The cartilage within the joint may begin to degenerate when bones become misaligned or when repetitive stress on the joint occurs. Ultimately, the joint may lose all its cartilage leaving it in a state of bone-on-bone without the cushioning effect of the cartilage tissue. At that point the ligaments become overly stretched as they try to support the joint, leading to further ligament laxity and excess motion. The end result is joint instability and disabling chronic musculoskeletal pain.
The human body has 360 joints, each of which contains at least two bones connected to one another by one or more ligaments. The ligaments that connect the bones on each side of the joint may become torn via injury/overuse or otherwise stretched as they try to support the joint, leading to ligament laxity and excess motion in the joint.
The following are risk factors associated with joint instability: History of sprains or dislocations of a joint, engaging in repetitive motions in sports, hobbies, occupations, loose joints, diseases such as Ehlers-Danlos or Marfans, youthful age (i.e. incomplete development of tendons, ligaments, bones). Patients with joint instability or ligament laxity may complain of recurring dislocations or subluxations (i.e. partial dislocations), a feeling of joint looseness or giving out, pain, numbness, or tingling in the joint as a result of injury. Arthritis may an eventual sequela of joint instability as stated above.
Joint instability can be limited or prevented by: minimizing or avoiding high risk and repetitive activities, wearing proper protective equipment during sports, maintaining strength and flexibility in muscles surrounding joints via exercise/yoga/weight training/physical therapy.
Seek care if you experience swelling, bruising, severe pain as a result of physical trauma to the joint or if you have chronic symptoms associated with unstable joints. Medical professionals can usually diagnose a dislocated shoulder by a physical examination and imaging. Plain x-rays can often evaluate the bones of a joint for any displacement or dislocation. Stress x-rays can evaluate the ligament integrity of a joint as well as joint stability.
Non-trauma related instability is treated by strengthening the stabilization muscles around a joint. Physical therapy exercises to improve joint movements and range of motion may also be recommended. Acute trauma-related instability is treated with ice and anti-inflammatory medications. Stabilizing the joint may require temporary use of a sling or brace followed by a physical therapy program of strengthening and coordination exercises.
Regenerative medicine procedures are replacing surgery as an alternative. The aim of using regenerative medicine is to support your body’s self-healing processes, reverse disease progression and suppress inflammatory reactions that can worsen pain, leading to symptom relief and recovery of function. We utilize regenerative medicine procedures including patients’ stem cells to repair the ligaments naturally. Stem cells exist in high concentrations in bone marrow and fat, which can be aspirated with minimal discomfort, and then injected into the affected area often with concentrated platelet rich plasma. Platelet rich plasma has a high concentration of growth factors that activate the stem cells and prompt them to produce additional growth factors and anti-inflammatory cytokines, thereby changing the environment in the joint from inflammatory to healing and regenerating. Stem cells will begin to heal the injury by stimulating cellular proliferation and local repair processes, and by reducing inflammation, resulting in pain relief and improved function.
Surgery to repair and strengthen tendons, ligaments, or muscles is only recommended when
more conservative measures fail.
Although Stem Cell Therapy is considered by some people to be experimental, various research studies show that regenerative stem cell therapy and platelet rich plasma injections can provide excellent relief from joint and musculoskeletal pain and ongoing inflammation