USE OF PRP AND LASER THERAPY IN SHOULDER LAMENESS
By Dr. Heather Mitchell
Seamus is a 4.5 year old, male mini schnauzer that came to our clinic near the end of October 2018 regarding a lameness on the LF leg. He was limping on the leg, he could still jump, but he would vocalize in pain often. X rays of the bone of the leg showed no abnormalities, and we decided to treat conservatively with pain meds and rest.
A few weeks later, Seamus was back, still limping. He did very well on pain medication but when he was off the pain medication for 1-2 days, the limping returned and he would be painful and often not walking on that LF leg. X rays were performed while Seamus was under sedation. X rays showed no changes from the previous X rays in October. Even under sedation, Seamus was painful upon extension of the L shoulder and during palpation of the supraglenoid tubercle on the shoulder. The supraglenoid tubercle is a normal bony projection on the shoulder bone in which the biceps tendon attaches to. At this time, a tendonopathy or a tendon tear is likely the culprit of the lameness. We discussed treatment options and decided to pursue PRP (platelet rich plasma) and laser therapy.
PLATELETT RICH PLASMA (PRP)
Platelet-rich plasma (PRP) represents an innovative therapeutic approach to lameness treatment. PRP falls into the category of regenerative medicine. PRP contains growth factors that promote soft tissue healing and stimulates new blood vessel growth, as well as providing long lasting anti-inflammatory effects. A simple blood collection is harvested from the pet and a skilled veterinary technician prepares the sample to ultimately yield PRP. The PRP, is then injected into the area of concern, in Seamus’ case, the left shoulder joint.
For Seamus, I recommended using PRP in conjunction with laser therapy. Laser therapy is a photobiomodulation (PBM) therapy achieved when a sufficient dose of light energy reaches target tissues and cells and results in decreased inflammation, decreased pain, and accelerated healing. Laser therapy can effectively reduce pain and inflammation associated with a variety of acute and chronic conditions, including degenerative joint disease, osteoarthritis, bone fractures, skin wounds, inflammatory bowel disease, inflammation, gingivitis, muscle strains/sprains and post-surgical incisions. For more info on laser therapy, click here.
Seamus was doing very well at his 3 week recheck appointment. Less than 2 weeks following the PRP injection and laser therapy sessions, the owner was able to decrease the pain medication given to Seamus. At the 3 week recheck appointment, the left shoulder was 90% better and the owner felt Seamus didn’t need any pain medications at all! The laser therapy sessions were reduced to once per week for the next 3 weeks and another PRP injection was performed 1 month after the first injection.
Approximately 2 months after instituting PRP and laser therapy, Seamus is completely recovered! The combination of PRP and laser therapy gave Seamus’ shoulder joint the proper matrix to promote healing and reduce inflammation. Seamus was able to maintain complete range of motion of the shoulder joint without the need for prolonged pain medication use. The combination of PRP and laser therapy allowed Seamus to resume normal function of the left shoulder faster and reduce the need for pain medications to control discomfort.