Dr. Cabaret was in the April 30th Acorn Newspaper for his work at the Westminster Free clinic.
Recent scientific studies have looked at the use of adult stem cells taken from fat and bone marrow for treating patients who suffer from knee osteoarthritis, with promising results.
Researchers have concluded that not only does the therapy produce an improvement in symptoms, but healing and regeneration of cartilage might be taking place.
Director of the Arthritis Treatment Center in Maryland, Dr. Nathan Wei, has noted that the options for helping patients with osteoarthritis used to be limited to simply helping relieving symptoms. Now, however — thanks to stem cell therapy — he says medicine is entering an era where therapies are available that “may also rebuild lost cartilage.”
Knee osteoarthritis (commonly called OA or “wear and tear” arthritis) is a very common condition, affecting over 20 million Americans. For patients who have osteoarthritis, the cartilage in the joint has been damaged or is starting to get lost — and bone has started grinding against bone.
As a result, a reactive bony overgrowth is produced that in turn creates significant pain and limited mobility. Being active makes the pain even worse, though it is still usually present when patents are resting as well.
Osteoarthritis is particularly common in patients who are overweight or over age 45. Trauma can accelerate it, so younger patients may also develop osteoarthritis.
Traditionally, knee osteoarthritis has been treated with steroids or hyaluronic acid injections. Unfortunately this usually only gives temporary relief. Many patients eventually face going through total knee replacement surgery. This procedure results in a great deal of post-operative pain and requires a prolonged recovery.
However, stem cell treatment means it is frequently possible to avoid going through a major procedure. This treatment uses cells taken from the body in order to regenerate the joint tissues, thus alleviating pain and dysfunction. Since it’s done on an in-office outpatient basis, there’s not even any hospital say required.
According to Dr. Wei, administering adult stem cells carefully may be able to restore the lost cartilage which is causing the osteoarthritis, thus treating the underlying problem rather than the symptoms. He observes that this phenomenon has already been shown in “multiple animal models,” but until recently it was only described in humans in “anecdotal reports.” Now, however, he states that researchers are performing clinical studies which are “much better controlled” as well as “more scientifically valid.”
Wei added that stem cell treatment did not just positively affect arthritis through the transformation of stem cells into cartilage — it’s also a consequence of the way stem cells release proteins which attract other healing cells into the affected area. It’s a phenomenon known as the “paracrine” effect.
“We are excited,” he said, “about the early results” from their investigation and hope further research will be as promising. If so, according to Wei, knee replacement surgery could end up being a “thing of the past.”
Regenerative Medicine Specialists uses both stem cell and PRP treatments to help treat knee osteoarthritis. In our experience, these related therapies help relieve joint pain, restore normal functioning, and often manage to produce results without the sometimes serious problems which may result from other therapies. In most cases, it’s possible to produce results in a single office visit.
For patients who have been diagnosed with “weaver’s bottom,” “tailor’s bottom,” “runner’s butt,” or one of the many other names for ischial tuberosity bursitis pain, the condition is an awkward and uncomfortable one.
For some patients the pain only appears when they sit down, for others it is present all the time. Fortunately, it’s a treatable condition.
Ischial tuberosity bursitis is a common condition which happens when the fluid-filled sac between the hamstring and the ischial tuberosity bone becomes inflamed.
The ischial tuberosities are two bony projections — one on either side of the pelvis — which bear the weight when we sit down. Under normal conditions these tuberosities are padded by fat and muscle as well as special fluid-filled sacs known as the bursae. However, under certain conditions this padding fails or is not sufficient, at which point the bursae become inflamed and painful.
Originally, this condition developed as an occupational disorder among weavers and tailors, who had to sit for hours at a time on hard stools or benches as they worked. Moving back and forth in a constant rocking motion irritated the bursae, producing a disorder which came to be called “weaver’s bottom.” Nowadays it’s sometimes associated with being slim while spending too much time in front of a computer while sitting on a hard chair. It’s also commonly caused by sports injuries — especially those which also result in hamstring strain or tendonitis.
Any injury which produces strain in the hamstrings can also produce an ischial bursitis. Hamstring strains are sometimes called “pulled hamstrings,” and this happens when overstretching tears the hamstring tendons or fibers. How severe the injury may be varies: doctors rate hamstring strains from 1 to 3, with a “3” being the worst (the strain is so severe the hamstring has been completely torn, the patient is no longer mobile). If a patient has experienced a hamstring strain the injury is clear and nearly impossible to miss — it generally comes on as a very severe, sudden pain which is accompanied by a “popping” sound from the hamstring region. Quickly thereafter the rear area of the thigh becomes bruised, tender, and swollen.
However, it is also possible for an ischial bursitis to appear without any injury to the hamstring. Regardless of whether the hamstring is involved, signs of an ischial tuberosity burisits tend to be lower buttock pain while sitting down or running. Symptoms may also include numbness or tingling when flexing the knee or in the lower leg.
Ischial Tuberosity Pain Treatment
Ischial tuberosity pain treatment comes in many forms. When conventional, conservative therapies fail, the doctors at Regenerative Medicine Specialists focus on techniques which still allow in-office treatment on a same day basis — avoiding the need for a hospital stay. In most cases this means platelet rich plasma or stem cell-based treatment.
Stem cell treatment, for example, uses cells which already exist in your body. They are normally dormant, but when called into action they can form almost any type of cell needed to produce healing. These cells also trigger the release of many other healing-promoting factors. When isolated from your body and injected into an injured area, they can produce dramatic recoveries.
Platelet rich plasma, or PRP injections perform a similar function — they create an environment which tends to favor healthy tissue regeneration at a rapid pace, encouraging healing in a rapid and healthy manner.
Scottish soccer player Rory McKenzie recently underwent the same state-of-the-art PRP treatment that tennis star Rafa Nadal used to cure his knee tendonitis — and, like Nadal, McKenzie is back in full training.
The 21-year-old McKenzie recovered from a two-month break using the same therapy which he previously used to recover from a similar medical problem back in 2012.
In PRP therapy like McKenzie underwent, blood is taken from the system, spun in a centrifuge, sometimes with chemicals like calcium chloride and thrombin, and then subsequently re-injected into the affected area.
“I was trying to play through” the injury, McKenzie told reporters, but eventually “it got to the stage” where he simply couldn’t do it. Some mornings he woke up unable to get out of bed or even move.
Eventually he went to a clinic and had the PRP procedure done, after first trying more conservative therapies which failed to produce results. “The surgeon who gave the [PRP treatment] to me said all the top [soccer] clubs are using it now,” McKenzie noted.
Originally McKenzie had feared that his injury was the result of playing on the artificial turf at his home stadium, which would mean he would likely experience the same problems again and again. Yet he’s observed plenty of players on other teams — who play on natural grass — experience similar issues, so McKenzie feels it was “just bad luck” that he got hurt.
McKenzie Far From The First To Benefit From PRP Therapy
McKenzie isn’t the first athlete to benefit from PRP treatment by any means.
Tiger Woods, New York Giants’ defensive tackle Chris Canty, and Phillies pitcher Cliff Lee (among many others) have used it to treat sore knees, hamstrings, and abdomens respectively.
Tiger Woods received not one but four separate PRP injections in his left knee before he played in all four of 2009’s professional golf majors, this following surgery.
Los Angeles Dodgers pitcher Takashi Saito may have been able to return for 2008’s Major League Baseball playoffs thanks to PRP injections to his elbow.
The theory is that by centrifuging a person’s blood to the point where it contains a concentrated blend of growth factors and plasma cells, then re-injecting it into injured tissue, the mixture will speed healing and improve tissue health. According to some doctors, PRP treatment may enable delivery of healing or growth factors to areas where the body has difficulty supplying them on its own — such as regions like the Achilles tendon.
Lab studies have shown that when scientists used surgery to produce lesions in lab animals’ tendons or other tissues, the PRP treatment encouraged the tissues to quickly produce new blood vessels and collagen. Professional athletes’ testimonials from using the therapy have created a great deal of excitement around the therapy, with sports enthusiasts using it to treat a variety of conditions from back pain to tennis elbow.
In fact, PRP therapy was originally used to help speed bone healing and soft tissue recovery following spinal injuries and plastic surgery. It wasn’t until around 2008 that it started seeing wide use for sports injuries, after the Pittsburgh Steelers’ Troy Polamalu and Hines Ward used it right before they won the Super Bowl. As a result, more and more patients started asking about the therapy.
Ischial tuberosity bursitis is a common running injury that results in a deeply seated, aching sensation in the patient’s buttock crease. It can significantly affect your ability to run.
Unfortunately, it’s also often misdiagnosed — which leads to long periods of not running, as well as unnecessary pain.
If you have pain the hamstring or gluteal region, it’s crucial to get an accurate diagnosis and effective treatment so you can return to running pain-free. In fact for many patients, ischial tuberosity bursitis treatment means the difference not just between painful and pain-free running, but also between painful and pain-free sitting.
The Basics of Ischial Bursitis
The ischial tuberosity bursa is a fluid-filled sac located between the ischial tuberosity bone and the gluteus maximus. If it becomes inflamed, the condition is known as an ischial tuberosity bursitis — sometimes called “runner’s butt” (since it can hurt while running) or “tailor’s bottom” (because it also frequently shows up in occupations which involve prolonged sitting on hard surfaces).
The pain can and usually does get progressively worse over time as the runner keeps running — with the result that they experience a deep ache or throbbing pain in the lower buttock.
Besides the feelings of weakness or stiffness, the runner may also experience specific pain and tenderness on the buttock, located right against the bone area which contacts the chair when they sit. This bone is often known as the “SITS bone” but the proper term is the ischial tuberosity — this is the place where the hamstring inserts. As a result of this, the hamstring muscles can also be involved; this sometimes leads doctors to misdiagnose a hamstring strain.
Fortunately, it’s fairly easy to manually test the hamstring muscle to see if pain or weakness result. If weakness or pain don’t appear in a manual test of the hamstring, then it can be eliminated as a diagnosis.
Another possible, but not as common symptom of an ischial tuberosity bursitis is tingling or numbness in the gluteal region. If it appears, it may radiate down the thigh or rear of the hamstring. This resembles sciatica and is one reason why ischial bursitis is frequently misdiagnosed as and confused with sciatica.
In many cases, runners with ischial bursitis will misdiagnose themselves through Internet research or have been misdiagnosed by another doctor. In most cases, this means their ischial bursitis has been confused with one or more of:
Therefore, we feel it’s crucial to perform a thorough examination as well as history in order to eliminate the “standard” diagnoses and ensure our conclusions are accurate.
Ischial Tuberosity Bursitis Treatment
After making a correct diagnosis, ischial tuberosity bursitis treatment is fairly straightforward. If conservative treatments like rest and stretching are not successful, we often recommend regenerative therapies like PRP or stem cells. These enable the body to regenerate its own tissues at an accelerated pace, producing stronger but natural healing.
Iliolumbar pain is produced by inflammation or tearing in the iliolumbar ligaments, and problems here may be very painful. The reason is that the hip bones are connected to the lower lumbar spine by these ligaments.
The whole lumbar region of the body is quite vulnerable to pain and injury, and the iliolumbar ligaments are responsible for stabilizing it, providing support, and allowing the body to move around the lumbar vertebrae (notably the 4th and 5th vertebrae).
Usually, it’s a sports injury that sets off iliolumbar ligament pain. Sprains, tears, strains, and many other kinds of injuries can damage the iliolumbar ligaments. As a result, the whole surrounding area starts to stiffen up — which only makes things worse. As the area stiffens up, the level of pain increases, and the chances of a complete tear (called iliolumbar syndrome) go up significantly.
As it happens, lower back pain (including the iliolumbar ligaments) is one of the most common reasons that patients seek medical help or even work disability compensation. The most common major treatments — until now — have been chronic opioids, or sometimes surgery. These treatments often produce mixed results, and sometimes patients end up worse than before the treatment.
Fortunately, stem cell and PRP treatments represent a viable alternative. With these treatments, the tissue is itself repaired by cells taken from elsewhere in your body. They allow treatment on an in-office basis, with no hospital stay and minimum downtime following treatment.
What Causes Iliolumbar Pain?
Sports injuries are the most common cause of iliolumbar ligament pain, but car accident trauma may also trigger it. If a sports injury is the cause, it’s most commonly from a sport that requires repeatedly bending and twisting the back — volleyball and golf are common examples.
Since the iliolumbar ligaments go from the back of the pelvis (known as the iliac crest) and up the spine, inflammation in the iliolumbar ligaments can produce “referred pain” in a variety of areas in the body: it may produce pain in the pelvis, the back, the groin, the hip, as well as testicular, vaginal, and rectal areas.
However, the most common symptoms are recurring attacks of lower back pain in a triangularly shaped area which is located in between the iliolumbar ligaments, quadratus lumborum, lumbar fascia, facet joints, and erector spinae muscles.
Especially painful attacks of iliolumbar pain may be brought on by physical exercises that involve twisting or bending the lumbar spine area.
In other cases, patients experience pain only after long periods of sitting, or briefly in the morning after they get out of bed. They may also experience groin or hip pain, or tenderness in the iliolumbar area.
Using Regenerative Medicine to Treat Iliolumbar Ligament Pain
It’s our experience that regenerative medical techniques like stem cell and platelet rich plasma therapies can produce effective relief with often just a single office visit. The reason is that these therapies improve your body’s power to heal itself.
By isolating specific cells from other areas of your body and injecting them into the injured area, these therapies greatly speed healing and promote rapid tissue regeneration. No hospital stay is necessary, and there’s very little downtime or recovery required.
At Regenerative Medicine Specialists, we focus on treatments that allow patients to recover from a broad variety of conditions quickly: treatments that actually heal the body, rather than merely masking the symptoms produced by an underlying condition.
In particular, we specialize in stem cell as well as platelet rich plasma (PRP) treatment. These treatments often eliminate the need for surgery and produce very rapid healing on an in-office basis, with no hospital stay and sometimes just a single visit required.
We would like to help you avoid the risks and side effects associated with surgery and steroid injections.
Instead, with both of these treatments, the principle is roughly the same: cells taken from your own bone marrow, fat, and blood are harvested, then separated and finally reintroduced to the area which has the problem. There, these cells take an active role in helping your body heal itself.
How Adult Stem Cell Therapy Works
Adult stem cells taken from your own body are a remarkable tool for healing. They can be found and isolated from a number of tissue types: bone marrow, fat, synovial fluid, menstrual blood, umbilical cord blood, even dental pulp. (We focus on bone marrow, fat, and ordinary blood.) The stem cells taken from these tissues are able to differentiate — transform — themselves into many other types of cells, which lets them treat many different kinds of diseases.
Stem cells taken from bone marrow and from various types of blood have seen extensive clinical use for the last 20 years for treating many different diseases. Clinical studies have identified more than 80 different diseases which may be treated with stem cells taken from blood, including cancer, metabolic disorders, and anemia. In our office we successfully use them for treating musculoskeletal conditions and joint conditions of almost any type.
The most amazing things about these stem cells — besides the way they can be used to treat a huge variety of different conditions — is that it’s possible to harvest them using minimally invasive procedures. This makes it possible to do stem cell treatments without going to the hospital or suffering through a long recovery. In most cases, we are able to treat patients in just a single office visit.
For many patients, it’s a surprise to hear that they even have their own stem cells. Unfortunately, many have only heard about controversial ’embryonic’ stem cell therapies, since those have been debated in politics and on the news.
Yet those therapies have very little to do with the treatments we perform. We use stem cells found in adults — taken from the patient, in fact — and there are no political, ethical, or moral issues surrounding the treatments we do.
PRP: An Easy, Effective, and Affordable Therapy
Besides stem cell therapy, we also do therapy with platelet rich plasma injections, or PRP. This is an injected concentrate of platelets isolated from your body’s whole blood — it also contains some stem cells as well.
PRP therapy works on the principle that platelets are circulating blood cell fragments which are crucially important to healing. Once they are activated, they release many different signaling molecules to attract healing cells to an injured area. The result is an environment which promotes healing, better blood flow, and healthy regeneration of tissue with minimal scarring.
PRP is also the least expensive option, since PRP is the easiest concentrate to obtain. Nevertheless it is extremely effective (especially for soft tissue conditions) and may be all you need to recover.
There are a few major muscles at the back of the neck which are responsible for holding up your neck and head. They run from the top of the neck area (or the base of the skull) down towards the upper torso and the scapulae. The levator scapulae are two muscles located on either side of the neck, and they’re frequently a cause of neck pain.
Since the levator scapulae are used to shrug the shoulders and make many other movements, if levator scapulae pain treatment is not applied then the consequence is usually many sleepless nights — and irritable days. In fact, untreated levator scapulae have been associated with depression and anxiety.
What can trigger levator scapulae neck pain?
Levator scapulae pain may be caused by many different factors. Whiplash in an automobile accident is a common cause, as is standing, sitting, or sleeping with poor posture. In some cases, emotional and mental stress can even cause levator scapulae pain.
The pain begins as a mild soreness and stiffness in the neck area. As the muscle starts to become more injured, burning or an increased dull ache may develop. Eventually, the patient develops a deep and throbbing ache — generally down the inside area of the shoulder blade, across the shoulders, or towards the head. Resting, icing, as well as stretching all improve the referred pain, and many patients try “over the counter” pain medications or NSAID‘s to handle the pain.
In many cases, levator scapulae pain is also associated with trapezius pains and tension headaches. This is because activities and postures that strain the trapezius often also produce injuries in the levator scapulae. If activities like working on the computer, carrying children, or driving aggravate the pain, the trapezius and levator scapulae may be in trouble.
Another warning sign for levator scapulae problems is posture and movement. Patients with levator scapulae trouble tend to move awkwardly, attempting to hold their head in position atop their body and making only deliberate, slow movements. Often, these patients will turn the whole body to look at a person, and they tend to move their eyes in an unnatural manner so they do not need to turn the head.
Where most people tend to project their heads outward in front of the body while they walk, patients with levator pain will hold their heads directly over their shoulders. Finally, they tend to complain of stiff necks and they might even suffer from anxiety — having a shortness of breath that resembles a panic attack, or a feeling that they “bear the world” atop their shoulders.
How we treat levator scapulae pain
Standard levator scapulae pain treatments range from rest, ice, and stretches to massage, yoga, posture corrections, and exercise. Some doctors may prescribe anti-inflammatory drugs or pain medications. Chiropractic care may also be an option for some patients.
The Regenerative Medicine Specialists find that PRP or stem cell treatments represent a remarkably powerful way to treat levator scapulae pain. In our experience it often permanently solves the problem without any downtime from valued daily activities. The reason is that these regenerative treatments allow the body to regenerate itself by using cells specially extracted from the patient’s body. Injected back into the body at the site of the damage, these cells promote tissue regeneration and proper healing.
Ischial bursitis is an extremely painful condition which usually arises after sports injuries — in particular those injuries which produce a hamstring strain or tendonitis. It used to be known as “tailor’s bottom” because it can also be caused by sitting too long on a hard surface, and symptoms tend to involve pain in the lower buttocks while sitting and tingling or numbness in the lower leg (especially while flexing the knee).
PRP and/or stem cell treatments are an extremely effective way of treating ischial bursitis. However, traditional conservative therapies are usually indicated before attempting a clinical treatment. Simple therapies like “RIMS” can provide immediate relief and facilitate later therapy with regenerative medicine.
What Is Ischial Bursitis? & Does it Need Treating?
Treatment for Ischial bursitis cannot be avoided, it is a chronic or acute inflammation of the bursa sac, which is a fluid filled sac located between the ischial tuberosity and the hamstring tendon. The exact cause is still not known to medicine, but trauma as well as inflammation from accompanying arthritis or gout may also trigger ischial bursitis.
In cases of acute bursitis, patients may experience inflammation and extreme pain. Their ability to move around may be limited, as moving the joint can produce a sharp increase in pain.
If the patient experiences multiple episodes of an acute bursitis, their condition may develop into a chronic one. At this point the bursa may thicken and readily develop adhesions to the surrounding tissue, which limits the range of motion. Muscles may weaken and atrophy.
Immediate Treatments You Can Do
In order to prevent an acute bursitis from developing into a chronic condition, it’s important to see a doctor and apply treatment as quickly as possible. While the ideal case is of course a consultation at our clinic, within the first 24 to 48 hours of the injury a “RIMS” program is usually recommended to prevent further damage while waiting for more advanced treatment. RIMS stands for:
R — Rest. It’s crucial to rest for the 24-48 hour period after the bursitis appears. Try to rest the affected joint as much as possible. With ischial bursitis, using a cane (at least briefly) may be advisable in order to ensure the area is free of pressure.
I — Ice. Apply ice in order to reduce swelling and inflammation. Ice should be applied 3-4 times a day for the next 24-48 hours.
M — Mobility. Attempt to GENTLY increase movement in the injured joint, if possible, in order to ensure it does not become frozen.
S — Strengthen. If this has been enough to relieve the pain, slowly begin to restore the normal range of motion using exercise.
Unfortunately, in many cases simple treatment like this is not enough to fully deal with an ischial bursitis. On the other hand, PRP or stem cell based treatment can frequently eliminate the inflammation and regenerate the involved tissues quickly, and it is often able to do this even when traditional treatments failed.
Ischial Bursitis – What do we focus on?
The doctors at Regenerative Medicine Specialists focus on Ischial Bursitis treatment that provide relief on a same-day in-office basis, without requiring a hospital stay. For most cases, this means either platelet rich plasma (PRP) or stem cell treatments. These use your body’s own cells to allow the injured or swollen area to regenerate itself quickly and safely.
Even minor hip problems can strongly impact quality of life and daily activities by triggering limited mobility and pain. The reason is that the hip is a complex joint, with several structures which all work together to ensure proper functioning: a bony ball and socket joint between the pelvis and thigh bone, a covering of cartilage, a fibrous capsule, and many muscles, ligaments, and tendons which hold the joint together and enable proper movement.
If any of these structures is damaged, limited mobility and pain often follow. Until quite recently the only treatment options were addictive opioids, steroid injections, and surgery such as total hip replacement if patients failed to respond to more conservative treatments.
Thanks to regenerative techniques (stem cell and/or PRP therapy) we can treat many of the most common hip problems without surgery. The cost of hip pain treatment is much less than an involved surgical procedure, and there are many fewer risks as well as none of the prolonged rehabilitation and pain.
Arthritis of the Hip
The most common hip arthritis is osteoarthritis or OA, also known as degenerative (“wear and tear”) arthritis. If you have osteoarthritis of the hip the cartilage in the hip joint has become damaged or lost, the bones have begun grinding against each other.
The result of osteoarthritis is a reactive bony overgrowth which in turn produces limited mobility and significant pain. Activity makes the pain worse, but it’s often present even when resting.
Hip osteoarthritis is very common in patents over 45 and overweight patients. Hip trauma accelerates arthritis, meaning younger patients can develop it prematurely too.
Traditional treatments for hip osteoarthritis involve steroid injections for temporary relief, but usually patients eventually require a total hip replacement. This means significant post operative pain and a long recovery time.
With PRP or stem cell treatment, total hip replacement surgery or steroid injections can often be avoided. Instead, the treatment is done on an outpatient basis — with no hospital stay at all.
Greater Trochanteric Bursitis
Greater trochanteric bursitis sometimes appears with no apparent cause. It is a very painful condition which hurts even when resting and often causes a limp. Greater trochanteric bursitis happens when the fluid filled bursa sac, located between the thigh bone and the tendons above it, becomes inflamed.
There was no permanent treatment for this condition until recently, only ways to provide temporary relief. PRP and stem cell treatment, though, allow the body to repair itself and provide long-term relief.
ONFH (Osteonecrosis of the Femoral Head)
ONFH is generally associated with elderly patients but it can in fact appear at any age: in younger patients the cause is usually trauma or injury, but the cause is unknown in many cases. ONFH is a condition where the femur bone head actually dies due to the blood supply being compromised.
Patients, until recently, were forced to deal with the pain of this condition until it was possible to get full hip replacement surgery. However, regenerative medicine (PRP or stem cells) make it possible to regenerate the bone tissue and eliminate pain without need for surgery.