Stem Cell Therapy for Pain

A new approach to care

We believe that starting with the least invasive therapy for any disease or condition, before progressing toward more drastic procedures, is a fundamental part of practicing medicine. That’s why Dr. Kim begins with a thorough diagnosis and the most conservative options for care.

When your musculoskeletal condition calls for a more robust intervention, the body itself often provides the best raw materials in the form of bone marrow aspirate, lipoaspirate and the platelet-rich plasma (PRP) available from your own blood.

Part 1

How to Prepare for Noninvasive Treatment

Part 2

What to Expect During the Procedure

Part 3

How to Make Your Recovery Successful

Part 1

How to Prepare for Non-Invasive Treatment

The first step in treatment is to meet with Dr. Kim for a consultation, either in person or using Skype or similar technology. He’ll go over your medical history and supporting information such as imaging reports and procedure notes, discuss your problems with you, make a diagnosis—if needed—and work with you to create a treatment plan.

Part of that treatment plan, especially if you will be preparing for stem cell therapy, is nutrition counseling with our affiliated nutritionist. To ensure your body chemistry is in the best condition to support active stem cells, we’ll recommend dietary adjustments for the timeframe leading up to—and following—your procedure.

In some cases, you may not need any of the advanced therapies we offer. In that case, Dr. Kim will work with you according to your treatment plan timeline. If you do require advanced therapy, these steps will help you understand what to expect.

Four Weeks Before

Avoid steroid injections in the target joint or area. These can alter the effectiveness of your procedure.

Two Weeks Before

Stop drinking alcohol or taking nonsteroidal anti-inflammatory drugs (NSAIDs, such as aspirin and ibuprofen). These can alter the effectiveness of your procedure. For a headache or similar minor pain, please take Tylenol (acetaminophen).

Five Days Before

Your cardiologist or primary care doctor will tell you when to stop taking aspirin, Plavix or a similar medication that you may have been prescribed as part of a long-term cardiac care plan. Ideally, we suggest suspending these medications five days before your procedure.

The Day Before

Hydrate well. Remember to call our office if you have any questions or concerns.

Part 2

What to Expect During the Procedure

The day of your procedure and the two to four days that follow will be the most intense. Here’s what you can expect.

Before You Arrive

Ask someone to drive you home after the procedure. Although you can technically drive yourself, we don’t recommend doing so.
You won’t be given general anesthesia, but you may feel discomfort or instability after the procedure.
Bring a brace, crutch or sling with you if Dr. Kim recommended one during your consultation. Not everyone requires one of these tools.

In the Office

The whole procedure is done on the same day, beginning to end. You’ll be walking in and out under your own power.
  1. We’ll insert a catheter into your elbow or arm to collect blood. This feels just like a routine blood draw. Then, you can watch us spin your blood sample in the centrifuge to separate out the platelets to create the PRP.
  2. We’ll use lidocaine (an anesthetic) to numb the bone marrow aspirate concentrate (BMAC) extraction site and use a special needle to extract bone marrow from the posterior portion of your pelvis.
  3. We’ll use a cannula to extract a small amount of adipose tissue (fat) from a lidocaine-numbed area of your waist or abdomen, then isolate the material we need to increase the active stem cells injected into your body and provide a foundation on which they can regenerate the appropriate type of tissue.
  4. We’ll spin the “slurry” of PRP, BMAC and fat cells together in the centrifuge with an anesthetic and an anticoagulant to ensure that these building blocks will behave properly in your body.
  5. Finally, we’ll use another specialized needle, guided by ultrasound or fluoroscopy, to inject the slurry into the target joint or muscle, where it can begin to regenerate. After we bandage your extraction sites, you’ll be on your way.
Remember that these procedures, while less invasive than surgery, still carry risks:
  • Injury to a nerve, artery, vein, muscle, bone, tendon or ligament could occur, although we use ultrasound or fluoroscopic guidance to minimize that risk.
  • It is possible to contract an infection during any procedure, although we work under sterile conditions while obtaining and injecting bone marrow, fat aspirate and PRP to minimize that risk.
  • The procedure may not work, despite the care we take in making a diagnosis and the unique considerations we give each treatment process. No medical therapy is guaranteed to deliver the desired and expected result.

After the Procedure

  1. Fill your prescription for pain medication on your way home.
  2. Hydrate well and continue to drink plenty of nonalcoholic fluids.
  3. Do not apply ice or heat directly to the joint. Avoid baths, hot tubs or saunas.
  4. Discomfort—even pain—will likely develop four to eight hours after the procedure. To stay ahead of it, take your pain medication on a regular schedule for the first two to four days instead of waiting to feel pain before you take the next dose. Pain should dissipate by the fourth or fifth day after the procedure.

Part 3

How to Make Your Recovery Successful

After the initial pain fades, it will take some time for the extraction wounds to heal and the treated area to recover mobility. Remember that you can call anytime, night or day, if you feel that something unusual is happening: (518) 871-9900.

As part of your recovery, Dr. Kim will ensure that you receive physical therapy to keep the treated area loose and mobile, and continue to improve your range of motion as your body heals.

One Week

Shower, don’t bathe or swim, while your bandages are on. Five to seven days after the procedure, you can remove the outer bandages. If these become wet before that, replace them with clean, dry bandages until the end of the first week.

Whenever you feel up to it, you can resume gentle activity such as stretching, yoga (not hot yoga) or tai chi. Avoid vigorous activity until your four-week follow-up appointment.

Two Weeks

The sticky-strip inner bandages will fall off on their own about two weeks after the procedure. By this point, you should be feeling less discomfort.

Four Weeks and Beyond

Much of the initial pain should be relieved by the end of the first month after your procedure. You can resume taking NSAIDs and drinking alcohol.

This is also the time of your first follow-up visit. If your healing is progressing as expected, you’ll be able to resume normal activity.

PRP Follow-Up

Typically, this is the only follow-up scheduled if you have a PRP injection and it’s usually accompanied by a physical therapy session to help you make the most of your new potential mobility. PRP injections can be repeated as needed..

Stem Cell Follow-Up

This is normally the first of two follow-up sessions if you have a stem cell injection; the second is at 12 weeks. Both visits typically feature an additional injection and are accompanied by physical therapy to help improve your mobility. Injections can be repeated as needed.