Prolotherapy for Glenoid Labrum
In this study, which you can read online in its entirety Prolotherapy for Glenoid Labrum Tear New Research, we talk about our experiences in treating patients with shoulder pain.
In summary we note that tears of the glenoid labrum are a common cause of shoulder instability and a frequent finding in patients with shoulder pain.
Management of these patients typically involves an attempt to avoid surgery through conservative treatment, but these treatments are lacking at promoting labral healing.
Regenerative injection therapies, including Prolotherapy, have shown promise in the treatment of several musculoskeletal disorders, but have not
Patients following Prolotherapy treatment reported highly significant improvements with respect to pain, stiffness, range of motion, crunching, exercise and need for medication.
Patients reported complete relief of 69% of recorded symptoms. One patient reported worsening of some symptoms.
We see a lot of different shoulder injuries here at Caring Medical, and these cases are actually something I have taken a special interest in, in my practice. So I wanted to take the time to talk about a few of the most common shoulder injuries that we see here, and today I am actually going to talk about the glenoid labral tear.
So for those of you who might not know, the glenoid labrum is a ring of fibrocartilage tissue that just helps to deepen our shoulder joint. If you look here on our model skeleton, you’ll see we have the shoulder joint. We have our collar bone, our shoulder blade, and our humerus, which is our upper arm bone, that all come together. What the labrum does is it actually is a ring of tissue that comes out here to help keep our humerus, or the head of the humerus, in place and to keep the joint more stable.
When someone suffers a labral tear, they most likely suffer it in one of three ways. One is they were doing some kind of activity and they fell and they outstretched their hand to catch their fall. Well this transmits the force up, moves the humerus, and can actually tear that labrum. A second way is if they have a sudden blow to the shoulder. Whether it’s from football, hockey, or any other sport really, any kind of sudden blow can tear that labrum. The third way is just wear and tear from repetitive motion. For example, people that are carpenters, body-builders, even volleyball players can cause wear and tear on the labrum and can cause a labral tear.
When people come to Caring Medical for labral tears usually they say kind of the same things: there’s a lot of clicking, there’s a lot of locking, even some “clunking” sounds in the shoulder, a lot of pain, a loss of strength, or even less range of motion. Often times they will have pain if they are brushing their hair, reaching for something on a high shelf, maybe even putting their wallet in their back pocket. All these kinds of things kind of point to a labral tear. So when patients come in here at Caring Medical with shoulder injuries we examine them, give them a proper diagnosis and if they are a good candidate then we treat them with Prolotherapy. Like I said it is an injection technique. We use dextrose to stimulate the healing of injured structures, whether it’s the ligaments, the tendons, or the labrum. We might also use something called Platelet Rich Plasma Therapy. That involves drawing out blood, spinning it in a centrifuge, and collecting all of the platelets, growth factors, and a little bit of the plasma, which is kind of the water of your blood. We actually inject that back into the shoulder joint to help healing. It is more of an aggressive approach than the standard dextrose treatment.
PRP works really well for labral tears because it almost acts as glue to kind of glue the tear back down. We all know the saying, “Blood is thicker than water.” Well, PRP (a blood product) is a lot thicker than the dextrose solution so it works really well at gluing those tears down. It also helps to stimulate healing of all the structures around the joint, like the ligaments and tendons like I had mentioned before. Especially if someone has an old injury that has on-going wear and tear where they’ve lost a lot of cells, PRP actually helps to kind of put those cells back in that place. Typically for a shoulder we like to see patients 4 times. Each treatment is based about 4-6 weeks apart, and again that depends on the severity of the case. Sometimes people do really well with 3 treatments and sometimes it might take 8 or 9, depending on the complexity of the injury. On average we see patients about 4 times.