Top Questions
please call or email us if you have any unanswered questions
What should I do before my stem cell or PRP (platelet rich plasma)
After you have been scheduled for a stem cell treatment, your goal is to increase the number of stem cells that will be available when you are treated. Dr. Flanagan will provide you with some information about which medications you should stop, if possible. Also, a healthy balanced nutritional approach combined with exercise can help increase your stem cell count before the procedure. Two important indicators of a positive response are the overall health and wellness of the patient, and the area being treated.
What should I do after my stem cell or PRP (platelet rich plasma) treatment?
Rehabbing your injury after these treatments is significantly easier than after most typical surgeries. The goal is almost always to increase activity as tolerated. Nutrition, sleep, medication management and exercise all play important roles. Dr. Flanagan will provide you with information to guide you through this process, and he is available at all times for any questions you have along the way. Ideally, about 7 to 10 days after treatment, you will start therapy with a physical therapist who can guide you through specific plans for optimizing healing of the treated areas.
How is prolotherapy different from PRP or stem cell treatments?
Prolotherapy refers to injections with a substance that will stimulate the area around it to heal. Traditionally this has been done with a dextrose solution and may be referred to as "sugar shots."
These treatments are much weaker than PRP or stem cell treatments, and usually require anywhere from 4 to 6 injections over many months to get an optimal result.
These treatments stimulate a patient's natural healing response where Dr. Flanagan thinks it can be helpful, but the response is not boosted with extra platelets, plasma, growth factors or stem cells as it would be with a PRP or stem cell injection.
How many treatments will I need?
There is some evidence that multiple treatments can continue to improve patient's conditions, but the treatment plan depends on the goals of the patient being treated. If a patient is satisfied after 1 treatment there is nothing to suggest that another treatment must be done.
Also, the improved pain and function associated with PRP and stem cell treatments tends to last much longer than cortisone injections, so it is not common for patients to return for injections every 3 months as they would for cortisone shots.
Does the age of my stem cells matter?
While it is true that the numbers of stem cells we have generally declines with age, aging does not seem to be the most important factor. Other, more important factors are things generally related to health like medication use, nutrition and exercise.
What if my arthritis is severe?
There are cases documenting cartilage regrowth in mild to moderate arthritic conditions. In severely arthritic joints, we don't see this same cartilage growth. However, the function of a joint and the pain associated with a joint are not only related to the amount of cartilage. While patients with severe arthritis are not the best candidates for these treatments, there may still be treatment plans that can help improve pain and function.
How much do stem cell treatments cost?
Stem cell treatments are the most costly of the regenerative orthobiologic procedures offered by Dr. Flanagan.
All treatments are guided in real time by live x-ray and live ultrasound as needed.
The price includes the bone marrow aspiration or fat harvesting, as well as the injection of the concentrated cells. The treatment typically takes about 2 hours.
As part of a plan to optimize outcomes, there may be a recommendation for pre and/or post injections as well.
After a thorough evaluation Dr. Flanagan can give you a recommendation if you are a candidate, including a price.
How much do PRP (platelet rich plasma) treatments cost?
PRP treatments are less invasive and considerably less costly than stem cell treatments. The final cost will depend on the areas being treated, ranging from simple joint injections to precisely targeted soft tissue injuries to complicated treatments of the functional spinal unit.
How do the stem cells know what to do?
The stem cells obtained from your fat or your bone marrow communicate with the local environment where they are injected. This healing process is a normal biological process, often referred to as a regenerative process. The mesenchymal stem cells stay locally and can proliferate as part of this process. They will respond to signals that direct them to stop growing at a later stage of the repair process, as they normally would.
The research and studies guiding these orthopedic regenerative stem cell treatments are also referred to as orthobiologic treatments.
Do stem cell treatments cause cancer?
Using adult cells from the patient's own body has been shown to be extremely safe, when using mesenchymal stem cells (MSC's) from a patient's bone marrow or fat tissue. There are studies going back over 15 years treating patients with mesenchymal stem cells that have not shown a risk of cancer.
It has been demonstrated that these adult mesenchymal stem cells function in a way after injection as they would naturally in the body. They are regulated by processes in the body that organize them to stop proliferating as they would after repairing an injury.
Where do the stem cells come from?
Dr. Flanagan treats patients with cells from their own body, "autologous adult stem cells."
These are the stem cells that have been studied the most in orthopedic applications to treat the spine and joints - bone, cartilage, ligaments, tendons, muscles.
The two main areas to get these cells are in the bone marrow and in the fat tissue from the patient being treated. The stem cells from the bone marrow have been shown to grow bone and cartilage better.
Dr. Flanagan does not use embryonic stem cells.
Dr. Flanagan does not use umbilical cord stem cells, wharton's jelly stem cells, placental stem cells, or another person's adult stem cells. These are not considered safe treatments as they can carry disease and/or interact with the treated patient's immune system in a negative way. Also, many products claiming to have stem cells from these sources have been shown to have no cells at all.
Does bone marrow aspiration hurt?
Dr. Flanagan's patients are continuously surprised at how well they tolerate this procedure.
Local anesthetic is used during bone marrow aspiration to numb the tissue before the procedure starts, so placing the needle for aspiration is well tolerated.
Drawing the bone marrow into the syringe is often described as a strange feeling, and patients report a tolerable pain that is very brief, lasting for a second or two while the bone marrow is being drawn out.
The entire procedure usually lasts about 30 minutes, and then the bone marrow aspirate is concentrated and prepared to inject around the injured and painful areas. This concentration process takes about 15 minutes.
How long do the procedures take?
Every individual treatment is started and completed on the same day. The time may vary from 30 minutes to 2 hours depending on the treatment.
Some patients may be recommended to have more than one treatment over a few days to weeks to optimize their outcomes. This is decided after a thorough evaluation.
Which stem cells work the best?
Dr. Flanagan treats patients with cells from their own body, "autologous adult stem cells."
These are the stem cells that have been studied the most in orthopedic applications to treat the spine and joints - bone, cartilage, ligaments, tendons, muscles.
The two main areas to get these cells are in the bone marrow and in the fat tissue from the patient being treated. The stem cells from the bone marrow have been shown to grow bone and cartilage better.
Dr. Flanagan does not use embryonic stem cells.
Dr. Flanagan does not use umbilical cord stem cells, wharton's jelly stem cells, placental stem cells, or another person's adult stem cells. These are not considered safe treatments as they can carry disease and/or interact with the treated patient's immune system in a negative way. Also, many products claiming to have stem cells from these sources have been shown to have no cells at all.
Do you offer financing options?
We do not offer financing options because these companies end up costing the patients more money over time. Dr. Flanagan prices his treatments as reasonably as he can because he wants to make these treatments more accessible for everyone who is a good candidate.
Can I get a same-day appointment?
Sometimes it is possible to get an appointment the same day you call to see Dr. Flanagan. He does not run a clinic that is overbooked, and can usually see patients within a couple of days if there is not a same day appointment available.
Will my insurance cover my visit?
If you see Dr. Flanagan for a general consultation about pain or injury, we can often bill your insurance, as long as he is in network with your provider or if you have out of network benefits. There are self pay prices for patients who need that option.
If you see Dr. Flanagan for a regenerative medicine injection, this cannot be billed to your insurance because major health insurance companies do not cover PRP (platelet rich plasma) or stem cell treatments at this time.
