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Prolotherapy (aka regenerative injection therapy -RIT) is a non-cortisone type of injection that can treat many orthopedic conditions. “Prolo” is short for proliferation, because the treatments cause the proliferation (growth, or formation) and remodeling of new ligament or tendon tissue in areas where it has become weak. Ligaments are bands of tissue that hold bones together. Ligaments can become weak or injured and may not heal back to their original strength or endurance. The blood supply to ligaments is limited and therefore limits healing in these areas. The ligaments have many nerve endings; therefore patients will feel pain at the areas where ligaments are damaged or loose. Tendons help to connect muscle to bone and also lack blood supply which lead to poor healing. Prolotherapy uses dextrose (sugar water) solution mixed with a numbing agent such as lidocaine and injects this into the tendon or ligament at the attachment to the bone. This causes localized inflammation in these weak areas which then increases the blood supply and flow of nutrients and growth factors and can stimulate the tissue to repair itself.
The treatment is useful for many different types of disorders, including neck and back pain, sports injuries, partially damaged tendons or ligaments, arthritis, and fibromyalgia.
The response to treatment varies from individual to individual, and depends upon one’s healing ability. Some people may only need a few treatments while others may need 10 or more. The average number of treatments in 4-6, and there is not the concern of repeated injections as with cortisone. Once you begin treatment, your doctor can tell better how you are responding and make appropriate recommendations.
This procedure is safe when performed with sterile ultrasound and proper sterile injection techniques. The most common side effect is discomfort which is temporary. The other risks involve infection, bleeding, and worsening of pain. Ice is not allowed post injection for prolotherapy as it is used post biopuncture or steroid injection therapy. Ice directly inhibits inflammation, which is what we are trying to induce and is the purpose of the prolotherapy. This may be the reason for increased pain post injection in comparison with other injection therapies.
PRP is an exciting, natural, non-surgical treatment that involves the injection of patient’s own blood after extracting the platelets and reinjecting them with the areas of injury and degeneration. It has been shown to be safe and effective in treating a variety of sports injuries, from chronic conditions to acute trauma. The growth factors contained within platelets provide a powerful stimulus for tissue healing and regeneration. This treatment can often completely repair tissue and eliminate the need for surgery. PRP treatment is a safe, injection technique.
Platelets are best known for their ability to stick to one another and stop bleeding in the body via the clotting cascade, but they have many other functions. They also release numerous growth factors which stimulate the proliferation of collagen connective tissue, tissue regeneration and healing. The platelets are often responsible for initiating a healing cascade in soft tissue injuries such as abrasions and lacerations.
The rationale for the utilization of platelets is the myriad of growth factors derived from platelets that alter the healing response and tissue regeneration. These growth factors can enhance healing, grafting, and connective tissue repair include: TGF-β, Platelet derived growth factor(PDGF), Insulin-like growth factor (IGF), Vascular endothelial growth factors(VEGF), Epidermal growth factor (EGF), Fibroblastic growth factor-2 (FGF-2).
The use of platelet rich plasma injection for the purpose of treatment of areas which are resistant to healing due to lack of blood flow to the area, repetitive stress and erosion of tissue. Treatment of chronic tendinopathy, cartilage erosion, and muscle injury has become common in the world of sports medicine.
It can be used any site of injury in the body. In musculoskeletal medicine, it is used to repair:
A patient’s blood is drawn similar to a normal blood draw and placed into a centrifuge where the platelets are concentrated. Harvest labs is able to concentrate the platelets 16% over baseline and is considered one of the best technologies for platelet extraction. The highly concentrated platelets mixed with a bit of lidocaine is then injected into the area of injury via ultrasound guidance. The entire procedure can be completed in less than one hour.
Because platelets are autologous, from one’s own body, there is no chance of developing an allergic or autoimmune reaction post injection. The side effects are limited to a little soreness at the injection site. If the patient suffers from an anti-phospholipid antibody syndrome or any platelet disorder, the procedure should not be performed as the quality of the platelets may be compromised.
Two to three weeks after the first PRP treatment, the doctor will evaluate the progress and determine whether more therapy is needed. Depending on the severity and duration of the injury or disorder, most patients require between 1 and 4 treatments.
As PRP therapy now gains popularity in the U.S., it is getting recognized by doctors and patients alike for having a terrific rate of success. Many believe PRP has the potential to revolutionize sports medicine, orthopedics and beyond, with new applications being discovered daily.
Our pain management doctors provide world-class, utmost professional care and a dynamic, team-oriented approach to offer relief for chronic pain.
Dr. Jignyasa Desai has devoted her life to health care and the improvement of pain conditions.
Mission statement:
iHeal Pain Center is founded by Dr. Jignyasa Desai with a dedication to eliminate pain and optimize health. Through traditional and innovative approaches, the center focuses upon healing of sports injuries and spinal disorders in all patients ranging from the athletic to the elderly. Dr. Desai methodology involves a holistic approach encompassing therapy, nutrition, and non-surgical techniques with the ultimate goal of improving daily function and lifestyle.
Training
College: East Tennessee State University B.S. Biology with honors
Medical School: Lake Erie College of Osteopathic Medicine
Internship: Aria Health System via Philadelphia College of Osteopathic Medicine
Residency: Physical Medicine and Rehabilitation- Stonybrook University
Fellowship training: Pain Medicine- Temple University (ACGME accredited training program)
Board Certifications:
• Physical Medicine and Rehabilitation (AAPMR)
• Pain Medicine (ABA)
Society Memberships:
American Board of Physical Medicine and Rehabilitation (AAPMR)
American Society of Interventional Pain (ASIP)
Society of Interventional Pain (SIS)
American Society of Physicians of India (APPI)
American Society of Osteopathic Physicians (AOA)
State Licenses:
New York and New Jersey
Publications
• Frankenberger V, Desai J. Prosthetic Management of Residual Limb Ulcerations with a Vacuum Assisted Socket Suspension: American Journal of Physical Medicine and Rehabilitation. Volume 87 (3), Page S49, March 2008
• Tang N, Desai J, Stickevers S, Awan G. Hip, Buttock, and low back pain associated with ischiogluteal bursitis a case report: American Journal of Physical Medicine and Rehabilitation. Volume 88, (3) Page S12, March 2009.
• Desai J, Stickevers S. Treatment of post amputation focal dystonia with Botulinum Toxin A: American Journal of Physical Medicine and Rehabilitation. Volume 88, No 3. Page S20, March 2009.
• Desai J, Lai Y. Methylmethacrylate (MMP) hypersensitivity reactions post orthopedic hardware implantation: A case report: American Journal of Physical Medicine and Rehabilitation. Oct 22, 2009.
• Desai, J, Fahmy, M. Herpes Zoster associated with Recurrent Bell’s Palsy: A Case Report: American Journal of Physical Medicine & Rehabilitation: 89(4): S79, April 2010.
• Desai, J, Semel, J. Assessing Fall Data in Rehabilitation Hospitals Leading to Prevention Strategies. American Journal of Physical Medicine & Rehabilitation: 89(4): S83, April 2010.
• Kohane, Dan, Desai, J. Case Report: Brachial Amyotrophic Diplegia (BAD). 2011 (AAP) Association of Academic Physiatrists. Annual Meeting in Phoenix, Arizona, April 12-16, 2011.
• Desai J, Falco F. A case study: Peripheral Nerve Stimulator (PNS) in treatment of intractable migraines. To be submitted for publication 2011
• Vesga R, Falco F, Husain A, Desai J. Chapter 12: Abdominal Pain and Treatment Options. In: Kaye A, editor. Understanding Pain: Taking Control of Your Life. Praeger/ABC-CLIO Press; 2011.
• Falco F, Desai J. Stimulation produced analgesia. In: Manchikanti L, Christo P, Trescot A, Falco F (eds.). Comprehensive Pain Medicine and Interventional Pain Management Board Review. Paducah, KY: ASIPP Publishing; 2011.
• Zhu Z, Falco F, Desai J. Intrathecal drug delivery. In: Manchikanti L, Christo P, Trescot A, Falco F (eds.). Comprehensive Pain Medicine and Interventional Pain Management Board Review. Paducah, KY: ASIPP Publishing; 2011.
• Onyewu C, Desai J, Falco F. EEG, MEG. In: Manchikanti L, Christo P, Trescot A, Falco F (eds.). Comprehensive Pain Medicine and Interventional Pain Management Board Review. Paducah, KY: ASIPP Publishing; 2011.•Desai, J, Sakheim, K. Anti-Depressants in Pain Management. Pain Management Clinical Pocket Guide. Currently in Publishing for spring of 2013.