At OrthoRegen®, we offer non-surgical shoulder repair in the Los Angeles area. We have seen many patients suffering from shoulder pain, and some have even been told they need surgery. Your diagnosis may be arthritis, or it may be a rotator cuff tear. Either way, if you have been told you need surgery, regenerative therapies may be able to help you avoid the surgery.
It is not unusual for our patients to tell us about the long list of treatment options they have tried. Some brought temporary relief. But these patients are in our office because they continued to have pain and are seeking a treatment that will actually bring pain relief and repair the problem.
Our goal is to help shoulder pain patients accomplish their pain relief and restoration of function goals! Once we do a physical examination and take a medical history, we can assess which regenerative treatment will most effectively repair your shoulder from the degeneration or damage sustained from an injury.
The shoulder is a pretty amazing joint! The shoulder’s muscles and other soft tissue allow it to move through a remarkable range of motion, making it one of the most mobile joints in the human body. The shoulder can rotate, be raised in front of and behind the torso, and allow the arm to move a full 360°. This tremendous range of motion of the shoulder also makes it extremely unstable and far more prone to injury than other joints.
Shoulder pain from an injury often involves the rotator cuff! There are four muscles inside the shoulder that allow us to rotate our arms. These four muscles form a cuff of tendons around the top of the arm. With a rotator cuff tear, one or more of the tendons of those four rotator cuff muscles of the shoulder are involved.
The rotator cuff helps with all that shoulder movement we discussed earlier. When there is a tear, the tendons are weakened and will degenerate, increasing their susceptibility to even more tears. Rotator cuff tears will create a cycle of instability in the shoulder and set it up for more damage if not treated.
Common treatments for shoulder instability from tears often involve rotator cuff strengthening exercises to help stabilize the shoulder and assist with movement. Unfortunately, even though these treatments may help to strengthens the shoulder muscles, they often do not resolve the underlying problem of shoulder instability.
To fix shoulder joint instability, the shoulder tendons, ligaments, and shoulder capsular structures must all be strengthened. And that’s where Regenerative Orthopedics comes in!
Regenerative Orthopedics, like Prolotherapy, PRP, and Stem Cells, are excellent options for rotator cuff injuries because the treatments involve the repair and regeneration of soft tissue. Plus, these non-surgical therapies offer repair with a short recovery time.
As a first-line alternative to costly and invasive surgery, Regenerative Orthopedics addresses the root cause of the problem by repairing the tear and the instability. And that leads to a better recovery.
The regenerative treatment of choice will depend on the severity of the injury or degeneration.
In the journal Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders, Dextrose Prolotherapy was able to reduce pain and disability of traumatic and non-traumatic rotator cuff conditions.1
The Orthopedic Research and Reviews journal reports, “Stem cell treatment for rotator cuff tears is a promising development because they have been shown to result in an anti-inflammatory response, improved tendon regeneration, optimized collagen fiber arrangement, higher load-to-failure, and higher tensile strength. . . In a non-randomized controlled trial comparing the effects of an exercise regime to PRP combined with bone marrow aspirate (BMAC-PRP complex) on partial rotator cuff tears, the experimental group demonstrated a significantly greater improvement in (pain, function and disability) scores compared to controls at three months. Tear size decreased after BMAC-PRP injection although this did not significantly differ from controls.”2
Was a shoulder replacement surgery recommended due to degeneration from arthritis? We commonly see people who are looking at non-surgical alternatives to shoulder replacement. Sometimes they have already had surgery, but they are not satisfied with the results. Or, possibly, the patient is exploring their options.
Again, they’ve often tried a bunch of treatments, but the symptom relief was only temporary. And the orthopedic surgeon wants to pursue a shoulder replacement. Is surgery the only option? The patient doesn’t want to continue to only “manage symptoms” but rather would like to fix the issue once and for all. Regenerative Orthopedics can do that!
Arthritis of the shoulder means there is a gradual wearing of the articular cartilage. The arthritis is commonly also accompanied by degenerative rotator cuff tears.
The degeneration occurs because the shoulder is unstable and allows abnormal movement. The shoulder is a ball and socket joint. When the shoulder is unstable, the ball and shoulder socket rub against each other in an abnormal way because the rotator cuff tendons, muscles, labrum, and shoulder ligaments are damaged and are not able to stabilize as they should. At some point, there was injury to the soft tissue structures, making the joint weaker and unstable. That allowed for the abnormal motion that began the cycle leading to the degeneration of the shoulder joint and the eventual shoulder arthritis.
Shoulder replacement is not without risk. It may come with complications. Surgical patients also face surgical recovery and the time for rehabilitation. There may be a lot of downtime and limitation in exercise, physical activity, work, and sports involvement. But shoulder replacement surgery is not the only way!
Patients with chronic shoulder pain from arthritis report significant improvements in many clinically relevant parameters and overall quality of life after receiving Regenerative Orthopedics such as Dextrose Prolotherapy.
Previously, we mentioned the results in the journal Clinical Medicine Insights. Arthritis and Musculoskeletal Disorders showed that Dextrose Prolotherapy could reduce pain and disability in both traumatic and non-traumatic rotator cuff conditions (including degenerative arthritis).
The research revealed that the ligament and tendon attachment treatment resulted in superior long-term pain improvement and patient satisfaction compared with blinded saline injection.
Another study published in the journal Archives of Physical Medicine and Rehabilitation demonstrated that dextrose Prolotherapy improved pain levels, disability, strength, and shoulder active range of motion in patients with chronic rotator cuff disease. Again, chronic disease will include a degenerative condition.3
Regenerative Orthopedics is the non-surgical alternative that can offer repair without the risks and prolonged recovery time of surgery.
PRP or Stem Cells may be recommended depending on the injury or degeneration involved. PRP and Stem Cells accelerate healing by using your own blood platelets and/or stem cells. These are always used in conjunction with Dextrose Prolotherapy to provide the most comprehensive treatment and repair.
Please contact us at OrthoRegen®, and tell us more about your case to determine if you are a good candidate for Comprehensive Regenerative Orthopedics.
1Hauser RA, Lackner JB, Steilen-Matias D, Harris DK. A systematic review of dextrose prolotherapy for chronic musculoskeletal pain. Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders. 2016 Jan;9:CMAMD-S39160.
2Thangarajah T, Lo IK. Optimal Management of Partial Thickness Rotator Cuff Tears: Clinical Considerations and Practical Management. Orthopedic Research and Reviews. 2022;14:59.
3Bertrand H, Reeves KD, Bennett CJ, Bicknell S, Cheng AL. Dextrose prolotherapy versus control injections in painful rotator cuff tendinopathy. Archives of physical medicine and rehabilitation. 2016 Jan 31;97(1):17-25.
