Advanced Treatment Options

Platelet Rich Plasma (PRP) is no longer just for professional athletes and is now available at Medical Associates for athletes of all levels of competition from professional, college, high school, and recreational! PRP provides options for nonsurgical treatment of common injuries through use of the patients own blood cells to stimulate the healing of an injury.

When you suffer a musculoskeletal injury, the injury creates a signal to your body to begin a healing response. This response includes an inflammatory cascade, that while working on healing the injured area, can result in pain and discomfort at the injured body part. This associated discomfort can be treated with nonsteroidal or steroidal anti-inflammatory medication, steroid injections or ice.  However this can suppress the normal healing process.

PRP works by injecting a concentrated amount of your own platelets into the injured part of your body. These procedures are always performed in our clinic with image guidance, e.g. ultrasound-guided or fluoroscopy- guided technology to ensure accurate placement of the treatment medicine (PRP).

PRP contains an increased concentration of growth factors and inflammatory mediators that help stimulate the body’s natural ability to heal through tissue repair at the area of injury. PRP can aid in decreasing pain and reducing inflammation. PRP can be used to treat a variety of chronic and acute injuries including joints, tendons, ligaments, cartilage, and muscles.

What types of injuries are common for treatment with PRP?

• Joint osteoarthritis, especially knee joint osteoarthritis
• Tendon Injuries, for example tennis or golfer’s elbow and Achilles’ tendonitis
• Muscle strains, for example hamstring strains
• Ligament injuries, for example ulnar collateral ligament of the elbow
• Rotator cuff injuries
• Plantars fasciitis
• Meniscal tears

How does the process work?

We encourage you to schedule a consultation with one of our specialists who performs PRP. Your consultation will include a thorough review of your medical record, physical examination, and discussion of treatment options that are tailored to you and your particular injury.

If you decide to pursue treatment with one of our specialists the procedure will be performed in an outpatient basis in the office. One of our skilled lab technicians will draw your blood as they would in a routine blood test. The blood is then placed in a specialized version of a centrifuge machine that separates the platelet rich plasma from the remainder of the blood. Your doctor will then use image guidance with either ultrasound or fluoroscopy technology to ensure accurate placement of the PRP. After the injection you will receive a custom-tailored rehabilitation plan along with regular follow-ups with your treating physician.

*PRP is not always covered by insurance and is one of many treatment options for the aforementioned injuries. We recommend you discuss the most up to date research in regards to your specific injury with your treating provider.

Musculoskeletal ultrasound can be used to diagnose acute and chronic injuries to tendons, ligaments, muscles, and nerves throughout the body. It is also used to guide procedures such as injection of joints, tendons, and nerves, which can be used for diagnostic and treatment purposes.

Musculoskeletal ultrasound is performed by a physician with specialized training and experience. The physician will use a handheld ultrasound transducer with gel over the area of concern to produce real time images on a computer screen. This procedure can be performed at the bedside in the hospital, in an outpatient clinic appointment, in an athletic training setting, and even on the sidelines of athletic contests.

In contrast to other forms of imaging (MRI, CT scans, and X-rays), there is no radiation used or requirement to lie still in a narrow tube. The patient is able to move into a position of comfort and/or shift positions during the testing. The ability to move the injured body part during testing is of significant benefit when the symptoms are only reproduced with movement. Musculoskeletal ultrasound is also safe for patients with metal implants and medical devices, such as a pacemaker. Musculoskeletal ultrasound is unable to penetrate through bone or reach deep structures inside joints, therefore, some injuries will still benefit from additional imaging (MRI, X-ray, or CT) for further evaluation.

Musculoskeletal ultrasound is interpreted by the physician completing the imaging. Therefore, there is no waiting to receive results at follow-up appointments. The results are shared at the time of the testing.

Injuries that may benefit from musculoskeletal ultrasound include:

• Ligament sprains (For example, ulnar collateral ligament of thumb or elbow)
• Tendon or muscle strains (For example, rotator cuff, hamstrings, and Achilles tendons)
• Joint or bursal inflammation or fluid accummulation (For example knee, shoulder, elbow, and hip)
• Ganglion cysts
• Foreign bodies (For example, splinters and glass)
• Nerve entrapments (For example, carpal tunnel syndrome)

Musculoskeletal ultrasound can also be used to guide diagnostic and treatment procedures such as injection of joints, tendons, and nerves, as well as for aspiration of joints and cysts. The musculoskeletal ultrasound machine allows the physician to guide a needle to the intended target throughout the procedure. The benefit is an accurate injection of medicine to improve diagnostic and treatment outcomes, as well as improved safety by avoiding unintentional damage to blood vessels, nerves, and soft tissues. That said, not every procedure requires musculoskeletal ultrasound guidance, and your treating physician will discuss your individual case prior to performing any procedures.

Dry needling, also known as functional dry needling or trigger point dry needling, uses a thin, solid filament needle to treat muscle discomfort. It is referred to as “dry” needling because there is no medication used or injected during the procedure. Trigger points are “knots” in muscles which occur from injury or overuse and can cause tightness and discomfort in muscles. Trigger points can refer pain to other parts of the body when pressure is applied to them. This is also known as referred pain.

While dry needling utilizes similar tools as acupuncture (acupuncture needles), it is not the same as acupuncture treatment. Dry needling is guided by Western medicine training involving evaluation of pain patterns, functional movement, and anatomic structures. Acupuncture is guided by traditional Chinese medicine and includes inserting needles into meridians to re-balance your body’s chi or electromagnetic field.

Dry needling helps assist the injured muscle in relaxation, increasing blood flow, decreasing discomfort, and improving range of motion.

Dry needling is almost always used as an adjunctive treatment modality to aid in a comprehensive rehabilitation and treatment program.

Your treating provider will perform a full history and physical examination to determine whether you would be a good candidate for dry needling. Dry needling cannot be performed if there is evidence of infection, lymphedema, or in the presence of open wounds. Patients with diabetes, vascular disease, taking prescribed blood thinners, or who are pregnant should discuss this with the treating provider prior to performing dry needling to ensure this is the right treatment for their condition.

Musculoskeletal ultrasound can be used to diagnose acute and chronic injuries to tendons, ligaments, muscles, and nerves throughout the body. It is also used to guide procedures such as injection of joints, tendons, and nerves, which can be used for diagnostic and treatment purposes.

Musculoskeletal ultrasound is performed by a physician with specialized training and experience. The physician will use a handheld ultrasound transducer with gel over the area of concern to produce real time images on a computer screen. This procedure can be performed at the bedside in the hospital, in an outpatient clinic appointment, in an athletic training setting, and even on the sidelines of athletic contests.

In contrast to other forms of imaging (MRI, CT scans, and X-rays), there is no radiation used or requirement to lie still in a narrow tube. The patient is able to move into a position of comfort and/or shift positions during the testing. The ability to move the injured body part during testing is of significant benefit when the symptoms are only reproduced with movement. Musculoskeletal ultrasound is also safe for patients with metal implants and medical devices, such as a pacemaker. Musculoskeletal ultrasound is unable to penetrate through bone or reach deep structures inside joints, therefore, some injuries will still benefit from additional imaging (MRI, X-ray, or CT) for further evaluation.

Musculoskeletal ultrasound is interpreted by the physician completing the imaging. Therefore, there is no waiting to receive results at follow-up appointments. The results are shared at the time of the testing.

Injuries that may benefit from musculoskeletal ultrasound include:

• Ligament sprains (For example, ulnar collateral ligament of thumb or elbow)
• Tendon or muscle strains (For example, rotator cuff, hamstrings, and Achilles tendons)
• Joint or bursal inflammation or fluid accummulation (For example knee, shoulder, elbow, and hip)
• Ganglion cysts
• Foreign bodies (For example, splinters and glass)
• Nerve entrapments (For example, carpal tunnel syndrome)

Musculoskeletal ultrasound can also be used to guide diagnostic and treatment procedures such as injection of joints, tendons, and nerves, as well as for aspiration of joints and cysts. The musculoskeletal ultrasound machine allows the physician to guide a needle to the intended target throughout the procedure. The benefit is an accurate injection of medicine to improve diagnostic and treatment outcomes, as well as improved safety by avoiding unintentional damage to blood vessels, nerves, and soft tissues. That said, not every procedure requires musculoskeletal ultrasound guidance, and your treating physician will discuss your individual case prior to performing any procedures.