to repair a badly injured shoulder, and it did the job. He’s back to 100% now. According to Rogan, “Injuries heal super quick… permanent results within days… it’s insane!”
Stem cell treatments are even being combined with PRP and prolotherapy for a super-potent healing cocktail. It’s certainly a fast-growing field. Currently, the expense is high, but this may be a game-changer in the future.
It would be nice to go to your local walk-in clinic to request any one of these injection methods and have it covered by your health insurance plan. Unfortunately, it doesn’t work that way! These are specialized procedures that require specialized doctors to perform them. In my area, we have several physicians that do these procedures, like Anthony Galea, Michael Clarfield, Douglas Stoddard, Gordon Ko, and Fred Hui. You’ll need to do some research and ask around to find someone competent in your area.
And if you think that your insurance plan will pay for the procedure, think again. You’ll likely have to pay out of pocket and it’s usually a hefty bill, but if the alternative is constant pain, compromised strength, mobility, and performance, and possible surgery, well that’s a price I’d be willing to pay!
Cortisone injections are a popular first-line treatment for recurring joint pain, but they can have negative side-effects down the road. Instead of cortisone injections, there are other safer and perhaps more effective options, such as vitamin B12 and Traumeel, PRP, prolotherapy, hyaluronic acid, peptide BPC-157, Botox, GH, and stem cells. If the only other option left is surgery, I say these injections are worth a shot!