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I have a question about a herniated disk injury (L5-S1) and rehabilitation using platelate rich plasma therapy therapy, prolotherapy and regenokine.

I know platelet rich plasma therapy draws your blood, spins out the platelets and re-injects them into your injury area to promote inflammation and healing...which makes sense. Prolotherapy basically does the same thing but with saline and dextrose...make sense also. But regenokine takes IL1-RA out of the blood to enhance natural anti-inflamation response. That seems opposite to the therory behind PRP therapy and Prolotherapy.

Which promotes healing the best rather than just pain relief?

Category: Orthopedic Surgeon

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Category: Spine Surgeon
 27 Doctors Online

Thank you for your query at
I have worked with PRP Therapy as well as prolotherapy.In my practice i did found good response to PRP therapy because there are multiple healing factors involved.
The platelets release good amount of growth factors & also add to present inflammation at diseased site.The prolotherapy just help in increasing the inflammation or inducing inflammation by irritative substances.
In my opinion the best treatment for your problem is PRP Therapy.
Feel free to discuss further,
Hope this will help you.

Patient replied :

Thanks for your response. As I know it, PRP works at increasing and repairing the connective tissue, such as ligaments. With disc herniations I know the cause a lot of time is ligament weakness or damage, hence increasing and repairing ligament strength should go to helping the injury. My particular injury came from lifting weights (deadlifts) and going on a long run (5 miles) afterwards...according to the orthopedic surgeon who looked over my MRI it was a cue on chronic injury meaning I guess there was some damage predating this immediate time.
With the existing injury, and signifigant deflation of my disc due to tears in the annular wall of the dics, I was wondering if PRP and its increase of ligament strength was just more of a profalactic measure and tangential area to heal to go towards recovery, or if something about the growth factors and the increased irritation would actually go towards healing the tears in the annular wall, rehydrating the disc, getting it back into place...basically, how exactly would PRP be repairing the injury itself rather than just making strong and healthy the tangential things around it, such as increased ligament strength?
I am kind of recent to this whole therapy so sorry if I totally butchered how the therapy actually works.

You have a fair understanding of how PRP therapy works and I appreciate it.

It works on all connective tissue including the ligaments as well as the disc. So it acts directly as well as tangentially.

PRP with its growth factors increases inflammation at the site of disc herniation.This leads to an increase in blood flow in the affected area. Due to this, there is an increased inflow of inflammatory factors & other substances which leads to repair of the rent in disc. This repaired disc, as time progresses, acquires natural strength with increase in load on it.

Hope this was clear and helpful to you. Feel free to ask queries.

With best wishes.

Dr. Mukesh Tiwari
Category: Spine Surgeon
Fellowship - Khandaka Hospital, Jaipur
Residency - MS, Rabindranath Tagore Medical College, Udaipur, 2000
Medical School, Internship - MBBS, SMS Medical College, Jaipur, 1995
Dr. Mukesh Tiwari and 4 other Medical Specialists are ready to help you

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