Regenerative Injections
PRP and Biologics Injection Orthopedics
These are just a few recent comments from our wonderful patients:
“I went to see Dr. Birch in hopes of finding relief for my Plantar Fasciitis. I was tired of waking up hobbling around in so much pain. So when I heard of other success stories from people I knew who went in for injections, I decided to give it a try. I am so happy to say that it has been a few months now, and I have been pain free. Dr. Birch took the time to explain everything so well, and the procedure was fairly quick. I think I was in and out of the office in less than two hours. I'm very happy with the results from PRP, and I would recommend it to my family and friends. Dr. Birch is very knowledgable in what he does, and makes you feel comfortable during the procedure.” - AM
“Started seeing Dr. Birch about a month ago, received injections on multiple places on my body. So glad to have met him. super professional caring and helpful. Dr. Birch spent more time with me than any doctor I've ever had. His knowledge and help with the injections and help with my diet have been amazing. I would highly recommend Dr. Birch and his group” - CL
“The treatment I received at purity family medical clinic from Dr. Jonathan Birch has been an amazing experience. For forty- plus years I have been highly athletic and my knees payed for it. My activities included dance team, cheerleading, marathon running, USTA tennis, mountain biking and my favorite sport- skiing. I have had two ski accidents resulting in one surgery and last year my surgeon told me I was going to have to have knee replacements in both knees. Swelling, arthritis and pain were something I lived with everyday. I could barely ski or mountain bike more than an hour or two and I was unable to walk afterwards... never mind tennis, running and dance. I tried steroid treatments, was living on Advil, and going to sports massage regularly to relieve the pain I was experiencing. My sports massage therapist mentioned Dr. Birch to me, he told me he was working on someone who had treatment from him and it had been very successful. He claimed this person was very active their whole life just like me and had miraculous results. I decided to give Dr. Birch a call. I can tell you right now it was the best decision I ever made! After my first treatment I skied all day for two days and afterwards I ran downstairs to catch my dog and keep him from running out into the street. I didn't even realize it until after I had ran to get him that I just fully sprinted after skiing and was experiencing absolutely no pain! I skied most of last season and I am skiing again this season with virtually no pain and I am able to walk and run if necessary afterwards! I am completely blown away.
Dr. Birch is not only kind and super considerate he is a very gentle Doctor who talked me through each step of the way and continues to check in on me.
I am a firm believer in his work and the care I received has been superior! I will probably continue to schedule treatments perhaps yearly or ever other year, depending on how my knees are doing. I hope to never have surgery and continue to live an active lifestyle. Just a side note- One of the perks to the treatment has been losing about 12 pounds. I had no idea how much I avoided stairs and walking around due to pain. Thanks to Dr. Birch and Purety Family Medical Clinic I have my life back and it's awesome!” - BC
“The Purety Family Medical Clinic is a great place to go if you have chronic or even acute issues. Although I'm still in my 20's, years of college athletics and military time have taken a toll on my body. The front desk is always very welcoming and quick to find spaces available, and Dr. Birch is extremely knowledgeable on not just healing but attaining longevity. Since I've come in I have had injections on my patella tendinitis, Hamstring Strains, and my 6 year long chronic Achilles Tendonosis. For the most part I have had a complete recovery. There is still some occasional slight tenderness in my Achilles, but it is leaps and bounds better after the therapy. He also has gone out of his way to provide me with alternative workouts and stretching in order to maximize my athletic performance and to hellp prevent other future issues that may arise.” - PT
“It is with great admiration that I write this review! I am a teacher with DeQuervain Tendonitis---started the school year unable to write with lots of pain! Dr. Jonathan Birch treated me with the utmost respect, listened and began with the least restrictive treatment, but moved it right along without hesitation dependent on my needs. He demonstrated knowledge of current treatments and was decisive about what to do; combined with care, gentleness and concern. All the while listening to me; making me feel like an active participant in my own care. I am teaching without pain, thanks to Dr. Birch.
I wholeheartedly recommend Drs. Birch....and my experience at the clinic 200%.” - MG
How it works
When we incur an injury or develop pain due to overuse, our tissue goes through an initial attempt at healing. Either this is successful and you feel and function back to normal, or the amount of attention and bloodflow necessary for complete healing simply ends and your body walls off the rest of the injury. Of course, this is what leads to chronic pain and dysfunction.
In the space of Regenerative Medicine, we now have options to help heal orthopedic conditions. PRP ( platelet rich plasma ) treatments are an excellent way to kickstart and hopefully complete the healing process of this chronic injury and pain. By drawing and spinning your blood, a concentrated platelet solution can be created which holds millions of growth and healing factors. By applying this directly in conjunction with natural biologics to a targeted tendon, ligament, labrum, meniscus or even joint, you can achieve great benefits in re-stimulation and continuation of necessary healing. PRP is also frequently used as a prep or support to the biologics injections.
The biologics injections available today are:
Autologous (i.e. coming from one’s own body) regenerative tissues - these are typically taken from the bone marrow or adipose (fat) cells. These have the advantage of no risk of rejection by the body, but the procedure to harvest bone marrow or fat cells is long, uncomfortable, and risky. Drilling a hole into bone, typically the pelvis, to get bone marrow, and making an incision in the abdomen to macerate, or “mash up” adipose cells, in effect a mini liposuction, can cause pain, bleeding, and even serious infection given the degree of bone and soft tissue penetration.
Additionally, it’s been documented that the cells sought in doing such procedures drop severely in number as we age. A study by AI Caplan et. al. showed that the percentage of MSCs to bone marrow cells, drops from around 1 in 10,000 at birth, to 1 in 100,000 by the teenage years, to as low as 1 in 400,000 by age 50 and 1 in 1,000,000 by age 70. While some physicians have claimed to be able to boost this number in older patients by selective exercises and a nutrition program, the concern still exists that you’re going through a long, uncomfortable ordeal without much yield to show for it.
Some of the most well-known of biologics today are those that come from the umbilical cord (the tube attached the baby’s navel that provides oxygen, food, a blood supply and waste removal up until birth). The umbilical cord contains several valuable substances that are being used at the cutting edge of regenerative medicine today which our patients have benefitted from:
1. Wharton’s jelly: this makes up much of the substance, or tissue, of the umbilical cord that provides most of the support around the blood supply (umbilical artery), and yes, it looks like clear jelly. This is composed of a multitude of “scaffolding” proteins (which provide an “anchor” or network for the other injected substances to stick to and not drain away), growth factors, and in some cases (depending on the preparation) live cells that can stimulate your body’s own healing factors to repair damaged tissue.
2. Exosomes: these are tiny vesicles that “bud” off from live cells, that are the newest exciting frontier in regenerative medicine. Exosomes are composed of messenger-RNA (which sends a “code” to the host’s cells to begin repair), micro-RNA (which has anti-inflammatory properties), cytokines (small proteins that act as messengers for cell-to-cell signaling that can, among other things, strengthen the immune system, carry growth factors, and provide instructions from one cell or cell to others). Because of their small size, they can cross the blood-brain barrier, and have higher concentrations of growth factors than adult cells.
Each of these regenerative modalities has been used and can be applied with great success for partial tendon and ligament tears, tendinosis, tendonitis, joint inflammations, arthritis conditions, as well as chronic nerve pain.
Dr Birch has performed over one thousand regenerative injection treatments under ultrasound guidance. This has helped him hone his skills and expertise in order to develop his own special techniques and protocols for orthopedic support and healing. Every orthopedic injection you will receive will be under ultrasound guidance in order to minimize pain and maximize benefit of the treatment modality you choose.
Orthopedic conditions most commonly treated include:
Back pain
Low back - lumbar ad sacroiliac
Neck (cervical spine)
Facet joint pain
Shoulder pain
Frozen shoulder
Rotator cuff tear - infraspinatus, supraspinatus, subscapularis etc.
Biceps tendon tear and tendinosis
Elbow Pain
Tennis elbow
Golfer’s elbow
Elbow joint arthritis
Wrist and finger pain
Wrist and finger arthritis
Wrist tendonitis
Trigger finger
Knee pain
Knee arthritis
MCL and LCL ligament instability and partial tears
Meniscus tears
Foot and ankle pain
Tibiotalar arthritis and other ankle and toe joint arthritis
Partial tendon and ligament tears
Tibial nerve pain and vague pain under the foot
Q: What are regenerative injections?
A: Regenerative injections are treatments that aim to stimulate the body's natural healing process by injecting concentrated growth and healing factors, such as platelet-rich plasma (PRP) and biologics into damaged or injured tissues including tendons, ligaments, or joints.
Q: What is PRP (platelet-rich plasma) treatment?
A: PRP treatment is a regenerative therapy that uses a concentrated platelet solution derived from the patient's own blood. This solution, rich in growth and healing factors, is injected directly into a targeted area like a tendon, ligament, or joint to stimulate and promote healing.
Q: How are natural biologics used for regenerative orthopedic injections?
A: Natural biologics have the potential to differentiate into various cell types, are used for regenerative orthopedic injections to promote tissue repair and healing. They can be obtained from sources such as bone marrow aspirate concentrate (BMAC), adipose tissue, placenta, and umbilical cord from Wharton's jelly matrix.
Q: What conditions can be treated with regenerative injections?
A: Regenerative injections can be used to treat a range of orthopedic conditions, including partial tendon and ligament tears, tendinosis, tendonitis, joint inflammations, arthritis, and chronic nerve pain.
Q: Who performs regenerative injection treatments at the clinic?
A: Dr. Jonathan Birch NMD, RMSK, an experienced specialist, performs regenerative injection treatments under ultrasound guidance to ensure precision and minimize pain while maximizing the treatment's benefits.
Q: What orthopedic conditions are most commonly treated with regenerative injections?
A: The most commonly treated conditions include back pain, low back pain, neck pain, facet joint pain, shoulder pain, frozen shoulder, rotator cuff tears, biceps tendon tears, elbow pain, tennis elbow, golfer's elbow, wrist and finger pain, arthritis, wrist tendonitis, trigger finger, knee pain, meniscus tears, foot and ankle pain, and tibial nerve pain.
Q: Are regenerative injections performed under guidance?
A: Yes, all regenerative injections are performed under ultrasound guidance, ensuring the precise delivery of the treatment and minimizing pain while maximizing the benefits.