Non -Surgical Treatment s of Avascular Necrosis – Osteonecrosis
PRP injections, A2M injections, or Stem cell injections
If osteonecrosis is diagnosed while damage is limited to a small area of bone sometimes doctors can try PRP injections, A2M injections, or Stem cell injections which is said to be the gold standard of injections.
I will get into those treatment options another day . And it may also be effective in up to stage 3 of AVN-ON but the faster you get it treated the better the outcome. It also depends on how you got your avn that will determine the outcome.
Let’s be real here
Avascular Necrosis –Osteonecrosis can be incredibly painful. And only those who have it understand the pain.
Medication to treat osteonecrosis may not be effective in people who have medical conditions that require treatment using corticosteroids, immunosuppressant medications, or chemotherapy. These medications may counteract osteonecrosis treatment.
During treatment with medication to stop the progression of osteonecrosis, your doctor monitors bone damage by taking periodic images of the affected bone for six months to a year or more. Some doctors may also recommend using crutches or a brace to remove stress from the affected bones.
As the bone starts to heal, physical therapy can help you maintain joint mobility, strengthen muscle groups that support the joint, and make changes to the way you walk to protect the affected bones. If the disease does not progress and putting weight on the joint becomes less painful, nonsurgical treatment may be all that is needed to recover from osteonecrosis.
Bisphosphonates are prescription medications that reduce bone loss by destroying cells that contribute to the degeneration of bone. This helps preserve healthy bone tissue.
Your doctor may recommend that you take this medication by mouth or injection for six months or more, depending on the size of the osteonecrosis lesion or lesions and whether symptoms improve during the first six months. If an injected form of medication is prescribed, your doctor may give the injection in his or her office or show you how to administer your injections at home. Some bisphosphonates are taken by mouth or injection once a week or once a month, others less frequently.
Your doctor will continue to evaluate the effectiveness of treatment, using periodic X-rays or MRI that can reveal changes in the bone’s health. The doctor also looks for signs of side effects from bisphosphonates, which may include bone fractures outside the affected joint, and conducts regular blood tests.
Long-term use of bisphosphonates should be monitored by your doctor. And also may cause avn-on in jaw if you need on going dental work.
Nonsteroidal Anti-inflammatory Drugs
Bone loss due to osteonecrosis may be painful, especially in the hip and knee joints, which bear much of the body’s weight. Nonsteroidal anti-inflammatory drugs, or NSAIDs, sometimes work by reducing inflammation in the soft tissues surrounding the joint, relieving pain and swelling. These over-the-counter pain relievers include ibuprofen, naproxen, and aspirin. It may help in the short term but again talk to your doctor.
Long-term use of NSAIDs can cause side effects, including upset stomach or ulcers. If joint pain persists for more than a month, talk to your doctor before continuing use.
Statins are medications that lower cholesterol levels by reducing the amount of fatty substances called lipids in the bloodstream. If statins remove lipids from blood vessels leading to a diseased bone, more blood can reach the bone, allowing it to rebuild bone tissue. This may slow or stop the progression of osteonecrosis.
Statins can cause liver abnormalities and muscle damage, so your doctor takes your overall health and medical history into consideration before prescribing them for long-term use.
No other pain relieving medication is less toxic than cannabis, even aspirin or Tylenol. This is why cannabis as medicine can be an excellent choice for pain. A proper cannabis recommendation requires more than just a few minutes of a doctor’s time, and includes information on cannabinoid content, strain selection, and delivery methods. If you’re not getting this information from your doctor, you’re not getting a real cannabis consultation and are missing information on the full value and healing potential of the plant. Cannabidiol, a nonpsychotropic component of marijuana, may enhance the healing process of bone fissures, according to a new study.
CBD oil is an entirely different compound, and its effects are very complex. It is not psychoactive, meaning it does not produce a “high” or change a person’s state of mind. Instead, it influences the body to use its own endocannabinoids more effectively and can ease pain.
Most pain medications for bone pain are taken by mouth, in pill or liquid form. If swallowing is difficult, pain medication can also be delivered through a patch placed on the skin, an injection,talk to your doctor or see a pain management specialist if needed . No one needs to suffer in pain
When prescribed in addition to medication, physical therapy may slow down the progression of osteonecrosis and provide some pain relief. During the early stages of treatment, if the disease has affected the hip or knee, physical may suggest using crutches or a cane to help you move around without putting any weight on the affected joint.
You may use crutches or a cane for six weeks or more, depending on your age, the location of the lesion, and the severity of the disease. This gives the lesions time to heal and may prevent further joint damage.
Rehabilitation experts also offer heat and ice therapy, which may provide temporary pain relief deep within the joint, as well as acupuncture and acupressure, in which very thin needles or massage are used to stimulate blood flow and reduce inflammation.
After you can put weight on the affected joint without pain, physical therapists can customize a routine of simple, low-impact exercises to maintain range of motion in the affected joint as well as build strength in muscles that surround and support the joint. For example, stretching exercises and movements such as leg lifts or squats can prevent the joint from becoming stiff.
In addition, adding exercise such as tai chi or or my favorite is qi gong , or using a stationary or recumbent bike another favorite of mine or add swimming to your regular workout routine can help you maintain flexibility in the joints without putting too much stress on the bones. These exercises may prevent the disease from limiting your ability to walk and participate in everyday activities. They also improve blood flow throughout the body, which may help the bone heal more quickly.
A physical therapist can also help you alter the way you walk to avoid limping or putting too much stress on the affected joint. This helps ensure that you are able to use the joint without feeling pain for the long term.
The duration of physical therapy varies depending on the location of a lesion and how quickly your body responds to medication and physical therapy. After four to eight weeks, your therapist and physician assess your progress and determine whether additional treatment is required.
The most important thing you can do is have a good ortho , talk to him or her openly and honestly about your condition, your pain, your limitations etc…. together you can work together to find the best treatment plan for you . And also remember if you are unsatisfied you can always get a second opinion and or new ortho.
Hyperbaric-Oxygen Therapy and Osteonecrosis
Hyperbaric oxygen therapy involves breathing pure oxygen in a pressurized room or tube. Hyperbaric oxygen therapy is a well-established treatment for decompression sickness, a hazard of scuba diving. Other conditions treated with hyperbaric oxygen therapy include serious infections, bubbles of air in your blood vessels, and wounds that won’t heal as a result of diabetes or radiation injury.
In a hyperbaric oxygen therapy chamber, the air pressure is increased to three times higher than normal air pressure. Under these conditions, your lungs can gather more oxygen than would be possible breathing pure oxygen at normal air pressure.
Your blood carries this oxygen throughout your body. This helps fight bacteria and stimulate the release of substances called growth factors and stem cells, which promote healing.
Why it’s done
Your body’s tissues need an adequate supply of oxygen to function. When tissue is injured, it requires even more oxygen to survive. Hyperbaric oxygen therapy increases the amount of oxygen your blood can carry. An increase in blood oxygen temporarily restores normal levels of blood gases and tissue function to promote healing and fight infection.
PRP and Stemm Cells
Doctors who use PRP therapy to treat osteoarthritis theorize that the platelet-rich plasma might: Inhibit inflammation and slow down the progression of osteoarthritis. Stimulate the formation of new cartilage. Increase the production of natural lubricating fluid in the joint, thereby easing painful joint friction. It has been shown to also help Osteonecrosis in early stage 0-1-2
Stem Cell injections – Do your home work and make sure they are qualified- non-surgical option for many suffering from pain and loss of function due to a degenerative condition or orthopedic injury.
Stem cells are the body’s raw materials — cells from which all other cells with specialized functions are generated. Under the right conditions in the body or a laboratory, stem cells divide to form more cells called daughter cells.
These daughter cells either become new stem cells (self-renewal) or become specialized cells (differentiation) with a more specific function, such as blood cells, brain cells, heart muscle cells or bone cells. No other cell in the body has the natural ability to generate new cell types.
Both A2M and PRP occur in the blood naturally, in fact, A2M is present in PRP. … The difference between modified plasma and platelets with the blood flowing inside the body is concentration. In blood plasma and platelets are lower than those modified because for it to be effective, it should be highly concentrate.
Alpha 2 macroglobulin (A2M) is a molecule that occurs naturally in blood. It protects the body by blocking the functions of the proteinases responsible for the destruction of important tissues. Even though they are present in the blood, they are not able to travel to areas they are needed the most due to their form of structure and this is why scientist came up with an A2M injection. The proteinase is attracted to the A2M molecules for bonding which in turn gets eliminated by the body.
According to the facts stated here, both PRP and A2M have their own unique advantages. PRP prevents the cartilage from being destroyed further by the protein inhibiting enzymes and at the same time restores the damaged tissue to its original structure.
A2M is equally as useful a treatment for chronic arthritis because it quells inflammation in an attempt to reduce pain and prevent further damage.
In chronic arthritis, the cartilage has already started getting destroyed and if there’s any medication that will correct and restore it that will be PRP. With its restoration properties, the cartilage will be able to regrow and assume its normal structure. On the flip side, A2M will capture the proteinase and prevent further cartilage damage, making it equally viable for chronic arthritis.
Both A2M and PRP occur in the blood naturally, in fact, A2M is present in PRP. It is due to this reason both of them are safe to use since they don’t present any form of adverse effect. The difference between modified plasma and platelets with the blood flowing inside the body is concentration. In blood plasma and platelets are lower than those modified because for it to be effective, it should be highly concentrated.
Administration of A2M and PRP injections is on site this enhances and speed up treatment. It is unlikely to develop a reaction to both therapies since they are prepared using the patient’s blood.
PRP has been around for quite a while, while A2M therapy is relatively new.