New and Effective Non-Surgical Treatment for Bone and Joint Injuries
By Dr Chiam Tut Fu

Almost everyone will experience pain in the musculoskeletal system eg pain from muscle aches or ligament injuries. At least one third of the general population will experience lower backstrain with a higher incidence amongst those who engage in physically demanding activities. The usual treatment prescribed by doctors, if surgery is not a treatment option, will include pain killers, physiotherapy which includes heat treatment and of course abstinence from activities that aggravate the symptoms. Very often, the outcome is less than satisfactory and the quality of life is affected and the patient can no longer participate in the activities he or she loves.

Doctors are now recognizing that cellular regeneration at the injury site holds the key to effective and lasting pain relief. One of the exciting treatment options is low powered laser. Low powered lasers have been proven by many clinical trials overseas to give effective pain relief for BOTH acute and chronic injuries. For chronic injuries, the lasers have the added advantage of promoting cellular and tissue repair and the laying down of new tissues. The lasers are safe, will not cause burns unlike high powered lasers and are completely free of any side effectives. Studies have shown effective pain relief from the first treatment session and pain killers are no longer needed for many cases treated with lasers starting from the first session. Usually, 6 treatment sessions will result in total pain relief while promoting cellular regeneration.

The other exciting new treatment option is the use of Platelet Rich Plasma (PRP) into the injury site. PRP is obtained by spinning the patient’s blood, which is simply drawn from a vein at the clinic, in a centrifuge and a platelet rich portion of the centrifuged blood is then extracted and injected into the injury site. PRP is most effective for chronic injuries of the tendons like tennis elbows, rotator cuff tendinitis, Achilles’ tendinitis and patellar tendinitis. These are the most common overuse musculoskeletal injuries and they are extremely difficult to treat with conventional treatment modalities. One injection of PRP is usually all it needs to accelerate healing. PRP works by providing growth factors into the injured site and these growth factors then accelerate tissue healing.

Traditional Chinese Medicine (TCM) techniques like acupuncture have slowly crept into Western medicine practice. The dry needling of a painful site involves the use of acupuncture needles. TCM acupuncture involves the insertion of needles into acupuncture points but dry needling involves the insertion of needles into painful areas like trigger points which may not correspond to TCM recognized acupuncture points. Pain eg in lower backstrain is primarily contributed by spasm of the supporting muscles. Within these muscles there are areas of severe pain when pressure is applied to these points. These points are called trigger points. Under the microscope, the trigger points are muscle tissues which are tightly contracted. Dry needling and the manipulation of the needles will cause trigger point relaxation and overall reduction of muscle spasm, giving dramatic relief, starting from the first session. Trigger points may be completely pain free after a few sessions of dry needling.

The above three techniques give the patient more options but more importantly, more effective treatment options. Musculoskeletal pain is no longer something that one has to live with and suffer from.

Q & A

Q: I have other medical conditions besides my injuries. Will my medical conditions prevent me from getting these treatments?

Ans: No, these treatments are safe and can be used in most people. Medical conditions like bleeding disorders will exclude the use of PRP and dry needling as there may be uncontrolled bleeding at the treatment site.

Q: Can I combine all three treatment modalities for one injury site?

Ans: Your Sports Medicine Physician will assess your injuries and recommend the modality required based on the patient’s needs which will include urgency to return to full exercise participation and availability of the patient to come for repeat treatment sessions.

Q: Can I continue my pain medication while undergoing treatment?

Ans: Pain medication are not without their side effects and if they are no longer needed, you are advised not to consume them.

Q: Can I supplement these treatment with massages at spas or manipulation by TCM practitioners?

Ans: Massages may give pain relief but very often relief is only temporary. If done by unskilled hands, massages and manipulation like “tui nar” will aggravate the injuries.

Q: Can I start my activity regime even before all the treatment sessions are completed?

Ans: The principle of “Active Rest” will apply here. “Active Rest” means having the required rest of the injured part of the body but the patient is encouraged to start limited use of that joint, muscle etc. However, this must be pain free. Please consult your Sports Medicine Physician if you are unsure.

Q: I already had surgery done previously for the injury but pain is still present. Can I still be treated with these treatment modalities?

Ans: Yes, of course and these modalities will further improve your eventual outcome and functional status.