Intraarticular injection of autologous PRP in combination with transplantation of autologous ADSCs by local adherent technique enhances the quality of cartilage defect repair with better results in comparison with microfracture surgery in a rabbit model.
Stromal vascular fraction (SVF) can easily be obtained from a mini-lipoaspirate procedure of fat tissue and platelet rich plasma (PRP) can be obtained from peripheral blood. We evaluated the safety and preliminary efficacy of administering SVF and PRP intra-articularly into patients with osteoarthritis grade 1 and 2.
Ozone, one of the most important air pollutants, is a triatomic molecule containing three atoms of oxygen that results in an unstable form due to its mesomeric structure. It has been well-known that ozone has potent ability to oxidize organic compounds and can induce respiratory irritation. Although ozone has deleterious effects, many therapeutic effects have also been suggested. Since last decades, the therapeutic potential of ozone has gained much attention through its strong capacity to induce controlled and moderated oxidative stress when administered in precise therapeutic doses. A plethora of scientific evidence showed that the activation of hypoxia inducible factor-1α (HIF-1a), nuclear factor of activated T-cells (NFAT), nuclear factor-erythroid 2-related factor 2-antioxidant response element (Nrf2-ARE), and activated protein-1 (AP-1) pathways are the main molecular mechanisms underlying the therapeutic effects of ozone therapy. Activation of these molecular pathways leads to up-regulation of endogenous antioxidant systems, activation of immune functions as well as suppression of inflammatory processes, which is important for correcting oxidative stress in diabetes and spinal pain.
Lateral elbow pain is common with a population prevalence of 1%-3%. The study was a comparative trial to validate the efficacy of single injection of platelet-rich plasma (PRP) for tennis elbow as compared with single injections of triamcinolone and placebo (normal saline) over a short term period.
Over a short term period, PRP gives better pain relief than triamcinolone or normal saline in tennis elbow which needs to be validated over long term period by further studies.
Low back pain is one of the painful disorders of higher prevalence. It has several etiologies and surgery may be indicated in the presence of neurological deficits or compression syndromes. However, in up to 40% of cases, patients develop worsening of pain and failed back surgery syndrome (FBSS), which is an important cause of chronic pain with high morbidity and disability. In the last two decades, ozone has been shown to be a new therapeutic option for FBSS due to its analgesic and anti-inflammatory properties.
Our results suggest that epidural ozone therapy can be a treatment option in FBSS to reduce the intensity of the pain.
Neuropathic pain is a complex type of chronic back and/or leg pain (eg, sciatica) usually caused by nerve injury. When a nerve is damaged it may not be able to transmit messages completely or correctly between the injury site and the brain. Neuropathic pain is persistent and is sometimes described as unrelenting, although the intensity and characteristics (eg, dull, sharp, shock-like) of pain may change throughout the day and night.
Scrambler Technology for Neuropathic Pain
Scrambler technology (Calmare® Pain Therapy Treatment) is a non-invasive therapy that treats neuropathic and chronic pain by surface electro-stimulation. Electrode patches are precisely placed on the appropriate skin area, but not directly on the painful area. Rather, the electrode patches are placed on one or more dermatomes. A dermatome is an area of skin served by the fibers of a single spinal nerve root. The dermatomes map the front and back of the body as shown below.
Precise Biophysical Electro-Stimulation
Each electrode patch is connected to the scrambler device by a thin cable. The clinician controls the administration of low doses of electro-stimulation delivered through the patches. The therapy scrambles the pain messages transmitted between the pain site and the brain.
Placement of electrode patches on a patient’s low back
Typically, treatment consists of a series of 10 daily treatments that last 30- to 45-minutes. Patients with neuropathic and chronic back pain are as unique as their pain. Therefore, some patients may benefit by more than 10 treatments and/or may periodically return for individual therapy.
Some patients report pain relief as early as the first therapy session. However, many patients experience less pain after several scrambler treatments. As the number of treatments increase, the duration of pain relief may be sustained for a longer period of time. Patients who have experienced chronic pain for a shorter amount of time will generally experience faster results.
An experienced chiropractor has tips to help you get the care you need at your next appointment
For more than three decades, I’ve been treating patients with acute and chronic pain from around the corner here in Rutherford, New Jersey to as far away as Australia and South Africa.
From our patient’s first consultation to the last treatment office visit, the success of any pain treatment we prescribe is contingent upon us (the health care provider) accurately treating the root cause of your pain.
As the patient, precisely describing your acute pain or neuropathic pain is a “high stakes” conversation.
I can read your medical history, referring doctor reports and lab results, but this is all secondary to understanding each patient’s pain mechanics.
It is absolutely essential that this is communicated to your pain management provider as accurately as possible.
If you or a loved one are combatting short-term (acute) pain or a neuropathy (pain lasting 12 weeks or longer), I’d like to offer my own simple tools to help you accurately convey the unique characteristics of your pain so that the most effective treatment protocol can be set into motion.
You may wish to bring this article to your next doctor visit and go over each of the key pain description points I’ve outlined below.
I hope your doctor will ask you these questions, but if not, you can act as your own pain advocate and offer this information.
“Tell Me About Your Pain”
Based upon your medical records, we already know the cause of your pain (injury or disease). Our goal is to eliminate or minimize this symptom so you can resume your highest quality of life possible.
Pain symptoms are personal, unique–and subjective. (What Joe describes as “unbearable pain” may be considered “pretty unpleasant pain” to Mike). Over the years, I developed my own “pain diagnostic” conversation with patients to help my team and I understand what, where, when and how much pain patients are feeling.
I’ve outlined key points below:
This is key to a proper diagnosis. Don’t assume we know you’ve battled this pain for a year, a month or a decade.
Spell it out:
I’ve had this pain for _________________.
How frequently and how long does it last?
What ignites (flare) or lessens your pain and for how long?
Location, Location, Location
Where does it hurt? There is a graphic of a human figure with a back view and a front view (see above).
Doctors may instruct you to mark the area/s where your pain is concentrated. They may also ask you to note a difference between pain that is on the surface and pain that is under the surface.
This tool comes from the McGill Pain Questionnaire which includes other measurements, but the front and back of the unisex human figure are the most recognizable.
How Bad is Your Pain – A Measurement Tool
Most referring physicians, regardless of their medical specialty, use a simple 1 to 10 point pain scale, so I stick with this to keep everyone on the same page.
Simply stated, think about where your pain level falls the majority of the time—unless you experience extreme pain fluctuations.
0 – Pain-free
1 – Pain is very mild, barely noticeable. Most of the time you don’t think about it.
2 – Minor pain. Annoying and may have occasional stronger twinges.
3 – Pain is noticeable and distracting, however, you can get used to it and adapt.
Moderate Pain—Disrupts normal daily living activities
4 – Moderate pain. If you are deeply involved in an activity, it can be ignored for a period of time, but is still distracting.
5 – Moderately strong pain. It can’t be ignored for more than a few minutes, but you still can manage to work or participate in some social activities.
6 – Moderately strong pain that interferes with normal daily activities. Difficulty concentrating.
Severe Pain—Disabling; debilitating, reduces daily quality of life, cannot live independently
7– Severe pain that dominates your senses and significantly limits your ability to perform normal daily activities or maintain social relationships. Interferes with sleep.
8– Intense pain. Physical activity is severely limited. Conversing requires great effort.
9– Excruciating pain. Unable to converse. Crying out and/or moaning uncontrollably.
10– Unspeakable pain. Bedridden and possibly delirious. Mobility may be compromised.
“My Pain Feels Like…”
Most of the time, patients experience one or two consistent pain “feelings” but some can experience a range of sensations.
The most common pain types are:
Sharp stabbing pain
Extreme heat or burning sensation
Throbbing, “swollen,” inflamed tissue
Sensitivity to contact / touching
Numbness, tingling, pins and needles
Create a Pain Journal
I always encourage patients or their loved ones to document a week-long pain cycle before they meet with their pain management, chiropractic or alternative medicine team.
Also, jot down any treatments or actions that lessen or increase your discomfort.
For example, perhaps you’ve found that hot showers or cold weather makes you feel worse, but Epsom salt baths or exercise makes the pain more manageable.
If you come prepared with all this information, your time with the doctor can be better spent focusing on next steps and a treatment plan, rather than a lengthy Q & A review of the information provided here.
More importantly, addressing these issues in advance will ensure your doctor receives up-to-date, higher quality information.
As a result, your case can be assessed more quickly and a pain management plan can be put into action to start reducing or eliminating your discomfort as quickly and effectively as possible.
Think about the day after you had a really horrible night’s sleep: You couldn’t think as clearly, you were in a bad mood, perhaps you had a headache and there was no way you were going to exercise. You didn’t feel like eating right and were too tired to socialize.
What if you felt like this every day?
As many of you know all too well, living with chronic pain has a plethora of symptoms and negative side effects. In addition to the physical and emotional pain, may people don’t even remember what it feels like to enjoy a good night’s sleep.
Chronic Pain and Sleeping Problems
For people with RSD, fibromyalgia or pain after surgery, cancer and cancer treatment, sleep problems and insomnia are often nightly occurrences. In fact, up to two-thirds of patients with chronic pain conditions suffer from sleep disorders. If that’s not bad enough, insomnia has been proven to exacerbate chronic pain systems.
Sleeping problems can range from difficulty falling asleep to staying asleep or being unable to enter a deep REM sleep stage. As a result, the normal sleep pattern is disrupted; as a result, in a state of exhaustion, many people sleep during the day (and then awake all night).
Many prescription pain medications can also disrupt or inhibit sleep, in addition to the laundry list of additional negative side effects from these drugs.
When I talk with new Calmare patients about their quality of life before treatment begins, the majority tell me that their inability to get a proper night’s rest is one of the main causes of their mental and physical debilitation.
Lack of sleep can cause mental confusion, inability to exercise or move the body, emotional instability and depression.
How Calmare Helps Patients Sleep Again
Some patients reach out to me after their 10-treatment series concerned about how much they are sleeping—sometimes 12 hours a night or even more. “Is this normal?” I’m asked. “Is something wrong with me?”
No, actually, this a good thing–The improvement in sleep patterns is a response to the calming effect of Calmare MC-5A technology algorithms. “Calmare” in Italian means to calm or soothe. This effect is a result of a reduction of hypersensitivity which caused the chronic pain condition, such as CRPS / RSD. As the brain is retrained, it can also reset its healing priorities.
I respond by asking them how long it’s been since they slept through the night without awakening. Most respond in terms of years, not weeks or months.
“Your body is just catching up on all that missed sleep,” I respond. In most cases, those who report needing extra sleep after scrambler therapy eventually resume normal sleep patterns within a few months.
Six Calmare Patients Share Their Sleep Stories
I posed a query on my Facebook timeline last week inviting people who underwent Calmare Therapy to share their feedback about how their quality of sleep changed after their treatment cycle.
The responses were insightful and enthusiastic:
“I remember the best sleep after my first treatment of Calmare as I had not slept comfortably and I was in constant pain even with high doses of meds for nearly 8-10 months since being diagnosed with CRPS. After my Calmare treatment, I was able to sleep throughout the whole night in any position with even linen and blankets touching my skin.”
“Whenever I get the Calmare treatment, I sleep better than ever. I can sleep for hours at a time and still be tired. Too bad Calmare therapy can’t be used as a treatment option for insomnia!”
“I haven’t been a patient of yours but I’ve had 2 sets of Calmare treatments, once for 10 days and once for 5. I could sleep through the night without waking every 3 to 4 hours to take pain pills. Your articles and efforts help so much. Thank you so, so much for all you do!!”
“Prior to Calmare treatment, I would go days without sleeping and then when I did manage to sleep, it was broken and interrupted. Now… I can sleep all night and sometimes that’s even with an afternoon nap. 💤😘”
“Not only sleep–but dream !! When you take pain meds ( at least for me) I don’t remember dreams and in my dreams I am healthy and pain free so to not only get sleep but dream❤ Thank You Calmare NJ for all you do ! :)”
“I can now sleep on my right side which I haven’t been able to do in over 10 years! So yes! Sleep has improved for sure!!”
Improving Quality of Life
Since we introduced scrambler therapy in 2011, one of the resounding benefits, in addition to lessening chronic pain and other related physical symptoms, is the resumption of the quality of life for patients, including just being able to sleep.
We appreciate when healthcare professionals seek Calmare Therapy, an FDA-cleared treatment to combat many types of neuropathic chronic pain. They have seen firsthand that opioids and invasive treatments may not provide the sustained pain relief they need to achieve a better quality of life.
Beth had managed to work as a nurse in Pennsylvania while silently battling RSD in her foot after a failed surgery. To combat the increasingly severe burning sensation she sustained, she had a spinal cord stimulator implanted, nerve block injections and was prescribed more pain medications than she was willing to take.
But the intensity of the pain only increased over time.