PRP for Sacroiliac Ligament | Why I do it?
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- Опубліковано 17 вер 2024
- The sacroiliac ligament can be a source of pain. Dr Musson, Interventional Pain and Regenerative Medicine Specialist, discusses his journey treating the SI ligament and why he uses PRP for sacroiliac ligament pain and injuries.
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I truly think ligament damage is the source of most my problems. I have annular tears in my lower discs, but when I get those treated, it only relieves temporarily. It's hard to find a doctor that really knows anything
Hey Marcie, sorry to hear! I've found over the years, when I test the discs prior to treatment, the ligaments are also problematic 100% of the time. Sometimes the disc will actually be ok but all the pain is from ligaments. I've never seen a painful disc without associated problematic ligaments. Best of luck on your quest!
Very interesting
Indeed.
had discs inserts incl S1L5, now SI joint in pain, here in Hong Kong
Sorry to hear. Hope you can get that fixed up! Sometimes an SI belt can be helpful while you're trying to get things treated. In addition to some good physical therapy. Best of luck!!
You may have just found my problem. I’ve had tons of epidural injections etc. in my lower back and si joint, but never any focus on the ligaments. I’ll ask my doctor.
Thanks
Ya, it's always good to explore additional options if the traditional treatments are helping. Best of luck!
Is it risky to have this done without ultrasound to avoid nerve damage?
I am getting prolozone currently. Second session was 2 weeks ago. I have had SIJ dysfunction for 2 years. I am only 17. Since October. I have not seen any benefit from my prolozone treatments so far. I am almost certain I have a ligament problem. (I had cortisone injection and had relief for 1 month, but it wore off) (also the original numbing for the cortisone was successful as well) I know most chronic SIJ instability comes from a ligament issue. So what do you think my path should be? I have one more prolozone treatment in a couple weeks, and then after a month we will see if I have had any results. If this doesn't work should I try prp? Stem cells? Bpc 157? I know you cannot evaluate me right here, but I would love to hear your thoughts sir!
Hello doctor! Do you perform prp with fluoroscopy?
Ya, on the spine I'll use fluoroscopy. I'll typically use ultrasound on peripheral joints/tendons/ligaments.
Been been watching your videos. Good info thanks for posting. I Have what I think is an illiolumbar injury from a fall in 2019. Dr.s can't find the issue. Flares up with doing hinge movements at the gym. Nothing shows on MRIs. Did prp 3 times but can seem to find the correct spot. Injected into point of pain directly above illiac crest, si joint and surrounding areas. Any thoughts you can share on this?
Ya, this can definitely be tough getting the right spot. Sometimes it's super clear and I hit the spot just right, feels just like the spot, and feels almost completely better when I numb it up. Then it's an easy call to treat it with PRP. I do these all under fluoroscopy and even with that it's not super easy. If I did it without xray guidance there would be a good chance that I may miss the spot. If I block the iliolumbar and sacroiliac ligaments and they don't alleviate the pain I may consider doing discography. Disc pain can seem similar to ligament pain. They also go hand in hand. I think every time I've had a positive discography the patient also had at least some painful ligaments.
@@BlackStonePhysicalMedicine Did a test injection with numbing agent right above the illiac crest. Completely got rid of the pain until it wore off. That's why I decided to do the prp it seemed to pass the test. Been doing imagine guide injections and they seemed to help the first two sessions. The third one didn't cause any improvement. That's why I think it might be the wrong spot. Was looking for areas you concentrate injections so I can suggest to my doctor. Where are you located?
I'm in Oregon USA. There are a lot of variables that can affect the outcome of a PRP injection. Sounds like your doc is on the right path. Right placement of the PRP is half the battle. There are a few other things that can help optimize the outcome.
I just had the first injection 2 days ago
Awesome! Best of luck!!
@how did it work
@@ryanwilson2194 you lucky I am online and saw this question.. so after 9 months passed I can tell you all that treatments are very temporary . What I succeed is the infra red light therapy that I do at home.. the belt cost me $40 on Amazon and I use 3 times a day usually. Started not long time ago but I see major improvement.. less pain some days no pain at all !
How long does it take for pain to be subside post PRP injection into the SI ligament?
Usually a few days. We've had some folks where it lingers longer. Some where it's not bad at all. Definitely not a perfect science. Using imperfect diagnoses and imperfect treatments. But the potential upside to provide significant relief and a long term remedy is much better than many of the alternatives.
@@BlackStonePhysicalMedicine Sorry I think I wasn’t clear. I mean not the pain from the injection itself, but the pain from the dysfunctional SI joint to subside after receiving treatment.
@@SuperSlimShaady Oh sorry about that. I typically tell people to not expect much the first month. Then gradual improvement between months 1 and 3. Then things typically plateau at 6 months. Sometimes we have to repeat. 3-6 months down the road.
Is the testing procedure you mentioned also referred to "wet needling?" My buddy from the gym said he got that in his elbow vs. the PRP that didn't work for him, but he's the only person I spoke to who received zero benefit from PRP. He did go to a Military doctor, which for me raises caution... I have nothing against mil docs generally, but they are the reason Im here trying to undo what they did regarding my pain. I'm scheduled for PRP this week in both SIJ's. Not too sure what to expect, but Ill be heading straight to my last 2 HBO treatments after that which have had a noticeable effect on overall pain as well as other benefits (2.0ata for :60 minutes, 5 days on, 2 off for 35-40 tx- but its expensive)
That sounds like a good set up! Wet needling is usually injecting lidocaine while doing dry needling of a tendon or muscle. So similar but a little different goal. With the diagnostic block my goal is to anesthetize the target ligament, tendon, or joint. But sometimes patients will have lasting relief with the test which is similar to "wet needling". PRP is not 100% successful. We're seeing that sometimes we need to do more than PRP for a real bad tendinopathy, like at the elbow. When the tendinopathy is real bad, sometimes we'll do inta-osseus PRP and MFAT into the tendon defect.
@@BlackStonePhysicalMedicine hey, thanks for the response! The prp was not as painful as I imagined it would be. I'm 4 days post and it still hurts, but instead of feeling like a chemical burn in my SIJ, it feels like a bruise (which I'll take any day over the other.) Side note, I had a chemical burn in my face before and yes, I can confidently compare the 2. I have a follow up in 6 weeks, so we will see. Trying to take it easy with a toddler is challenging, but I flew my mom out to help just in case. Thanks for all the advice as I'm certain that your insight helped ME to figure out what's occurring. I've sent some of your videos to my pain management doctor who has been really receptive and supportive. I appreciate the information you pass on and the insight you provide. Not enough providers can think outside the box and that's highly appreciated. Thanks again, doc :)
@@IzKadence That's fantastic! Best of luck with recovery!!
@@BlackStonePhysicalMedicine SO MUCH WORSE. I couldn't walk on three separate occasions since I had PRP. I have the 6 week follow up next week where I'll asking for the lidocaine. I just emailed my pain management doc for additional imaging ASAP. I had nerve conduction testing done last week as well, but that whole test had zero to do with the pain I'm in which is 100% localized to my SIJ. I do have occasional sciatica, but this pain is not nerve related in any respect IMO. I'm Not sure what else to do for testing/ doctor referrals/ therapy recommendations. Any thoughts???
So PRP works for ligament injuries?
Hey Darian, it is an option for ligament injuries. If conservative management like physical therapy doesn't improve it with time. It falls into the realm of prolotherapy. So some docs will use a variety of prolotherapy solutions. I prefer PRP simply because I have a hard time finding the real potent prolotherapy solutions.
My Physio did so knee and pelvic manipulation which lead to si dysfunction (I had prior disc bulge which is better now). Now the pain can this be due to ligament damage laxity or I have a real bone problem? How can I confirm this and lastly in your practice what is better prolotherapy or prp
Would it be best injected with longer pins like a 4in length as they do in prolo?
Ya, I have to use at least a 3.5 inch needle. Even on a smaller fit person. The angle to get down to SI ligament at the upper portion can be pretty deep.
@@BlackStonePhysicalMedicine So, as accidentally I had e steroid pinned in my SI joint yesterday, how long should I wait to do prolo or prp?
Would an SI belt help to heal an SI joint or si ligament?
I think it would help manage the symptoms. I don't know if it would actually help heal a damaged ligament though.
@@BlackStonePhysicalMedicine so I would need to get a prp injection into the SI ligament? I live in the UK. Will need to make enquires
Dr. Mussum how do I contact you?
On our channel page we have an email address and website info.
It is disingenuous to refer to your self as a physician if you are not an MD.
In the US DOs are complete physicians who, along with MDs, are licensed to prescribe medication and perform surgery in all 50 states