As one the largest joints in the body, the knees often suffer the most from the wear-and-tear that comes with a lifetime of use (or abuse). Whether damaged by an injury such as a ligament or tendon tear, or simply worn down by years of standing, running, jumping, lifting, etc., the result is often the same: chronic pain, inflammation, and reduced movement.
Depending on the extent of the injury or damage to the knee, patients can often gain some temporary relief from steroid injections that decrease swelling or from other interventional treatments such as hyaluronic acid injections that increase lubrication in the joint. But when these options have been expended, many look to surgery as their last, best hope to repair the damage and bring sought-after pain relief.
But now, non-surgical cellular treatments are providing long-term relief to patients with knee pain by putting the body’s own natural healing abilities to work to undo the damage brought on by injury or degeneration.
How Do Cellular Treatments Work?
Known as regenerative medicine, cellular treatments harness powerful healing properties within the body’s building blocks—its own cells—to help repair and, in some cases, replace injured tissues. These treatments promote healing of injuries to the cartilage in the knee joint, as well as soft tissues such as tendons and ligaments in the knee.
To adhere to Federal Food and Drug Administration (FDA) guidelines, only autologous (from the patient’s own body) cellular products can be used to treat orthopedic conditions. Donor products, including cord or amniotic cells, are not approved to treat knee osteoarthritis or soft tissue injuries in the knee.
Cellular products are taken from the patient’s own blood, bone marrow, or fat (adipose) tissues to maximize the benefits of their unique healing properties:
- Platelet Rich Plasma: Platelets in blood release growth factors and proteins that promote tissue repair, while the plasma carries the hormones, electrolytes and nutrients required to nourish cells during the healing process. Platelet rich plasma treatments can be customized to create specific formulations for each type of tissue being treated (muscle, tendon, ligament, cartilage).
- Cellular Therapy: Cells derived from the patient’s own bone marrow or adipose (fat) tissue called “pericytes” produce molecules that spur the production of new blood vessels, awaken other stem cells and encourage newly forming cells to produce collagen and other proteins essential for creating new healthy tissues. These specific cells can develop into the specific kind of cell needed, whether that be tendon, ligament, cartilage, or bone.
After these products are removed from the patient, they are concentrated and reinjected directly to the injured area to address the degeneration or injury.
Do Cellular Treatments for the Knees Work?
Regenerative medicine practitioners have scores of anecdotal evidence from satisfied patients that support the powerful pain-relieving and healing properties of cellular treatments for the knees.
But because the field of regenerative medicine is relatively new, until recently, there has been a limited amount of clinical data to bolster this anecdotal evidence. We believe the quantitative, controlled data that clinical trials will produce will not only further the use of cellular treatments for orthopedic conditions but will also confirm what hundreds of our satisfied patients have been telling us for years: cellular treatments have helped their bodies heal naturally while allowing them to resume the activities that help them regain their quality of life.
The experts at SDOMG help patients with knee injuries and knee osteoarthritis find the relief they need using expert technology and treatments. To learn more about cellular therapy for knee injuries, contact SDOMG using the form below.
A free webinar on healing orthopedic injuries with BioWave therapy was held on September 13, 2022 featuring Drs. Diaz, Ambach, and Rogers. See the video here.
Dr. Christopher Rogers is one of the world’s leading experts in orthopedic regenerative medicine and a renowned speaker at national medical conferences. He has developed new approaches for the treatment of tendon injuries, osteoarthritis and disc degeneration which provide a safe and viable alternative to surgery.
Dr. Mary Ambach specializes in non-surgical orthopedics, regenerative therapies and interventional pain management. As a key thought leader in the field of Regenerative Medicine, Dr. Ambach conducts research, trains physicians and lectures at international medical conferences.
Facet joints are small joints that connect the bones of the spine called vertebrae. They come in pairs on each side of the vertebral bones. They allow for motion of the spine like bending and twisting. The orientation of the facet joint dictates the direction of the motion it allows.
There are various causes of pain coming from the facet joint. Similar to the joints in your arms and legs, the facet joints are prone to wear and tear. They can develop degenerative changes or joint osteoarthritis. This is a common condition in older people. The capsule surrounding the facet joint, which is made of ligaments and connective tissue, can be overstretched creating a sprain injury. Autoimmune or Inflammatory conditions like rheumatoid arthritis can also affect the facet joints by causing inflammation and deterioration.
Pain in the facet joints are typically felt in the local region of the affected joint segmetns. The pain can be felt close to the midline in the neck, upper back, mid-back or low back. Sometimes the pain is referred to the head, shoulder blade, shoulder, thigh or buttock. Stiffness, grinding in the joints (crepitus) and muscle spasm are other symptoms associated with facet joint disorders.
The standard treatment for facet joint pain include a course of physical therapy, non-steroidal anti-inflammatory medications, pain relieving medications, and home exercise program. When conservative measures fail, injection therapy to the facet joints or to the nerves leading to the facet joints can be helpful.
What is a Facet Joint Injection?
Facet joint injection is a minimally invasive procedure that is performed in an outpatient medical clinic. Local anesthesia is typically used in the procedure. There is no need for sedation in most cases. The procedure is performed under fluoroscopic (live digital x-ray) guidance. The typical substances that are injected to the facet joint are steroid medication to decrease inflammation and local anesthesia to provide immediate pain relief. The effects of these medications can provide temporary pain relief that typically last for 3-4 months.
Another injection that can provide pain relief does not involve injection to the joint, rather it involves the injection of numbing agents to the pain transmitting nerves (medial branch) called a nerve block. If this procedure results to a positive reponse, another procedure called Radiofrequency Ablation (RFA) can be performed. This involves inducing a heat lesion to the medial branches to prevent transmission of pain signals to the brain.
The use of Orthobiologics is an alternative treatment to facet joint conditions. Although the research on these treatments for spinal conditions is relatively new, it has the potential to improve arthritis and provide long term pain relief.
Risks Associated with the Facet Joint Injection Procedure
Facet joint injections are relatively safe with minimal risks. Risks associated with this procedure may include:
- Discomfort at the Injection Site: These effects are temporary and typically resolve in a few hours.
- Adverse reaction to medications: Some of the medications used in the procedure can cause adverse reaction in susceptible individuals. It is important to review your medications with your physician prior to the procedure. Severe allergic reactions are rare.
- Bleeding: Patients who are taking blood thinners or have a bleeding disorder are at risk for bleeding when undergoing an injection procedure. Blood thinners are typically stopped for 3-5 days prior to the procedure, with the permission of your primary doctor, to avoid this risk.
- Infection: Infection is rare when the procedure is performed under strict sterile protocols and proper procedure technique.
Natural therapies have been a valuable option for patients seeking alternative options to traditional medical treatments. These natural remedies can help relieve pain and stiffness associated with joint arthritis. It can also play an important role in one’s overall wellness.
Natural Ways to Reduce Joint Pain
Massage therapy has shown many health benefits for thousands of years. It can help improve flexibility, improve circulation, manage chronic pain, and improve rehabilitation. It can also promote overall well-being by reducing anxiety, promoting relaxation and improving sleep.
Acupuncture is a form of traditional Chinese medicine which involves very thin small needles that are inserted through the skin at specific acupuncture points on the body. It is believed to stimulate the central nervous system, improve blood flow and activate the body’s natural painkillers. A meta-analysis study showed that acupuncture can not only improve chronic knee pain associated with osteoarthritis, it can also improve short and long term physical function.
Yoga is an ancient Indian practice that uses deep breathing, meditation and body postures. Several studies have shown significant reduction in pain and function with improved strength, balance and gait, when used as an adjunct in the management of arthritis.1 The psychological benefits of Yoga therapy have been shown in the published literature to help reduce blood pressure, heart rate, anxiety and many other benefits.
Exercise keeps your joints flexible and improves the strength of supporting muscles. Low impact exercises such as walking, cycling, and aquatic therapy are great options for patients with joint arthritis. Working with a physical therapist or a personal trainer offers many benefits in addition to getting proper exercise. They can perform manual therapies, counsel on proper positioning and body movement and recommend assistive devices such as braces. Aquatic therapy, also known as pool therapy or water therapy, is an alternative option for those who can not perform land-based therapies with less risk of exacerbating their joint pain. The gravity reduced environment of water can allow for gentle movements to improve strength, flexibility, and endurance that is better tolerated by some.
It is important to maintain a regular home exercise routine to continue the benefits of exercise and maintain overall health.
Being overweight is a major risk factor for the development of osteoarthritis. Losing weight removes extra pounds of pressure on swollen, painful joints. Maintain a healthy weight by combining a balanced diet with regular physical activity.
Heat and Cold
Heat can relieve muscle and joint stiffness while cold can reduce inflammation, swelling and pain. These are easily available modalities that can help manage joint pain and reduce the need for pain medications .
Natural alternative arthritis treatments are generally safe and can be a good adjunct to standard medical treatments. Some do have scientific evidence to support their efficacy, however others need more research to evaluate their benefits. Patients can discuss these treatments with their doctor to determine if these are appropriate for their specific needs.
1 Ebnezar J, Nagarathna R, Yogitha B, Nagendra HR. Effect of integrated yoga therapy on pain, morning stiffness and anxiety in osteoarthritis of the knee joint: A randomized control study. Int J Yoga. 2012;5(1):28-36. doi:10.4103/0973-6131.91708