Regenerative Medicine is led by our Double Board Certified Spine & Sports Interventional Pain Specialist and Anesthesiologist, Tanuj Palvia, MD. Regenerative Medicine is a game-changing area of medicine with the potential to fully heal damaged tissues, possibly offering solutions and hope for people who wish to avoid surgery.
Regenerative Medicine treatments have been utilized by many fields of medicine in the past but, advances in the medical world have unlocked new opportunities to refine existing Regenerative Medicine Therapies and develop new ones that are applicable to the Orthopedics, Sports, Spine, and Pain Medicine Specialists.
The basic principle behind Regenerative Medicine, as it applies to the musculoskeletal system, is the potential for repair, regeneration, restoration, and pain control. Regenerative Medicine includes Prolotherapy, PRP Treatment (or Platelet Rich Plasma Therapy), and Stem Cell Therapy (harvested from bone marrow or amniotic fluid).
When you come for your visit you should bring all the medications you are currently taking in their original bottles or an accurate, updated list. Bring all your medical records with you. Bring the films or CDs of any X-rays, MRIs or CT scans that you have had recently.
Wear comfortable clothes and leave unnecessary valuables at home. The medical assistant will bring you back to an exam room, review your history and verify your current medications.
Your physician will evaluate you and perform a physical exam. If a treatment is indicated, your physician will discuss the steps involved in the procedure, the expected outcomes and potential risks and then answer any remaining questions you have. You will be required to provide consent to permit your physician to do the procedure.
For most procedures, you will then be taken into the procedure room and positioned on a procedure table.
We make every effort to make you comfortable during the entire process. After completion of the procedure, you will be monitored for any side effects. You will be given follow-up instructions during the discharge process.
After your discussion and exam, the doctor will review with you potential treatment options that are safe and efficacious during pregnancy.
Although most procedures take five to fifteen minutes, you may remain at our facility for a longer period of time because of admission, evaluation, procedure, recovery, and discharge time.
The vast majority of our patients indicate that the procedures are relatively painless. Most procedures are performed with a local anesthetic, which usually reduces the discomfort of the procedure. When appropriate, sedation is also provided.
Take all of your usual medications for other health conditions. The ONLY exception would be blood thinners, such as Plavix®, Pletal®, Coumadin®, Lovenox® and similar medications that “thin” the blood. Please let us know if you are taking Aspirin, Ibuprofen, Aleve® or other anti-inflammatory medications. Supplements like Vitamin E or fish oil may not be allowed before some injections. If you are taking a blood thinner, please inform our office and nurse at your first visit. With your physician’s approval, you will need to stop taking your blood thinner medication three to five days prior to your procedure.
If you’ve had an epidural steroid injection, you should have a relaxing remainder of the day. You should limit your activities to your home. We do not recommend that you go back to work or do any major physical activity or air travel that day.
If you’ve had medial branch nerve blocks, facet joint injections or sacroiliac joint injections, you should do things that would normally aggravate your pain in order to test the effectiveness of the block.
For example, if you’ve had lumbar medial branch blocks for your lower back and you normally wouldn’t be able to touch your toes or mow the lawn, you should try to do those things over the six to eight hours after your medial branch nerve blocks. This “test” of your pain will let our physician know whether or not the procedure was successful.
You may need to take off of work after your procedure. We can provide a physician’s note for the day of the procedure at your request. We are NOT able to provide a “work excuse” for any day other than the day of your procedure.
“Dr. Szaro and Dr. Palvia were very helpful and informative. They answered my questions thoroughly. Dr. Szaro has been helping me heal for years, especially in regards to my shoulder and back pain. The front desk were excellent. Phil was very helpful as well. I’ve been coming to Physio Logic since they were still located at the Remsen Street location, back when Dr. Gehrman was the only practitioner available. There are great people that work here.”
During ski season, no one told me I should stop. In fact, they figured out ways to keep me performing well enough to prevent injury. I love the fact that they believe in a balance between rehab and still being able to physically challenge yourself.
Platelet Rich Plasma (PRP) Therapy uses a high concentration of your own blood’s platelets to help decrease inflammation, improve cell growth and stimulate the regeneration of damaged tissues and bone.
Your body has an amazing ability to heal itself. When we get injured, be it a cut, a broken bone, or torn ligament, our bodies come readily equipped with healing agents and growth factors that travel through our bloodstream.
These natural healing agents and growth factors are found in our blood’s Platelets, which are small colorless disk-shaped cells containing proteins and cytokines.
There are certain parts of our body that lack an adequate supply of blood flowing to aide in the natural healing process. Tendons and ligaments, for example, are avascular, meaning they have no blood supply. When these vital structures become damaged their healing is not only significantly impeded, but sometimes it’s virtually impossible, often times requiring complicated and painful surgery.
This is where Platelet Rich Plasma (PRP) Therapy really shines. By using only your own blood, we are helping your body heal itself. A small sample of your blood is taken and spun down in a special centrifuge, separating the platelets from your red blood cells and other undesirable cells from the plasma.
Your physician then uses ultrasound guided injection techniques to apply this platelet rich plasma directly to the injured part of the body. The platelets go to work immediately and the healing begins.
Most of our patients return to normal activity relatively quickly after the procedure. Our Sports Medicine team can treat joints, tendons, ligaments, muscles, and even injuries of the spine with PRP. Since there are no drugs or chemicals used, this totally organically derived material is 100% safe, and side effects are incredibly rare.
Injection procedures can help relieve painful injuries that could otherwise cause long periods of recuperation and possible surgery. All of these injection procedures can help you but they’re best when done in conjunction with Physical Therapy and/or Chiropractic Care to give you the best “shot” at living pain free!
Stem Cells are the only cells in the body able to morph into other types of specialized cells. Stem cells are found in many parts of the body, but are concentrated mostly in the bone marrow.
We are able to aspirate bone marrow derived stem cells from a specific location of the pelvis (hip bone) called the iliac crest. The iliac crest contains a high concentration of stem cells.
The procedure is simple, nearly painless (a local anesthetic is used), and takes about 30 minutes to complete. After the extraction, the stem cells are concentrated after being spun in a special centrifuge, increasing its potency and healing potential. The stem cells are then injected directly into the damaged area.
By using your body’s own natural healing powers and our knowledge we can repair the targeted tissue and relieve your pain. Once injected in the site, stem cells react with other cells to repair and rebuild the damaged tissue, which in turn accelerates healing, reduces pain, promotes strength and improves joint function.
There have been numerous clinical studies that show significant and lasting reduction in pain for a variety injuries. Stem Cell Therapy can be used to treat injured or degenerating ligaments, tendons, cartilage, and even bone. Research shows an 85% success rate.
There may be mild soreness in the joint for up to a week after the procedure. Heavy exertion should be avoided during this period. Anti-inflammatory products such as aspirin, Motrin, Advil, and Aleve should be avoided for the first 2 weeks as it can adversely affect the stem cell function. We recommend taking Tylenol instead.
Most patients feel improvement a few months after the procedure.
Umbilical Stem Cells also retain similar properties to PRP and BM Stem cells. This biologic is Amniotic fluid that has been aseptically recovered from a donor and is compliant with FDA “Good Tissue Practices”. It is also very low in immunogencity and it is extremely rich in growth factors and anti-inflammatory agents which promote growth and recovery.