Archive for the ‘elbow’ Category

Entrapped Ulnar Nerve Treated through a Needle with Less Recovery Time

Thursday, April 5th, 2012

DD is a 51 year old athletic woman with a two year history of neck and arm/hand pain. While she had bulging discs in her neck and had Dr. Schultz perform cervical epidurals to help that issue, she continued with pain in the elbow and into her hand. She was diagnosed with ulnar neuropathy (a bad nerve) at the elbow and was considering an ulnar transposition (where the nerve is moved from it’s normal spot in the ulnar groove to another spot). The issue with that surgery is it’s very invasive and can result in a damaged ulnar nerve. In addition, the ulnar nerve surgery recovery time can be significant. Instead of this invasive surgery, she had Dr. Hanson perform an injection based nerve hydro-dissection, where the entrapped nerve is treated by dissecting away the scar tissue with fluid (in this case the growth factors from her own blood platelets). The recovery time was minimal, as it was all done under ultrasound guidance through a needle. Here is her report after the ulnar nerve procedure:

“Just wanted to let you know that I think the 2nd go round of hydro nerve dissection on my right ulnar nerve at wrist and elbow really did the trick. You treated me initially at end of Dec (R side), early Feb (L side) and then March 8th (R side). Since that last tx  the incidence of numbness in my pinky and ring fingers is gone, and even on the rare occasion I forget and flex the elbows completely in, the numbness, if it occurs, is not nearly as profound, especailly on the right. If I find myself working in Colorado in the future I may have you do a 2nd tx on the left too.

I am very greatful to Dr Schultz as well (didn’t have his email). I believe my neck has improved quite a bit due to his treatments. Thank you both.  The interruption in sleep my symptoms caused is something I don’t miss. Your skills and attitudes are greatly appreciated!  You rock!”

It’s always good to “rock”!

Share

Exact Tennis Elbow Injections of Stem Cells using Imaging Guidance

Monday, January 3rd, 2011

Tennis elbow or lateral epicondylitis is one of the most common problems of active adults. Usually it involves pain at the outside of the elbow that gets worse with bending the wrist backwards such as using a racquet to hit a tennis ball. Injections of steroids into the area can reduce swelling and pain, but also likely weaken tissue and cause the pain to come back more than it was before the injection. Many times surgeons will perform a procedure where they “rough up” the area with a scalpel (fenestrate), but this involves big recovery time. We’ve had success with injecting the patient’s own platelets and stem cell cells into this area. In particular, we often use the Regenexx-SCP procedure to treat this kind of condition. Like with any injection, accuracy helps. At the Centeno-Schultz clinic, rather than performing this injection blind and placing the stem cells into the wrong spot, we often inject cells using musculoskeletal ultrasound. Above is a video of this injection. To the left is the epicondyle bone and the needle comes in horizontally off from the right side. Watching the needle move toward the epicondyle (looks like a mountain off on the left), you get an appreciation of just how easy it would be to inject cells into the wrong spot (miss the mountain). Placing stem cells without knowing where your needle is going is like driving a car with a blacked out windshield, you can do it, it’s just not a good idea.

Share