Regenerative medicine in the field of pain medicine: Prolotherapy, platelet-rich plasma therapy, and stem cell therapy—Theory and evidence

Abstract

The concept of “regenerative medicine” (RM) has been applied to musculoskeletal injuries dating back to the 1930s. Currently, RM is an umbrella term that has been used to encompass several therapies, namely prolotherapy, platelet-rich plasma therapy (PRP), and stem cell therapy, which are being used to treat musculoskeletal injuries. Although the specific treatments share similar concepts, the mechanism behind their reparative properties differs. Recently, treatments that possess a regenerative quality are resurfacing and expanding into the musculoskeletal field as potential therapeutic treatment modalities. RM, in the form of prolotherapy, was first used to treat tendon and ligament injuries. With the advancement of technology, RM has expanded to PRP and stem cell therapy. The expansion of different RM treatments has lead to its increase in the application for ligament and tendon injuries, muscle defects, as well as pain associated with osteoarthritis and degenerative disks. Recently, the use of ultrasound has been added to these therapies to guide the solution to the exact site of injury. We review 3 forms of RM injection: prolotherapy, PRP therapy, and stem cell therapy.