Dr. Silva does not require imaging (X-RAY, MRI, CT) for your initial consultation. If he deems it necessary, he can order it for you. However, if you already have imaging, he requests that you bring the report along with the images on a CD to your appointment. You can easily acquire these records by contacting the facility that provided the service and requesting it.

“Stem cells” from a bottle are quite popular right now. These amniotic/placental/Wharton’s jelly products are acquired from a variety of donors around the world, sterilized and dehydrated into a powder, or cryopreserved, packaged, and finally sold to doctors for use on their patients. Currently, there is a disturbing trend of undertrained physicians selling these donor tissue products as live stem cells or “stem cell therapy” to patients who don’t know any better, but these are dead tissues and are regulated as such by the FDA. Therefore, any doctor or practitioner who calls these therapies as “stem cell therapy” is practicing fraudulent medicine. Part of Dr. Silva’s mission is to provide education to his patients and the greater community so that they can be empowered consumers of medicine, armed with the knowledge needed to protect themselves from being ripped off by practitioners making such false claims.

Stem cell therapy for musculoskeletal conditions is derived from bone marrow concentrate (BMC). Inside your bone marrow live a variety of immune cells, including mesenchymal stem cells, which are extracted and then concentrated into to be used as your cellular medicine in orthopedic procedures. BMC is one of the strongest biologics used in orthopedic procedures and is typically used for more severe cases of tendon or ligament tears, osteoarthritis, and joint degeneration. Stem cells act as a general contractor to organize the repair through a variety of cytokines and exosomes, but they may also become the brick and mortar needed for tissue repair. The end result is stronger tissue and an improved ability to handle stress which will result in better biomechanics and decreased pain.

Prolotherapy is short for proliferative therapies which are various types of injectates which stimulate an inflammatory response which encourages the body’s healing process with the intent of repairing injured tissue such as ligaments and tendons. The end goal would be to stabilize and strengthen joints to reduce your pain and improve their function.

There are multiple types of prolotherapy, from mild to very strong, and this should be customized to the patient’s pathology.

Regenerative medicine is a non-surgical approach to heal damaged tissue and disease that contributes to pain and dysfunction. In our practice, we attempt to address underlying problems that are creating the patient’s complaints. This is in contrast to the majority of medical treatments that are designed to address symptoms without addressing the underlying cause of those symptoms. To regenerate a joint, we utilize therapies that aim to strengthen all of the tissues that make the joint work appropriately, and the subsequent improvement of biomechanics will lead to reduced or eliminated pain, improved stability, and a better functioning joint for the long run.

A regenerative procedure works with the body’s natural process of healing, starting by stimulating inflammation, followed by the proliferation of new tissue, and then maturation of that new tissue over time. When utilizing Prolotherapy, PRP and/or Cellular Therapy, these stages of healing occur over several weeks to months. In order for this process to occur, and for the patient to achieve their optimal outcome, these must be precisely placed under image guidance into the degenerative tissue. You cannot get this result of healing by just blindly injecting the substance into the joint (be it PRP or Cellular Therapy), although this is how many of the less skilled practitioners administer PRP and fake “stem cells” from a bottle. Always check your “regenerative medicine” doctor’s credentials, as many practitioners inflate or misrepresent their experience, credentials, and expertise with regard to the substances they inject, ultrasound and fluoroscopic image guidance, and musculoskeletal injection techniques. Dr. Silva is a board-certified Physical Medicine & Rehabilitation doctor with specialty fellowship training in Interventional Orthopedics. Click here to learn more about his credentials.

There are a variety of things that need to be done before and after injections to improve the overall outcome. Unfortunately, many doctors are not aware of all of the protocols and precautions necessary to support the optimal outcome.

Many times, this includes lifestyle modifications, rehabilitation exercise, changing /reducing/discontinuing medications, optimizing disease, and utilizing a brace. Dr. Silva recommends a PREhab protocol to prepare for the procedure and then a rehab protocol for a minimum of 6 weeks after injections. Your PREhab and rehab will and should be customized to you, and Dr. Silva will talk about this at length during your evaluation in order to maximize your long-term results.