TeleMedicine visits available now - Get remote care from the safety of your home. Click to schedule an appointment.
TeleMedicine visits available now - Get remote care from the safety of your home. Click to schedule an appointment.

Weekly educational meeting Live! 20200706

img
Weekly educational meeting Live! 20200706
We are going live 2x per week. Live on Facebook, Instagram, and Youtube!
Topics discussed during this broadcast:
Heel pain:
Plantar fasciitis and Achilles tendinitis
Case 1
Case 2
Avoid steroids!
Nerve related pain.
PRP vs Amniotic fluid.
#heel #heelpain #heelpainrelief #heelpaintreatment #heelpainsucks #plantarfasciitis #plantarfasciitisrelief #plantarfasciitissucks #achilles #achillestendonitis #achillestendon #achillespain #prp #prptreatment #stemcells #stemcelltherapy #regenerativemedicine #regenexx #chicago #chicagomed

Weekly Education- 20200629

img
Weekly Education- 20200629
-Expectations post regenerative procedure for arthritis, tendinitis, injuries, and back pain.
-Can prp or bmac help after a prior surgery?

Hello, this is Siddharth Tambar from Chicago Arthritis and Regenerative Medicine. It’s June 29th, 2020, and welcome to our weekly educational meeting. So this meeting is typically me discussing with my team typical issues that come up in the scope of our practice clinically, and discussing how we generally approach those issues, either questions that specific team members have, patients have, or things that I’m seeing, to give a bigger picture perspective in terms of how we handle clinical issues and problems to not only add value to individual patients, but based on how we’re handling them, to also give a sense for how we try to approach medical issues so that the general public gets a sense for what are best practices and how we evaluate things. So today’s going to be a little bit different, namely because I actually have a couple of folks who are on vacation today. So this is going to be more me just discussing directly, questions that have come up in the last week from patients that I think can help to clarify some things and offer some value.

So the first one is from a recently treated patient who had his knee and lower back treated, who had described some discomfort roughly one week after treatment, and discussion I had with him regarding expectations regarding post-treatment care, post-treatment progression and discomfort, and progressive improvement that will occur over time. So in his case, treated about a week ago, and he had sent me a text message over the weekend saying, “Hey, still having some stiffness, what are some expectations?” And so reviewing that with him again to make sure we’re on the same page. So after any sort of regenerative treatment, there is an expectation of inflammation up front. That’s normal. So inflammation for the first two, three days after treatment is expected. That can go out to roughly about a week and that inflammation can get presented as swelling in a joint that’s been treated or a tendon that’s been treated, and more discomfort or even pain for the first few days after treatment. We normally treat that with things that are not going to impair or impact the actual treatment that we’re using. So what I recommend is avoiding anti-inflammatory medications, ice, things of that nature that are meant to reduce inflammation on a more profound level. On the other hand, utilizing things like Tylenol, possibly a short term narcotic, heat, some compression, bracing, manual therapy, all those things are okay, cause they’re not going to limit the effectiveness of what we’re trying to achieve.

So this individual’s gotten over that initial post-treatment discomfort and he’s still having some stiffness and milder discomfort. And what I generally expect is some degree of that sort of stiffness for the first week up to even three weeks. The most I’ve seen is up to four weeks, but normally it’s in that first week to two weeks that people will have that. Again, that’s a normal process of what’s going on here. And that’s because the inflammation component of what we’re trying to trigger with treatment is going to lead to these kind of symptoms. So when you have that initial acute inflammation, that swelling of the structure that’s been treated, you’ll see for that first week or so, there’s still then that lower level inflammatory process that’s bringing in other cells and growth factors that you should expect for the next couple of weeks afterwards. So stiffness immediately afterwards and for the first couple of weeks is normal. If that goes beyond that sort of normal course, then reevaluation may be needed.

So to me, a more significant or concerning aspect would be if someone’s developed fevers. That shouldn’t happen. Some low grade warmth can happen immediately after treating a joint. But it shouldn’t be outright fevers that someone’s having systemically. you would want to make sure that gets checked out to make sure that an individual doesn’t have an infection. In addition, if somebody has something like gout, pseudogout, rheumatoid arthritis, psoriatic arthritis, or any other kind of autoimmune condition, getting a more significant inflammatory component for that first week in a treated joint is certainly common and expected. And I’ve seen that quite often. And that generally comes down after about a week, and then there’s that progressive sort of improvement that will develop. Other things that would have me concerned would be if somebody said after a week, “Hey, knee’s feeling or the joint’s feeling more unstable.” I’d probably want to check that out then at that point. But for the most part, swelling will slowly, progressively improve, and improvement in pain and function I’d want to be hearing at roughly the four to six week mark with a slow, progressive improvement, then going on for the next, roughly three months up to six months. There’s some data showing that with some of these treatments improvement, even up to the first year or so. But my general approach is inflammation, stiffness up front and then slow progressive improvement for the next few months.

Second question that I got was from someone who was interested in learning more about our treatments, who is asking that, she had had surgery for her joint, could this treatment still be helpful? So there’s layers to this question. The first question is obviously what kind of surgery did they have, and then in addition, what’s actually their pain? So I gave an example, I believe last week, on this same broadcast, about how someone who’d had hip replacement surgery had persistent hip pain, and it turned out that his hip pain was actually coming from his SI joint. So in that kind of case where someone’s had surgery, if they still have pain, the exact same pain, perhaps their pain is coming from a different structure. In which case, yes, they can still benefit from treatment because the area that’s already been treated was not actually their pain generating structure.

Number two, let’s say someone’s actually had treatment. Let’s say arthroscopic surgery for the knee or some kind of surgery for the back, and they’re still having pain. Why would they still be having pain, or is the pain different than what they’ve had before, and can they benefit from treatment? So, number one, let’s say someone who’s had arthroscopic surgery, they’ve had some benefit from treatment initially, but they’re still having some discomfort or progressive pain. So that can happen for a number of reasons. Number one, again, their pain is not coming from just that one area that’s been treated. They may have pain that’s coming from chronic instability in the joint. And in which case that’s not something that’s going to get naturally better with routine arthroscopic washout kind of surgery, but can still get better from the regenerative treatments that we offer, whether that’s platelets or bone marrow or even prolotherapy, where if you can improve some of the instability in a soft tissue structure, that that person’s pain and functional impairment may actually get better.

Number two is if you’ve treated an area with surgery, let’s say a lumbar fusion, they can still get what’s called adjacent segment disease, where the areas above and below what’s been treated can still get stressed. And that’s expected in the sense that if you have a surgical procedure that fuses a segment, you still will have the same normal forces and weight that’s going through that area. And instead of now being taken up by that area that’s been fused, it’s now offloaded to the area above or below. And so people can then develop that same degenerative process in that area above and below. Or in some of the soft tissue components over that same segment that had already been fused. And so in that kind of person, now they can still benefit from treatment because now you’re treating those other segments that are now being stressed. Not to mention those same ligaments that were previously in that segment that’s already been fused, those ligaments may be taking on more stress. Just because you’ve taken it off one structure, the other structures around it are now still having to take on the load. So in someone that’s had surgery, if they’re still having pain, yes they can still respond to treatment if their pain is coming from a different structure or if their pain is coming because now the stress has been offloaded to other structures.

So the short answer is yes it’s possible to get benefit from treatment, but the more nuanced answer is, why do you still have pain, what structures are involved, and what else can be helped? Now, without a doubt, if you have, let’s say, something like a knee replacement, and if you still have pain, not only consider is the pain coming from another structure, but you would also want to make sure with your surgeon that there isn’t anything wrong with the hardware that’s in place. That should always be step one. But then also consider whether other structures are problematic. So the more nuanced answer is, get to more of the details and the why, but the short answer is yes you may be able to still benefit from treatment.

Well, this was a shortened version of this week’s educational meeting. I hope those two issues are ones that, if people have been thinking about them or having questions, I hope that gives some additional explanation and answers. And until next week I hope everyone is doing well. Be safe, be healthy, have a good day and live well. Bye bye.


Content- Weekly Education
Weekly educational meeting for the team at Chicago Arthritis and Regenerative Medicine where we discuss the basics of what we do for arthritis, tendinitis, injuries, and back pain.

***For more educational content:
Sign up for our email newsletter:

Subscribe to our Newsletter

See our blog:

Chicago Arthritis Blog

Listen to the Regenerative Medicine Report podcast:
https://www.chicagoarthritis.com/regenerative-medicine-report/

***For evaluation and treatment at Chicago Arthritis and Regenerative Medicine:
Determine if you are a Regenerative Medicine treatment candidate:

Candidate Form

Contact us for more information or to schedule an appointment:
https://www.chicagoarthritis.com/contact-us/

MEDICAL ADVICE DISCLAIMER: All content in this message/video/audio broadcast and description including: infor­ma­tion, opinions, con­tent, ref­er­ences and links is for infor­ma­tional pur­poses only. The Author does not pro­vide any med­ical advice on the Site. Access­ing, viewing, read­ing or oth­er­wise using this content does NOT cre­ate a physician-patient rela­tion­ship between you and it’s author. Pro­vid­ing per­sonal or med­ical infor­ma­tion to the Principal author does not cre­ate a physician-patient rela­tion­ship between you and the Principal author or authors. Noth­ing con­tained in this video or it’s description is intended to estab­lish a physician-patient rela­tion­ship, to replace the ser­vices of a trained physi­cian or health care pro­fes­sional, or oth­er­wise to be a sub­sti­tute for pro­fes­sional med­ical advice, diag­no­sis, or treatment. You should con­sult a licensed physi­cian or appropriately-credentialed health care worker in your com­munity in all mat­ters relat­ing to your health.

***About this video***
In this video Siddharth Tambar MD from Chicago Arthritis and Regenerative Medicine discusses expectations post regenerative procedure for arthritis, tendinitis, injuries, and back pain. And also whether prp or bmac treatment can help after a prior surgery?


#chicago
#chicagoarthritis
#chicagoarthritisregenerativemedicine
#westloop
#westloopisthebestloop
#regenerativemedicine
#prp
#stemcells
#arthritis
#osteoarthritis
#tendinitis
#knee pain
#hip pain
#back pain
#ankle pain
#feet pain
#shoulder pain
#elbow pain
#wrist pain
#hand pain
#neck pain
#rheumatology
#rheumatologist
#rheumatoidarthritis
#psoriaticarthritis
#anklyosingspondylitis
#autoimmune
#covid19
#telemedicine

Inflammation, Pain, and Musculoskeletal Health

img
Inflammation, Pain, and Musculoskeletal Health
Inflammation is complicated. But it definitely has a role in musculoskeletal health, pathology, and pain.
Hello, this is Siddharth Tambar from Chicago arthritis and regenerative medicine. On this video today I am talking about a fundamental issue when it comes to your musculoskeletal health and that is inflammation. First and foremost it’s important to understand the difference between acute and chronic inflammation. Acute inflammation would be when you’ve sprained an ankle, acutely injured your shoulder or knee, and it feels very inflamed, hot, warm, maybe a little bit swollen as well. That is generally the body’s normal way of trying to recover from an injury. Meaning you have an acute injury, trauma, your body brings in platelets, red blood cells, growth factors to help try to heal that kind of injury. In most circumstances that’s a good process. Occasionally too much acute inflammation can be problematic, but normally that is the normal process of trying to recover from an acute trauma. On the other hand, there’s chronic inflammation.
Chronic inflammation is a problem. And the reason why is because it’s your body’s way of trying to function and recover but is not doing so appropriately, and will actually prevent a normal healing process and normal function. So when it comes to chronic inflammation, it’s important to understand the difference between systemic or total body inflammation, versus local chronic inflammation. So systemic inflammation or total body inflammation is a problem because it can cause a number of issues including inflammation in the joints, damage in the joints, and sort of permanent damage and persistent functional problems. It can also make you more prone to metabolic syndrome as well as cardiovascular disease. Chronic inflammation is on a systemic level is a big problem and leads to a lot of pathology and pain and dysfunction long term. There’s then chronic inflammation at a local level meaning at a one joint, one tendon level. You could see that as persistent inflammation within a knee that is chronically swollen, or a tendon that is chronically strained or inflamed as well. That leads to not only persistent pain, instability, dysfunction, but also damaged in some cases as well. You can have that chronic inflammation if you have a joint or tendon that is chronically unstable or if you have some other process systemically that is causing that inflammation in that joint.
So chronic inflammation is a problem. Ways that you can control that include trying to be as clean and healthy when it comes to an anti-inflammatory diet. That can mean different things to different people, but as a general rule it, to me, at least it means more of a plant-based diet, reduced refined sugars. Each person probably has some degree of susceptibility to inflammation based on their diet and that can vary from person to person. Working with an expert, proper nutritionist can help you in that regard.
There are certain supplements that can also help with chronic inflammation- omega-3 and turmeric have benefit as well that’s been shown to help not only osteoarthritis, and rheumatoid arthritis in some cases. And can be as useful as chronic Anti-inflammatory medications as well. In some cases if there’s significant chronic inflammation, medications are necessary to help control those kind of conditions. Those medications work by modulating your immune system to prevent that chronic inflammation. And then lastly in some cases regenerative medicine treatments, orthobiologic treatments, can be helpful as well either because the actual treatment itself has an anti-inflammatory effect or because if you have an instability issue by improving instability, you can reduce the chronic inflammation with that joint as well.
Inflammation has some good parts if it’s acute but is a problem if it’s chronic. It’s something that can be treated and evaluated. It’s important to recognize, it’s important to treat it. And if it’s a component of your pain and inflammation and dysfunction, it’s something that should be checked out. Have a good day. Be well, and bye-bye.
***For more educational content:
Sign up for our email newsletter:
https://www.chicagoarthritis.com/newsletter/
See our blog:
https://www.chicagoarthritis.com/blog/
Listen to the Regenerative Medicine Report podcast:
https://www.chicagoarthritis.com/regenerative-medicine-report/

***For evaluation and treatment at Chicago Arthritis and Regenerative Medicine:
Determine if you are a Regenerative Medicine treatment candidate:
https://www.chicagoarthritis.com/regenexx-candidate-form/
Contact us for more information or to schedule an appointment:
https://www.chicagoarthritis.com/contact-us/

MEDICAL ADVICE DISCLAIMER: All content in this message/video/audio broadcast and description including: infor­ma­tion, opinions, con­tent, ref­er­ences and links is for infor­ma­tional pur­poses only. The Author does not pro­vide any med­ical advice on the Site. Access­ing, viewing, read­ing or oth­er­wise using this content does NOT cre­ate a physician-patient rela­tion­ship between you and it’s author. Pro­vid­ing per­sonal or med­ical infor­ma­tion to the Principal author does not cre­ate a physician-patient rela­tion­ship between you and the Principal author or authors. Noth­ing con­tained in this video or it’s description is intended to estab­lish a physician-patient rela­tion­ship, to replace the ser­vices of a trained physi­cian or health care pro­fes­sional, or oth­er­wise to be a sub­sti­tute for pro­fes­sional med­ical advice, diag­no­sis, or treatment. You should con­sult a licensed physi­cian or appropriately-credentialed health care worker in your com­munity in all mat­ters relat­ing to your health.
***About this video***
In this video Siddharth Tambar MD from Chicago Arthritis and Regenerative Medicine discusses inflammation, pain, arthritis, tendinitis, and injuries.

Joint Stability- Your Musculoskeletal Health

Continue reading “Joint Stability- Your Musculoskeletal Health”

Fundamentals- Why Regenerative Medicine for Musculoskeletal care

img
Regenerative medicine in Musculoskeletal care
In this video we discuss why regenerative medicine is being used for arthritis, tendinitis, injuries, and back pain.
Hello, this is Siddharth Tambar from Chicago arthritis and regenerative medicine. In this video I’ll be talking about a fundamental issue which is “why regenerative medicine in musculoskeletal care”.
So regenerative medicine is the utilization of cell based treatments like your own blood, platelets, other chemicals, bone marrow derived stem cells to treat orthopedic and musculoskeletal conditions including arthritis, tendinitis, injuries, and back pain. So why Regenerative medicine. Why is that even an option that we should be considering and discussing.
First and foremost it’s because our current options can be better. As an example in 2015 the British medical journal came out with a article that showed that only 20% of current Orthopedic surgeries meet level 1 evidence. That’s the highest level of evidence that scientific and medical studies can go through and only 20% of the surgeries that are done really meet that criteria. That means 80% may have some utility but are not really hitting the highest mark. It’s an opportunity for can we do better? Not just only on the surgical end, but are there ways that we can treat some of those conditions non-surgically to get an equivalent or better response.
Number two, we need to look for lower risk options that can give similar or better results. So for an example a number of studies over the last 10 to 15 years have shown that if somebody already has knee osteoarthritis a routine meniscectomy surgery where you shave down the meniscus or routine arthroscopy to shave down some of the cartilage is no better than just physical therapy. We need more lower risk options. Those are opportunities where regenerative medicine can actually help.
Lastly traditional medicine for Orthopedic conditions is generally to take a very conservative approach until a condition reaches a very end stage level where now only a surgical solution may be beneficial. And in the meantime, utilizing conservative measures such as physical therapy, manual therapy, acupuncture, and Chiropractic which are all good low-risk options. But to also use other options that have a bit more risks, including anti-inflammatory medications, narcotic medications, and even steroid injections which all have potential risks if utilized in a long-term fashion. So again areas where we can do better and regenerative medicine has the potential to fill in that gap.
So how can we do better? Well, we can help with regenerative medicine to improve instability to improve certain degenerative conditions, including osteoarthritis and tendinitis. To reduce chronic inflammation in a joint or tendon. If a joint has been acutely traumatized we may be able to help in that kind of case as well. If someone has an acute soft tissue injury of a ligament a lot of time that can partially repair but you may be able to get a better response in terms of repair and functional Improvement if you can utilize a regenerative medicine treatment. And there’s also some evidence that you can augment some surgeries of the knee and the shoulder with cell based treatments as well. These are all places where regenerative medicine has a role.
So why regenerative medicine, it’s because we can do better in a lot of traditional cases. It’s because we don’t have a lot of great options in some cases. And it’s because some of the options that we’re using already can be augmented with some cell-base regenerative medicine treatments as well. Hope that gives some perspective on where and why regenerative medicine It is something that has a role in Orthopedic care and musculoskeletal care. Thank you for your time. Have a good day and live well, bye bye.

Continue reading “Fundamentals- Why Regenerative Medicine for Musculoskeletal care”