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Weekly Educational Broadcast Replay- 20200713

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Weekly Educational Broadcast Replay- 20200713
-How do we decide which Regenerative Medicine treatment to use. PRP vs BMAC.
-Why do we recommend PRP for back problems.
-Using treatments that get to the root of the problem, not just masking symptoms.

Content- Weekly Education
Live 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.
Watch live on FB/IG/Youtube Monday at 915a cst.
https://www.Instagram.com/ChicagoArthritis
https://www.Facebook.com/ChicagoArthritis
https://www.youtube.com/c/chicagoarthritis

***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 how we choose between regenerative medicine treatments including PRP and Bone marrow aspirate concentrate stem cell options.

Weekly Live Replay 2020-07-08

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Weekly Live Replay 2020-07-08
-Fix imaging vs Fix your life.
How we can fix your fix without changing the imaging.

-Incremental progress/Improvement
Covid protocol/plan.
Personal professional development.
Regenerative medicine protocols.

Chicago Arthritis and Regenerative Medicine Weekly Live broadcast.
Check us out live on Instagram, Facebook, or Youtube every Wednesday at 12:15pm cst.
Discussing relevant issues regarding state of the care for arthritis, tendinitis, injuries, and back pain.
https://www.Instagram.com/ChicagoArthritis
https://www.Facebook.com/ChicagoArthritis
https://www.youtube.com/c/chicagoarthritis


Hello everyone, this is Siddharth Tambar from Chicago Arthritis and Regenerative Medicine. Welcome to our weekly live live event. So I’ve been doing this for the last couple of months now where basically, talking live about different topics, something new that I also started within the last five weeks or so was starting a weekly educational meeting that I’m taping, where I’m talking to my own team at work, where we’re kind of discussing different topics, different questions that patients have, different questions that the team has about medical issues and what’s nice about is, it’s just a nice way to connect with the rest of the team and sort of answer what their questions are and patient’s questions are and it’s very just kind of very focused on educational topics and we started to do that one live as well, so that’s our weekly educational live event. This one is a little bit different because not so much answering direct questions, more sort of talking about different topics that are relevant to us, here at Chicago Arthritis and Regenerative Medicine and things that are relevant to me professionally as well. So this is our weekly live live event. You need the extra live because we’ve got the live attached to the weekly educational meeting event as well.

So couple of things that I want to talk about. Two topics, number one is fixed versus optimized and the other one is incremental progress and improvement, something that I’m kind of obsessed about. So fixed versus optimized is an interesting topic in that, you know I have patients frequently ask me can you fix this problem? And I understand what they’re asking, which is, can you help me out with my life? As a physician, I’m so reticent to use that word, fix. Because when it comes to musculoskeletal medicine, it’s not like we’re changing a tire at work, right. We’re literally taking someone whose got a chronic musculoskeletal issue and we’re trying to make it as good as it can be.

And so that term, fix, has always kind of thrown me off but I’ve spent some time thinking about it and I kind of realized that it’s important for people to understand that there’s a difference between fixing your imaging, X-Ray, MRI, ultrasound versus fixing your life. So imaging there’s a lot of things that we just cannot correct, if they’re old enough. So as an example, if you’ve had a chronically damaged knee for decades, we’re not gonna be able to get that to look dramatically different on x-ray. But there are certain things that we can actually get to look different on imaging. So if you have a mild to moderate ligament or tendon injury, we can actually get that to look improved on ultrasound and MRI. That’s pretty exciting because with regenerative medicine treatments, you can actually get that. You can’t get that with traditional steroids and other types of treatments. Another imaging find that you can get better if you have swelling in the bone that we can actually reduce that swelling or edema in the bone which correlates with pain relief as well. So there are things on imaging that we can actually get better, but there’s a lot that we can’t. And so a really great minor example that I like to give to people is I was scanning my own knee once, not because I had any pain or dysfunction, but because I was just practicing some hand-eye coordination things. I had some down-time in the office and it’s a good way to sort of stay productive. And everything looked find on my ultrasound. As I got up, I banged my knee, the medial part of my knee against the ultrasound machine. So at that point, I had some temporary pain. I thought, well, what an interesting time to actually see, what does that look like on an ultrasound. And what you could see on the ultrasound was a little bit of swelling around the medial collateral ligament and not much else. So to this day, I don’t have any pain, I don’t have any instability or any dysfunction because of that, but when I look at my ultrasound on my knee, I do have a tiny little bit of calcification in that ligament, something that is chronic that really can’t be totally fixed, and doesn’t really need to be treated or addressed either because it’s not causing any kind of clinical problems. But it’s one of those kind of examples of where certain imaging things you can’t fix, although there are some that can be fixed.

Fixing your life, like we can still do that. So a question that comes up is how can we fix your life without dramatically improving the imaging. So, and there’s a couple different ways that we can do that. So number one, if you do have something like let’s say a arthritic knee or lower back. So what you see in a joint that is chronically arthritic is that the joint itself is no longer pumping out the right sort of proteins, enzymes, or other chemicals that make a healthy joint. You have a pathologic joint, and so biologically, it’s unhealthy, chemically, it’s unhealthy, and the kind of regenerative medicine treatments that we’re using, either your own blood, platelets, stem cells, can actually help to optimize that joint by getting those cells to start pumping out the correct enzymes and proteins that you see in a healthy joint. So you’re optimizing the health of the joint, the biologic health of the joint.

Number two, a really key aspect for how we treat patients with regenerative treatments is that if there’s a component of instability, which most degenerative issues have, that we can actually strengthen the ligaments, tendons, soft tissue structures around that joint or area so that it’s a more stable joint, it’s a more functionally stable joint. The ligaments, the soft tissue gets stronger, and so there’s better stability. Lastly, if you have any component of inflammation in the joint, which a lot of joints and tendons do even when they’re osteoarthritic or chronically degenerative, that we can actually help to return that to a healthier, non-inflammatory state as well. All of those things result in less pain, improved activity, and more stability. More stability generally gets expressed as somebody saying, you know what, before, I could only stand for 15 minutes or walk four blocks, and now I can do double that amount of time without my knee or back feeling tired or painful or fatigued. So that’s really fixing somebody’s life, right. And so if trying to fix something is improving pain and function, those are the things that we can fix, but fixing imaging is a much harder thing, but fixing life we can definitely help out with. So, I know that’s how I started to think about when people ask that question, can you fix my problem. It’s, well let’s be clear about what are the objectives and measures that we’re trying to fix.

Second thing that I’ve been thinking a lot about is incremental progress and improvement. I think about this a lot in large part because that’s what we have to do at work. From a business end, but even from a professional end, how are constantly getting a little bit better. And so two things that come to mind right now. The first is our COVID protocol that we use internally. So, you know, when you look at what are the guidance and protocols for how do you handle COVID testing, how do you handle people that are COVID positive or exposed to COVID, the recommendations are not that solid, quite frankly, when you look at what the CDC has to offer. There are some guidelines that make sense, but the CDC’s guidelines come to a point where if someone’s been exposed to COVID that when is the time that they can get back to work? There is ambiguity at that moment where the CDC very clearly says, well, you could do two things. You could either get retested or you could just get quarantined for a specific amount of time, and if you’re asymptomatic, well, then talk to your doctor and then figure out what you should do. That’s not ideal, right. That leaves a lot of ambiguity, and what’s interesting is so, on a week to week basis, I sit down with my own team with Devi and Leah in my office and we kind of talk out what’s the right thing to do. And a lot of times, you kind of settle out as, well, I think this is the right thing to do, and what else have we learned in this last week, what did we learn from talking with colleagues over the last week, what’s the right thing to do now. And we make slight adjustments, incremental adjustments week to week based on what we’re hearing, what we’re learning, the feedback we’re getting from colleagues, feedback that we’re hearing from specialty societies, and it’s just making incremental improvement of progress. That’s the way to do this, especially in a moment in time of ambiguity, just slowly, progressively, and that incremental progress and improvement. And I’m proud of the way that we’ve done that because we’ve had occasions where patients or people that we know turn out to be COVID positive, and because we’ve taken this incremental, dedicated process of trying to figure out what’s the right thing to do, we’ve been able to make smart, healthy decisions for not only our patients, for ourselves as well, and protect all of us here at work, patients, and I think the community at large.

The second way that I think of incremental progress is also, you know, how are we, how am I personally practicing when it comes to certain things. So when I first started practice in 2008 and I was really utilizing what I learned in my training, which was very helpful for certain things, but I quickly realized that there were certain conditions that really were not able to get better with the traditional kind of things that I had learned, and then I had to really sort of kick-start or kinda take my training and education to a higher level on my own. That’s actually how I originally got involved in things like musculoskeletal ultrasound as well as platelet-rich plasma and then eventually things like bone marrow stem cells and prolotherapy. And so along that way, there’s just been a slow and progressive improvement in terms of my understanding for what a lot of this musculoskeletal pathology is, my understanding of how to get a better response from treatment, and how to treat different types of patients and people in a way that’s going to get a better and ideal outcome for their particular issues.

Some examples of that would be when I first started practice or first started utilizing some of these treatments, I didn’t have a full appreciation for the thoroughness that you needed to treat every structure and layer involved in pathology. So an example, if somebody has something like knee pain, it’s very rarely that they have a problem that’s only at the joint level. They have a ligament, tendon, muscle, cartilage, bone, other things that are kind of driving problems, fascial layers, and if you treat each one of those layers, you get a progressively better response to treatment. And what’s interesting about that is in my own incremental progress of my professional career, I came to appreciate each one of those layers in a more and progressive fashion so that as I progressively sort of improved that comprehensive treatment approach, it’d lend to better outcomes.

Another aspect would be when it comes to how important nerve-related health is, neuromuscular health, is when it comes to joint and tendon problems. It took me a while, but I came to appreciate that what’s happening in let’s say a knee or an ankle or a shoulder can very much be impacted by what’s going on in the neck or the lower back as well. Meaning if somebody has knee pain, they also have a mild pinched nerve in the lower back. If you don’t address that either with strengthening, physical therapy exercises, posture related things, symmetry related things, or even injection-related treatments, you’re not going to get the ideal outcome. So there’s been a slow, incremental improvement in that, and then even seeing the value in other structures. Something big in the world of regenerative medicine now is the value of bone swelling in someone that’s got osteoarthritis. And there are certain findings on MRI that indicate somebody has significant inflamed bone that if you treat that, you’ll actually get a better response to their regenerative medicine treatment. And it’s just an incremental progress in terms of making people better.

From my own personal, professional standpoint, that slow, incremental process is how I personally get better. It’s how I can also do better for patients as well. And I think in a moment during COVID where in real time, we’re literally learning on the fly how to do a better job and what are legitimate treatments and how to deliver better care, there is that incremental process. What works, what doesn’t work, There was something published on LinkedIn by one of my colleagues recently where they were talking about, hey, here’s this brand new study showing that yes, hydroxychloroquine can help in COVID. And they were looking at the headline, and the headline was published in CNN and I went out of my way to then look deeper to look at the actually article to say, look, is there some incremental progress here? Is this actually making things better? And it turned out, that’s not the case. It turned out, what was actually helping was they were using steroids in people who are developing progressive COVID and cardiopulmonary symptoms, and that that’s actually what made them better, and it actually kinda verified another study that came out a couple weeks ago that showed that high doses of steroids in people with pulmonary complications from COVID could actually make a difference. And so in this incremental process, it’s important to understand to take that one depth layer deeper to really understand what’s legit, what works, what doesn’t work, but that slow incremental progress is how we get better so that we can take something that maybe isn’t responding well to treatment and that is challenging, and then we can actually optimize the situation and maybe even fix people that have those kind of problems.

Fixing their life, not just fixing their imaging, not just fixing what is their testing show, but actually getting them to a higher quality of life, and in that regard, I think we can still help to fix people by actually taking that kind of incremental progress of improvement.

Thank you for your time. I appreciate everyone for listening and watching. If you have more things you’d like to hear about or listen about, let me know. Again, we have two weekly live broadcasts, the weekly education broadcast at the beginning of the week, and the weekly live live broadcast midweek, and I’ll keep doing this as long as everyone’s interested in listening and watching. Until next week, be safe, have a good week, and stay healthy, and live well. Bye bye.


***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 fixing your life vs fixing your imaging, incremental progress in covid19, musculoskeletal care, regenerative medicine, and professionalism.

 

Weekly educational meeting Live! 20200706

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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 Live event replay- 20200701

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Weekly Live event replay- 20200701
Trying to thrive in a world of heightened uncertainty by focusing on:
-Small wins.
-Falling forward.

Chicago Arthritis and Regenerative Medicine- Weekly Live
Check us out live on Instagram and Facebook every wednesday at 12:15pm cst.
Discussing relevant issues regarding state of the care for arthritis, tendinitis, injuries, and back pain.
https://www.Instagram.com/ChicagoArthritis
https://www.Facebook.com/ChicagoArthritis


Hello everyone, this is Siddharth Tambar from Chicago Arthritis and Regenerative Medicine. Welcome to our weekly Live event. It’s July 1st, 2020. I hope everyone’s doing well. This feels like the beginning of summer, even though that started a couple of weeks ago. Here in Chicago, we’ve started to enter phase four of the coronavirus response, which generally means that certain retail establishments, including restaurants, I believe bars, are now allowed to allow something like 25% of their normal volume of patrons. That’s a nice small win for us here in Chicago, since we had so really clamped down pretty hard for a couple of months, we’ve been able to start slowly easing into, you know, this new normal. At the same time we have other parts of the country that weren’t quite as… I don’t know if I want to say diligent or aggressive when it came to precautions when they were reopening. And now they’re in a position where they have to start kind of pulling back as well. My sense is that this sort of cautiousness and variability that we’re seeing throughout the country is something we’re going to be dealing with for at least the next several months. Meaning as some places are able to reemerge a little bit, more steady, other places may need to retract, and there’s going to be a bit of give and take, and pull and push as we, you know, as we grow into what this new world is.

And in that kind of world where you have so much uncertainty and volatility, I want to touch base on how can, how can we as individuals, still thrive in a world with heightened concerns? So it goes without saying that for folks that have active medical issues that require treatment or are being delayed because of COVID-19, those are really harsh things that obviously need to be addressed in a hardcore medical way. A lot of the things I’m talking about are more about, you know, how should we be approaching, how should we be approaching things from a mental and emotional standpoint with some of the heightened concerns that we have, and volatility that we have in this world. And so there’s two things that I think of, number one is being able to focus on small wins. And number two is really a concept that I believe in which is falling forward.

So in terms of small wins, I think it’s critical that we really appreciate when we do take those baby steps, when we are, when we are actually moving forward and when we have wins. So as an example, phase four in Chicago, that’s a big deal. I mean, we really were pretty clamped down and shut down from a business standpoint throughout, you know, our, the Metro Chicago economy for the last, for the last few months. And so to see restaurants starting to open up a little bit is a big deal. This past weekend, my family, we were able to go to the Chicago Zoo. And then the next day we were able to go on a picnic with some friends and we maintained appropriate precautions in terms of mask, as well as social distancing. But you know, that, those are small wins, and that’s important to recognize.

So in a professional component, when I think of how do we get small wins for our patients who have arthritis, tendinitis, injuries and back pain, there’s a few things that I think of. The first is, small wins help out in a couple of ways. For example, they help out with maintaining forward momentum or forward progress. In addition, small changes sometimes can equal bigger, bigger wins longterm as well. So as an example, maintaining forward progress, I think physical therapy is a great example of where small wins on a day-by-day basis go a long way. In particular, small gains in strength, small improvements in range of motion, go a long way in terms of improving a person’s function, a person’s pain relief, and a person’s quality of life on a daily basis. So key because small changes in strength, small changes in stability make a huge difference in quality of life. Regenerative medicine sometimes has a similar effect, for example, improving stability, which is a lot of what we’re doing when we’re treating ligaments, soft tissue structures, tendons, muscles, labrum, meniscus, that even just a small amount of improvement in stability and strength in those tissues goes a long way in terms of improving function as well. So that classic sort of example would be a patient who says, “Look Doc, I’m doing okay when it comes to my knee, when it comes to rest, and I can do some basic activities okay. But now when I’m walking about four blocks is when my knee is causing problems. I start to feel fatigue and pain and it starts to feel a bit loose.” Well, improving some of that stability with physical therapy, but also with the regenerative medicine techniques, whether it’s injecting your own platelets, dextrose, bone marrow stem cells, that that goes a long way in terms of taking somebody from walking four blocks to walking eight blocks. Quality life improvement there is pretty big. The original prolotherapy, dextrose prolotherapy, where you’re injecting sugar water, which has been going on for decades as a treatment modality for arthritis and tendinitis, that worked by improving that tissue integrity of ligaments. And by improving that function just a little bit, made a huge difference in terms of functional improvement, and quality of life, and pain relief as well. So small changes, small wins, when it comes to things like physical therapy and regenerative medicine, help to maintain forward progress, and help to push forward a person’s abilities.

The other thing is sometimes small changes can actually be equivalent to humongous gains. So two examples of that. Number one is a patient I saw recently who was having a lot of hand and wrist pains, who I think has probably early rheumatoid arthritis. You know, the next step in her evaluation is actually to check a diagnostic ultrasound of her hands and her wrists. And the reason why is I’m expecting to see some subtle changes of fluid. But really what I want to see is does this person have what’s called power Doppler uptake or active inflammation in those small joints, because if they do, that makes a big difference in terms of what our next steps would be. In particular, because if they have that small vascular change on ultrasound, it’s a sign of very significant inflammation, and it’s a very significant sign of progression or risk for progression of their condition, including actual damage in the joint as well. So identifying that small change is huge because we can actually make a difference with treatment there. If you start a person on the right kind of medication treatment who has that condition, you can reverse or actually get that inflammation signal to resolve, and that will then predict a reduction in chance of progression of their condition, and a reduction in chance of actual damage from their condition as well. So that’s humongous, making small changes, small win for that one small change can go a long way to improving that person’s condition, pain, inflammation, and longterm outcomes as well.

The second concept that I think that’s important is something that I think a lot about is this idea of falling forward. So, you know, I got this idea originally, I am a big football fan, and every once in a while, you’ll find a running back who’s in the league who is not the fastest, not the quickest, not very elusive in his movements, but he’s someone who based on his size, his agility and the way he plays, that anytime you hit him, he still falls forward. He still somehow gains yardage. So if you hit him after a three-yard gain, he gets five yards total. If you hit them behind the line of scrimmage, instead of a one-yard loss, he still somehow ekes out two yards. Falling forward. I think that’s important mainly because, in my own personal and professional life, I find that when you have to make tons of decisions, it’s hard to make all those decisions perfectly and correctly. And sometimes you just have to make a good decision that makes sense on paper. And hopefully if it’s enough of an improvement, that even if the result is not ideal, you still fall forward, meaning you’re still getting some forward momentum. You’re still inching forward, so that you’re not as concerned about, “Did I make the exact perfect decision?” You’re more thinking about, “Did I at least move things forward? Did I at least move my life forward, my business forward, the effect on this individual forward?” So that we’re still moving forward in a positive way. I think that’s key because it’s important that when you make decisions that you are learning, you’re adapting, and you’re moving forward.

This is, this is important, not only from a life standpoint, a business standpoint, I think it’s so key from a musculoskeletal standpoint as well, namely for the following two reasons, two examples. I had a patient ask me recently about what to expect after his regenerative medicine treatments. And the key for him to understand is that, that first couple of weeks are going to be a little bit up and down, that he may feel like he is, his progress is a little bit up, a little bit down, but the key is to understand that as long as you’re inching forward, falling forward, you’re making progress. And that long term, that sort of slow progress of falling forward will eventually equal big gains longterm. I think physical therapy and exercise is the same thing. There’ll be moments where you feel like you’re doing well. And there may be the moments where you feel like you have a little bit of retraction. That little bit of retraction, that can occur. And that’s okay because that’s part of the process of healing and improving, meaning that it’s not a linear straight line. A lot of times it is actually just getting small improvements and there may be a small setback, which you learn from that, you adapt from that, and then you kind of get back on that upward trajectory. Falling forward is key because I think in a world of uncertainty, we’re not going to have full visibility of what’s coming next. We’re not going to have full visibility of, are we making always good progress? But as long as we’re making micro progress falling forward, I think that’s, that’s a way to gauge that. Are we actually in the right direction?

So in this world of heightened uncertainty and concern, I think whether it comes to your own personal life, whether it comes to your own professional life, and certainly when it comes to your own musculoskeletal health, those are the key things. Are you making small wins again and again. And are you falling forward. I think if you are, then you’re heading in the right direction. You’re still growth-oriented. You’re still moving positively. I think that goes a long way.

Thank you for your time. Until we connect again next week, I hope everyone stays healthy and is safe. As a reminder again, I’m publishing two things right now. The first is obviously this Weekly Live kind of interaction. The other one is a Weekly Educational meeting that I have with my own team every week. We’re publishing that as well. Good way to kind of learn from both of them in a slightly different way, but until next week, I hope everyone stays healthy and live well. Bye, bye.


***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 how to thrive in a volatile world- 1) Small wins. 2) Falling forward.

#chicago
#chicagoarthritis
#chicagoarthritisregenerativemedicine
#westloop
#westloopisthebestloop
#regenerativemedicine
#prp
#stemcells
#arthritis
#osteoarthritis
#tendinitis
#rheumatology
#rheumatologist
#rheumatoidarthritis
#psoriaticarthritis
#anklyosingspondylitis
#autoimmune

 

Weekly Education- 20200629

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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.


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***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?


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