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FOR REFERRING CLINICIANS

For referring physicians and clinicians, please use this referral form.

REFERRALS

Physicians, Physiotherapists, and other practitioners wanting to refer to my services can use their letterhead or my downloadable referral PDF.

 

Click here to download the referral

INDICATIONS FOR REGENERATIVE THERAPIES

Regenerative therapies, including Platelet-Rich Plasma (PRP), Prolotherapy, Hydrodissection/Perineural Injections, and other injectable treatments, utilize the body's natural healing processes to treat a variety of musculoskeletal conditions. These therapies are non-surgical options designed to promote tissue repair, reduce inflammation, and improve function.

IMPORTANT REFERRAL NOTE

Please ensure that the patient has completed an adequate course of physiotherapy before submitting the referral unless the patient is specifically requesting Platelet-Rich Plasma (PRP) or Prolotherapy injections. In cases where physiotherapy has been unsuccessful, or the patient has plateaued, regenerative therapies may be considered as the next step.

 

Common Indications for Regenerative Therapies:

  1. Osteoarthritis (OA):

    • Chronic degenerative joint conditions, particularly in the knee, hip, shoulder, hands, feet and spine, where traditional treatments (e.g., NSAIDs, corticosteroid injections) have provided limited or short-term relief.

  2. Tendon and Ligament Injuries:

    • Chronic tendonitis, tendinopathy, and ligament sprains/tears that have not responded well to conservative treatments (e.g., physical therapy, bracing, corticosteroid injections).

    • Conditions like patellar tendonitis, rotator cuff injuries, and Achilles tendinopathy are frequently treated with PRP and Prolotherapy.

  3. Chronic Muscle Pain or Myofascial Dysfunction:

    • Persistent myofascial pain or trigger points secondary to underlying hypermobility or trauma that have not responded to physiotherapy, dry needling, or other manual therapy techniques.

  4. Nerve Entrapments or Neuropathies:

    • Chronic conditions related to nerve irritation or entrapment (e.g., peripheral neuropathies like mild-moderate carpal tunnel syndrome and cubital tunnel syndrome, where a patient wants to avoid surgical intervention) and other entrapments, like occipital neuralgia that are unresponsive to conservative management or injections.

  5. Joint Instability or Ligament Laxity:

    • Patients with chronic joint instability or ligament injuries secondary to trauma or hypermobility who have not improved significantly with physical therapy or other conservative approaches.

WHEN TO REFER FOR REGENERATIVE THERAPY

Regenerative therapies are most effective when conservative treatments have plateaued or when symptoms persist despite efforts to address them through more conventional means. Consider referral for regenerative therapies when the following conditions apply:

  1. Failure to Improve with Physiotherapy:

    • If the patient has participated in physical therapy for a reasonable period and has plateaued or continues to experience persistent pain or dysfunction, regenerative treatments may be considered to enhance healing and improve outcomes.

  2. Persistent Symptoms After Conservative Treatment:

    • For patients experiencing chronic pain or persistent symptoms despite interventions such as medications, physical therapy, lifestyle modifications, and other non-invasive treatments, regenerative therapy may be the next step to promote tissue healing and repair.

  3. Chronic Conditions Refractory to Standard Treatments:

    • For conditions such as chronic tendonitis, osteoarthritis, or ligament injuries that have not responded to NSAIDs, corticosteroid injections, or other traditional approaches.

  4. Patients with Inadequate Response to Injections:

    • When patients have tried steroid injections in conjunction with physiotherapy with minimal or short-term benefit, regenerative therapies (PRP, Prolotherapy) offer an alternative that may provide longer-lasting relief.

  5. Joint, Tendon, or Ligament Damage Beyond Acute Stages:

    • For patients with injuries or conditions in the subacute or chronic stages, where standard treatments have not provided sufficient relief, regenerative therapies may stimulate tissue repair and regeneration.

  6. Nerve-Related Pain:

    • Patients with nerve entrapment syndromes or neuropathic pain (e.g., carpal tunnel, cubital tunnel, occipital neuralgia) that have not improved with physical therapy, medications, or standard injections, and who wish to avoid surgical interventions, may benefit from hydrodissection or perineural injections.

  7. Residual Symptoms Following Motor Vehicle Accidents (MVAs):

    • Patients with residual symptoms following a motor vehicle accident, including headaches, whiplash, or upper extremity, neck and back pain, may benefit from regenerative therapies if they continue to experience pain or dysfunction despite physical therapy or other conservative treatments. This is particularly true when symptoms persist well beyond the acute recovery phase or if they are chronic.

SUMMARY

Referral for regenerative therapies is most appropriate when the patient has:

  • Exhausted conservative treatments, including physical therapy, medications, and lifestyle modifications, with limited or no improvement.

  • Chronic or persistent symptoms, such as joint pain, tendonitis, or nerve-related pain, that, have failed to respond to standard interventions.

  • Specific conditions such as osteoarthritis, tendon injuries, ligament sprains, nerve entrapments, or residual symptoms from MVAs, including headaches and neck pain, have plateaued or remain unresolved despite ongoing management.

Regenerative therapies can be a vital next step in managing complex musculoskeletal conditions and improving patient outcomes when more traditional approaches are no longer effective.

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