Are you having constant plantar fasciitis pain? Is that Achilles tendonitis just not going away? Do you feel like you’ve exhausted all conservative options? Does surgery appear inevitable?
Here at Dr. Bob, we have some non-surgical regenerative medicine options that could very well end your pain. And there is no need to go through the invasive process of surgery. We offer the latest advances in stem cell alternative therapy right in our offices. These alternatives include PRP (platelet rich plasma) and Amniox injections.
The Basics of Inflammation Are Important to Know
Let’s look at two types of inflammation: acute and chronic.
Acute inflammation is your body’s initial response to injured tissue. It may be due to trauma or repetitive stress to the area. This type of inflammation generally resolves itself within a few weeks to months with proper care. Conservative treatments include anti-inflammatories, physical therapy and cortisone injections.
If your injury remains untreated, the body develops chronic inflammation. During this chronic phase, macrophage cells multiply in the injured area and can cause further problems. The body gives up on healing the injury, the chronic situation becomes the new norm and cannot heal itself. This is a big reason why it’s so important to seek treatment after an injury does not improve after a number of days, instead of weeks or months.
When we see a patient with a chronic inflammation or condition, they usually explain that their level of pain is becoming intolerable.
How Regenerative Medicine Promotes Healing
With acute inflammation, the body heals itself by increasing blood flow to the injured area and delivering cells called platelets. These platelets promote growth factors (stem cells) to stimulate healing.
Both Amniox and platelet rich plasma injections convert a chronic condition back to the acute phase, to a state in which your body can heal itself.
Amniox and platelet rich plasma injections have become the standard in regenerative medicine. Rather than dealing with chronic pain from plantar fasciitis or Achilles tendonitis with conservative treatments, these new advancements work quickly to repair your damaged tissue. The result is decreased pain, quite often eliminating it altogether.
What is PRP?
PRP, also known as platelet rich plasma is a process that includes drawing a small amount of a patient’s blood and then spinning it in a centrifuge. The blood becomes concentrated with five to ten times more platelets than the same volume of your regular blood. These platelets are then injected into the inflamed area and the cells stimulate the tissue to heal.
What is Amniox?
Amniox is derived from amniotic fluid. It is acquired during scheduled caesarean sections from consenting donors. Amniotic fluid is an amazing source of concentrated growth factors and stem cell activators. These properties promote tissue regeneration and repair. Even though Amniox is not comprised of your own cells, it does not cause an immune or rejection reaction.
How are PRP and Amniox Administered?
Both of these treatments are given via ultrasound guided injections so we can accurately identify the exact areas of injury. Patients may experience some temporarily increased pain to the area. To limit this, we generally immobilize the injected foot in a walking boot. It will take pressure off the tendon or fascia for a couple of weeks. The healing process is now off to a good start!
Patients won’t be using any prescription anti-inflammatory medicine during this time. Both PRP and Amniox are inciting a very special inflammatory response that allows these technologies to heal the injured foot. If you take any anti-inflammatory medication during this prime healing time, you will inhibit the platelets and growth factors that stimulate healing. Extra-strength Tylenol is enough to help with any pain. After two weeks, anti-inflammatory and physical therapy treatments can resume.
So, What’s the Deal with Cortisone?
Cortisone is one of the main hormones that are naturally released by your body as a result of stress or injury. Cortisone injections contain a synthetic version of this hormone and are injected directly into the injured area.
While it is a strong anti-inflammatory, cortisone works in a totally different way than PRP or Amniox and sadly can have some very serious downsides.
Once cortisone was thought to be a miracle drug. It almost instantly reduced, or eliminated, the inflammation and the inflammatory response in tendon and muscle injuries. But its overuse decades ago taught us that it can damage tissue and muscle and cause permanent weakness and damage.
While we usually try to avoid cortisone injections, one or two at the most may calm severe swelling and pain. In very limited cases, it helps break the inflammation cycle of plantar fasciitis. It can bring almost immediate short-term relief from pain and, sometimes, longer-term relief.
It’s very important to note that we never inject cortisone into the Achilles tendon. Cortisone can make the Achilles injury worse and increase the risk of a complete tendon rupture.
Cortisone injections do not stimulate healing, nor do they address the core issue of the pain, whatever that may be. The benefit of regenerative medicine is that unlike cortisone injections, PRP and Amniox do not weaken or damage tissue. Rather, they regenerate the body’s ability to heal itself.
How Do I Know If PRP or Amniox Is Right for Me?
As an alternative to surgery, it’s good to explore non-surgical treatments for healing plantar fasciitis and Achilles tendonitis. Give regenerative treatments a try, if you can, before surgery. Even though we are well-respected surgeons, and very good at what we do, we almost always try to avoid surgery whenever possible. Our experience in this area shows us to be over 90% effective with our more conservative measures, thus avoiding surgery.
One of the best first treatments for plantar fasciitis or Achilles tendonitis, is Physical Therapy (PT). It is often covered by insurance (where PRP and Amniox are more often not covered). PT helps strengthen the main muscles and tendons, as well as those that are nearby, often eliminating the pain. If PT falls short or your injury is too severe, then regenerative medicine is often the next best step and, for about half of our patients, avoids the need for surgery.
If you’re experiencing heel pain, schedule a visit with Dr. Bob Baravarian for a thorough evaluation. He can provide custom orthotics and night splints to stretch the fascia while you sleep. With decades of experience effectively treating plantar fasciitis, Dr. Bob is a leader in the research and treatment of all foot and ankle conditions.
To schedule a consultation, please call (855) 557-5400 or make an appointment now.
Dr. Bob Baravarian is conveniently located in Los Angeles, near Cedars-Sinai Medical Center, providing expert foot and ankle care for patients throughout Southern California.
