Back and Leg Pain Regenerative Treatments: Platelets vs Steroids

At the Centeno-Schultz Clinic we acknowledge that lower back and leg pain can be debilitating.  Treatment options include epidural injections utilizing platelet growth factors (Regenexx PL-Disc) which are intended to increase blood blow and decrease inflammation.  Stem cell therapy is an alternative to low back surgery.

Our most recent data comparing the Regenexx PL-Disc procedure to traditional steroid epidural is shown below. The interesting points are that while 11 patients didn’t respond to steroid epidurals and switched over to the Regenexx-PL-Disc procedure, none switched the other way. In addition, note the dramatically higher increases in patient function with the Regenexx-PL-Disc.

Traditional steroid injections have signficant risks:

Increased risk of bone fracture

Changes in cortisol levels lasting weeks

Cause ligament breakdown and failure

Cartilage degeneration

Suppress stem cell function

Also alarming is the increase risk of osteonecrosis (bone death) associated with oral steroids.

Lateral Elbow Pain: Posterior Interosseous Nerve Compression

At the Centeno-Schultz Clinic we acknowledge that lateral elbow pain can be debilitating and impact daily function.

Not all lateral elbow pain is lateral epicondylitis as illustrated by a recent patient seen in clinic.

Joey is a 17 y/o hocky player with 1 year history of lateral elbow pain which was constant, progressive in nature and aggravated with rotation of his palm upward (supination).  He has undergone PT, trial of NSAID’s, heat, ice and 2 steroid injections without relief.  High dose steroids have signficant side effect both on tissue and stem cell function.

Joey had compression of posterior interosseus nerve which was confirmed by MSK ultrasound.  Treatment options include US guided Regenexx PL/SCP injections and possible hydrodissection.   A patient’s testimonial illustrates the potential of treating nerve injuries with ulrasound guided platelet therapy.

The posterior interosseous nerve (PIN) is nerve in the forearm. 

Posterior Interosseous Nerve

It is the continuation of the deep branch of the radial nerve.  It passes thru supinator muscle in its course from anterior to the posterior surface of the forearm. The PIN may become entrapped at the tendinous border of the supinator known as Aracade of Froshse. Posterior interosseous neuropathy is purely a motor syndrome resulting in finger drop, and radial wrist deviation on extension.  

Other causes of PIN dysfunction include trauma, synovitis, tumors, and iatrogenic injuries.

Exam:

Pain with resisted supination of the forearm.

Pain with resisted extension of extension of middle finger.

Tenderness over lateral epicondyle and distally over the aracade of Froshe. 

Other causes of lateral elbow pain which warrant consideration include:

C7 radiculopathy

Lateral epicondylitis

Extensor tendon rupture

Successful Stem Cell Treatment in Collegiate Field and Track Athlete: Update

Stem cell therapy is an alternative to traditional ankle surgery as discussed in a prior blog.

KW is a 21 y/o university track and field athlete whose ankle pain restricted her ability to compete.

At the Centeno-Schultz Clinic in 8/2011 she underwent Regenexx SD for cartilage loss in the tibial-talar joint(ankle).  In addition she underwent the following therapies:

– prolotherapy of the loose ankle ligaments

-Epidural injections of platelet derived growth factors:  Regenexx PL-disc.

-Injection of the loose spinal ligaments with Regenexx DDD.

KW recently emailed me with an update which she has allowed me to share.

 ”Hello Dr. Schultz,

It’s been a while since I have updated you on my progress and I felt that I had to share how well I have been doing.

I had my procedure done on my ankle last August. Until the past few months, I kept expecting something to go wrong or for my ankle to begin hurting again because it just felt too good to be true. However, I honestly can say that I believed I am healed and 100%. It took about 6 months post-injection for the pain and stiffness to stop, and since then I have been training to gain back my endurance and strength for running.
I am participating in weight lifting, hurdle drills and most importantly back to running 60+ miles a week with NO pain or stiffness in my ankle joint.

I feel so blessed to have had this opportunity…I am applying to medical school this coming year, and it was your compassion and high quality of patient care that has really pushed me to do so. This treatment and the concept of stem-cell is fascinating, and I anticipate future advances in medicine and treatments involving stem-cells. Thank you for helping me run again and for strengthening a passion of mine!”

Fantastic!

Posterior Knee Pain: Popliteus Tendonitis

At the Centeno–Schultz Clinic we acknowledge that knee pain can be disabling. Knee pain can arise as result of loss of cartilage, ligament instability, meniscus degeneration or tears, bursa inflammation and tendon irritation. Stem cell therapy is a non surgical treatment option for many types of knee pain. At the Centeno –Schultz Clinic other treatment options include IMS, prolotherapy, Regenexx SCP and RegenexxPL.

All knee treatments utilize guidance in the form of MSK US and or x-ray to insure accurate needle placement.

Popliteus tendonitis can be a cause of posterior lateral knee pain.

The popliteus muscle originates from the lateral femoral condyle and the posterior horn of the lateral meniscus. The popliteus tendon runs deep to the LCL and passes through the hiatus to attach to the posterior surface of the tibia.

The popliteus muscle unlocks the knee in the standing or walking position whereby it rotates the tibia inward, pulls the lateral meniscus backwards and flexes the leg upon the thigh.

Popliteus tendonitis is common among runners and typically presents as pain in the posterior aspect of the knee.

Below are images of the popliteus tendon.