Physiology of a Back Strain:
Nociceptive effect:
• Activation of nociceptive nerve fibers
• Signal sent down to neurons via spinal cord to brain.
• Signals upregulate the feeling of pain and initiates the inflammatory response
Inflammatory effect:
• Damaged cells release cytokines and other mediators
• Initiates vascular dilation and permeability
• PMLs, followed by macrophages enter the scene
• Stimulates the migration and proliferation of fibroblasts
Proliferation Phase:
• Connective tissue begins to heal
• Fibroblasts encourage synthesis of procollagen matrix (2-3 days following injury)
• Vascular buds from increasing blood supply
Remodeling Phase:
• Collagen type I changes to collagen type II
• Fibrils increase along lines of stress to become tightly packed (2-3 weeks post injury)
• Collagen thickens and increases to preinjury length but with only 50-70% tensile strength.
With severe injury, the healing process may stop before the tissue is sufficiently competent for every day use leading to chronic pain.
PRP effect on back injury:
Formulates collagen:
• Main component of connective tissue
• Found in ligaments, tendons, skin, blood vessels, cartilage and other parts
• New collagen shrinks as it matures – tightening damaged tissue making it stronger
Releases growth factors:
• Regulates cell division and cell survival
• Activates cellular proliferation and differentiation
• Promotes cell growth
• Function as hormones, regulating signals
Secretes cytokines (Cytokines are a category of signaling molecules that mediate and regulate immunity, inflammation and hematopoiesis.):
• Proteins released by cells
• Lymphokine, monokine, chemokine and interleukin
• There are anti- and pro-inflammatory cytokines available
Platelet Rich Plasma treats structural ligaments, muscle strains, and muscle fibrosis and improves stability and dispersion of weight.