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If you have a chronic orthopedic issue then often an injection based procedure is part of your treatment plan. There are different types of procedures available in orthopedics and sports medicine used to treat our patients and athletes with these chronic conditions.

Most people are familiar with the conventional treatment, which is a steroid (corticosteroid) injection. While this can be an effective treatment for reducing pain, it typically will not fix the problem. It will temporarily make it feel better, which can hopefully allow you to fix the problem around the area, but the steroid can lead to the deterioration of the tissue, notably in your joints. These steroid injections can further increase the chance as well as accelerate the time to needing a joint replacement. This has been validated by recent research which has demonstrated the detrimental effects of steroids on tissue.

So if getting a steroid can provide pain relief, but it might cause wear and tear on your joints and tissues, then what other treatments can you possibly do? This is where the field of regenerative injection therapy (RIT), also known as orthobiologics, has taken off, notably in the past decade.

A good analogy for what we are trying to accomplish when performing these regenerative, or orthobiologic procedures, is “fixing a chronic pothole in the road.”

If we think about our body as like a city street, sometimes we injure ourselves, essentially causing a pothole to develop in the road, or a sprain or tear of a ligament, strain or tear of a muscle or tendon, or injury to a joint. Typically when a pothole develops in the road the city workers will come out to repair the pothole. This is very similar to the healing pathway that occurs in our bodies directly after an injury. If we let the body’s city workers “fix the pothole”, and then give the pothole time to fully heal, then usually our body will fully heal itself. Our bodies are capable of self-healing, self-regulation, and health maintenance.

Very often we push through the pain or sometimes we are not even aware of how badly we injured ourselves, so essentially we start driving down the road before the pothole has had time to heal itself. This is how a chronic injury sets in. If the pothole appears to be dug back up, then the city will often send the workers back to repair it. If the process keeps repeating itself, then the body essentially lays down scar tissue or dysfunctional tissue that no longer functions as well as the original tissue; so the pothole becomes more permanent at this point. We may not notice this pothole all the time, but every time we drive over that area (or use that muscle, stress that ligament, and/or use that joint) our body will feel it, typically with the experience of pain and/or instability. At this point the body has essentially forgotten how to heal itself, and it no longer sends workers to fix our chronic pothole.

So are we now stuck with this chronic pothole in our body’s road?! What can we do to get our body to heal itself?! This is where regenerative injection therapy comes in. The big theme of what we are trying to do is call attention to the area of injury (the pothole). The body needs to send oxygen, nutrients, and other healing factors to the area to get it to repair itself. The various regenerative injection treatments have different mechanisms of action allowing this to occur:

Prolotherapy most commonly uses a concentrated dextrose solution to help stimulate up the healing process. So it helps dig up the pothole, and then it puts in the call to the city workers to ensure that they will come out there and work on it.

Platelet rich plasma (PRP), is performed by taking blood from the patient, spinning it down in a specialized centrifuge to

concentrate the blood to obtain the platelet rich plasma, which is enriched with healing factors. This is then injected into the area of need. So it helps by digging up the road, and then it puts the workers directly there to repair it, so you get a more pronounced effect.

Stem cell therapy is performed by harvesting the stem cells from either your adipose (fatty) tissue, Adipose Derived Stem Cells (ADSC), or from your bone marrow (usually from your posterior hip), Bone Marrow Aspirate Concentrate (BMAC). This tissue is then concentrated and the stem cells may or may not be combined with PRP and injected in to the area of need. So with our pothole analogy it helps by digging up the road, filling the pothole with new healthy road, and then having the workers directly there to repair it, all while the mayor is there to supervise it and ensure everything is done correctly. This tends to have the most significant effect on tissue repair.

All of these treatments can be performed safely in our office. If you are interested in having one of these performed then arrange to have a consultation with Dr. Clearfield. By taking an appropriate history and physical exam, and often correlating with imaging that may include ultrasound, x-rays, and/or MRI, he can determine how bad the “pothole is in your road“, and then determine what will be the best treatment for you. Our goal is for you to be able to “drive down your body’s road” as safely and comfortably as possible!

Motion is Medicine, let’s get you moving!