Conditions Treated
A Review of the Basics
Welcome to the exciting new field of Stem Cell Orthopedics. Regenerative Orthopedics is all about healing the pain of joints and the connective tissue that holds us together. Every single joint in the body is held together with ligaments and tendons that stabilize and help us move joints. Ligaments hold joints together passively while muscles and tendons also help stabilize joints but in addition allows us to move them with intention. Surgical orthopedics mainly concerns itself with bones, cartilage and discs because that’s what we see on x-ray and MRI. MRI of course also sees connective tissue so it also helps evaluate ligaments and tendons. In regenerative orthopedics we concern ourselves mainly with ligaments and tendons because that’s what holds every joint together. For us, the stability of the joint or region is of primary importance. Here’s a very important point: ligaments and tendons are much more highly innervated than bones or cartilage (or discs) because that’s what gives us the joint feedback (proprioception) which allows us coordinated movement. In fact, as we will explore, this connective tissue that holds the whole body together is a much bigger pain generator than bones, cartilage and discs.
So if our main goal is to heal the localized pain of joints and make the joints of the body more functional, we need to understand the root-cause of pain and address the ligaments and tendons that may be sprained and strained. These stretched structures form tears and micro-tears at their attachments which are highly innervated and can become huge pain generators. Here’s another key point. Most of these tears are actually micro-tears which are too small to be seen on MRI and ultrasound. How can we accurately identify these “trigger points”? The only way to accurately detect these microtears, which are often the primary pain generators and the main cause of pain, is with a technique called palpation interrogation.
And the only way to heal these microtear trigger points is with regenerative injections at the precise points of greatest damage, which are the points where the patient’s “jump sign” is most pronounced. Targeted injections at those key points with stem cells taken from a patient’s own fat (autologous, DNA-matched tissue) and mixed with a patient’s own PRP from their blood is the fastest and most direct way to heal this damage. However, please note that if a patient is more patient and willing to come for four or five sessions over a few months, prolotherapy with dextrose based solutions or PRP alone might also work. (note: Prolo and PRP can also be used as primers or boosters to stem cell/PRP treatment).
With these basics in mind let’s explore the details of applying these principles to every joint and region of the body. If you or someone you know is suffering from some orthopedic issue, this knowledge of stem cells and how they can be properly applied gives us a safe, effective and elegant option to conventional surgical approaches.
Knee Pain
The knee, being the largest joint in the body, is particularly susceptible to degeneration. We see a wide range of cases, from mild wear and tear to advanced bone-on-bone osteoarthritis. Our primary goal is to help patients avoid knee arthroscopy or replacement surgery. Even in severe cases, we achieve an approximately 80% success rate. Our focus is not merely on delaying surgery but on healing the knee to ensure long-term avoidance of surgical intervention. I believe surgery should always be the last resort, and my aim is to explore every nonsurgical option available to help patients return to a full, active life with restored joint function.
Low Back Pain
Low back pain is a common problem and a leading cause of disability both in the US and worldwide. Most people will encounter significant back pain at some point in their lives, and in many cases, it’s due to temporary, self-limiting muscular strains. However, over 50 million Americans suffer from more serious, chronic back pain that limits their activities and diminishes their quality of life. This figure rises even further when including those who experience periodic, recurrent episodes of pain.
Shoulder Pain
The shoulder, with its distinctive ball-and-socket structure, is a remarkable feat of human anatomy. It offers the greatest range of motion of any joint, enabling us to perform everything from throwing a ball to reaching for objects on high shelves. However, this exceptional flexibility comes at a cost: instability. This natural instability makes the shoulder susceptible to various injuries and conditions, which can significantly affect one’s quality of life.
Hip Pain
Most painful hip conditions, whether due to chronic sprain or osteoarthritis (OA), often stem from underlying instability in the hip joint. When the hip becomes unstable, it starts to move in ways that exceed its normal range of motion, leading to destructive patterns that can worsen pain and cause additional damage. Therefore, the primary focus in treating these conditions is to stabilize the hip joint.
Neck Pain
Most neck pain arises from cervical vertebral instability or enthesopathy, which involves microtears in the attachments of the neck and upper back muscles. The ligaments responsible for maintaining cervical vertebrae alignment can be compromised by sudden trauma, like a football tackle or whiplash, or through gradual ligament stretching, known as creep, often resulting from prolonged poor posture at a computer or excessive smartphone use.
Elbow, Wrist & Hand Pain
Elbow, wrist, and hand pain are often caused by repetitive strain injuries, such as tennis elbow, carpal tunnel syndrome, and tendinitis. These conditions result from overuse, leading to inflammation, irritation, and pain in the affected areas. Trauma, such as fractures or sprains, can also cause pain, particularly in the wrist and hand. Arthritis, including osteoarthritis and rheumatoid arthritis, is another common culprit, leading to joint pain, stiffness, and swelling. Nerve compression, such as in cubital tunnel syndrome, can cause pain and numbness in the elbow and hand, further complicating daily activities and reducing quality of life.
Ankle & Foot Pain
The ankle joint, though sturdily designed, is susceptible to considerable stress and injury because of its crucial role in bearing the body’s weight during various activities. Chronic ankle pain, whether from recurrent sprains or advanced osteoarthritis, presents a significant challenge due to the joint’s intricate structure and the often limited effectiveness of surgical treatments.
