Regenerative Interventional Functional Orthopedic Medicine › attachments... · Regenerative...

Regenerative Interventional

Functional Orthopedic

Medicine

What are the Patient OptionsPhillip Zinni III DO FAOASM MS ATC

Past-President

American Osteopathic Academy of Sports Medicine

National Medical Director

The Industrial Athlete

Disclaimer

Stockholder of Canopy Growers

Associate of CTFO


Functional Orthopedic Medicine1 What causersquos MSK (Musculoskeletal)

pain and disability

2 What are treatment options for OA

(Osteoarthritis)

3 What are treatment options for MSK

pain and disability

What Causes Musculoskeletal Pain

bull Trauma

ndash Falls

ndash Injuries

ndash MVA

bull Overuse Repetitive

motion

bull Postural imbalance

strain

Rapid Onset Insidious Onset

4

Symptoms amp Types of Pain

bull Sharp

bull Severe

bull Ache

bull Burn

bull Dull

bull Acute

bull Chronic

Symptoms Types

5

Types of Pain

bull Falls

ndash Fractures

ndash Dislocations

bull Injuries

ndash Work Related

Hobby

ndash Strain Sprain

bull MVA

bull Overuse Repetitive motion

ndash Inflammatory

bull Bursitis

bull Tendonitis

ndash Non-Inflammatory

bull Tendonosis

bull Postural imbalance strain

ndash Kyphosis

ndash Lordosis

Acute Chronic

6

Form Follows Function or Deformity Delineates Dysfunction

SANS ndash Christopher Centeno MD

Tensegrity

Biotensegrity

ndash Buckyball


BIOTENSEGRITY

Buckyball BuckminsterfullereneOrganism approach states everything is

in balance even at the cellular level


bullBIOTENSEGRITY a unifying theory of biological architecture with

applications to osteopathic practice education and research-- to identify the mechanical causes of disease and to understand the bodys structure-function relationship at all size scales in the human body

bullAt the cellular level allows the cell to mechanically sense its environment and convert mechanical signals into biochemical changes

bullApplied to principles of osteopathic medicine biotensegrity provides a conceptual understanding of the hierarchical organization of the human body and explains the bodys ability to adapt to change

bullExplains how mechanical forces applied during osteopathic manipulative treatment could lead to effects at the cellular level providing a platform for future research on the mechanisms of action of osteopathic manipulative treatment

Swanson RL 2nd1 J Am Osteopath Assoc 2013 Jan113(1)34-52


TENSEGRITY


TENSEGRITY DEFINITION (Buckminster Fuller 1975)

ldquoSynergeticsrdquo and the relation between continuous tension elements and

its continuous compression elements which are responsible for a structure

as follows

ldquoThe word tensegrity is an invention it is a contraction of tensional

integrity Tensegrity describes a structural‐relationship principle in which

structural shape is guaranteed by the finitely closed comprehensively

continuous tensional behaviors of the system and not by the discontinuous

and exclusively local compressional member behaviors

Tensegrity provides the ability to yield increasingly without ultimately

breaking or coming asunder

The integrity of the whole structure is invested in the finitely closed

tensional‐embracement network and the compressions are local islandsrdquowwwosteopathic-researchcompaper_pdfPfluegerpdf


Myofascial system on macroscopic scale behaves like

a tensegrity structure

TENSEGRITY



pain and disability

Abnormal forces and environment2 What are treatment options for OA (Osteoarthritis)3 What are treatment options for MSK pain and disability


Functional Orthopedic Medicine1 What causersquos MSK (Musculoskeletal) pain and disability


(Osteoarthritis)3 What are treatment options for MSK pain and disability

What are the Regenerative Interventional Orthopedic

Functional Medicine options

1st Body AlignmentBalance PTEgoscue OMM Adjustment CBD steroids

1) VISCOSUPPLEMENTATION INJECTION

2) Prolotherapy

3) PRP (Platelet Rich Plasma)

4) STEM CELLBiologic Therapy

What are Treatment Options for Musculoskeletal Pain

bull Pharmaceutical

bull Manipulation

bull Physical Therapy

bull Acupuncture

bull Dietary

bull Herbal

bull Homeopathic

bull Massage

bull Mind-Body Therapy

TraditionalComplementary and

Alternative

17

Pain ManagementPharmaceuticals

bull Acetaminophens

bull NSAIDS

ndash Oral

bull Increased GI Side Effects

ndash Topical

bull Decreased GI Side Effects

bull zolpidem (Ambien)

bull amitriptyline

bull trazodone

bull gabapentin (Neurontin)

Analgesia Anti-Inflammatory Sedative Other

18


bull NSAIDS

ndash Topical Studies of diclofenac ibuprofen amp ketoprofen

ndash Less Plasma concentrations

ndash Increased Meniscus and Cartilage concentrations

bull Do NOT want this

1 C Rolf et al Intra-articular absorption and distribution of ketoprofen after topical plaster application and oral intake in 100 patients undergoing knee arthroscopy Rheumatology 1999 38 564-567

2 CA Heyneman et al Oral versus topical NSAIDs in rheumatic diseases A comparison Drugs 2000 60 555-574

3 J Radermacher et al Diclofenac concentrations in synovial fluid and plasma after cutaneous application in inflammatory and degenerative joint disease British Journal of Clinical Pharmacology 1991 31 537-541

Anti-Inflammatory

19


What about CBD Few contraindications ndash similar as CYP450 enzyme pathway Philpott ldquoAttenuation of early phase inflammation by cannabidiol prevents pain

and nerve damage in rat osteoarthritisrdquo Pain 2017 Dec NIH Database

ldquoShowed 1st time local CBD administration inhibited pain amp peripheral sensitization in

established OA Topical treatment with CBD reduced leukocyte trafficking and joint

hyperemia during the early stages of MIA (Joint irritant) By attenuating this initial

inflammatory response with CBD end-stage OA pain and peripheral neuropathy were

abrogated Thus CBD may be a safe therapeutic to treat OA pain locally as well as

block the acute inflammatory flares that drive disease progression and joint

neuropathyrdquo

Hammell ldquoTransdermal cannabidiol reduces inflammation and pain-related

behaviors in a rat model of arthritisrdquo Eur J Pain 2016 NIH Database

ldquoThese studies demonstrate topical applied CBD has long-lasting therapeutic effects wo

psychoactive side-effects Thus topical CBD has potential as effective treatment of

arthritic symptomatology At present one in five (21) adults worldwide are diagnosed

with some form of arthritis by their physicians (Helmick et al 2008) The data

presented suggest transdermal CBD is a good candidate for developing improved

therapies for these debilitating diseaserdquo


CBD (Continued) Blake DR ldquoPreliminary assessment of the efficacy tolerability and safety of a

cannabis-based medicine - nabiximols in the treatment of pain caused by rheumatoid arthritisrdquo Rheumatology (Oxford) 2006 NIH Database

ldquoThe 1st ever controlled trial of a CBM (Cannabis Based Medicine) in RA a significant

analgesic effect was observed and disease activity was significantly suppressed

following nabiximols (Sativex) treatment While the differences are small and variable

across the population they represent benefits of clinical relevance and show the

need for more detailed investigation in this indicationrdquo

CBD Oil Should You Try It for Arthritis Symptoms

httpswwwarthritisorgliving-with-arthritistreatmentsnaturalsupplements-

herbscannabidiol-oilphp


CBD (Continued) The Health Effects of Cannabis and Cannabinoids The Current State

of Evidence and Recommendations for Research The committee reached nearly 100 research conclusions based on

consideration of more than 10000 research articles The committee found three medical applications for cannabis use

supported by conclusive evidence1 In adults with chemotherapy induced nausea and vomiting oral cannabinoids are effective antiemetics2 In adults with chronic pain patients who were treated with cannabis or cannabinoids are more likely to experience a clinically significant reduction in pain symptoms3 In adults with multiple sclerosis (MS) related spasticity short term use of oral cannabinoids improves patient-reported spasticity symptoms For these conditions the effects of cannabinoids are modest for all

other conditions evaluated there is inadequate information to assess their effects

httpwwwnationalacademiesorghmd~mediaFilesReport20Files2017Cannabis-Health-EffectsCannabis-public-release-slidespdf


1) What about Steroid Injections Steroids if individual will NOT out live their joint or body part (PZ)

Juumlni P Intra-articular corticosteroid for knee osteoarthritis Cochrane Database Syst Rev Oct 2015

Unclear if clinically important benefits of intra-articular corticosteroids after one to six weeks effects decrease over time and no evidence that an effect remains six months after a corticosteroid injection

Wernecke C The Effect of Intra-articular Corticosteroids on Articular Cartilage A Systematic Review Orthop J Sports Med Apr 2015

Corticosteroids have a time- and dose-dependent effect on articular cartilage with detrimental effects at high doses and durations

Bellamy N Intraarticular corticosteroid for treatment of osteoarthritis of the knee Cochrane Database Syst Rev Apr 2006

Longer term benefits have not been confirmed based on the RevMan analysis The response to HA products appears more durable


2) What about Viscosupplementation

Injection (AMSSM Position Statement)

Knee OA with viscosupplementation injection [hyaluronic acid

(HA)] vs steroid [intra-articular corticosteroid (IAS)] vs

placebo [intra-articular placebo (IAP)] treatment effect using

Outcome Measures in Rheumatoid Arthritis Clinical Trialsndash

Osteoarthritis Research Society International (OMERACT-

OARSI) criteria

Systematic literature search relevant articles 1960 to August 2014

in the MEDLINE EMBASE and Cochrane CENTRAL using a

network meta-analysis (NMA) of relevant literature determine a

benefit from HA vs IAS vs IAP

11 articles met inclusion criteria from the search strategy

Subjects receiving HA were 15 and 11 more likely to

respond to treatment by the OMERACT-OARSI criteria than

those receiving IAS or IAP respectively (P lt 005 for both)

Recommends HA for the appropriate patients with knee OA


3) What is Prolotherapy

Nonsurgical treatment

Strengthen and tighten the ligaments and tendons that hold

bones and muscles in place

Series of injections stimulate bodys natural healing

response

Restores proper joint alignment and relieves pressure on

sensitive tissues

Dramatic and lasting pain relief


How Does Prolotherapy Work

Injections of a mildly irritating solution into the painful area

Diluted anesthetic solution triggers the bodys natural healing response

and causes the proliferation of new collagen fibers which are the building

blocks of ligaments and tendons

Tissue growth continues the ligaments and tendons become thicker and

stronger regaining their ability to stabilize the joint and take the pressure

off sensitive nerve endings

Pain subsides range of motion returns and cartilage degeneration slows

down

Sometimes one treatment is enough to achieve complete pain relief but it

usually takes several treatments administered at 3-5 weeks apart to

produce sufficient collagen growth to relieve pain and restore normal

function


How Does Prolotherapy Injection Relieve Chronic Pain

Addresses pain at the source weakness in the ligaments and tendons

Ligaments and tendons are tough fibrous bands of tissue that connect

bone to bone or bone to muscle

Stabilizers of the musculoskeletal system

As long as they are strong and taut they keep bones joints and

muscles in place allowing for pain-free smooth movement

When ligaments and tendons become injured weak or lax these other

structures become unstable and move out of position

Resulting misalignment impinges on nerves and blood vessels

damaging tissues and causing pain

Lasting relief can only be obtained by restoring the proper alignment to

these structures and taking the pressure off sensitive tissues


How Does Prolotherapy Compare to Drug Therapy

Most common NSAIDs

NSAIDs relieve joint pain by countering inflammation and pain

Inflammation is the first stage of your bodys healing process these

drugs may hinder recovery

NSAIDs notorious for GI side effects and destroy cartilage

NSAIDs do not address underlying laxity of ligaments and tendons

which is the source of chronic pain

More severe or chronic musculoskeletal pain corticosteroids used next

Also counter inflammation and suppress immune function

increasing susceptibility to infection and interfering with healing

Long-term use associated with increased risk HTN osteoporosis AVN

and destroy cartilage

Prolotherapy does not mask pain

Corrects underlying problem

Extremely safe therapy has none of the risks of NSAIDs and

corticosteroids and its only side effect is mild discomfort during the

first few days of healing


What Conditions Can be Treated With Prolotherapy

Partial List

Achilles Injury

Arthritis

Back pain

Carpal Tunnel

Fibromyalgia

Headaches

Knee pain

Ligament sprains

Neck pain

ldquoSciaticardquo

Shoulder pain

Spondylolisthesis

Sports injuries

Tendinitis

Tennis Elbow

Unresolved whiplash injuries


LANDMARK RESEARCH STUDIES

656 pts chronic low back pain treated with Prolotherapy

Ave pain duration prior to treatment 45 yrs up to 65 yrs

Half of pts had undergone back surgery wo success

82 pts considered themselves cured

Hackett G Ligament and Tendon Relaxation Treated by Prolotherapy 3rd edition

Springfield IL Charles C Thomas 1958

81 pts chronic low back pain randomly assigned either Prolotherapy or injections of

saline (an inactive placebo)

6 mths after treatment 875 those who had received Prolotherapy rated as gt50

improved compared to 39 of those in the placebo group

About 4x as many patients in the Prolotherapy group were completely free of

disability as in the placebo group

Ongley M Klein R Dorman T Eek B Hubert L A New Approach to the

Treatment of Chronic Low Back Pain Lancet 19872143-146


REFERENCES Hackett GS et al Back pain following trauma and disease Military

Medicine July 1961 517-525

Faber WJ amp Walker M Pain Pain Go Away Mountain View CA ISHI Press

International 1990

Ko G A new old treatment for chronic back pain Natural Med J 1998

Jul1(6)12-17

Hauser RA Punishing the pain Treating chronic pain with Prolotherapy

Rehab Manag 199912(2)26-28 30

Practical Pain Management October 2007

Kim WM A randomized controlled trial of intra-articular Prolotherapy

versus steroid injection for sacroiliac joint pain

J Altern Complement Med Dec 2010

Rabago Dextrose Prolotherapy Knee OA Randomized Controlled

Trial Ann Fam Med MayJune 2013

Bertrand H Reeves KD Bennett CJ Bicknell S Cheng AL Dextrose

Prolotherapy versus Control Injections in Painful Rotator Cuff

Tendinopathy Arch Phys Med Rehabil 2015 Aug 21


REFERENCES Rabago Hypertonic dextrose injection (prolotherapy) for knee osteoarthritis

Long term outcomes Comp Therapies in Medicine June 2015

Background Dextrose injection is reported to improve knee osteoarthritis (KOA)related clinical outcomes but its effect on articular cartilage is unknown A chondrogenic effect of dextrose injection has been proposed

Design Case series with blinded arthroscopic evaluation before and after treatment Participants 65 symptomatic KOA for at least 6 months arthroscopy-confirmed medial compartment exposed subchondral bone and temporary pain relief with intra-articular lidocaine injection

Intervention 4 to 6 monthly 10-mL intra-articular injections with 125 dextrose

Conclusions Prolotherapy resulted in safe significant progressive improvement of knee pain function and stiffness scores among most participants through a mean follow-up of 25 years and may be an appropriate therapy for patients with knee OA refractory to other conservative care


REFERENCES

Topol etal Chondrogenic Effect of Intra-articular Hypertonic-Dextrose (Prolotherapy) in Severe Knee Osteoarthritis Am Academy Phys Med Rehabil

March 2016

Intervention and outcome measures

bull6 participants received 3ndash5 monthly interventions and were assessed using the validated Western Ontario McMaster University Osteoarthritis Index (WOMAC 0ndash100 points) at baseline 12 26 52 weeks and 25 years

Conclusions

bullPositive clinical and chondrogenic effects were seen after prolotherapy with hypertonic dextrose injection in participants with symptomatic grade IV KOA suggesting disease-modifying effects and the need for confirmation in controlled studies Minimally invasive arthroscopy (single-compartment single-portal) enabled collection of robust intra-articular data

4) PRP (Concentrated Platelets) =Platelet Rich Plasma

How Does PRP Injection Work

Injections of concentrated platelets with growth factors and low or high leukocyte concentrations into the damaged area

Triggers and provides the bodys natural healing response and causes the proliferation of new tissue of ligaments tendons or chondral surface

Tissue growth continues the ligaments and tendons become thicker and stronger regaining their ability to stabilize the joint and take the pressure off sensitive nerve endings

Pain subsides range of motion returns and cartilage degeneration slows down halts or reverses

Sometimes one treatment is enough to achieve complete pain relief but it usually takes 3 treatments administered at 3-5 weeks apart to produce sufficient tissue growth to relieve pain and restore normal function

vs

Machine vs Man Machine processes autologous blood to create PRP

Preparations with sufficient platelet concentrations

Less expensive

Bed-side process

Laboratory procedures to create a platelet concentrate by hand

Preparations that can be higher concentrations

More expensive

Requires Lab set-up maintenance and Quality Control

Concentrated platelets promote healing

High Concentration PRP

Low Concentration PRP

Leukocyte Poor (Low)

ndash PRP may be better

for joints ie OA

Leukocyte Rich (High)


for Ligaments and

Tendons

5) What are

the different

types of Stem

Cells

Adult Stem Cells

NOT

Pluripotent

Whatrsquos an MSC

bull Mesenchymal stem cell

bull Present in adipose and orthopedic tissues like bone periosteum synovial tissue cartilage bone marrow muscle ligaments and tendon

bull Can differentiate into all orthopedic tissues and orchestrate repair of same

Two Different Types of Bone Marrow Stem Cell Processes

Bone MarrowNucleated Cell

IsolationThe stem cell fraction

of bone marrow is isolated via a

centrifuge and re-injected the same day

Bone Marrow Mesenchymal Stem

Cell CultureThe stem cells themselves are isolated and cultured

to greater numbers over a few weeks This produces

a ldquopurerdquo population of stem cells which is

different than the mix of cells produced by same

day procedures

Simple Adipose Graft

The fat is separated from the oil and

liquid and the fat is injected (however the stem cells are still trapped in the

fat and are not concentrated)

Stromal Vascular

Fraction (SVF)The fat is separated and then chemically digested to release

the stem cell fraction which is

then concentrated

Adipose Mesenchymal

Stem Cell CultureThe stem cells are

isolated and cultured to greater numbers over a few weeks This produces

a ldquopurerdquo population of stem cells which is different

than the mix of cells produced by same day

procedures

Three Different Types of Fat Stem Cell Processes

Sam

e D

ay

Sam

e D

ay

Sam

e D

ay

Ad

van

ced

Ad

van

ced

DrugNeeds FDA Approval



TissueNo FDA Approval


Bone MarrowStem Cells

AdiposeStemCells

6

AmnioticFluid

Stem Cells

PubMed search of US National Library of Medicine on 52316

bone marrow derived stem cells cartilage repair

adipose derived stem cells cartilage repair

amniotic fluid derived stem cells cartilage repair

synovial fluid derived stem cells cartilage repair

umbilical cord blood derived stem cells cartilage repair

embryonic stem cells cartilage repair

SynovialFluid

Stem Cells

CordStem Cells

109

EmbryonicStem Cells

362

163

17 25

SVFAdipose Stromal Vascular Fraction

AmnioticFluidStemCells

PubMed search of US National Library of Medicine on 6142016 knee bone marrow mesenchymal stem cells human knee bone marrow mesenchymal stem cells complications safety autologous bone marrow mesenchymal stem cells cartilage repair osteonecrosis stem cells outcome osteonecrosis mononuclear cells osteonecrosis gangji bone marrow nucleated osteoarthritis stromal vascular fraction osteoarthritis stromal vascular fraction osteonecrosis Pak J[Author] stromal vascular fraction fracture amniotic fluid stem cells osteoarthritis amniotic fluid stem cells osteonecrosis amniotic fluid stem cells fracture synovial fluid stem cells osteoarthritis synovial fluid stem cells osteonecrosis synovial fluid stem cells fracture cord stem cells osteoarthritis cord stem cells osteonecrosis cord stem cells fracture embryonic stem cells osteoarthritis embryonic stem cells osteonecrosis embryonic stem cells fracture

FDA Trials Data or Review Articles httpwwwosiristxcomprod_chondrogenphp httpwwwncbinlmnihgovpmcarticlesPMC2964482pdfSCI2010-410170pdf

SynovialFluidStemCells

CordStemCells

EmbryonicStemCells

BoneMarrow

NucleatedCells

1106

48 0 01 011

SVF wPRP

US National Library of Medicine Search searched 5916 using terms ldquoadipose bone marrow mesenchymal stem cell chondrogenesisrdquo End date of search was 42015 Only papers showing head to head quantitative chondrogenesis considered

Bone Marrow Stem Cells

Fatty Tissue(Adipose Stem Cells)

16 papers

3 papers

Procedure History Latest Registry Data14

2372 Patients

3012 Procedures

Cells collected from one of several sources (bone

marrow aspirate adipose)

IV blood sample taken to isolate

PRP

MSC Procedure (Autologous Orthopedics Only)

Injected same day

MSCrsquos isolated by

lab bedside

How do Various Biologic Therapies for Knee OA Stack up

Knee OA-MSCs vs PRP

Update Biological Therapies Knee OA Curr Rev Musculoskeletal Medicine

Sept 2014

Biological therapies increasingly are being sought as alternatives for treating

OA Studies using these therapies show great promise for patients with mild

to moderate knee OA further research on biological therapies for knee OA is

needed to assess the risks and benefits and especially to understand the

mechanism of action as well as long-term outcomes

Does Intra-articular Platelet-Rich Plasma Injection Provide Clinically Superior

Outcomes Compared Other Therapies in Treatment of Knee Osteoarthritis A

Systematic Review of Overlapping Meta-analyses J Arthroscopic and

Related Surgery Nov 2015 (Level IV systematic review of Level II-IV

studies)

IA-PRP is a viable treatment for knee OA and has the potential to lead to

symptomatic relief for up to 12 months IA-PRP offers better

symptomatic relief to patients with early knee degenerative changes

and its use should be considered in patients with knee OA

Treatment with Autologous conditioned serum (ACS) and physiotherapy produced a rapid decline in pain which was sustained for the entire two years of the study This was accompanied by a large improvement in WOMAC scores at two years These results confirm that ACS combined with physiotherapy is an effective treatment for OA of the knee Plos One December 2015

Treatment of Osteoarthritis of the Knee with a Combination of Autologous Conditioned Serum amp Physiotherapy A Two-Year Observational Study

When used for orthopedic injuries whatrsquos the target tissue for PRP

bull Human Mesenchymal Stem Cells can differentiate and effect repair in cartilage bone muscle ligament and tendon

bull As a result the big question is how your PRP prompts the bodyrsquos resident MSCrsquos to proliferate

Summary

bull In 60 ndash 70+ YO Patient Hand made PRP may be better to stimulate orthopedic repair cells (MSCs) better than bed side PRP (in one study)

bull No studies comparing PRP to Prolotherapy to HA

Conclusionsbull Based on the published research for orthopedic

conditions bone marrow stem cellsgtgtadipose stem cellsgtgtPRPgtgtProlotherapy

ndash Cost

1) BMAC $5000 ndash 20000

2) ASC $3000 ndash 5000

3) PRP $500-1000

4) Prolotherapy Some Insurance Cover

Conclusions

bull Stem cell procedure helps patients with knee OA (outcome data) if cost not an issue

Consider ldquoArthritis in the Militaryrdquondash A Lifetime Of Disability for the rest of his or her life

require arthritis-related health care paid for by US taxpayers in the form of doctor visits medications procedures and physical therapy

ndash Average annual health care expenditures for a disabled veteran are $7450

ndash Lifetime care cost anticipated at $976172

wwwarthritisorgadvocate

ConclusionsldquoArthritis in the Militaryrdquo (continued)bull Cost Example Based on a US Army soldier diagnosed with post-traumatic OA at age 24

(two years after a traumatic injury) who is discharged and requires knee replacement surgery in his or her thirties (Amounts will vary in individual situations including the kind of treatment surgery required number of dependents etc)




I Viscosupplementation

II Prolotherapy

III PRP

IV MSC3 What are treatment options for MSK pain and disability



2 What are treatment options for OA (Osteoarthritis)


pain and disability

How Is Musculoskeletal Pain Treated

bull Pharmaceutical

bull Manipulation


bull Acupuncture

bull Dietary

bull Herbal

bull Homeopathic

bull Massage


TraditionalComplementary

and Alternative

56

Pain ManagementDietary

bull Decreasing dietary fat

intake ampor eating plant

foods that contain anti-

inflammatory agents

ease pain by limiting

inflammation

bull Raw vegetarian diet

bull Weight reduction

Daily Doses

bull Glucosamine sulfate

ndash 1500 mg

bull Chondroitin sulfate

ndash 1500 mg

bull MSM

ndash 800 mg

bull Omega-3 Fish oils

ndash 1500 mg EPA

Macronutrients Supplements

57

Pain ManagementEnergy Based

bull Activate the self-healing processes of an individual and therefore reduce pain

bull Does not require actual physical contact they do involve close physical proximity between practitioner and patient

Therapeutic Touch amp Reiki Healing

58

Pain ManagementHerbal

Daily Doses

bull Boswellia Serrata Extract 1200 mg

bull Curcumin Extract (Turmeric) 1200 mg

bull Cayenne 360-2400 mg

bull Devilrsquos Claw 1530 mg

bull Feverfew 85-125 mg

bull Ginger 1200 mg

bull White Willow Bark (Salicin) 360-720 mg59

Pain Management CBD

60

What is a good starting dose

Start low and go slow (I donrsquot Rx THC)

Usual starting dose of CBD is 1-5mgkg in

1-2 divided doses up to 10-20mgkg

Different delivery methods have different

onset and duration times ndash be aware (oral

ingested delayed vs sublingual faster

acting)

Conservative Therapybull Body AlignmentBalance (PTEgoscue) OMM DC

Adjustment

bull Inj TxPRP Substitute for ldquosteroidrdquo epidural nerve

ligament tendon muscle and joint injections

bull Repair Heal joint surface ligaments tendon muscle and

nerve injurydamage

Achilles Injury

Arthritis

Back pain

Carpal Tunnel

Fibromyalgia

Headaches

Knee pain

Ligament sprains

Neck pain

ldquoSciaticardquo

Shoulder pain

Spondylolisthesis

Sports injuries

Tendinitis

Tennis Elbow






pain and disability

Conservative Therapy

Thank you for your time and

care of patients

Phillip Zinni III DO FAOASM MS ATC

Past-President




209-324-2255

JockOccDocHotmailcom

Disclaimer

Stockholder of Canopy Growers

Associate of CTFO



pain and disability


(Osteoarthritis)


pain and disability


bull Trauma

ndash Falls

ndash Injuries

ndash MVA


motion


strain


4


bull Sharp

bull Severe

bull Ache

bull Burn

bull Dull

bull Acute

bull Chronic

Symptoms Types

5

Types of Pain

bull Falls

ndash Fractures

ndash Dislocations

bull Injuries

ndash Work Related

Hobby

ndash Strain Sprain

bull MVA


ndash Inflammatory

bull Bursitis

bull Tendonitis


bull Tendonosis


ndash Kyphosis

ndash Lordosis

Acute Chronic

6



Tensegrity

Biotensegrity

ndash Buckyball


BIOTENSEGRITY











TENSEGRITY





as follows













TENSEGRITY



pain and disability










2) Prolotherapy




bull Pharmaceutical

bull Manipulation


bull Acupuncture

bull Dietary

bull Herbal

bull Homeopathic

bull Massage



Alternative

17


bull Acetaminophens

bull NSAIDS

ndash Oral


ndash Topical



bull amitriptyline

bull trazodone



18


bull NSAIDS








Anti-Inflammatory

19










neuropathyrdquo











































OARSI) criteria
















response


sensitive tissues












down




function

















Most common NSAIDs



















Partial List

Achilles Injury

Arthritis

Back pain

Carpal Tunnel

Fibromyalgia

Headaches

Knee pain

Ligament sprains

Neck pain

ldquoSciaticardquo

Shoulder pain

Spondylolisthesis

Sports injuries

Tendinitis

Tennis Elbow






















International 1990


Jul1(6)12-17


Rehab Manag 199912(2)26-28 30


















REFERENCES


March 2016



Conclusions









vs



Less expensive

Bed-side process



More expensive







for joints ie OA



for Ligaments and

Tendons

5) What are

the different

types of Stem

Cells

Adult Stem Cells

NOT

Pluripotent

Whatrsquos an MSC














day procedures





Stromal Vascular



then concentrated

Adipose Mesenchymal





procedures


Sam

e D

ay

Sam

e D

ay

Sam

e D

ay

Ad

van

ced

Ad

van

ced







AdiposeStemCells

6

AmnioticFluid

Stem Cells








SynovialFluid

Stem Cells

CordStem Cells

109

EmbryonicStem Cells

362

163

17 25






CordStemCells

EmbryonicStemCells

BoneMarrow

NucleatedCells

1106

48 0 01 011

SVF wPRP




16 papers

3 papers


2372 Patients

3012 Procedures




PRP


Injected same day


lab bedside


Knee OA-MSCs vs PRP


Sept 2014










studies)










Summary





ndash Cost

1) BMAC $5000 ndash 20000

2) ASC $3000 ndash 5000

3) PRP $500-1000


Conclusions













II Prolotherapy

III PRP






pain and disability


bull Pharmaceutical

bull Manipulation


bull Acupuncture

bull Dietary

bull Herbal

bull Homeopathic

bull Massage



and Alternative

56





inflammatory agents


inflammation



Daily Doses


ndash 1500 mg


ndash 1500 mg

bull MSM

ndash 800 mg


ndash 1500 mg EPA


57





58


Daily Doses






bull Ginger 1200 mg


Pain Management CBD

60








acting)


Adjustment




nerve injurydamage

Achilles Injury

Arthritis

Back pain

Carpal Tunnel

Fibromyalgia

Headaches

Knee pain

Ligament sprains

Neck pain

ldquoSciaticardquo

Shoulder pain

Spondylolisthesis

Sports injuries

Tendinitis

Tennis Elbow






pain and disability



care of patients


Past-President




209-324-2255




pain and disability


(Osteoarthritis)


pain and disability


bull Trauma

ndash Falls

ndash Injuries

ndash MVA


motion


strain


4


bull Sharp

bull Severe

bull Ache

bull Burn

bull Dull

bull Acute

bull Chronic

Symptoms Types

5

Types of Pain

bull Falls

ndash Fractures

ndash Dislocations

bull Injuries

ndash Work Related

Hobby

ndash Strain Sprain

bull MVA


ndash Inflammatory

bull Bursitis

bull Tendonitis


bull Tendonosis


ndash Kyphosis

ndash Lordosis

Acute Chronic

6



Tensegrity

Biotensegrity

ndash Buckyball


BIOTENSEGRITY











TENSEGRITY





as follows













TENSEGRITY



pain and disability










2) Prolotherapy




bull Pharmaceutical

bull Manipulation


bull Acupuncture

bull Dietary

bull Herbal

bull Homeopathic

bull Massage



Alternative

17


bull Acetaminophens

bull NSAIDS

ndash Oral


ndash Topical



bull amitriptyline

bull trazodone



18


bull NSAIDS








Anti-Inflammatory

19










neuropathyrdquo











































OARSI) criteria
















response


sensitive tissues












down




function

















Most common NSAIDs



















Partial List

Achilles Injury

Arthritis

Back pain

Carpal Tunnel

Fibromyalgia

Headaches

Knee pain

Ligament sprains

Neck pain

ldquoSciaticardquo

Shoulder pain

Spondylolisthesis

Sports injuries

Tendinitis

Tennis Elbow






















International 1990


Jul1(6)12-17


Rehab Manag 199912(2)26-28 30


















REFERENCES


March 2016



Conclusions









vs



Less expensive

Bed-side process



More expensive







for joints ie OA



for Ligaments and

Tendons

5) What are

the different

types of Stem

Cells

Adult Stem Cells

NOT

Pluripotent

Whatrsquos an MSC














day procedures





Stromal Vascular



then concentrated

Adipose Mesenchymal





procedures


Sam

e D

ay

Sam

e D

ay

Sam

e D

ay

Ad

van

ced

Ad

van

ced







AdiposeStemCells

6

AmnioticFluid

Stem Cells








SynovialFluid

Stem Cells

CordStem Cells

109

EmbryonicStem Cells

362

163

17 25






CordStemCells

EmbryonicStemCells

BoneMarrow

NucleatedCells

1106

48 0 01 011

SVF wPRP




16 papers

3 papers


2372 Patients

3012 Procedures




PRP


Injected same day


lab bedside


Knee OA-MSCs vs PRP


Sept 2014










studies)










Summary





ndash Cost

1) BMAC $5000 ndash 20000

2) ASC $3000 ndash 5000

3) PRP $500-1000


Conclusions













II Prolotherapy

III PRP






pain and disability


bull Pharmaceutical

bull Manipulation


bull Acupuncture

bull Dietary

bull Herbal

bull Homeopathic

bull Massage



and Alternative

56





inflammatory agents


inflammation



Daily Doses


ndash 1500 mg


ndash 1500 mg

bull MSM

ndash 800 mg


ndash 1500 mg EPA


57





58


Daily Doses






bull Ginger 1200 mg


Pain Management CBD

60








acting)


Adjustment




nerve injurydamage

Achilles Injury

Arthritis

Back pain

Carpal Tunnel

Fibromyalgia

Headaches

Knee pain

Ligament sprains

Neck pain

ldquoSciaticardquo

Shoulder pain

Spondylolisthesis

Sports injuries

Tendinitis

Tennis Elbow






pain and disability



care of patients


Past-President




209-324-2255



bull Trauma

ndash Falls

ndash Injuries

ndash MVA


motion


strain


4


bull Sharp

bull Severe

bull Ache

bull Burn

bull Dull

bull Acute

bull Chronic

Symptoms Types

5

Types of Pain

bull Falls

ndash Fractures

ndash Dislocations

bull Injuries

ndash Work Related

Hobby

ndash Strain Sprain

bull MVA


ndash Inflammatory

bull Bursitis

bull Tendonitis


bull Tendonosis


ndash Kyphosis

ndash Lordosis

Acute Chronic

6



Tensegrity

Biotensegrity

ndash Buckyball


BIOTENSEGRITY











TENSEGRITY





as follows













TENSEGRITY



pain and disability










2) Prolotherapy




bull Pharmaceutical

bull Manipulation


bull Acupuncture

bull Dietary

bull Herbal

bull Homeopathic

bull Massage



Alternative

17


bull Acetaminophens

bull NSAIDS

ndash Oral


ndash Topical



bull amitriptyline

bull trazodone



18


bull NSAIDS








Anti-Inflammatory

19










neuropathyrdquo











































OARSI) criteria
















response


sensitive tissues












down




function

















Most common NSAIDs



















Partial List

Achilles Injury

Arthritis

Back pain

Carpal Tunnel

Fibromyalgia

Headaches

Knee pain

Ligament sprains

Neck pain

ldquoSciaticardquo

Shoulder pain

Spondylolisthesis

Sports injuries

Tendinitis

Tennis Elbow






















International 1990


Jul1(6)12-17


Rehab Manag 199912(2)26-28 30


















REFERENCES


March 2016



Conclusions









vs



Less expensive

Bed-side process



More expensive







for joints ie OA



for Ligaments and

Tendons

5) What are

the different

types of Stem

Cells

Adult Stem Cells

NOT

Pluripotent

Whatrsquos an MSC














day procedures





Stromal Vascular



then concentrated

Adipose Mesenchymal





procedures


Sam

e D

ay

Sam

e D

ay

Sam

e D

ay

Ad

van

ced

Ad

van

ced







AdiposeStemCells

6

AmnioticFluid

Stem Cells








SynovialFluid

Stem Cells

CordStem Cells

109

EmbryonicStem Cells

362

163

17 25






CordStemCells

EmbryonicStemCells

BoneMarrow

NucleatedCells

1106

48 0 01 011

SVF wPRP




16 papers

3 papers


2372 Patients

3012 Procedures




PRP


Injected same day


lab bedside


Knee OA-MSCs vs PRP


Sept 2014










studies)










Summary





ndash Cost

1) BMAC $5000 ndash 20000

2) ASC $3000 ndash 5000

3) PRP $500-1000


Conclusions













II Prolotherapy

III PRP






pain and disability


bull Pharmaceutical

bull Manipulation


bull Acupuncture

bull Dietary

bull Herbal

bull Homeopathic

bull Massage



and Alternative

56





inflammatory agents


inflammation



Daily Doses


ndash 1500 mg


ndash 1500 mg

bull MSM

ndash 800 mg


ndash 1500 mg EPA


57





58


Daily Doses






bull Ginger 1200 mg


Pain Management CBD

60








acting)


Adjustment




nerve injurydamage

Achilles Injury

Arthritis

Back pain

Carpal Tunnel

Fibromyalgia

Headaches

Knee pain

Ligament sprains

Neck pain

ldquoSciaticardquo

Shoulder pain

Spondylolisthesis

Sports injuries

Tendinitis

Tennis Elbow






pain and disability



care of patients


Past-President




209-324-2255



bull Sharp

bull Severe

bull Ache

bull Burn

bull Dull

bull Acute

bull Chronic

Symptoms Types

5

Types of Pain

bull Falls

ndash Fractures

ndash Dislocations

bull Injuries

ndash Work Related

Hobby

ndash Strain Sprain

bull MVA


ndash Inflammatory

bull Bursitis

bull Tendonitis


bull Tendonosis


ndash Kyphosis

ndash Lordosis

Acute Chronic

6



Tensegrity

Biotensegrity

ndash Buckyball


BIOTENSEGRITY











TENSEGRITY





as follows













TENSEGRITY



pain and disability










2) Prolotherapy




bull Pharmaceutical

bull Manipulation


bull Acupuncture

bull Dietary

bull Herbal

bull Homeopathic

bull Massage



Alternative

17


bull Acetaminophens

bull NSAIDS

ndash Oral


ndash Topical



bull amitriptyline

bull trazodone



18


bull NSAIDS








Anti-Inflammatory

19










neuropathyrdquo











































OARSI) criteria
















response


sensitive tissues












down




function

















Most common NSAIDs



















Partial List

Achilles Injury

Arthritis

Back pain

Carpal Tunnel

Fibromyalgia

Headaches

Knee pain

Ligament sprains

Neck pain

ldquoSciaticardquo

Shoulder pain

Spondylolisthesis

Sports injuries

Tendinitis

Tennis Elbow






















International 1990


Jul1(6)12-17


Rehab Manag 199912(2)26-28 30


















REFERENCES


March 2016



Conclusions









vs



Less expensive

Bed-side process



More expensive







for joints ie OA



for Ligaments and

Tendons

5) What are

the different

types of Stem

Cells

Adult Stem Cells

NOT

Pluripotent

Whatrsquos an MSC














day procedures





Stromal Vascular



then concentrated

Adipose Mesenchymal





procedures


Sam

e D

ay

Sam

e D

ay

Sam

e D

ay

Ad

van

ced

Ad

van

ced







AdiposeStemCells

6

AmnioticFluid

Stem Cells








SynovialFluid

Stem Cells

CordStem Cells

109

EmbryonicStem Cells

362

163

17 25






CordStemCells

EmbryonicStemCells

BoneMarrow

NucleatedCells

1106

48 0 01 011

SVF wPRP




16 papers

3 papers


2372 Patients

3012 Procedures




PRP


Injected same day


lab bedside


Knee OA-MSCs vs PRP


Sept 2014










studies)










Summary





ndash Cost

1) BMAC $5000 ndash 20000

2) ASC $3000 ndash 5000

3) PRP $500-1000


Conclusions













II Prolotherapy

III PRP






pain and disability


bull Pharmaceutical

bull Manipulation


bull Acupuncture

bull Dietary

bull Herbal

bull Homeopathic

bull Massage



and Alternative

56





inflammatory agents


inflammation



Daily Doses


ndash 1500 mg


ndash 1500 mg

bull MSM

ndash 800 mg


ndash 1500 mg EPA


57





58


Daily Doses






bull Ginger 1200 mg


Pain Management CBD

60








acting)


Adjustment




nerve injurydamage

Achilles Injury

Arthritis

Back pain

Carpal Tunnel

Fibromyalgia

Headaches

Knee pain

Ligament sprains

Neck pain

ldquoSciaticardquo

Shoulder pain

Spondylolisthesis

Sports injuries

Tendinitis

Tennis Elbow






pain and disability



care of patients


Past-President




209-324-2255


Types of Pain

bull Falls

ndash Fractures

ndash Dislocations

bull Injuries

ndash Work Related

Hobby

ndash Strain Sprain

bull MVA


ndash Inflammatory

bull Bursitis

bull Tendonitis


bull Tendonosis


ndash Kyphosis

ndash Lordosis

Acute Chronic

6



Tensegrity

Biotensegrity

ndash Buckyball


BIOTENSEGRITY











TENSEGRITY





as follows













TENSEGRITY



pain and disability










2) Prolotherapy




bull Pharmaceutical

bull Manipulation


bull Acupuncture

bull Dietary

bull Herbal

bull Homeopathic

bull Massage



Alternative

17


bull Acetaminophens

bull NSAIDS

ndash Oral


ndash Topical



bull amitriptyline

bull trazodone



18


bull NSAIDS








Anti-Inflammatory

19










neuropathyrdquo











































OARSI) criteria
















response


sensitive tissues












down




function

















Most common NSAIDs



















Partial List

Achilles Injury

Arthritis

Back pain

Carpal Tunnel

Fibromyalgia

Headaches

Knee pain

Ligament sprains

Neck pain

ldquoSciaticardquo

Shoulder pain

Spondylolisthesis

Sports injuries

Tendinitis

Tennis Elbow






















International 1990


Jul1(6)12-17


Rehab Manag 199912(2)26-28 30


















REFERENCES


March 2016



Conclusions









vs



Less expensive

Bed-side process



More expensive







for joints ie OA



for Ligaments and

Tendons

5) What are

the different

types of Stem

Cells

Adult Stem Cells

NOT

Pluripotent

Whatrsquos an MSC














day procedures





Stromal Vascular



then concentrated

Adipose Mesenchymal





procedures


Sam

e D

ay

Sam

e D

ay

Sam

e D

ay

Ad

van

ced

Ad

van

ced







AdiposeStemCells

6

AmnioticFluid

Stem Cells








SynovialFluid

Stem Cells

CordStem Cells

109

EmbryonicStem Cells

362

163

17 25






CordStemCells

EmbryonicStemCells

BoneMarrow

NucleatedCells

1106

48 0 01 011

SVF wPRP




16 papers

3 papers


2372 Patients

3012 Procedures




PRP


Injected same day


lab bedside


Knee OA-MSCs vs PRP


Sept 2014










studies)










Summary





ndash Cost

1) BMAC $5000 ndash 20000

2) ASC $3000 ndash 5000

3) PRP $500-1000


Conclusions













II Prolotherapy

III PRP






pain and disability


bull Pharmaceutical

bull Manipulation


bull Acupuncture

bull Dietary

bull Herbal

bull Homeopathic

bull Massage



and Alternative

56





inflammatory agents


inflammation



Daily Doses


ndash 1500 mg


ndash 1500 mg

bull MSM

ndash 800 mg


ndash 1500 mg EPA


57





58


Daily Doses






bull Ginger 1200 mg


Pain Management CBD

60








acting)


Adjustment




nerve injurydamage

Achilles Injury

Arthritis

Back pain

Carpal Tunnel

Fibromyalgia

Headaches

Knee pain

Ligament sprains

Neck pain

ldquoSciaticardquo

Shoulder pain

Spondylolisthesis

Sports injuries

Tendinitis

Tennis Elbow






pain and disability



care of patients


Past-President




209-324-2255




Tensegrity

Biotensegrity

ndash Buckyball


BIOTENSEGRITY











TENSEGRITY





as follows













TENSEGRITY



pain and disability










2) Prolotherapy




bull Pharmaceutical

bull Manipulation


bull Acupuncture

bull Dietary

bull Herbal

bull Homeopathic

bull Massage



Alternative

17


bull Acetaminophens

bull NSAIDS

ndash Oral


ndash Topical



bull amitriptyline

bull trazodone



18


bull NSAIDS








Anti-Inflammatory

19










neuropathyrdquo











































OARSI) criteria
















response


sensitive tissues












down




function

















Most common NSAIDs



















Partial List

Achilles Injury

Arthritis

Back pain

Carpal Tunnel

Fibromyalgia

Headaches

Knee pain

Ligament sprains

Neck pain

ldquoSciaticardquo

Shoulder pain

Spondylolisthesis

Sports injuries

Tendinitis

Tennis Elbow






















International 1990


Jul1(6)12-17


Rehab Manag 199912(2)26-28 30


















REFERENCES


March 2016



Conclusions









vs



Less expensive

Bed-side process



More expensive







for joints ie OA



for Ligaments and

Tendons

5) What are

the different

types of Stem

Cells

Adult Stem Cells

NOT

Pluripotent

Whatrsquos an MSC














day procedures





Stromal Vascular



then concentrated

Adipose Mesenchymal





procedures


Sam

e D

ay

Sam

e D

ay

Sam

e D

ay

Ad

van

ced

Ad

van

ced







AdiposeStemCells

6

AmnioticFluid

Stem Cells








SynovialFluid

Stem Cells

CordStem Cells

109

EmbryonicStem Cells

362

163

17 25






CordStemCells

EmbryonicStemCells

BoneMarrow

NucleatedCells

1106

48 0 01 011

SVF wPRP




16 papers

3 papers


2372 Patients

3012 Procedures




PRP


Injected same day


lab bedside


Knee OA-MSCs vs PRP


Sept 2014










studies)










Summary





ndash Cost

1) BMAC $5000 ndash 20000

2) ASC $3000 ndash 5000

3) PRP $500-1000


Conclusions













II Prolotherapy

III PRP






pain and disability


bull Pharmaceutical

bull Manipulation


bull Acupuncture

bull Dietary

bull Herbal

bull Homeopathic

bull Massage



and Alternative

56





inflammatory agents


inflammation



Daily Doses


ndash 1500 mg


ndash 1500 mg

bull MSM

ndash 800 mg


ndash 1500 mg EPA


57





58


Daily Doses






bull Ginger 1200 mg


Pain Management CBD

60








acting)


Adjustment




nerve injurydamage

Achilles Injury

Arthritis

Back pain

Carpal Tunnel

Fibromyalgia

Headaches

Knee pain

Ligament sprains

Neck pain

ldquoSciaticardquo

Shoulder pain

Spondylolisthesis

Sports injuries

Tendinitis

Tennis Elbow






pain and disability



care of patients


Past-President




209-324-2255



BIOTENSEGRITY











TENSEGRITY





as follows













TENSEGRITY



pain and disability










2) Prolotherapy




bull Pharmaceutical

bull Manipulation


bull Acupuncture

bull Dietary

bull Herbal

bull Homeopathic

bull Massage



Alternative

17


bull Acetaminophens

bull NSAIDS

ndash Oral


ndash Topical



bull amitriptyline

bull trazodone



18


bull NSAIDS








Anti-Inflammatory

19










neuropathyrdquo











































OARSI) criteria
















response


sensitive tissues












down




function

















Most common NSAIDs



















Partial List

Achilles Injury

Arthritis

Back pain

Carpal Tunnel

Fibromyalgia

Headaches

Knee pain

Ligament sprains

Neck pain

ldquoSciaticardquo

Shoulder pain

Spondylolisthesis

Sports injuries

Tendinitis

Tennis Elbow






















International 1990


Jul1(6)12-17


Rehab Manag 199912(2)26-28 30


















REFERENCES


March 2016



Conclusions









vs



Less expensive

Bed-side process



More expensive







for joints ie OA



for Ligaments and

Tendons

5) What are

the different

types of Stem

Cells

Adult Stem Cells

NOT

Pluripotent

Whatrsquos an MSC














day procedures





Stromal Vascular



then concentrated

Adipose Mesenchymal





procedures


Sam

e D

ay

Sam

e D

ay

Sam

e D

ay

Ad

van

ced

Ad

van

ced







AdiposeStemCells

6

AmnioticFluid

Stem Cells








SynovialFluid

Stem Cells

CordStem Cells

109

EmbryonicStem Cells

362

163

17 25






CordStemCells

EmbryonicStemCells

BoneMarrow

NucleatedCells

1106

48 0 01 011

SVF wPRP




16 papers

3 papers


2372 Patients

3012 Procedures




PRP


Injected same day


lab bedside


Knee OA-MSCs vs PRP


Sept 2014










studies)










Summary





ndash Cost

1) BMAC $5000 ndash 20000

2) ASC $3000 ndash 5000

3) PRP $500-1000


Conclusions













II Prolotherapy

III PRP






pain and disability


bull Pharmaceutical

bull Manipulation


bull Acupuncture

bull Dietary

bull Herbal

bull Homeopathic

bull Massage



and Alternative

56





inflammatory agents


inflammation



Daily Doses


ndash 1500 mg


ndash 1500 mg

bull MSM

ndash 800 mg


ndash 1500 mg EPA


57





58


Daily Doses






bull Ginger 1200 mg


Pain Management CBD

60








acting)


Adjustment




nerve injurydamage

Achilles Injury

Arthritis

Back pain

Carpal Tunnel

Fibromyalgia

Headaches

Knee pain

Ligament sprains

Neck pain

ldquoSciaticardquo

Shoulder pain

Spondylolisthesis

Sports injuries

Tendinitis

Tennis Elbow






pain and disability



care of patients


Past-President




209-324-2255










TENSEGRITY





as follows













TENSEGRITY



pain and disability










2) Prolotherapy




bull Pharmaceutical

bull Manipulation


bull Acupuncture

bull Dietary

bull Herbal

bull Homeopathic

bull Massage



Alternative

17


bull Acetaminophens

bull NSAIDS

ndash Oral


ndash Topical



bull amitriptyline

bull trazodone



18


bull NSAIDS








Anti-Inflammatory

19










neuropathyrdquo











































OARSI) criteria
















response


sensitive tissues












down




function

















Most common NSAIDs



















Partial List

Achilles Injury

Arthritis

Back pain

Carpal Tunnel

Fibromyalgia

Headaches

Knee pain

Ligament sprains

Neck pain

ldquoSciaticardquo

Shoulder pain

Spondylolisthesis

Sports injuries

Tendinitis

Tennis Elbow






















International 1990


Jul1(6)12-17


Rehab Manag 199912(2)26-28 30


















REFERENCES


March 2016



Conclusions









vs



Less expensive

Bed-side process



More expensive







for joints ie OA



for Ligaments and

Tendons

5) What are

the different

types of Stem

Cells

Adult Stem Cells

NOT

Pluripotent

Whatrsquos an MSC














day procedures





Stromal Vascular



then concentrated

Adipose Mesenchymal





procedures


Sam

e D

ay

Sam

e D

ay

Sam

e D

ay

Ad

van

ced

Ad

van

ced







AdiposeStemCells

6

AmnioticFluid

Stem Cells








SynovialFluid

Stem Cells

CordStem Cells

109

EmbryonicStem Cells

362

163

17 25






CordStemCells

EmbryonicStemCells

BoneMarrow

NucleatedCells

1106

48 0 01 011

SVF wPRP




16 papers

3 papers


2372 Patients

3012 Procedures




PRP


Injected same day


lab bedside


Knee OA-MSCs vs PRP


Sept 2014










studies)










Summary





ndash Cost

1) BMAC $5000 ndash 20000

2) ASC $3000 ndash 5000

3) PRP $500-1000


Conclusions













II Prolotherapy

III PRP






pain and disability


bull Pharmaceutical

bull Manipulation


bull Acupuncture

bull Dietary

bull Herbal

bull Homeopathic

bull Massage



and Alternative

56





inflammatory agents


inflammation



Daily Doses


ndash 1500 mg


ndash 1500 mg

bull MSM

ndash 800 mg


ndash 1500 mg EPA


57





58


Daily Doses






bull Ginger 1200 mg


Pain Management CBD

60








acting)


Adjustment




nerve injurydamage

Achilles Injury

Arthritis

Back pain

Carpal Tunnel

Fibromyalgia

Headaches

Knee pain

Ligament sprains

Neck pain

ldquoSciaticardquo

Shoulder pain

Spondylolisthesis

Sports injuries

Tendinitis

Tennis Elbow






pain and disability



care of patients


Past-President




209-324-2255






as follows













TENSEGRITY



pain and disability










2) Prolotherapy




bull Pharmaceutical

bull Manipulation


bull Acupuncture

bull Dietary

bull Herbal

bull Homeopathic

bull Massage



Alternative

17


bull Acetaminophens

bull NSAIDS

ndash Oral


ndash Topical



bull amitriptyline

bull trazodone



18


bull NSAIDS








Anti-Inflammatory

19










neuropathyrdquo











































OARSI) criteria
















response


sensitive tissues












down




function

















Most common NSAIDs



















Partial List

Achilles Injury

Arthritis

Back pain

Carpal Tunnel

Fibromyalgia

Headaches

Knee pain

Ligament sprains

Neck pain

ldquoSciaticardquo

Shoulder pain

Spondylolisthesis

Sports injuries

Tendinitis

Tennis Elbow






















International 1990


Jul1(6)12-17


Rehab Manag 199912(2)26-28 30


















REFERENCES


March 2016



Conclusions









vs



Less expensive

Bed-side process



More expensive







for joints ie OA



for Ligaments and

Tendons

5) What are

the different

types of Stem

Cells

Adult Stem Cells

NOT

Pluripotent

Whatrsquos an MSC














day procedures





Stromal Vascular



then concentrated

Adipose Mesenchymal





procedures


Sam

e D

ay

Sam

e D

ay

Sam

e D

ay

Ad

van

ced

Ad

van

ced







AdiposeStemCells

6

AmnioticFluid

Stem Cells








SynovialFluid

Stem Cells

CordStem Cells

109

EmbryonicStem Cells

362

163

17 25






CordStemCells

EmbryonicStemCells

BoneMarrow

NucleatedCells

1106

48 0 01 011

SVF wPRP




16 papers

3 papers


2372 Patients

3012 Procedures




PRP


Injected same day


lab bedside


Knee OA-MSCs vs PRP


Sept 2014










studies)










Summary





ndash Cost

1) BMAC $5000 ndash 20000

2) ASC $3000 ndash 5000

3) PRP $500-1000


Conclusions













II Prolotherapy

III PRP






pain and disability


bull Pharmaceutical

bull Manipulation


bull Acupuncture

bull Dietary

bull Herbal

bull Homeopathic

bull Massage



and Alternative

56





inflammatory agents


inflammation



Daily Doses


ndash 1500 mg


ndash 1500 mg

bull MSM

ndash 800 mg


ndash 1500 mg EPA


57





58


Daily Doses






bull Ginger 1200 mg


Pain Management CBD

60








acting)


Adjustment




nerve injurydamage

Achilles Injury

Arthritis

Back pain

Carpal Tunnel

Fibromyalgia

Headaches

Knee pain

Ligament sprains

Neck pain

ldquoSciaticardquo

Shoulder pain

Spondylolisthesis

Sports injuries

Tendinitis

Tennis Elbow






pain and disability



care of patients


Past-President




209-324-2255





TENSEGRITY



pain and disability










2) Prolotherapy




bull Pharmaceutical

bull Manipulation


bull Acupuncture

bull Dietary

bull Herbal

bull Homeopathic

bull Massage



Alternative

17


bull Acetaminophens

bull NSAIDS

ndash Oral


ndash Topical



bull amitriptyline

bull trazodone



18


bull NSAIDS








Anti-Inflammatory

19










neuropathyrdquo











































OARSI) criteria
















response


sensitive tissues












down




function

















Most common NSAIDs



















Partial List

Achilles Injury

Arthritis

Back pain

Carpal Tunnel

Fibromyalgia

Headaches

Knee pain

Ligament sprains

Neck pain

ldquoSciaticardquo

Shoulder pain

Spondylolisthesis

Sports injuries

Tendinitis

Tennis Elbow






















International 1990


Jul1(6)12-17


Rehab Manag 199912(2)26-28 30


















REFERENCES


March 2016



Conclusions









vs



Less expensive

Bed-side process



More expensive







for joints ie OA



for Ligaments and

Tendons

5) What are

the different

types of Stem

Cells

Adult Stem Cells

NOT

Pluripotent

Whatrsquos an MSC














day procedures





Stromal Vascular



then concentrated

Adipose Mesenchymal





procedures


Sam

e D

ay

Sam

e D

ay

Sam

e D

ay

Ad

van

ced

Ad

van

ced







AdiposeStemCells

6

AmnioticFluid

Stem Cells








SynovialFluid

Stem Cells

CordStem Cells

109

EmbryonicStem Cells

362

163

17 25






CordStemCells

EmbryonicStemCells

BoneMarrow

NucleatedCells

1106

48 0 01 011

SVF wPRP




16 papers

3 papers


2372 Patients

3012 Procedures




PRP


Injected same day


lab bedside


Knee OA-MSCs vs PRP


Sept 2014










studies)










Summary





ndash Cost

1) BMAC $5000 ndash 20000

2) ASC $3000 ndash 5000

3) PRP $500-1000


Conclusions













II Prolotherapy

III PRP






pain and disability


bull Pharmaceutical

bull Manipulation


bull Acupuncture

bull Dietary

bull Herbal

bull Homeopathic

bull Massage



and Alternative

56





inflammatory agents


inflammation



Daily Doses


ndash 1500 mg


ndash 1500 mg

bull MSM

ndash 800 mg


ndash 1500 mg EPA


57





58


Daily Doses






bull Ginger 1200 mg


Pain Management CBD

60








acting)


Adjustment




nerve injurydamage

Achilles Injury

Arthritis

Back pain

Carpal Tunnel

Fibromyalgia

Headaches

Knee pain

Ligament sprains

Neck pain

ldquoSciaticardquo

Shoulder pain

Spondylolisthesis

Sports injuries

Tendinitis

Tennis Elbow






pain and disability



care of patients


Past-President




209-324-2255




pain and disability










2) Prolotherapy




bull Pharmaceutical

bull Manipulation


bull Acupuncture

bull Dietary

bull Herbal

bull Homeopathic

bull Massage



Alternative

17


bull Acetaminophens

bull NSAIDS

ndash Oral


ndash Topical



bull amitriptyline

bull trazodone



18


bull NSAIDS








Anti-Inflammatory

19










neuropathyrdquo











































OARSI) criteria
















response


sensitive tissues












down




function

















Most common NSAIDs



















Partial List

Achilles Injury

Arthritis

Back pain

Carpal Tunnel

Fibromyalgia

Headaches

Knee pain

Ligament sprains

Neck pain

ldquoSciaticardquo

Shoulder pain

Spondylolisthesis

Sports injuries

Tendinitis

Tennis Elbow






















International 1990


Jul1(6)12-17


Rehab Manag 199912(2)26-28 30


















REFERENCES


March 2016



Conclusions









vs



Less expensive

Bed-side process



More expensive







for joints ie OA



for Ligaments and

Tendons

5) What are

the different

types of Stem

Cells

Adult Stem Cells

NOT

Pluripotent

Whatrsquos an MSC














day procedures





Stromal Vascular



then concentrated

Adipose Mesenchymal





procedures


Sam

e D

ay

Sam

e D

ay

Sam

e D

ay

Ad

van

ced

Ad

van

ced







AdiposeStemCells

6

AmnioticFluid

Stem Cells








SynovialFluid

Stem Cells

CordStem Cells

109

EmbryonicStem Cells

362

163

17 25






CordStemCells

EmbryonicStemCells

BoneMarrow

NucleatedCells

1106

48 0 01 011

SVF wPRP




16 papers

3 papers


2372 Patients

3012 Procedures




PRP


Injected same day


lab bedside


Knee OA-MSCs vs PRP


Sept 2014










studies)










Summary





ndash Cost

1) BMAC $5000 ndash 20000

2) ASC $3000 ndash 5000

3) PRP $500-1000


Conclusions













II Prolotherapy

III PRP






pain and disability


bull Pharmaceutical

bull Manipulation


bull Acupuncture

bull Dietary

bull Herbal

bull Homeopathic

bull Massage



and Alternative

56





inflammatory agents


inflammation



Daily Doses


ndash 1500 mg


ndash 1500 mg

bull MSM

ndash 800 mg


ndash 1500 mg EPA


57





58


Daily Doses






bull Ginger 1200 mg


Pain Management CBD

60








acting)


Adjustment




nerve injurydamage

Achilles Injury

Arthritis

Back pain

Carpal Tunnel

Fibromyalgia

Headaches

Knee pain

Ligament sprains

Neck pain

ldquoSciaticardquo

Shoulder pain

Spondylolisthesis

Sports injuries

Tendinitis

Tennis Elbow






pain and disability



care of patients


Past-President




209-324-2255










2) Prolotherapy




bull Pharmaceutical

bull Manipulation


bull Acupuncture

bull Dietary

bull Herbal

bull Homeopathic

bull Massage



Alternative

17


bull Acetaminophens

bull NSAIDS

ndash Oral


ndash Topical



bull amitriptyline

bull trazodone



18


bull NSAIDS








Anti-Inflammatory

19










neuropathyrdquo











































OARSI) criteria
















response


sensitive tissues












down




function

















Most common NSAIDs



















Partial List

Achilles Injury

Arthritis

Back pain

Carpal Tunnel

Fibromyalgia

Headaches

Knee pain

Ligament sprains

Neck pain

ldquoSciaticardquo

Shoulder pain

Spondylolisthesis

Sports injuries

Tendinitis

Tennis Elbow






















International 1990


Jul1(6)12-17


Rehab Manag 199912(2)26-28 30


















REFERENCES


March 2016



Conclusions









vs



Less expensive

Bed-side process



More expensive







for joints ie OA



for Ligaments and

Tendons

5) What are

the different

types of Stem

Cells

Adult Stem Cells

NOT

Pluripotent

Whatrsquos an MSC














day procedures





Stromal Vascular



then concentrated

Adipose Mesenchymal





procedures


Sam

e D

ay

Sam

e D

ay

Sam

e D

ay

Ad

van

ced

Ad

van

ced







AdiposeStemCells

6

AmnioticFluid

Stem Cells








SynovialFluid

Stem Cells

CordStem Cells

109

EmbryonicStem Cells

362

163

17 25






CordStemCells

EmbryonicStemCells

BoneMarrow

NucleatedCells

1106

48 0 01 011

SVF wPRP




16 papers

3 papers


2372 Patients

3012 Procedures




PRP


Injected same day


lab bedside


Knee OA-MSCs vs PRP


Sept 2014










studies)










Summary





ndash Cost

1) BMAC $5000 ndash 20000

2) ASC $3000 ndash 5000

3) PRP $500-1000


Conclusions













II Prolotherapy

III PRP






pain and disability


bull Pharmaceutical

bull Manipulation


bull Acupuncture

bull Dietary

bull Herbal

bull Homeopathic

bull Massage



and Alternative

56





inflammatory agents


inflammation



Daily Doses


ndash 1500 mg


ndash 1500 mg

bull MSM

ndash 800 mg


ndash 1500 mg EPA


57





58


Daily Doses






bull Ginger 1200 mg


Pain Management CBD

60








acting)


Adjustment




nerve injurydamage

Achilles Injury

Arthritis

Back pain

Carpal Tunnel

Fibromyalgia

Headaches

Knee pain

Ligament sprains

Neck pain

ldquoSciaticardquo

Shoulder pain

Spondylolisthesis

Sports injuries

Tendinitis

Tennis Elbow






pain and disability



care of patients


Past-President




209-324-2255



bull Pharmaceutical

bull Manipulation


bull Acupuncture

bull Dietary

bull Herbal

bull Homeopathic

bull Massage



Alternative

17


bull Acetaminophens

bull NSAIDS

ndash Oral


ndash Topical



bull amitriptyline

bull trazodone



18


bull NSAIDS








Anti-Inflammatory

19










neuropathyrdquo











































OARSI) criteria
















response


sensitive tissues












down




function

















Most common NSAIDs



















Partial List

Achilles Injury

Arthritis

Back pain

Carpal Tunnel

Fibromyalgia

Headaches

Knee pain

Ligament sprains

Neck pain

ldquoSciaticardquo

Shoulder pain

Spondylolisthesis

Sports injuries

Tendinitis

Tennis Elbow






















International 1990


Jul1(6)12-17


Rehab Manag 199912(2)26-28 30


















REFERENCES


March 2016



Conclusions









vs



Less expensive

Bed-side process



More expensive







for joints ie OA



for Ligaments and

Tendons

5) What are

the different

types of Stem

Cells

Adult Stem Cells

NOT

Pluripotent

Whatrsquos an MSC














day procedures





Stromal Vascular



then concentrated

Adipose Mesenchymal





procedures


Sam

e D

ay

Sam

e D

ay

Sam

e D

ay

Ad

van

ced

Ad

van

ced







AdiposeStemCells

6

AmnioticFluid

Stem Cells








SynovialFluid

Stem Cells

CordStem Cells

109

EmbryonicStem Cells

362

163

17 25






CordStemCells

EmbryonicStemCells

BoneMarrow

NucleatedCells

1106

48 0 01 011

SVF wPRP




16 papers

3 papers


2372 Patients

3012 Procedures




PRP


Injected same day


lab bedside


Knee OA-MSCs vs PRP


Sept 2014










studies)










Summary





ndash Cost

1) BMAC $5000 ndash 20000

2) ASC $3000 ndash 5000

3) PRP $500-1000


Conclusions













II Prolotherapy

III PRP






pain and disability


bull Pharmaceutical

bull Manipulation


bull Acupuncture

bull Dietary

bull Herbal

bull Homeopathic

bull Massage



and Alternative

56





inflammatory agents


inflammation



Daily Doses


ndash 1500 mg


ndash 1500 mg

bull MSM

ndash 800 mg


ndash 1500 mg EPA


57





58


Daily Doses






bull Ginger 1200 mg


Pain Management CBD

60








acting)


Adjustment




nerve injurydamage

Achilles Injury

Arthritis

Back pain

Carpal Tunnel

Fibromyalgia

Headaches

Knee pain

Ligament sprains

Neck pain

ldquoSciaticardquo

Shoulder pain

Spondylolisthesis

Sports injuries

Tendinitis

Tennis Elbow






pain and disability



care of patients


Past-President




209-324-2255



bull Acetaminophens

bull NSAIDS

ndash Oral


ndash Topical



bull amitriptyline

bull trazodone



18


bull NSAIDS








Anti-Inflammatory

19










neuropathyrdquo











































OARSI) criteria
















response


sensitive tissues












down




function

















Most common NSAIDs



















Partial List

Achilles Injury

Arthritis

Back pain

Carpal Tunnel

Fibromyalgia

Headaches

Knee pain

Ligament sprains

Neck pain

ldquoSciaticardquo

Shoulder pain

Spondylolisthesis

Sports injuries

Tendinitis

Tennis Elbow






















International 1990


Jul1(6)12-17


Rehab Manag 199912(2)26-28 30


















REFERENCES


March 2016



Conclusions









vs



Less expensive

Bed-side process



More expensive







for joints ie OA



for Ligaments and

Tendons

5) What are

the different

types of Stem

Cells

Adult Stem Cells

NOT

Pluripotent

Whatrsquos an MSC














day procedures





Stromal Vascular



then concentrated

Adipose Mesenchymal





procedures


Sam

e D

ay

Sam

e D

ay

Sam

e D

ay

Ad

van

ced

Ad

van

ced







AdiposeStemCells

6

AmnioticFluid

Stem Cells








SynovialFluid

Stem Cells

CordStem Cells

109

EmbryonicStem Cells

362

163

17 25






CordStemCells

EmbryonicStemCells

BoneMarrow

NucleatedCells

1106

48 0 01 011

SVF wPRP




16 papers

3 papers


2372 Patients

3012 Procedures




PRP


Injected same day


lab bedside


Knee OA-MSCs vs PRP


Sept 2014










studies)










Summary





ndash Cost

1) BMAC $5000 ndash 20000

2) ASC $3000 ndash 5000

3) PRP $500-1000


Conclusions













II Prolotherapy

III PRP






pain and disability


bull Pharmaceutical

bull Manipulation


bull Acupuncture

bull Dietary

bull Herbal

bull Homeopathic

bull Massage



and Alternative

56





inflammatory agents


inflammation



Daily Doses


ndash 1500 mg


ndash 1500 mg

bull MSM

ndash 800 mg


ndash 1500 mg EPA


57





58


Daily Doses






bull Ginger 1200 mg


Pain Management CBD

60








acting)


Adjustment




nerve injurydamage

Achilles Injury

Arthritis

Back pain

Carpal Tunnel

Fibromyalgia

Headaches

Knee pain

Ligament sprains

Neck pain

ldquoSciaticardquo

Shoulder pain

Spondylolisthesis

Sports injuries

Tendinitis

Tennis Elbow






pain and disability



care of patients


Past-President




209-324-2255



bull NSAIDS








Anti-Inflammatory

19










neuropathyrdquo











































OARSI) criteria
















response


sensitive tissues












down




function

















Most common NSAIDs



















Partial List

Achilles Injury

Arthritis

Back pain

Carpal Tunnel

Fibromyalgia

Headaches

Knee pain

Ligament sprains

Neck pain

ldquoSciaticardquo

Shoulder pain

Spondylolisthesis

Sports injuries

Tendinitis

Tennis Elbow






















International 1990


Jul1(6)12-17


Rehab Manag 199912(2)26-28 30


















REFERENCES


March 2016



Conclusions









vs



Less expensive

Bed-side process



More expensive







for joints ie OA



for Ligaments and

Tendons

5) What are

the different

types of Stem

Cells

Adult Stem Cells

NOT

Pluripotent

Whatrsquos an MSC














day procedures





Stromal Vascular



then concentrated

Adipose Mesenchymal





procedures


Sam

e D

ay

Sam

e D

ay

Sam

e D

ay

Ad

van

ced

Ad

van

ced







AdiposeStemCells

6

AmnioticFluid

Stem Cells








SynovialFluid

Stem Cells

CordStem Cells

109

EmbryonicStem Cells

362

163

17 25






CordStemCells

EmbryonicStemCells

BoneMarrow

NucleatedCells

1106

48 0 01 011

SVF wPRP




16 papers

3 papers


2372 Patients

3012 Procedures




PRP


Injected same day


lab bedside


Knee OA-MSCs vs PRP


Sept 2014










studies)










Summary





ndash Cost

1) BMAC $5000 ndash 20000

2) ASC $3000 ndash 5000

3) PRP $500-1000


Conclusions













II Prolotherapy

III PRP






pain and disability


bull Pharmaceutical

bull Manipulation


bull Acupuncture

bull Dietary

bull Herbal

bull Homeopathic

bull Massage



and Alternative

56





inflammatory agents


inflammation



Daily Doses


ndash 1500 mg


ndash 1500 mg

bull MSM

ndash 800 mg


ndash 1500 mg EPA


57





58


Daily Doses






bull Ginger 1200 mg


Pain Management CBD

60








acting)


Adjustment




nerve injurydamage

Achilles Injury

Arthritis

Back pain

Carpal Tunnel

Fibromyalgia

Headaches

Knee pain

Ligament sprains

Neck pain

ldquoSciaticardquo

Shoulder pain

Spondylolisthesis

Sports injuries

Tendinitis

Tennis Elbow






pain and disability



care of patients


Past-President




209-324-2255











neuropathyrdquo











































OARSI) criteria
















response


sensitive tissues












down




function

















Most common NSAIDs



















Partial List

Achilles Injury

Arthritis

Back pain

Carpal Tunnel

Fibromyalgia

Headaches

Knee pain

Ligament sprains

Neck pain

ldquoSciaticardquo

Shoulder pain

Spondylolisthesis

Sports injuries

Tendinitis

Tennis Elbow






















International 1990


Jul1(6)12-17


Rehab Manag 199912(2)26-28 30


















REFERENCES


March 2016



Conclusions









vs



Less expensive

Bed-side process



More expensive







for joints ie OA



for Ligaments and

Tendons

5) What are

the different

types of Stem

Cells

Adult Stem Cells

NOT

Pluripotent

Whatrsquos an MSC














day procedures





Stromal Vascular



then concentrated

Adipose Mesenchymal





procedures


Sam

e D

ay

Sam

e D

ay

Sam

e D

ay

Ad

van

ced

Ad

van

ced







AdiposeStemCells

6

AmnioticFluid

Stem Cells








SynovialFluid

Stem Cells

CordStem Cells

109

EmbryonicStem Cells

362

163

17 25






CordStemCells

EmbryonicStemCells

BoneMarrow

NucleatedCells

1106

48 0 01 011

SVF wPRP




16 papers

3 papers


2372 Patients

3012 Procedures




PRP


Injected same day


lab bedside


Knee OA-MSCs vs PRP


Sept 2014










studies)










Summary





ndash Cost

1) BMAC $5000 ndash 20000

2) ASC $3000 ndash 5000

3) PRP $500-1000


Conclusions













II Prolotherapy

III PRP






pain and disability


bull Pharmaceutical

bull Manipulation


bull Acupuncture

bull Dietary

bull Herbal

bull Homeopathic

bull Massage



and Alternative

56





inflammatory agents


inflammation



Daily Doses


ndash 1500 mg


ndash 1500 mg

bull MSM

ndash 800 mg


ndash 1500 mg EPA


57





58


Daily Doses






bull Ginger 1200 mg


Pain Management CBD

60








acting)


Adjustment




nerve injurydamage

Achilles Injury

Arthritis

Back pain

Carpal Tunnel

Fibromyalgia

Headaches

Knee pain

Ligament sprains

Neck pain

ldquoSciaticardquo

Shoulder pain

Spondylolisthesis

Sports injuries

Tendinitis

Tennis Elbow






pain and disability



care of patients


Past-President




209-324-2255




































OARSI) criteria
















response


sensitive tissues












down




function

















Most common NSAIDs



















Partial List

Achilles Injury

Arthritis

Back pain

Carpal Tunnel

Fibromyalgia

Headaches

Knee pain

Ligament sprains

Neck pain

ldquoSciaticardquo

Shoulder pain

Spondylolisthesis

Sports injuries

Tendinitis

Tennis Elbow






















International 1990


Jul1(6)12-17


Rehab Manag 199912(2)26-28 30


















REFERENCES


March 2016



Conclusions









vs



Less expensive

Bed-side process



More expensive







for joints ie OA



for Ligaments and

Tendons

5) What are

the different

types of Stem

Cells

Adult Stem Cells

NOT

Pluripotent

Whatrsquos an MSC














day procedures





Stromal Vascular



then concentrated

Adipose Mesenchymal





procedures


Sam

e D

ay

Sam

e D

ay

Sam

e D

ay

Ad

van

ced

Ad

van

ced







AdiposeStemCells

6

AmnioticFluid

Stem Cells








SynovialFluid

Stem Cells

CordStem Cells

109

EmbryonicStem Cells

362

163

17 25






CordStemCells

EmbryonicStemCells

BoneMarrow

NucleatedCells

1106

48 0 01 011

SVF wPRP




16 papers

3 papers


2372 Patients

3012 Procedures




PRP


Injected same day


lab bedside


Knee OA-MSCs vs PRP


Sept 2014










studies)










Summary





ndash Cost

1) BMAC $5000 ndash 20000

2) ASC $3000 ndash 5000

3) PRP $500-1000


Conclusions













II Prolotherapy

III PRP






pain and disability


bull Pharmaceutical

bull Manipulation


bull Acupuncture

bull Dietary

bull Herbal

bull Homeopathic

bull Massage



and Alternative

56





inflammatory agents


inflammation



Daily Doses


ndash 1500 mg


ndash 1500 mg

bull MSM

ndash 800 mg


ndash 1500 mg EPA


57





58


Daily Doses






bull Ginger 1200 mg


Pain Management CBD

60








acting)


Adjustment




nerve injurydamage

Achilles Injury

Arthritis

Back pain

Carpal Tunnel

Fibromyalgia

Headaches

Knee pain

Ligament sprains

Neck pain

ldquoSciaticardquo

Shoulder pain

Spondylolisthesis

Sports injuries

Tendinitis

Tennis Elbow






pain and disability



care of patients


Past-President




209-324-2255








response


sensitive tissues












down




function

















Most common NSAIDs



















Partial List

Achilles Injury

Arthritis

Back pain

Carpal Tunnel

Fibromyalgia

Headaches

Knee pain

Ligament sprains

Neck pain

ldquoSciaticardquo

Shoulder pain

Spondylolisthesis

Sports injuries

Tendinitis

Tennis Elbow






















International 1990


Jul1(6)12-17


Rehab Manag 199912(2)26-28 30


















REFERENCES


March 2016



Conclusions









vs



Less expensive

Bed-side process



More expensive







for joints ie OA



for Ligaments and

Tendons

5) What are

the different

types of Stem

Cells

Adult Stem Cells

NOT

Pluripotent

Whatrsquos an MSC














day procedures





Stromal Vascular



then concentrated

Adipose Mesenchymal





procedures


Sam

e D

ay

Sam

e D

ay

Sam

e D

ay

Ad

van

ced

Ad

van

ced







AdiposeStemCells

6

AmnioticFluid

Stem Cells








SynovialFluid

Stem Cells

CordStem Cells

109

EmbryonicStem Cells

362

163

17 25






CordStemCells

EmbryonicStemCells

BoneMarrow

NucleatedCells

1106

48 0 01 011

SVF wPRP




16 papers

3 papers


2372 Patients

3012 Procedures




PRP


Injected same day


lab bedside


Knee OA-MSCs vs PRP


Sept 2014










studies)










Summary





ndash Cost

1) BMAC $5000 ndash 20000

2) ASC $3000 ndash 5000

3) PRP $500-1000


Conclusions













II Prolotherapy

III PRP






pain and disability


bull Pharmaceutical

bull Manipulation


bull Acupuncture

bull Dietary

bull Herbal

bull Homeopathic

bull Massage



and Alternative

56





inflammatory agents


inflammation



Daily Doses


ndash 1500 mg


ndash 1500 mg

bull MSM

ndash 800 mg


ndash 1500 mg EPA


57





58


Daily Doses






bull Ginger 1200 mg


Pain Management CBD

60








acting)


Adjustment




nerve injurydamage

Achilles Injury

Arthritis

Back pain

Carpal Tunnel

Fibromyalgia

Headaches

Knee pain

Ligament sprains

Neck pain

ldquoSciaticardquo

Shoulder pain

Spondylolisthesis

Sports injuries

Tendinitis

Tennis Elbow






pain and disability



care of patients


Past-President




209-324-2255












down




function

















Most common NSAIDs



















Partial List

Achilles Injury

Arthritis

Back pain

Carpal Tunnel

Fibromyalgia

Headaches

Knee pain

Ligament sprains

Neck pain

ldquoSciaticardquo

Shoulder pain

Spondylolisthesis

Sports injuries

Tendinitis

Tennis Elbow






















International 1990


Jul1(6)12-17


Rehab Manag 199912(2)26-28 30


















REFERENCES


March 2016



Conclusions









vs



Less expensive

Bed-side process



More expensive







for joints ie OA



for Ligaments and

Tendons

5) What are

the different

types of Stem

Cells

Adult Stem Cells

NOT

Pluripotent

Whatrsquos an MSC














day procedures





Stromal Vascular



then concentrated

Adipose Mesenchymal





procedures


Sam

e D

ay

Sam

e D

ay

Sam

e D

ay

Ad

van

ced

Ad

van

ced







AdiposeStemCells

6

AmnioticFluid

Stem Cells








SynovialFluid

Stem Cells

CordStem Cells

109

EmbryonicStem Cells

362

163

17 25






CordStemCells

EmbryonicStemCells

BoneMarrow

NucleatedCells

1106

48 0 01 011

SVF wPRP




16 papers

3 papers


2372 Patients

3012 Procedures




PRP


Injected same day


lab bedside


Knee OA-MSCs vs PRP


Sept 2014










studies)










Summary





ndash Cost

1) BMAC $5000 ndash 20000

2) ASC $3000 ndash 5000

3) PRP $500-1000


Conclusions













II Prolotherapy

III PRP






pain and disability


bull Pharmaceutical

bull Manipulation


bull Acupuncture

bull Dietary

bull Herbal

bull Homeopathic

bull Massage



and Alternative

56





inflammatory agents


inflammation



Daily Doses


ndash 1500 mg


ndash 1500 mg

bull MSM

ndash 800 mg


ndash 1500 mg EPA


57





58


Daily Doses






bull Ginger 1200 mg


Pain Management CBD

60








acting)


Adjustment




nerve injurydamage

Achilles Injury

Arthritis

Back pain

Carpal Tunnel

Fibromyalgia

Headaches

Knee pain

Ligament sprains

Neck pain

ldquoSciaticardquo

Shoulder pain

Spondylolisthesis

Sports injuries

Tendinitis

Tennis Elbow






pain and disability



care of patients


Past-President




209-324-2255


















Most common NSAIDs



















Partial List

Achilles Injury

Arthritis

Back pain

Carpal Tunnel

Fibromyalgia

Headaches

Knee pain

Ligament sprains

Neck pain

ldquoSciaticardquo

Shoulder pain

Spondylolisthesis

Sports injuries

Tendinitis

Tennis Elbow






















International 1990


Jul1(6)12-17


Rehab Manag 199912(2)26-28 30


















REFERENCES


March 2016



Conclusions









vs



Less expensive

Bed-side process



More expensive







for joints ie OA



for Ligaments and

Tendons

5) What are

the different

types of Stem

Cells

Adult Stem Cells

NOT

Pluripotent

Whatrsquos an MSC














day procedures





Stromal Vascular



then concentrated

Adipose Mesenchymal





procedures


Sam

e D

ay

Sam

e D

ay

Sam

e D

ay

Ad

van

ced

Ad

van

ced







AdiposeStemCells

6

AmnioticFluid

Stem Cells








SynovialFluid

Stem Cells

CordStem Cells

109

EmbryonicStem Cells

362

163

17 25






CordStemCells

EmbryonicStemCells

BoneMarrow

NucleatedCells

1106

48 0 01 011

SVF wPRP




16 papers

3 papers


2372 Patients

3012 Procedures




PRP


Injected same day


lab bedside


Knee OA-MSCs vs PRP


Sept 2014










studies)










Summary





ndash Cost

1) BMAC $5000 ndash 20000

2) ASC $3000 ndash 5000

3) PRP $500-1000


Conclusions













II Prolotherapy

III PRP






pain and disability


bull Pharmaceutical

bull Manipulation


bull Acupuncture

bull Dietary

bull Herbal

bull Homeopathic

bull Massage



and Alternative

56





inflammatory agents


inflammation



Daily Doses


ndash 1500 mg


ndash 1500 mg

bull MSM

ndash 800 mg


ndash 1500 mg EPA


57





58


Daily Doses






bull Ginger 1200 mg


Pain Management CBD

60








acting)


Adjustment




nerve injurydamage

Achilles Injury

Arthritis

Back pain

Carpal Tunnel

Fibromyalgia

Headaches

Knee pain

Ligament sprains

Neck pain

ldquoSciaticardquo

Shoulder pain

Spondylolisthesis

Sports injuries

Tendinitis

Tennis Elbow






pain and disability



care of patients


Past-President




209-324-2255




Partial List

Achilles Injury

Arthritis

Back pain

Carpal Tunnel

Fibromyalgia

Headaches

Knee pain

Ligament sprains

Neck pain

ldquoSciaticardquo

Shoulder pain

Spondylolisthesis

Sports injuries

Tendinitis

Tennis Elbow






















International 1990


Jul1(6)12-17


Rehab Manag 199912(2)26-28 30


















REFERENCES


March 2016



Conclusions









vs



Less expensive

Bed-side process



More expensive







for joints ie OA



for Ligaments and

Tendons

5) What are

the different

types of Stem

Cells

Adult Stem Cells

NOT

Pluripotent

Whatrsquos an MSC














day procedures





Stromal Vascular



then concentrated

Adipose Mesenchymal





procedures


Sam

e D

ay

Sam

e D

ay

Sam

e D

ay

Ad

van

ced

Ad

van

ced







AdiposeStemCells

6

AmnioticFluid

Stem Cells








SynovialFluid

Stem Cells

CordStem Cells

109

EmbryonicStem Cells

362

163

17 25






CordStemCells

EmbryonicStemCells

BoneMarrow

NucleatedCells

1106

48 0 01 011

SVF wPRP




16 papers

3 papers


2372 Patients

3012 Procedures




PRP


Injected same day


lab bedside


Knee OA-MSCs vs PRP


Sept 2014










studies)










Summary





ndash Cost

1) BMAC $5000 ndash 20000

2) ASC $3000 ndash 5000

3) PRP $500-1000


Conclusions













II Prolotherapy

III PRP






pain and disability


bull Pharmaceutical

bull Manipulation


bull Acupuncture

bull Dietary

bull Herbal

bull Homeopathic

bull Massage



and Alternative

56





inflammatory agents


inflammation



Daily Doses


ndash 1500 mg


ndash 1500 mg

bull MSM

ndash 800 mg


ndash 1500 mg EPA


57





58


Daily Doses






bull Ginger 1200 mg


Pain Management CBD

60








acting)


Adjustment




nerve injurydamage

Achilles Injury

Arthritis

Back pain

Carpal Tunnel

Fibromyalgia

Headaches

Knee pain

Ligament sprains

Neck pain

ldquoSciaticardquo

Shoulder pain

Spondylolisthesis

Sports injuries

Tendinitis

Tennis Elbow






pain and disability



care of patients


Past-President




209-324-2255






















International 1990


Jul1(6)12-17


Rehab Manag 199912(2)26-28 30


















REFERENCES


March 2016



Conclusions









vs



Less expensive

Bed-side process



More expensive







for joints ie OA



for Ligaments and

Tendons

5) What are

the different

types of Stem

Cells

Adult Stem Cells

NOT

Pluripotent

Whatrsquos an MSC














day procedures





Stromal Vascular



then concentrated

Adipose Mesenchymal





procedures


Sam

e D

ay

Sam

e D

ay

Sam

e D

ay

Ad

van

ced

Ad

van

ced







AdiposeStemCells

6

AmnioticFluid

Stem Cells








SynovialFluid

Stem Cells

CordStem Cells

109

EmbryonicStem Cells

362

163

17 25






CordStemCells

EmbryonicStemCells

BoneMarrow

NucleatedCells

1106

48 0 01 011

SVF wPRP




16 papers

3 papers


2372 Patients

3012 Procedures




PRP


Injected same day


lab bedside


Knee OA-MSCs vs PRP


Sept 2014










studies)










Summary





ndash Cost

1) BMAC $5000 ndash 20000

2) ASC $3000 ndash 5000

3) PRP $500-1000


Conclusions













II Prolotherapy

III PRP






pain and disability


bull Pharmaceutical

bull Manipulation


bull Acupuncture

bull Dietary

bull Herbal

bull Homeopathic

bull Massage



and Alternative

56





inflammatory agents


inflammation



Daily Doses


ndash 1500 mg


ndash 1500 mg

bull MSM

ndash 800 mg


ndash 1500 mg EPA


57





58


Daily Doses






bull Ginger 1200 mg


Pain Management CBD

60








acting)


Adjustment




nerve injurydamage

Achilles Injury

Arthritis

Back pain

Carpal Tunnel

Fibromyalgia

Headaches

Knee pain

Ligament sprains

Neck pain

ldquoSciaticardquo

Shoulder pain

Spondylolisthesis

Sports injuries

Tendinitis

Tennis Elbow






pain and disability



care of patients


Past-President




209-324-2255










REFERENCES


March 2016



Conclusions









vs



Less expensive

Bed-side process



More expensive







for joints ie OA



for Ligaments and

Tendons

5) What are

the different

types of Stem

Cells

Adult Stem Cells

NOT

Pluripotent

Whatrsquos an MSC














day procedures





Stromal Vascular



then concentrated

Adipose Mesenchymal





procedures


Sam

e D

ay

Sam

e D

ay

Sam

e D

ay

Ad

van

ced

Ad

van

ced







AdiposeStemCells

6

AmnioticFluid

Stem Cells








SynovialFluid

Stem Cells

CordStem Cells

109

EmbryonicStem Cells

362

163

17 25






CordStemCells

EmbryonicStemCells

BoneMarrow

NucleatedCells

1106

48 0 01 011

SVF wPRP




16 papers

3 papers


2372 Patients

3012 Procedures




PRP


Injected same day


lab bedside


Knee OA-MSCs vs PRP


Sept 2014










studies)










Summary





ndash Cost

1) BMAC $5000 ndash 20000

2) ASC $3000 ndash 5000

3) PRP $500-1000


Conclusions













II Prolotherapy

III PRP






pain and disability


bull Pharmaceutical

bull Manipulation


bull Acupuncture

bull Dietary

bull Herbal

bull Homeopathic

bull Massage



and Alternative

56





inflammatory agents


inflammation



Daily Doses


ndash 1500 mg


ndash 1500 mg

bull MSM

ndash 800 mg


ndash 1500 mg EPA


57





58


Daily Doses






bull Ginger 1200 mg


Pain Management CBD

60








acting)


Adjustment




nerve injurydamage

Achilles Injury

Arthritis

Back pain

Carpal Tunnel

Fibromyalgia

Headaches

Knee pain

Ligament sprains

Neck pain

ldquoSciaticardquo

Shoulder pain

Spondylolisthesis

Sports injuries

Tendinitis

Tennis Elbow






pain and disability



care of patients


Past-President




209-324-2255









vs



Less expensive

Bed-side process



More expensive







for joints ie OA



for Ligaments and

Tendons

5) What are

the different

types of Stem

Cells

Adult Stem Cells

NOT

Pluripotent

Whatrsquos an MSC














day procedures





Stromal Vascular



then concentrated

Adipose Mesenchymal





procedures


Sam

e D

ay

Sam

e D

ay

Sam

e D

ay

Ad

van

ced

Ad

van

ced







AdiposeStemCells

6

AmnioticFluid

Stem Cells








SynovialFluid

Stem Cells

CordStem Cells

109

EmbryonicStem Cells

362

163

17 25






CordStemCells

EmbryonicStemCells

BoneMarrow

NucleatedCells

1106

48 0 01 011

SVF wPRP




16 papers

3 papers


2372 Patients

3012 Procedures




PRP


Injected same day


lab bedside


Knee OA-MSCs vs PRP


Sept 2014










studies)










Summary





ndash Cost

1) BMAC $5000 ndash 20000

2) ASC $3000 ndash 5000

3) PRP $500-1000


Conclusions













II Prolotherapy

III PRP






pain and disability


bull Pharmaceutical

bull Manipulation


bull Acupuncture

bull Dietary

bull Herbal

bull Homeopathic

bull Massage



and Alternative

56





inflammatory agents


inflammation



Daily Doses


ndash 1500 mg


ndash 1500 mg

bull MSM

ndash 800 mg


ndash 1500 mg EPA


57





58


Daily Doses






bull Ginger 1200 mg


Pain Management CBD

60








acting)


Adjustment




nerve injurydamage

Achilles Injury

Arthritis

Back pain

Carpal Tunnel

Fibromyalgia

Headaches

Knee pain

Ligament sprains

Neck pain

ldquoSciaticardquo

Shoulder pain

Spondylolisthesis

Sports injuries

Tendinitis

Tennis Elbow






pain and disability



care of patients


Past-President




209-324-2255







for joints ie OA



for Ligaments and

Tendons

5) What are

the different

types of Stem

Cells

Adult Stem Cells

NOT

Pluripotent

Whatrsquos an MSC














day procedures





Stromal Vascular



then concentrated

Adipose Mesenchymal





procedures


Sam

e D

ay

Sam

e D

ay

Sam

e D

ay

Ad

van

ced

Ad

van

ced







AdiposeStemCells

6

AmnioticFluid

Stem Cells








SynovialFluid

Stem Cells

CordStem Cells

109

EmbryonicStem Cells

362

163

17 25






CordStemCells

EmbryonicStemCells

BoneMarrow

NucleatedCells

1106

48 0 01 011

SVF wPRP




16 papers

3 papers


2372 Patients

3012 Procedures




PRP


Injected same day


lab bedside


Knee OA-MSCs vs PRP


Sept 2014










studies)










Summary





ndash Cost

1) BMAC $5000 ndash 20000

2) ASC $3000 ndash 5000

3) PRP $500-1000


Conclusions













II Prolotherapy

III PRP






pain and disability


bull Pharmaceutical

bull Manipulation


bull Acupuncture

bull Dietary

bull Herbal

bull Homeopathic

bull Massage



and Alternative

56





inflammatory agents


inflammation



Daily Doses


ndash 1500 mg


ndash 1500 mg

bull MSM

ndash 800 mg


ndash 1500 mg EPA


57





58


Daily Doses






bull Ginger 1200 mg


Pain Management CBD

60








acting)


Adjustment




nerve injurydamage

Achilles Injury

Arthritis

Back pain

Carpal Tunnel

Fibromyalgia

Headaches

Knee pain

Ligament sprains

Neck pain

ldquoSciaticardquo

Shoulder pain

Spondylolisthesis

Sports injuries

Tendinitis

Tennis Elbow






pain and disability



care of patients


Past-President




209-324-2255


5) What are

the different

types of Stem

Cells

Adult Stem Cells

NOT

Pluripotent

Whatrsquos an MSC














day procedures





Stromal Vascular



then concentrated

Adipose Mesenchymal





procedures


Sam

e D

ay

Sam

e D

ay

Sam

e D

ay

Ad

van

ced

Ad

van

ced







AdiposeStemCells

6

AmnioticFluid

Stem Cells








SynovialFluid

Stem Cells

CordStem Cells

109

EmbryonicStem Cells

362

163

17 25






CordStemCells

EmbryonicStemCells

BoneMarrow

NucleatedCells

1106

48 0 01 011

SVF wPRP




16 papers

3 papers


2372 Patients

3012 Procedures




PRP


Injected same day


lab bedside


Knee OA-MSCs vs PRP


Sept 2014










studies)










Summary





ndash Cost

1) BMAC $5000 ndash 20000

2) ASC $3000 ndash 5000

3) PRP $500-1000


Conclusions













II Prolotherapy

III PRP






pain and disability


bull Pharmaceutical

bull Manipulation


bull Acupuncture

bull Dietary

bull Herbal

bull Homeopathic

bull Massage



and Alternative

56





inflammatory agents


inflammation



Daily Doses


ndash 1500 mg


ndash 1500 mg

bull MSM

ndash 800 mg


ndash 1500 mg EPA


57





58


Daily Doses






bull Ginger 1200 mg


Pain Management CBD

60








acting)


Adjustment




nerve injurydamage

Achilles Injury

Arthritis

Back pain

Carpal Tunnel

Fibromyalgia

Headaches

Knee pain

Ligament sprains

Neck pain

ldquoSciaticardquo

Shoulder pain

Spondylolisthesis

Sports injuries

Tendinitis

Tennis Elbow






pain and disability



care of patients


Past-President




209-324-2255


Whatrsquos an MSC














day procedures





Stromal Vascular



then concentrated

Adipose Mesenchymal





procedures


Sam

e D

ay

Sam

e D

ay

Sam

e D

ay

Ad

van

ced

Ad

van

ced







AdiposeStemCells

6

AmnioticFluid

Stem Cells








SynovialFluid

Stem Cells

CordStem Cells

109

EmbryonicStem Cells

362

163

17 25






CordStemCells

EmbryonicStemCells

BoneMarrow

NucleatedCells

1106

48 0 01 011

SVF wPRP




16 papers

3 papers


2372 Patients

3012 Procedures




PRP


Injected same day


lab bedside


Knee OA-MSCs vs PRP


Sept 2014










studies)










Summary





ndash Cost

1) BMAC $5000 ndash 20000

2) ASC $3000 ndash 5000

3) PRP $500-1000


Conclusions













II Prolotherapy

III PRP






pain and disability


bull Pharmaceutical

bull Manipulation


bull Acupuncture

bull Dietary

bull Herbal

bull Homeopathic

bull Massage



and Alternative

56





inflammatory agents


inflammation



Daily Doses


ndash 1500 mg


ndash 1500 mg

bull MSM

ndash 800 mg


ndash 1500 mg EPA


57





58


Daily Doses






bull Ginger 1200 mg


Pain Management CBD

60








acting)


Adjustment




nerve injurydamage

Achilles Injury

Arthritis

Back pain

Carpal Tunnel

Fibromyalgia

Headaches

Knee pain

Ligament sprains

Neck pain

ldquoSciaticardquo

Shoulder pain

Spondylolisthesis

Sports injuries

Tendinitis

Tennis Elbow






pain and disability



care of patients


Past-President




209-324-2255












day procedures





Stromal Vascular



then concentrated

Adipose Mesenchymal





procedures


Sam

e D

ay

Sam

e D

ay

Sam

e D

ay

Ad

van

ced

Ad

van

ced







AdiposeStemCells

6

AmnioticFluid

Stem Cells








SynovialFluid

Stem Cells

CordStem Cells

109

EmbryonicStem Cells

362

163

17 25






CordStemCells

EmbryonicStemCells

BoneMarrow

NucleatedCells

1106

48 0 01 011

SVF wPRP




16 papers

3 papers


2372 Patients

3012 Procedures




PRP


Injected same day


lab bedside


Knee OA-MSCs vs PRP


Sept 2014










studies)










Summary





ndash Cost

1) BMAC $5000 ndash 20000

2) ASC $3000 ndash 5000

3) PRP $500-1000


Conclusions













II Prolotherapy

III PRP






pain and disability


bull Pharmaceutical

bull Manipulation


bull Acupuncture

bull Dietary

bull Herbal

bull Homeopathic

bull Massage



and Alternative

56





inflammatory agents


inflammation



Daily Doses


ndash 1500 mg


ndash 1500 mg

bull MSM

ndash 800 mg


ndash 1500 mg EPA


57





58


Daily Doses






bull Ginger 1200 mg


Pain Management CBD

60








acting)


Adjustment




nerve injurydamage

Achilles Injury

Arthritis

Back pain

Carpal Tunnel

Fibromyalgia

Headaches

Knee pain

Ligament sprains

Neck pain

ldquoSciaticardquo

Shoulder pain

Spondylolisthesis

Sports injuries

Tendinitis

Tennis Elbow






pain and disability



care of patients


Past-President




209-324-2255



AdiposeStemCells

6

AmnioticFluid

Stem Cells








SynovialFluid

Stem Cells

CordStem Cells

109

EmbryonicStem Cells

362

163

17 25






CordStemCells

EmbryonicStemCells

BoneMarrow

NucleatedCells

1106

48 0 01 011

SVF wPRP




16 papers

3 papers


2372 Patients

3012 Procedures




PRP


Injected same day


lab bedside


Knee OA-MSCs vs PRP


Sept 2014










studies)










Summary





ndash Cost

1) BMAC $5000 ndash 20000

2) ASC $3000 ndash 5000

3) PRP $500-1000


Conclusions













II Prolotherapy

III PRP






pain and disability


bull Pharmaceutical

bull Manipulation


bull Acupuncture

bull Dietary

bull Herbal

bull Homeopathic

bull Massage



and Alternative

56





inflammatory agents


inflammation



Daily Doses


ndash 1500 mg


ndash 1500 mg

bull MSM

ndash 800 mg


ndash 1500 mg EPA


57





58


Daily Doses






bull Ginger 1200 mg


Pain Management CBD

60








acting)


Adjustment




nerve injurydamage

Achilles Injury

Arthritis

Back pain

Carpal Tunnel

Fibromyalgia

Headaches

Knee pain

Ligament sprains

Neck pain

ldquoSciaticardquo

Shoulder pain

Spondylolisthesis

Sports injuries

Tendinitis

Tennis Elbow






pain and disability



care of patients


Past-President




209-324-2255







CordStemCells

EmbryonicStemCells

BoneMarrow

NucleatedCells

1106

48 0 01 011

SVF wPRP




16 papers

3 papers


2372 Patients

3012 Procedures




PRP


Injected same day


lab bedside


Knee OA-MSCs vs PRP


Sept 2014










studies)










Summary





ndash Cost

1) BMAC $5000 ndash 20000

2) ASC $3000 ndash 5000

3) PRP $500-1000


Conclusions













II Prolotherapy

III PRP






pain and disability


bull Pharmaceutical

bull Manipulation


bull Acupuncture

bull Dietary

bull Herbal

bull Homeopathic

bull Massage



and Alternative

56





inflammatory agents


inflammation



Daily Doses


ndash 1500 mg


ndash 1500 mg

bull MSM

ndash 800 mg


ndash 1500 mg EPA


57





58


Daily Doses






bull Ginger 1200 mg


Pain Management CBD

60








acting)


Adjustment




nerve injurydamage

Achilles Injury

Arthritis

Back pain

Carpal Tunnel

Fibromyalgia

Headaches

Knee pain

Ligament sprains

Neck pain

ldquoSciaticardquo

Shoulder pain

Spondylolisthesis

Sports injuries

Tendinitis

Tennis Elbow






pain and disability



care of patients


Past-President




209-324-2255





16 papers

3 papers


2372 Patients

3012 Procedures




PRP


Injected same day


lab bedside


Knee OA-MSCs vs PRP


Sept 2014










studies)










Summary





ndash Cost

1) BMAC $5000 ndash 20000

2) ASC $3000 ndash 5000

3) PRP $500-1000


Conclusions













II Prolotherapy

III PRP






pain and disability


bull Pharmaceutical

bull Manipulation


bull Acupuncture

bull Dietary

bull Herbal

bull Homeopathic

bull Massage



and Alternative

56





inflammatory agents


inflammation



Daily Doses


ndash 1500 mg


ndash 1500 mg

bull MSM

ndash 800 mg


ndash 1500 mg EPA


57





58


Daily Doses






bull Ginger 1200 mg


Pain Management CBD

60








acting)


Adjustment




nerve injurydamage

Achilles Injury

Arthritis

Back pain

Carpal Tunnel

Fibromyalgia

Headaches

Knee pain

Ligament sprains

Neck pain

ldquoSciaticardquo

Shoulder pain

Spondylolisthesis

Sports injuries

Tendinitis

Tennis Elbow






pain and disability



care of patients


Past-President




209-324-2255



2372 Patients

3012 Procedures




PRP


Injected same day


lab bedside


Knee OA-MSCs vs PRP


Sept 2014










studies)










Summary





ndash Cost

1) BMAC $5000 ndash 20000

2) ASC $3000 ndash 5000

3) PRP $500-1000


Conclusions













II Prolotherapy

III PRP






pain and disability


bull Pharmaceutical

bull Manipulation


bull Acupuncture

bull Dietary

bull Herbal

bull Homeopathic

bull Massage



and Alternative

56





inflammatory agents


inflammation



Daily Doses


ndash 1500 mg


ndash 1500 mg

bull MSM

ndash 800 mg


ndash 1500 mg EPA


57





58


Daily Doses






bull Ginger 1200 mg


Pain Management CBD

60








acting)


Adjustment




nerve injurydamage

Achilles Injury

Arthritis

Back pain

Carpal Tunnel

Fibromyalgia

Headaches

Knee pain

Ligament sprains

Neck pain

ldquoSciaticardquo

Shoulder pain

Spondylolisthesis

Sports injuries

Tendinitis

Tennis Elbow






pain and disability



care of patients


Past-President




209-324-2255





PRP


Injected same day


lab bedside


Knee OA-MSCs vs PRP


Sept 2014










studies)










Summary





ndash Cost

1) BMAC $5000 ndash 20000

2) ASC $3000 ndash 5000

3) PRP $500-1000


Conclusions













II Prolotherapy

III PRP






pain and disability


bull Pharmaceutical

bull Manipulation


bull Acupuncture

bull Dietary

bull Herbal

bull Homeopathic

bull Massage



and Alternative

56





inflammatory agents


inflammation



Daily Doses


ndash 1500 mg


ndash 1500 mg

bull MSM

ndash 800 mg


ndash 1500 mg EPA


57





58


Daily Doses






bull Ginger 1200 mg


Pain Management CBD

60








acting)


Adjustment




nerve injurydamage

Achilles Injury

Arthritis

Back pain

Carpal Tunnel

Fibromyalgia

Headaches

Knee pain

Ligament sprains

Neck pain

ldquoSciaticardquo

Shoulder pain

Spondylolisthesis

Sports injuries

Tendinitis

Tennis Elbow






pain and disability



care of patients


Past-President




209-324-2255



Knee OA-MSCs vs PRP


Sept 2014










studies)










Summary





ndash Cost

1) BMAC $5000 ndash 20000

2) ASC $3000 ndash 5000

3) PRP $500-1000


Conclusions













II Prolotherapy

III PRP






pain and disability


bull Pharmaceutical

bull Manipulation


bull Acupuncture

bull Dietary

bull Herbal

bull Homeopathic

bull Massage



and Alternative

56





inflammatory agents


inflammation



Daily Doses


ndash 1500 mg


ndash 1500 mg

bull MSM

ndash 800 mg


ndash 1500 mg EPA


57





58


Daily Doses






bull Ginger 1200 mg


Pain Management CBD

60








acting)


Adjustment




nerve injurydamage

Achilles Injury

Arthritis

Back pain

Carpal Tunnel

Fibromyalgia

Headaches

Knee pain

Ligament sprains

Neck pain

ldquoSciaticardquo

Shoulder pain

Spondylolisthesis

Sports injuries

Tendinitis

Tennis Elbow






pain and disability



care of patients


Past-President




209-324-2255







Summary





ndash Cost

1) BMAC $5000 ndash 20000

2) ASC $3000 ndash 5000

3) PRP $500-1000


Conclusions













II Prolotherapy

III PRP






pain and disability


bull Pharmaceutical

bull Manipulation


bull Acupuncture

bull Dietary

bull Herbal

bull Homeopathic

bull Massage



and Alternative

56





inflammatory agents


inflammation



Daily Doses


ndash 1500 mg


ndash 1500 mg

bull MSM

ndash 800 mg


ndash 1500 mg EPA


57





58


Daily Doses






bull Ginger 1200 mg


Pain Management CBD

60








acting)


Adjustment




nerve injurydamage

Achilles Injury

Arthritis

Back pain

Carpal Tunnel

Fibromyalgia

Headaches

Knee pain

Ligament sprains

Neck pain

ldquoSciaticardquo

Shoulder pain

Spondylolisthesis

Sports injuries

Tendinitis

Tennis Elbow






pain and disability



care of patients


Past-President




209-324-2255




ndash Cost

1) BMAC $5000 ndash 20000

2) ASC $3000 ndash 5000

3) PRP $500-1000


Conclusions













II Prolotherapy

III PRP






pain and disability


bull Pharmaceutical

bull Manipulation


bull Acupuncture

bull Dietary

bull Herbal

bull Homeopathic

bull Massage



and Alternative

56





inflammatory agents


inflammation



Daily Doses


ndash 1500 mg


ndash 1500 mg

bull MSM

ndash 800 mg


ndash 1500 mg EPA


57





58


Daily Doses






bull Ginger 1200 mg


Pain Management CBD

60








acting)


Adjustment




nerve injurydamage

Achilles Injury

Arthritis

Back pain

Carpal Tunnel

Fibromyalgia

Headaches

Knee pain

Ligament sprains

Neck pain

ldquoSciaticardquo

Shoulder pain

Spondylolisthesis

Sports injuries

Tendinitis

Tennis Elbow






pain and disability



care of patients


Past-President




209-324-2255


Conclusions













II Prolotherapy

III PRP






pain and disability


bull Pharmaceutical

bull Manipulation


bull Acupuncture

bull Dietary

bull Herbal

bull Homeopathic

bull Massage



and Alternative

56





inflammatory agents


inflammation



Daily Doses


ndash 1500 mg


ndash 1500 mg

bull MSM

ndash 800 mg


ndash 1500 mg EPA


57





58


Daily Doses






bull Ginger 1200 mg


Pain Management CBD

60








acting)


Adjustment




nerve injurydamage

Achilles Injury

Arthritis

Back pain

Carpal Tunnel

Fibromyalgia

Headaches

Knee pain

Ligament sprains

Neck pain

ldquoSciaticardquo

Shoulder pain

Spondylolisthesis

Sports injuries

Tendinitis

Tennis Elbow






pain and disability



care of patients


Past-President




209-324-2255








II Prolotherapy

III PRP






pain and disability


bull Pharmaceutical

bull Manipulation


bull Acupuncture

bull Dietary

bull Herbal

bull Homeopathic

bull Massage



and Alternative

56





inflammatory agents


inflammation



Daily Doses


ndash 1500 mg


ndash 1500 mg

bull MSM

ndash 800 mg


ndash 1500 mg EPA


57





58


Daily Doses






bull Ginger 1200 mg


Pain Management CBD

60








acting)


Adjustment




nerve injurydamage

Achilles Injury

Arthritis

Back pain

Carpal Tunnel

Fibromyalgia

Headaches

Knee pain

Ligament sprains

Neck pain

ldquoSciaticardquo

Shoulder pain

Spondylolisthesis

Sports injuries

Tendinitis

Tennis Elbow






pain and disability



care of patients


Past-President




209-324-2255






pain and disability


bull Pharmaceutical

bull Manipulation


bull Acupuncture

bull Dietary

bull Herbal

bull Homeopathic

bull Massage



and Alternative

56





inflammatory agents


inflammation



Daily Doses


ndash 1500 mg


ndash 1500 mg

bull MSM

ndash 800 mg


ndash 1500 mg EPA


57





58


Daily Doses






bull Ginger 1200 mg


Pain Management CBD

60








acting)


Adjustment




nerve injurydamage

Achilles Injury

Arthritis

Back pain

Carpal Tunnel

Fibromyalgia

Headaches

Knee pain

Ligament sprains

Neck pain

ldquoSciaticardquo

Shoulder pain

Spondylolisthesis

Sports injuries

Tendinitis

Tennis Elbow






pain and disability



care of patients


Past-President




209-324-2255



bull Pharmaceutical

bull Manipulation


bull Acupuncture

bull Dietary

bull Herbal

bull Homeopathic

bull Massage



and Alternative

56





inflammatory agents


inflammation



Daily Doses


ndash 1500 mg


ndash 1500 mg

bull MSM

ndash 800 mg


ndash 1500 mg EPA


57





58


Daily Doses






bull Ginger 1200 mg


Pain Management CBD

60








acting)


Adjustment




nerve injurydamage

Achilles Injury

Arthritis

Back pain

Carpal Tunnel

Fibromyalgia

Headaches

Knee pain

Ligament sprains

Neck pain

ldquoSciaticardquo

Shoulder pain

Spondylolisthesis

Sports injuries

Tendinitis

Tennis Elbow






pain and disability



care of patients


Past-President




209-324-2255






inflammatory agents


inflammation



Daily Doses


ndash 1500 mg


ndash 1500 mg

bull MSM

ndash 800 mg


ndash 1500 mg EPA


57





58


Daily Doses






bull Ginger 1200 mg


Pain Management CBD

60








acting)


Adjustment




nerve injurydamage

Achilles Injury

Arthritis

Back pain

Carpal Tunnel

Fibromyalgia

Headaches

Knee pain

Ligament sprains

Neck pain

ldquoSciaticardquo

Shoulder pain

Spondylolisthesis

Sports injuries

Tendinitis

Tennis Elbow






pain and disability



care of patients


Past-President




209-324-2255






58


Daily Doses






bull Ginger 1200 mg


Pain Management CBD

60








acting)


Adjustment




nerve injurydamage

Achilles Injury

Arthritis

Back pain

Carpal Tunnel

Fibromyalgia

Headaches

Knee pain

Ligament sprains

Neck pain

ldquoSciaticardquo

Shoulder pain

Spondylolisthesis

Sports injuries

Tendinitis

Tennis Elbow






pain and disability



care of patients


Past-President




209-324-2255



Daily Doses






bull Ginger 1200 mg


Pain Management CBD

60








acting)


Adjustment




nerve injurydamage

Achilles Injury

Arthritis

Back pain

Carpal Tunnel

Fibromyalgia

Headaches

Knee pain

Ligament sprains

Neck pain

ldquoSciaticardquo

Shoulder pain

Spondylolisthesis

Sports injuries

Tendinitis

Tennis Elbow






pain and disability



care of patients


Past-President




209-324-2255


Pain Management CBD

60








acting)


Adjustment




nerve injurydamage

Achilles Injury

Arthritis

Back pain

Carpal Tunnel

Fibromyalgia

Headaches

Knee pain

Ligament sprains

Neck pain

ldquoSciaticardquo

Shoulder pain

Spondylolisthesis

Sports injuries

Tendinitis

Tennis Elbow






pain and disability



care of patients


Past-President




209-324-2255



Adjustment




nerve injurydamage

Achilles Injury

Arthritis

Back pain

Carpal Tunnel

Fibromyalgia

Headaches

Knee pain

Ligament sprains

Neck pain

ldquoSciaticardquo

Shoulder pain

Spondylolisthesis

Sports injuries

Tendinitis

Tennis Elbow






pain and disability



care of patients


Past-President




209-324-2255






pain and disability



care of patients


Past-President




209-324-2255



care of patients


Past-President




209-324-2255


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