This week’s subjects
- A Listener’s Experience with PRP Treatments
- Using Ultrasound Guidance for injections
- Athlete Case: Achilles Tendinitis and Possible Tear
- Risks of Steroid Injections
- Understanding Overuse Injury and Tendon Healing Phases
- Patient Perspective: Rapid Relief and Treatment Insights
- Do anti-inflammatory medications help with healing?
- Risks and Side Effects of NSAIDs
- Risks and Outcomes of Meniscectomy
- Neck Discomfort and Crunching Sensation
- Thumb Injuries
- Knee Pain
- Baker’s Cyst: Diagnosis and Treatment
Are you currently experiencing joint or muscle pain? If so, stay tuned—this program is designed just for you. Welcome to Living Pain-Free with Dr. Marc Darrow, MD, and Dr. Thomas Grove.
Meet the Hosts
Dr. Marc Darrow is a board-certified medical doctor, having completed his studies at UCLA. He practices at the Stem Cell Institute in West Los Angeles, where he uses cutting-edge treatments such as stem cell therapy and platelet-rich plasma (PRP) to help heal the body. Dr. Darrow also educates others about the use of stem cells, PRP, and prolotherapy for pain management and recovery.
Joining him is Dr. Thomas Grove, a specialist in regenerative medicine and an expert in ultrasound-guided injections. Dr. Grove brings a wealth of experience as both an athlete and a strength and conditioning coach, providing unique insights into treating pain and getting people back to an active lifestyle.
This program offers effective solutions for the pain you may have been living with. With the expertise of Dr. Darrow and Dr. Grove, today’s episode could be the beginning of a new, pain-free chapter in your life.
Regenerative Medicine: Natural Healing for Active Lifestyles
Welcome back. It’s that time of the week—this is Living Pain-Free, and I’m your host, Dr. Thomas Grove, board-certified physician and sports medicine specialist, fellowship trained.
My passion in life is getting people back to being active again. After years of working as a team physician for Division I athletes and treating countless active individuals, I’ve traveled around the world searching for the best ways to heal soft tissue injuries. Whether it’s a ligament, muscle, tendon, or joint issue, I know how important it is to recover quickly and safely to return to your routine and avoid surgery whenever possible.
Today, we’re focusing on regenerative medicine—the healing cells of the body. This includes treatments like platelets, which can be obtained from your own blood, and stem cells, which can be harvested from bone marrow, for example.
There are many excellent methods available to naturally stimulate your body’s healing process and help you recover without relying on pain medications or unnecessary surgical procedures. Our aim is to get you back in action, pain-free, using the most advanced and natural approaches available. Hopefully we can get you off the anti-inflammatories, the pain procedures, the unnecessary surgeries.
Listener Questions
As practitioners, we frequently receive emails from people not only in our local area but also across the country and around the globe. This ongoing communication is one of the most rewarding aspects of our work, allowing us to educate a diverse audience and explore whether regenerative medicine could be a suitable solution for their needs.
A Listener’s Experience with PRP Treatments
Recently, a patient reached out to share their experience after undergoing three rounds of platelet-rich plasma (PRP) therapy with a local physician. Despite multiple treatments, they reported no pain relief. The physician had explained that there was no need for advanced ultrasound guidance during the procedure, prompting the patient to question whether this was accurate.
The Value of Ultrasound Guidance
This scenario is common in regenerative medicine. In my opinion, not using ultrasound guidance reflects a lack of proper training, especially given how valuable this technology is today. Musculoskeletal ultrasound is my preferred imaging tool for soft tissue injections, as it enables precise targeting. For example, when injecting into a small joint, I can visually confirm the needle’s placement before delivering healing cells directly to the intended area.
Ultrasound not only assists in delivering treatment but also helps diagnose the underlying issue. The technology enables both the physician and the patient to observe the procedure live on screen, ensuring the healing cells are placed precisely. This reduces uncertainty about whether the cells reached their target, which can be a source of frustration for patients who have researched and invested in regenerative medicine but did not see the desired results. Often, the lack of ultrasound guidance is a contributing factor.
Training and Expertise Matter
Proper use of ultrasound requires dedicated training and experience. I have spent over a decade honing my diagnostic skills, including extensive time teaching anatomy to medical students, residents, and fellows. This foundation is essential for maximizing the benefits of regenerative treatments. In contrast, so-called “blind injections”—where no imaging is used—have been shown in numerous studies to be far less accurate.
Questions to Ask Your Provider
If you are considering a regenerative medicine procedure, it is wise to ask your provider about their experience with musculoskeletal ultrasound and how frequently they perform these guided injections. There is significant variability in training among practitioners, and your outcome may depend on their skill set.
Treatment Strategies
For those dealing with Achilles tendinitis—particularly athletes—regenerative medicine has shown promising results. The goal is to deliver healing cells directly to the affected area to promote recovery. Additionally, using a walking boot helps distribute force across the injured tissue, supporting healing and reducing further damage. This simple device, with Velcro straps, offers practical support for foot and ankle injuries.
Patient Perspective: Rapid Relief and Treatment Insights
The healing process is indeed a timeline, requiring patience and proper management. During a recent segment, a caller joined the discussion to share a personal experience with regenerative treatment.
Caller’s Experience with Shoulder Injection
The caller, Dr. Marc Darrow, recounted his own journey. After experiencing shoulder pain from repetitive golf swings, he received an injection in his right shoulder. Remarkably, he reported waking up completely pain-free the following day.
Understanding Rapid Pain Relief
In response, the host explained that while the overall healing timeline is typically long, clinical outcomes—how the patient feels—can sometimes shift quickly. Some individuals, described as “fast healers,” may experience rapid pain relief following treatment. For example, the host noted personal experiences of significant improvement in the thumb and wrist within days after treatment. This initial improvement may be attributed to the inflammatory phase: when tissues are damaged and inflamed, the resulting response can help “reset” the pain signals, leading to surprisingly quick relief in some cases.
Importance of Rest During Recovery
Despite fast symptom relief, both the Dr. Darrow and Dr. Grove emphasized the challenge of adhering to rest. To optimize healing, it is important to avoid returning immediately to physical activities, such as golf, that could re-injure the tissue. The best approach is to continue resting the affected area and allow the healing process to proceed.
Part 2
I’m your host, Dr. Thomas Grove, a board-certified physician with fellowship training in sports medicine.
Today’s Topic: Musculoskeletal Medicine and Orthopedics
Today, we’re returning to our topic: musculoskeletal medicine and orthopedics. We’re focusing on regenerative medicine—techniques that help the body heal itself. This includes treatments like platelet-rich plasma, which can be obtained from your own blood, and bone marrow-derived stem cells. These are powerful tools that promote healing and can help you return to activity naturally.
Benefits of Regenerative Techniques
These methods support the healing process and can help you avoid unnecessary surgery, getting you back in the game through natural recovery.
Anti-Inflammatory Medications and Healing After PRP Treatment
Here we address a frequently asked question regarding the use of anti-inflammatory medications following regenerative medicine treatments such as PRP (Platelet-Rich Plasma) therapy. The discussion is based on a recent email inquiry and reflects common concerns raised by patients.
A patient writes to Dr. Grove about a recent knee injury sustained while playing pickleball. An MRI revealed a small meniscus tear. By the time the patient met with their surgeon, the pain had already disappeared.
Surgeon’s Recommendation and Patient’s Concern
The surgeon recommended a meniscectomy, prompting the patient to ask: “What is that? Do I really need surgery?” This case involves someone who suffered a knee injury, underwent an MRI, and was diagnosed with a meniscus tear. Meniscus tears are quite common and often do not produce symptoms. In this situation, the patient’s pain resolved before seeing the surgeon.
Neck Discomfort and Crunching Sensation
Email reads: “Dr. Grove, please help.” I really appreciate when emails begin this way. It always motivates me to see how I can assist the patient.
The case describes a patient experiencing a peculiar crunching sensation accompanied by mild neck discomfort every time they turn their head to the side. The patient asks if this is something I can help with. Interestingly, I have personally experienced this same sensation myself, particularly after playing football, which involved considerable head trauma. The force exerted on the neck and base of the head can lead to these types of symptoms.
Whenever mechanical symptoms are present, it is crucial to quickly identify their source. In such cases, bringing the patient into the clinic for a comprehensive hands-on physical examination is essential to determine which anatomical structure is responsible for the sensation.
It is difficult to diagnose the cause from a brief question alone, but there is a good chance that facet arthritis could be involved. Reviewing spinal anatomy, the neck comprises several vertebrae with facet joints between them—one on each side at each level of the spine. The crunching sensation described by the patient is characteristic of facet arthritis, which I have also experienced. These joints are small, about the size of a finger joint, and can develop cartilage roughening and inflammation following trauma, whether minor or cumulative. This process often results in the crunching, uncomfortable sensation noted by the patient.
Treatment Approaches and Outcomes
This condition can be quite apparent; in my experience, the crunching sound was audible even across the room. Fortunately, with appropriate treatment, these symptoms can resolve. I have successfully treated this myself and found that surgery rarely addresses the mechanical symptoms like crunchiness. Pain can be managed with medications such as lidocaine injections, steroid injections, nerve blocks, and epidurals, but these do not necessarily promote healing.
When faced with such cases, regenerative medicine often proves to be highly effective. Treating these small joints can be challenging, but using ultrasound allows precise targeting, ensuring that healing cells are delivered directly to the affected area. This is especially beneficial for facet joint issues, where cells can also be injected into surrounding ligaments, tendons, and muscles to support the joint.
Regenerative Medicine and Its Applications
Many people assume that regenerative medicine is limited to hips, knees, or shoulders, but the tissue involved in facet joints is similar—collagen-based articular cartilage. Although these joints are located in different parts of the body and have different names, the underlying tissue is the same. The body has joints, ligaments, tendons, and muscles throughout, all of which can be targeted with regenerative medicine for effective treatment.
I have personally experienced how annoying and uncomfortable the crunchiness can be, requiring frequent adjustments for temporary relief. However, after undergoing regenerative treatment, I no longer needed those adjustments, demonstrating the excellent outcomes that can be achieved with these therapies.
Knee Pain
So, speaking of emails, let’s get right back into another one. This is a good one. This one says, “Hey, Dr. Grove. I’m told I have osteoarthritis under my right kneecap and I’m looking into stem cell treatments, acupuncture, cupping, ultrasound, and want to know, will I get some results with platelet rich plasma or a stem cell injection?”
This is probably the most common presentation of knee pain that we see in the clinic. Osteoarthritis is characterized by an inflammatory process occurring inside a joint. It’s not just a cartilage issue. Typically, as we do imaging reports, we note that the cartilage is thinned out, the joint space starts to narrow, and bone spurs develop. Recent understanding shows that osteoarthritis involves a complicated picture with cell-mediated inflammation that drives the inflammatory process. This is one of the most common conditions treated, and month to month, it’s likely the number one or number two concern addressed with regenerative medicine.
Understanding Osteoarthritis
The core idea in treating osteoarthritis is to break the inflammatory cycle. Chronic low-grade inflammation causes pain, and healing cells are not reaching the joint due to poor blood supply. Treatments like platelet rich plasma (PRP) or stem cell injections are delivered directly into the joint to spike inflammation and hit the reset button, aiming to create a more optimal internal healing environment.
The goal is to break the cycle, promote healing, and achieve long-term benefits with regenerative medicine. Unlike steroid injections, which only decrease pain, regenerative treatments provide healing cells directly at the site, leading to a prolonged anti-inflammatory effect. The hope is to slow down the progression of arthritis, and ideally, help regrow some of the tissue.
Conservative and Regenerative Treatment Options
Acupuncture, cupping, and other conservative approaches are often considered first, which is fantastic. When these methods are not effective, regenerative medicine serves as a valuable tool to give the healing process a boost and speed recovery. The overall aim is to avoid total joint replacement and keep patients out of the operating room, facilitating healing without surgery.
Baker’s Cyst: Diagnosis and Treatment
We’ve got Nancy. Nancy asked, “Do you fix baker’s cysts?” She explained that she has two and no one seems familiar with them.
Baker’s cysts are common and are treated daily. They are essentially a fluid collection felt on the backside of the knee, usually on the inner half. It’s a potential space, meaning everyone has the ability to develop a Baker’s cyst, but not everyone has enough damage or inflammation to cause a significant one. Excess production of synovial fluid leads to the cyst, and when they grow, the knees can feel stiff and tight, sometimes decreasing range of motion and causing irritation. The cyst runs between one of the calf muscles and one of the hamstring muscles, so even a small cyst, like one the size of a golf ball, can be very irritating, especially for active people.
