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Regenerative Medicine

What is regenerative medicine?

Citrin Wellness is at the forefront of regenerative medicine. One of our main specialties is regenerative and anti-aging medicine. If you are unfamiliar with what regenerative medicine is, please read below.

You may have heard about things like PRP (vampire facial), peptides or stem cells. All of these type of therapies fall into the category of regenerative medicine. There are many other of therapies that fall into this category.

Essentially, regenerative medicine is an innovative field of health care that triggers and stimulates your body’s natural ability to repair and heal itself. It has been around for 100 years but recently has been making much more traction in the public.

Many famous athletes — Tiger Woods, tennis star Rafael Nadal, and several others — have received this for various problems such as sprained knees and joint injuries. However, what you may not know if how extensive this field of medicine can be.

You may be able to avoid unnecessary surgery or suffering with regenerative medicine solutions that help people with joint issues such as: knee, shoulder, hip, back pain, elbow, wrist, and ankle pain.

It may also be able to help with neurological conditions such as multiple sclerosis (MS) as well as auto-immune conditions like Crohn’s and Ulcerative Colitis.

Dr. Citrin has treated over 1000 patients with regenerative medicine, as his residency was a combination residency of regenerative medicine and naturopathic primary care medicine. We have seen so much clinical success.

Conditions Regenerative Medicine is typically used for:

Dr. Citrin uses all the above regenerative medicine to address painful joint and soft tissue injuries, including:

PRF Injections

PRF stands for platelet-rich fibrin. This is a solution made directly from your blood, concentrated, and prepared to be re-injected into the area of damage. It can be applied into tendons, ligaments, joints, scalp for hair regenerative, and face for rejuvenation.

We used PRP historically (platelet rich plasma) but have switched to PRF as we noticed the injections are typically less painful and we have seen a higher percent of resolution for peoples symptoms and pain, mobility, and strength. We have also seen acne scars significantly heal better with PRF vs PRP.

The PRF contains a high amount of platelets. Platelets contain hundreds of proteins called growth factors which are very important in the healing of injuries.

Because we extract vials of blood through a simple blood draw in office, we can concentrate PRF so that the solution has a significantly higher concentration of platelets than what is typically found in the blood. The concentration of platelets — and, thereby, the concentration of growth factors — can be 4 to 10 times greater (or richer) than usual.

When injected into damaged tissue, scalp, or the face it triggers your body to start healing the tissue. This can be injected typically anywhere there is arthritis, degenerative conditions, sports injuries, strains, sprains, tears, spurs, calcifications, and more.

For facial aesthetics, it is applied with injections and then through microneedling after. This allows the skin to repair any collagen damage, which is what causes fine lines and wrinkles on the face and also contributes to hair loss. Therefore, it can also address hair loss or hair thinning, facial acne scars, fine lines, and wrinkles.


The Process:

When you have a PRF treatment, Dr. Citrin begins by drawing vials of your blood in the office, like a simple blood draw. He then separates the sample in a centrifuge and extracts a concentrated amount of platelets to create the PRF solution that has 5-10 times more platelets than a regular blood sample. Once this is created, the PRF is ready to apply to the area. That can be face, scars, ligaments, tendons and any other soft tissue typically.

Prolotherapy

Prolotherapy was founded in the early 1900s and works wonderfully for specific issues: typically ligament injury. This is an injection technique that works to relieve pain by injecting a simple irritant into damaged tissue. The irritant is made up of dextrose, lidocaine, and saline. The concept is that is when the irritant is injected into damage tissue, it creates an alert to the body which causes the body to respond by sending in platelets and growth factors. These results in a stimulation effect of regeneration by signaling a response to repair and lay down new tissue in replacement of the damaged tissue.. This technique works best for ligaments that never healed properly after an initial injury, but can also be used in tendinitis and other soft tissue injury.

Prolotherapy is made in the office. As your joint heals, your pain subsides, and then typically mobility and strength improve.

Peptides

Peptides are best described as the building blocks of proteins composed of amino acids that regulate the body’s biological processes and functions. There are over 8000 peptides, and each peptide has a very unique and specific function. Peptides occur naturally in the body and act as signaling mechanisms. They act as signaling molecules and can instruct other molecules and cells in the body to perform.

Each peptide is responsible for generating and facilitating a different body response and action.

So as you learn more about peptides, understand that every peptide you may be interested in is unique and particular to a specific function. Though the human body produces peptides naturally, their production may vary widely with age. The quality and amount of peptides are likely to decline as you get older. Peptide therapy can be a suitable option in such cases with minimal downside risk and almost no adverse side effects.

Peptide therapy can help with restoring your body’s ability to stimulate the cellular regrowth systems for specific conditions. At Citrin Wellness, we customize protocols for patients in regards to peptides.

BPC-157 is typically the most common peptide used in regenerative medicine.

To learn more about Peptide therapy and BPC: navigate to our peptide page.

Scar Therapy

One of the most over-looked regenerative medicine techniques is scar therapy. We have found that scars can create many, many symptoms including pain, lack of sensation, dysregulation among others.

Typically the first time a scar is formed, it is formed poorly as an immediate response to tissue injury. When this biological process goes wrong, it can create problems down the road. We have seen sensation return, mobility, functionality, among others when we repair scars.

The way we repair scars is by injecting a simple solution of lidocaine (as to numb the area) with saline into the scar and re-open the tissue slightly by adding the fluid. The mechanism of why this works is complicated, and we will list it below. However, this treatment may be the one you have been looking for if you’ve had issues post surgery or injury in around scar areas that never healed properly the first time.


Mechanism of a scar:

This can get a little technical since the mechanism of why scars can be so disruptive is complex. When there is a surgery or injury, the body reacts to a wound by sending in clotting factors (platelets) to immediately stop any bleeding. The body then lays down various collagen, fibrin, and others proteins to heal the skin. This is why scars appear the way they do. However, and often with surgery, this can disrupt what is called superficial nerves. Superficial nerves are the way you feel ANY sensation on the skin. They tell your brain when the area is touched, cold, heat, and if there is pain etc. When these nerves are squeezed or damaged by the scar, you can start to have chronic problems.


Why scar therapy works:

We inject the scar and provide the body with another opportunity to lay down new collagen which can provide the superficial nerves an ability to heal and function more properly. When this happens sensation, mobility, and pain can all improve. We have seen tremendous relief to areas that feel numb, painful, etc in around scars or after surgery.

Peri-Neural Therapy

Perineural Injection Therapy (PIT) is a proven safe, effective treatment for patients who experience pain. Perineural injection therapy treats inflamed and injured nerves. Chronic nerve pain is often due to trauma, arthritis, sports, overuse, occupational, and surgical injuries.

Perineural Injection Therapy involves the physician’s understanding the anatomy of these sensory nerves as they course throughout the body. A series of injections containing the dextrose solution is placed underneath the skin much in the same way as getting a TB test or a “pinprick.” A very short, small needle is used to treat along the course of the nerve. The injections are fairly pain free.

Since this is drug-free treatment, and dextrose is a part of normal human function, side effects are rare and including occasional small bruises at the site of injection. Allergies are also typically not an issue.

We have seen immense help with pain, but a consultation is best to determine if this treatment is right for you.

Regenerative medicine treatments can help recover from sports injuries, whiplash, and other musculoskeletal pain. Dr. Citrin may also suggest regenerative medicine treatments to address hair loss, and facial rejuvenation from fine lines and wrinkles.

What should I expect during regenerative medicine treatments?

A consult to discuss what area is problematic is best. Prolotherapy, Per-Neural, PRF, Peptides, and Exosomes are all options for regenerative medicine. A consultation is best to determine which approach is right for you.

Your body will need 5-7 days to start the repair of your joint or tissue. Over the following weeks, as your body continues the healing response you can start exercising and using the joint. We typically ask for 5-7 days of allowing the area to relax to give it the best chance of healing.

Depending on your condition, you may need a series of regenerative medicine treatments to achieve optimal results. Following a consultation and exam, Dr. Citrin provides customized advice on how many treatments you may need.

If you have painful joints or soft tissue injuries, call Citrin Wellness or make an appointment online today. We offer 15 minute free consultations to see if regenerative medicine is right for you.