​So you’ve decided that orthopedic regenerative medicine is right for you. That’s great! Now, there are a few things you can and should do to make sure you’re getting the most out of your treatment.

Before your ProlotherapyPRP or Stem Cell therapy procedure, I recommend you do the following:


There are so many reasons to avoid NSAIDS as a long-term method of pain control, and they should especially be avoided in the 2 weeks leading up to your PRP or stem cell treatment.

Here’s why:

  • The main function of NSAIDs is to provide an anti-inflammatory effect which is what helps to relieve your pain temporarily, but they also thin your blood which can contribute to more bleeding during your procedure. For PRP procedures, you’ll have your blood drawn the morning of your procedure. For Stem Cell Therapy procedures, you’ll have a bone marrow extraction the morning of the procedure. In both cases, we’ll be using your own cells for your injection therapy. NSAIDS also stop inflammation from occurring in the body, which is something we actually want to take place as part of the regenerative healing process. Believe it or not, inflammation is a sign of your body attempting to heal itself, so we do not want to impede that process from taking place.
  • Long-term use of NSAIDs can lead to a host of unwanted side effects, including increased risk of heart attack, stroke, stomach ulcers, kidney and liver damage, and more. I recommend acetaminophen (common brand name Tylenol) for pre and post-operative joint pain relief instead of NSAIDs such as Ibuprofen, Advil, Motrin, Aleve, Naproxen, Mobic, Voltaren, etc. Taking this one important step can potentially increase the results of your regenerative procedures.


For similar reasons, high-dose corticosteroid injections should also be avoided leading up to your regenerative medicine treatment, and they should never be used as a long-term solution to your pain problem. Repeat cortisone/steroid injections are commonly prescribed for short-term pain relief, but they do not promote healing. In fact, repeat cortisone injections have been shown to speed up the progression of joint degeneration leading to conditions like osteoarthritis, ruptured tendons and ligaments, along with the many other unwanted side effects such as high blood pressure, immune suppression, glucose resistance, promotion of osteoporosis, and more. Patients are not usually informed of these potential side effects and will continue to receive these injections until their joint degeneration progresses to the point that they finally resort to surgery.


We all know that we should eat a healthy diet in order to feel our best day today, but it’s especially advantageous to amp up your efforts in the weeks leading up to your treatment. During this period I recommend you make strides to improve your intake of nutrient-dense foods, avoid processed foods, avoid smoking, cut your alcohol intake, and stay hydrated. We can liken the process of tissue regeneration through injection of orthobiologics to the idea of growing crops. In this case, I’m the farmer, your autologous cells are the seeds, and your body is the soil. We want the seeds and the soil to be primed for growth so that you can help maximize your outcome. Continuing with better habits throughout your post-procedure healing process is also highly recommended.


After your post-treatment rest period, which is typically no more than a week or two, you’ll want to help your body heal with some form of rehab. I commonly recommend and refer patients to physical therapy or functional movement-based chiropractic care, Egoscue, or other rehab exercises. I can also recommend specific exercise protocols based on your specific treatment and recovery situation. Sometimes bracing is required for your optimal healing as well, especially for knees. If your best outcome requires this, I’ll be able to set you up with a brace as well.


This is perhaps my most important tip of all. Many healthcare providers are beginning to offer forms of orthopedic regenerative medicine using orthobiologics because the idea that your body may be able to heal itself is really catching on. This is good because eventually, this trend will lead to more access to regenerative therapies and treatments, and hopefully better insurance coverage as well. The downside of this growing popularity is that many under qualified health care providers are adding PRP and Stem Cell treatments to their menu with little to no training in this subspecialty. This can result in poor outcomes for an inflated price tag.

When exploring orthopedic regenerative medicine, I recommend you ask the following questions:

  • Is your provider an M.D. or D.O. who is specialized in orthopedic regenerative medicine, interventional orthopedics, or musculoskeletal conditions? Read about my experience and training here.
  • Is the practitioner that you consulted with the one actually performing the procedure, or will they be sending in a Nurse Practitioner or Physician Assistant?
  • Do they use image guidance (ultrasound or fluoroscopy) for all procedures?
  • Do they use autologous stem cells, meaning stem cells from your own body, for your treatment?
  • Do they address the entire functional unit as part of your injection therapy, meaning the ligaments and tendons that make up the joint, or do they claim to be able to treat your pain or injury with one simple injection into the joint?

These are all very important questions to consider when choosing your orthopedic regenerative medicine provider. Everybody’s body is different and there are many other factors that can impact your long-term outcome when it comes to treatments such as PRP and Stem Cell Therapy, but the right doctor will be there to guide you through your journey and will make realistic recommendations about your specific conditions, options, and expected outcomes. My mission is to be that guide for you and help you get back to being able to do the things you love.

If you’re wondering if regenerative therapies are right for you, use the online appointment request tool or give us a call at 425-326-1665 to schedule a consultation with Dr. Silva.


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