Nura delivers a comprehensive, multi-medical-disciplinary approach to chronic pain. One of the more promising tools in that tool box is regenerative medicine.
Regenerative medicine has been called a “game-changer” by both the National Institute for Health (NIH) and the Mayo Clinic. To paraphrase the NIH, regenerative medicine repairs or replaces damaged tissue by stimulating previously irreparable tissues to heal themselves. As such, it holds the promise of repairing many of the root causes of chronic pain. The Mayo Clinic states that regenerative medicine offers, “a solution and hope for people who have conditions that were previously beyond repair.”
Nura’s regenerative therapies harness a patient’s own cells and blood platelets to nurture the healing process. These healing cells are removed from your own body, concentrated in our lab, and reinjected into the precise location of degeneration, to kickstart the repair response.
Nura has partnered with Regenexx, who pioneered the use of stem cells to treat orthopedic injuries in the U.S. Regenexx is a world-wide network of specialty trained physicians providing regenerative medicine treatments in North America, Europe, The Middle East, Asia, Australia.
Regenexx provides Nura with cell concentrating technologies that deliver the best product on the market, with a much higher purity and concentration of cells than can be achieved with a bedside centrifuge. Regenexx also operates a world class research division that continues to refine and improve its protocols, with a large patient database that proves the safety and efficacy of their procedures. Because they publish their outcomes, Regenexx exclusively partners with physicians who are experts in the field of Interventional Orthopedics.
Stem Cell Therapy
Stem cells can be thought of as your body’s own general contractor for the repair process. They constantly replenish themselves to fix degeneration and slow the progression of aging. Your doctor will collect these cells from your bone marrow, found in the back of the pelvis bone. Then our specially-trained lab technician concentrates the stem cells in our in-house lab. Your doctor then reinjects them back into the precise area of degeneration and damage. The injected cells take their cues from their immediate surroundings: If injected into a tendon tear, they bridge the tear to mend the tendon. If they are injected into a cartilage defect, they lay down cartilage. It is therefore essential that image guidance be used to precisely place the cells.
Of important note: these therapies are all “autologous,” meaning that the patients’ own cells are harvested, concentrated, and then reinjected back into the same patient. Thus, one avoids many of the potential ethical or health concerns that might arise from using tissues obtained from other persons.
Platelet Rich Plasma Therapy (PRP)
The platelets in your blood contain numerous growth factors that turbocharge the healing process. They are especially useful in stimulating the healing process in damaged tendons and ligaments but can also help with mild arthritis. Unfortunately, these tissues do not get very much blood flow to support the repair process. To get these cells where they are needed, we take a blood sample from your arm and then concentrate your own platelet cells in a smaller volume of plasma (the ‘water’ of the blood’). This Platelet-enriched Plasma can then be precisely injected back into damaged tissue using image guidance to ensure the cells are getting where they need to be.
Platelet Lysate Therapy
When treating the nerves and spine with regenerative medicine, special care must be taken with the preparation of the platelets. With lysate therapies, the enriched platelet cells are cracked open (‘lysed’) to make a serum of the healing growth factors. These growth factors, free of the cells that once housed them, can now be injected around trapped nerves or into the epidural space to help with nerve irritation without causing excess inflammation.
Areas Most Responsive to Regenerative Treatment
An accurate diagnosis is an essential first step to a successful treatment. Even in a case that may seem to be clear-cut arthritis, there can be joint instability or nerve irritation that led to the arthritis and worsens pain. These supporting structures must be included in a comprehensive regenerative treatment plan. Each patient will receive a thorough examination and a personal review of his or her imaging- perhaps with a dynamic diagnostic ultrasound- to find any and all areas of degeneration that are contributing to pain.
These are some of the areas that may be contributing to your pain and which tend to respond to regenerative treatments.
Back and Neck
- herniated disks
- facets (joints of the vertebral column of the spine)
- radiculopathy (pinched nerves)
- sacroiliac (“SI”) joint of the pelvis
- ligament instability (i.e. from whiplash)
- bursitis (fluid-filled sac that cushions joints)
- patellar (knee cap) tendonitis or arthritis
- meniscus tears (rings of cartilage that stabilize and cushion the knee joint)
- baker’s cyst
- ligament sprains, tears & inflammation
(ACL, MCL, LCL, PCL)
- ACL tears
- rotator cuff tears or tendonitis
- bursitis or impingement
- instability or recurrent dislocations
- arthritis of shoulder
- golfer’s or tennis elbow
- trigger finger
- arthritis of thumb
(inflammation of joint cushion)
- tendinopathy (disease of tendon)
- fracture nonunion
Hip, Ankle, Foot
- labral tears
- plantar fasciitis (heel pain in the morning)
- trochanteric bursitis (outside of the hip pain)
- tendinopathy (degeneration of tendon)
- ligament strain/tears (i.e. from chronic ankle sprains)
- ankle pain and instability
- avascular necrosis
- entrapment syndromes such as: carpal tunnel (wrist), cubital tunnel (elbow), tarsal tunnel (ankle)
- nerve irritation across an artificial joint such as a knee replacement or hip replacement
- radiculopathy (nerve pain) of nerves exiting the epidural space of spine
Tip: just about any area that can be treated with steroids
can be treated with regenerative medicine.
Is Regenerative Covered by Insurance?
In most situations the initial consultation with the physician, including ultrasound and other diagnostic imaging will be covered by insurance. Likewise, any bracing or Physical Therapy after your procedure should also be covered. However, most insurers are currently not paying for treatments that use your own cells. If you decide to pursue Stem Cell, PRP or Platelet Lysate treatments, there will likely be an additional fee for these procedures. At the time of your evaluation we will let you know what these additional out-of-pocket expenses might be. You can use a pre-tax Health Savings Account for these, although it may not count towards your deductible. Some insurers are starting to cover these procedures, so you can try submitting your receipts for reimbursement. Some self-insured companies are specifically covering Regenexx procedures to reduce their costs and time-off from elective orthopedic surgeries.
Am I a Candidate for Regenerative Therapy?
Will regenerative therapies work for me? This is the central question which requires individualized answers, and we have multiple resources to help answer this for you. First, feel free to research online- Regenexx.com has many great resources including registry data, large studies, and testimonials from people with your same condition. Second, Nura provides the free services of a Regenerative Specialist who has been trained by our doctors to answer many of the common questions and can even help explain your MRI to you. If you’re not ready to make an appointment and just want to know if your condition is treatable, our Regenerative Specialist can save you a trip. But most of all, we would encourage you to make an insurance-covered consultation with a Regenerative Medicine Doctor to identify all areas of dysfunction and give you a specific prognosis. We pride ourselves on operating with integrity and look forward to providing you with the best care possible.