Stemcelldoc's Weblog

October 15, 2009

Steroids: Patients Beware

Filed under: Cervical Spine, Lumbar Spine — Tags: , , , , — stemcelldoc @ 2:51 pm

Steroids are commonly used to treat pain.  Common examples include cortisone injections into knees, elbows, hips and lumbar spine.

There is increasing concern by many authors about the side-effects of steroid injections.

Hossain demonstrated that steroids were capable of shutting down normal repair and maintenance functions in the joint.(Apoptosis) 

Nakazawa demonstrated that steroids can turn off the production of catilage.

Wong identified a correlation between steroid use and bone death. (avascular necrosis of the femoral head)

At the Centeno-Schultz Clinic we too are concerned and have changed our treatment protocols from large dose steroid injections to low dose.  Most steroid injections use 6 milligrams of steroid.  At Centeno-Schultz Clinic we use a very dilute concentration of steroid which is compounded for our clinic.  A nanogram is 1/1000 th of a milligram.  Steroid injections at Centeno-Schultz Clinic  are between 50 to 100 nanograms.  This dilute solution has positive effects on joint health by increasing the concentration of growth factors and stimulating stem cell production of cartilage.

Other options for the treatment of pain include prolotherapy, PRP and stem cell therapy.

January 11, 2009

Lumbar Epidural Steroid Injections

Lumbar epidural steroid injections are a common therapy for patients with lower back and leg pain as  a result of a disc bulge or herniation.   If the disc is bulging or herniated it can compress the nerve root causing leg pain and or weakness.

The epidural space is a area around the spinal cord and is adjacent to the disc.

epidural-space

Injection into this space allows medication to bathe the irritated nerve root and disc.   One can think of an epidural steroid injection as putting water on a large fire.  At the Centeno-Schultz Clinic all epidural steroid injections are performed under x-ray to ensure accurate placement of medication.  Unlike other clinics,  we do not use the conventional high concentrations of steroids.  For example most epidural steroid injections use  4 or more milligrams of steroids.  At the Centeno-Schultz Clinic we use only nano-grams concentrations because it is closer to the dose that the body uses naturally.  It also avoids the adverse effects of steroids which include suppression of immune and renal function, itching, increase in epidural fat, deterioration of the outer annuls of the disc, insomnia and weight gain.  If steroid therapy is not effective or not attractive to the patient,  through Regenexx we have the ability to inject natural growth factors  such as platelet lysate of VEGF supernatant into the epidural space.  These factors not only provide an anti-inflammatory effect for the irritated nerve and disc but they also promote increased blood blow to the disc and therefore healing.

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