Regenerative Injection Therapies (RIT)
An exciting new family of treatments for FIXING, not <palliating> joint discomfort and instability
What the goal is:
- Regenerating damaged, lax, old joints and connective tissue, with the goal of improved stability, strength, stamina and elimination/reduction of ongoing discomfort and pain. There are no steroids suppressing the body’s natural responses, no surgery damaging a structure that might have been returned to normal.
Why you want it:
- Who wouldn’t want a method to remove chronic discomfort and instability, in a way that uses the body’s own mechanisms, with minimal side effects and a promise of long term, low maintenance, success?
- This low cost and minimally invasive procedure should always be considered when surgery is being suggested, or when there has been long term non-improving discomfort or pain.
- Thousands of studies support these tools. Here are a few highlights! Or if you want to dig deep
How it works:
- A solution that drives a local healing response is injected into the joint and tissues that hold the joint together, stimulating the body’s own natural healing response. Cytokines, fibroblasts (collagen producing cells), platelets and stem cells are all attracted to the area, creating an enhanced healing process that would not have happened without that initial stimulation.
- After this initial inflammation stage, the area changes over to focusing on long term regeneration of the tissue. When that portion has started, another treatment is performed (4 weeks with prolo, sometimes longer with PRP) and the cascade is triggered again, leading to exponentially improved healing, hence multiple treatments for optimal regeneration.
Expected and Desired results
- Once the course is done, the ideal (and usual) outcome is an 80% or better improvement in pain, full return of function and no need for any further treatment (although some people with chronic conditions may have a yearly ‘tune up’)
- Remember: Healing takes time and patience is needed. This is not a one-shot-wonder, although some individuals may achieve full pain/symptom resolution after only one treatment, many will need the 3-6 treatments, depending on the procedure. Additionally, one may notice great improvement, then slight return of symptoms between treatments – this is absolutely normal, and varies person to person.
First Treatment is 50% Off.
You and I both want to make sure that this course is right for you, and that you respond well. Thus, I prefer to have the first visit be discounted.
- $100 per additional joint (i.e. both knees would be $300)
- Dextrose Prolotherapy is the original, and most studied, of the regenerative injections. While it takes more treatments than PRP, it’s faster, more comfortable and less expensive per treatment. I always suggest starting with Dextrose before considering PRP, to see how you feel during, and after, the procedure.
- Solution: Dextrose (the active ingredient), lidocaine and saline
- Recovery: 1-3 days
- Reduced Exercise: 7-14 days, gradually building to normal
- Pain: mild to moderate for 1-2 days
- # Treatments: 3-6, depending on severity, usually one month apart. Packages available, as we strongly encourage you to finish the full course.
- Prolo Wizard Dr Tyna Moore also has a great overview for Prolo.
Platelet Rich Plasma (PRP)
- $100 per additional joint (i.e. both knees would be $500)
- PRP is a fascinating approach towards Regenerative Injections, where your Platelets, super packed with healing factors, are separated out from your regular blood, concentrated to as much as 5x normal and injected directly into the target areas. This is much like Dextrose Prolotherapy, but with a very substantial punch. Ideal for conditions not improving with Prolotherapy, or for those that generally just respond better to PRP (tennnis elbow, etc).
- Solution: Concentrated platelets from your own blood, Calcium Chloride and possibly lidocaine and saline
- Recovery: 3 days
- Reduced Exercise: 14 days, gradually building to normal
- Pain: moderate to significant for 1-4 days.
- # Treatments: 2-3 depending on severity, usually 6 weeks apart. Packages available, as we strongly encourage you to finish the full course.
- PRP does require at least one Prolotherapy treatment prior, to assess your body’s response to these treatments.
- Curious to see some studies on Platelet Rich Plasma?
- $100 additional for Décolletage
- PRP Facelift, or the “Vampire Facelift” as popularized by the Kardashian crew, uses the same healing factors from the platelets in your blood as the joint injections, diluted to be optimally concentrated for maximum stimulation of skin, wrinkle and collagen repair.
- Solution: Concentrated platelets from your own blood, Calcium Chloride
- Expected results: Improved skin texture, tightness and coloration,reduction in pore sizes and reduction in both deep and shallow wrinkles.
- The procedure is fairly straight-forward – We will anesthetize the skin to be treated, do direct injections to deeper wrinkles, then “paint” the PRP over the entire face and use a Microneedling device to drive the PRP and it’s healing factors into the target skin. Additional attention may be paid to areas of particular concern. You should be in and out of the office in 60-90 minutes.
- What to expect: Redness to the face for the first day, followed by some dryness and possibly minor skin peeling (like a minor sunburn). You should look relatively “normal” in 2-3 days, perhaps with some darker areas where more therapeutic attention was paid. Over the course of the next 3 weeks, skin will continue to improve.
- If your goals are met after the first treatment, you may just consider the occasional touch-up, although it’s our experience that it may take 3-6 treatments to achieve FULL skin restoration, depending on your body’s ability to heal.
PRP Hair Restoration
- Similar to the PRP Facelift, the healing factors in the PRP are injected into balding areas of the scalp to stimulate the Papillary Dermal Cells (PDCs) that are responsible for hair growth. While a new procedure, it is being offered at all hair restoration and costmetic dermatology clinics, usually at 2-5x our price.
- Solution: Concentrated platelets from your own blood, Calcium Chloride and Lidocaine
- Expected results: Gradual thickening of existing hair, and regrowth of hair. It is most effective on Norwood 4 or below.
- In the procedure, many injections are made to the scalp, approximately 0.1cc of PRP per square centimeter. Given that it is very difficult to anesthetize hairy skin, PRP Hair Restoration may be significantly uncomfortable for some individuals (and amazingly enough, not for others). You should be in and out of the office in 60-90 minutes.
- What to expect: Some matting of the hair due to the solution, so plan on a hat or shower. It may “throb” for the rest of the day, perhaps into early the next day. Given that hair takes quite some time to grow, it is often difficult to determine regrowth until the course of treatment is complete.
- Adjunct treatment: Dr Sandford has a specialty cocktail of supplements that targets the 3 biochemical processes thought to be involved in hair loss. This is available to be custom compounded for you on request.
- Studies on PRP and Hairloss may be found here
How to prepare for your first Joint injection
If your body is optimized for healing, so goes your regenerative injection results. If it is impaired, you’ll have less of the response that we’re seeking. As my goal is to have you achieve maximal results with minimal expense, please strongly consider doing the below before we meet for your first injection:
- Hydration: Critical for collagen production. Most people should build to 3 Liters per day minimum.
- Adequate protein: 1 gram of protein per pound of body weight. I like our Vital Collagen, PurePaleo, Golden Ratio and Vital Clear, but any non-soy version should work.
- Sleep: Must be sleeping well, for optimal healing. Sleeping 8 hours during the dark hours is the most ideal – rest is how you heal.
- Diet: Inflammation control diet. At a minimum, reduce or eliminate grains, dairy, soy, sugar, and processed foods.
- Sleep: The body is incapable of serious regeneration if you’re not sleeping, ideally 8 hours, while it’s dark.
- Vitamin C. 3000mg per day
- Collagen. 1 tablespoon 3-4x per day, or 3 tablets/caps twice per day, with food.
- Bone broth
- Vitamin D. 5k per day with food. Lots of kale & dark leafy greens for Vitamin K.
- Designs for Health Twice Daily Multi. One, twice per day.
- Designs for Health Complete Mineral Complex. 3 at bedtime, 3 in AM for 2 weeks, then just 3 at bedtime.
In the days before your RIT treatment
- No exercise 48 hours prior to treatment.
- Stop Aspirin and NSAIDs (all painkillers that are not acetaminophen) 7 days before treatment. Baby aspirin for heart is ok. Discuss anti-coagulant medication with me well before.
Very important: NO anti-inflammatory anything (NSAIDs, cold treatment, turmeric) at all in the week following the procedure. These completely nullify the effects that we are shooting for.
What to expect during treatment.
- Slight pain initially at the injection points.
- The injection site might bleed for a short time and some bruising might occur.
- The type of procedure determines the amount of discomfort, with PRP joint and scalp injections being more uncomfortable than prolotherapy or PRP facials.
- Patients might experience an immediate change alleviation in symptoms, due to the anesthetic, that lasts for 2-5 hours.
- Some may also experience during the treatment sweating, some lightheadedness, headache, energy, euphoria, or emotional release (tears).
- Fatigue after the treatment may occur. Its very common for people to feel tired after the treatment and want to take a nap. This usually last for 10-15min and a nap if possible is encouraged.
- After the treatment is completed, we recommend patients to wait for 20 min or longer, until they feel they can safely drive.
COMMON CONDITIONS TREATED:
- Knee pain – meniscal, ACL, MCL, LCL tears
- Sprains & ligament injuries
- Degenerative joint disease
- Foot & ankle pain – plantar fasciitis, sprains, Morton’s neuroma
- Neck pain – whiplash, headache, migraines
- Shoulder pain – rotator cuff, glenoid labrum tears
- Elbow pain – golfer’s & tennis elbow
- Wrist pain – carpal tunnel, weak or sore wrists
- Hip Pain – arthritis, bursitis, labrum lesions
- Hand – thumb & finger pain
- Sports injuries
- Ligament laxity, joint instability & hyper mobility
- Over-Manipulation Syndrome
- Low back pain & sciatica
- Chondromalacia patella
Unfortunately, inflammatory diagnosed Rheumatoid Arthritis does not respond well to PRP or Prolo (although does to bee venom injections)
Fibromyalgia, Chronic muscle pains, severely herniated discs, complete ligament tears respond less favorably.