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FAQ

FREQUENTLY ASKED QUESTIONS

Ozone Therapy

Medical ozone injection therapy is a proven non-surgical treatment modality that has become one of the most popular treatments for spine, joint and muscle conditions in Europe, and many countries around the world. Study after study has been published to demonstrate its efficacy and safety.

The ozone disc injection treatment has many qualities that make it the best non-surgical disc treatment. There are numerous studies performed regarding the safety and efficacy of this type of therapy. Thousands of patients have experienced the effective outcome of this non-surgical herniated disc treatment. Ozone injections are the opposite of surgical intervention. These injections to treat herniated disc but do not mechanically disrupt the disc by removing a piece of it or subjecting it to destructive energy such as laser or heat. Ozone is a regenerative approach to restoring the disc to its normal functions by shrinking the damaged portion of the disc and promoting innate healing abilities in our body. Studies and statistics are widely available on the Web.

No, there is no evidence to suggest that the height of the disc will decrease.  The ozone treatment will shrink the herniated portion of the disc just enough to take the pressure off of the spinal nerves that are inflamed.  Surgery, on the other hand, can significantly decrease the height of the disc because a piece of the disc is actually being removed or vaporized with a laser.

A vast amount of clinical data indicates that medical ozone disc injections work in the majority of patients. Ozone injections reduce the size of a disc herniation enough to remove the pressure on a spinal nerve. Ozone also decreases inflammation, increases blood flow and activates the body’s natural healing mechanism.

The procedure involves guiding a small needle into the herniated disc and injecting a specific concentration of a pure medical oxygen ozone. There is no surgical incision or hospital admission. Ozone injections do not mechanically disrupt the disc by removing a piece of it or subjecting it to destructive energy such as laser or heat.

Yes, Dr. Bleiweiss is one of the very few US physicians who routinely perform this particular procedure, with excellent outcome for patients. He has an outstanding track record in successfully treating patients with disc herniation. Patients come from all over the country and often from other parts of the world to receive his expert care.

Based on our experience, usually only one treatment is necessary. When there is near total improvement of symptoms after the procedure, the procedure will not be repeated. Some patients will continue to improve over several months. If significant partial improvement is obtained such as a 60% relief, a second ozone disc injection will be recommended and discussed with the patient.

Ozone injection procedures have been performed all over the world for decades with almost no known significant complications. Multiple studies have shown that the risk ozone injection procedures is extremely low. For example, a study by Dr. Kieran Murphy at the University of Toronto calculated that the risk of ozone disc injections was near zero.

Most people require only a limited number of treatment. The majority of our patients fall into the category of 1 treatment or 2. Some patients who have repeated micro-traumas of the joints, for example, competitive athletes, may require periodic injections to keep the joints healthy. For ozone muscle injections, there is no set protocol. The number of ozone injection treatments depends on the body’s response to treatment and the amount of time that the condition has been present. For example, an acute muscle strain or sprain will usually respond to one ozone injection treatment. However, a chronic muscle spasm condition that has been present for years (for example an old whiplash injury or fibromyalgia) usually takes longer to treat. However, once the condition is treated and there is a positive outcome, that outcome is sustained and long lasting.

While some patients experience almost immediate improvement, significant relief can take 3-4 weeks. Some patients continue to experience improvement over several months after the treatment. A period of soreness after the injection may be present for approximately 24 hours or a few days. Ozone injection treatment triggers a natural healing process so the length of time it takes for an individual to experience improvement ranges from immediate to over several months.

For ozone muscle injections, most patients say that they are less uncomfortable than trigger point injections. Dr. Bleiweiss also knows this from his own experience, having received ozone muscle and joint injections and trigger point injections personally. For ozone disc injections, intravenous sedation is usually administered, therefore, there is no significant discomfort during the procedure. Intravenous sedation is not absolutely necessary for an ozone disc injection procedure, since it can also be performed under local anesthetic if requested. However, most patients request intravenous sedation. Our patients have not reported significant ozone disc injection post procedure discomfort.

Stem Cell

Our body has a large supply of stem cells which perform very differently from regular cells. A skin cell cannot become a muscle cell but a stem cell can become a skin cell or a muscle cell if needed. Think of these stem cells as super hero cells like firefighters on call. Stem cells are the body’s emergency repair system. They are in high demand when the body has an injury or suffers a trauma. When they are called upon, they are able to migrate to the damaged area of our body to perform repairs and proliferate (increase in numbers). They can also change into different types of mature cells as needed, which is a process called differentiation. We all have a large reservoir of stem cells in areas such as bone marrow and around blood vessels. As we age some of our stem cells decrease in number and become less active.

As we age, our bodies become less efficient with regards to activating stem cells and we also lose many of our stem cells. At age 30, it is estimated that we only have about half of the amount of stem cell activity that we had when we were born. By the age 60, we only have 5% of our stem cell activity left. That’s the reason why a knee injury at age 15 will heal quickly while the same type of injury at age 60 will not. When a 15 year old has an injured knee, a large number of stems cells will be rushing to the damaged site upon being signaled to do rapid repairs. A 60 years old person who suffers the same injury will not be able to assemble such a large number of stem cells to do rapid repairs. Traumatic injuries that normally occur throughout our lives creates a further demand for this stem cell repair system. That’s when stem cell treatments can be helpful. Focusing a large amount of your body’s bone marrow stem cells as therapy is like having a helping hand when you need it. It is important to point out that this treatment is essentially a natural cellular repair phenomenon that is using your own body’s ability to heal and rejuvenate.

Here are some of the unique abilities that stem cells have that make them so important to our ongoing health and wellbeing. Stem cells can help nurse an injured or dying cell back to health by sensing what the distressed cell needs and secreting the necessary compounds such as growth factors. Stem cells can donate mitochondria, which is a powerhouse of the cell, to an injured or distressed cell. Stem cells are also the only cells in the body that have the capability to change into different types of cells, such as cartilage cells.

As we age, we lose a significant amount of our large reservoir of stem cells and we have a diminished ability to activate our stem cells. Throughout life, we all undergo micro-traumas on a regular basis, even without any apparent acute injury. For example, the joints in our body undergo normal wear and tear throughout our lives when we walk, run, exercise or carry on day to day activities. The discs in our spine also undergo micro-trauma with normal activities such as lifting and bending. These micro-traumas are not significant on their own but over many years will result in damage to joints and spinal discs. We call this degeneration. Similarly, every organ in our body undergoes this process throughout our lives. Another good example is the skin, which is frequently exposed to damaging ultraviolet radiation from the sun. The goal of all regenerative medicine treatments is to actually repair the damage that has occurred to the tissues and organs of our body and to restore function. Autologous bone marrow derived stem cell treatments have the ability to nurse an injured or dying cell back to health by sensing what the distressed cell needs and secreting the necessary compounds such as growth factors. Stem cells can also donate mitochondria, which is the powerhouse of the cell, to an injured or distressed cell.  These are just two of the many natural regenerative properties of stem cells.

This is a very important question and it brings up a key point that is essential to all stem cell and regenerative medicine treatments. We are committed to treating our patients with the most advanced regenerative medicine technology that is available. We are also committed to assuring that the treatments that we provide have the best possible chance of working to achieve our healing goal. In his over 30 years of experience in treating patients, Dr. Bleiweiss knows that just having the best tools is not enough. A practitioner has to know what specific treatment is the best treatment for a specific condition and a specific patient. Sometimes, a combination of treatments is most effective. This is where the art and science of medicine meet with wonderful results. A practitioner also has to be skilled and confident in performing all of the procedures that are necessary for a specific treatment. The above, however, is only half of the equation. It’s the doctor and technology half. Unfortunately, many practitioners do not pay enough attention to the equally, if not more, important half of the equation, which is the presenting condition of the patient. To put it simply, your body has to be in the most optimal condition possible to heal after a procedure. That is why, in our practice, regenerative procedures are not a “one shot fits all” procedure. That is why we take the time and make the effort to assure that your body has the best possible chance to heal. That is why we are proud to call our method personalized precision medicine. Stem cells have to be appropriately nurtured and signaled at the proper time in order to obtain the desired clinical results. It is very important to have the proper environment for stem cells to flourish and that is what we do to achieve the best results for our patients.

As with every procedure that we perform, we want to take every step to assure that the procedure has the best chance of achieving optimal success. Most procedures require preparation to assure that your body is in optimal condition. Therefore, the first step is always the initial consultation, which includes a detailed history, a review of the medical records and a physical examination. After the consultation, Dr. Bleiweiss will recommend a regenerative procedure that is the most effective treatment for your condition. He will then discuss how to adequately prepare your body for the procedure. This usually requires vitamin supplementation, some dietary changes and aerobic conditioning in the weeks leading up to the procedure. Specific lab tests may also be necessary. These steps are important to assure that the procedure has the best chances of achieving our treatment goal which is to repair, regenerate, restore function and improve the quality of your life.

The procedure will be performed in the office or at a surgical center. You will go home to rest after the procedure. Most procedures, other than spinal disc procedures, are performed with a local anesthetic and are office outpatient procedures. A follow-up office evaluation will usually be performed approximately four weeks after the procedure. Vitamin supplementation will be continued after the procedure to assure that the body has the proper building blocks and microenvironment to stimulate cell repair and growth.

These procedures are highly customized to each individual, therefore, specific recommendations, regarding activity, nutrition and exercise will be discussed during the follow-up evaluations. There are some procedures that will require the injection of additional growth factors such as PRP at some point after the procedure to provide the best internal environment to stimulate cell repair and growth.

After office procedures, patients are encouraged to go home to rest and resume normal activities the following day. With disc injection procedures, patients are advised not to perform any type of exercise until their follow-up evaluation, which usually occurs two weeks following the procedure.

No, there isn’t. All procedures are done as either an office procedure or at an outpatient surgical center.

All procedures are office procedures that are performed under local anesthesia. The only exception is a spinal disc regenerative procedure. All spinal disc procedures, since they require fluoroscopic guidance, are performed at an outpatient surgery center with local anesthesia or with a combination of intravenous sedation and local anesthesia.

No. Most patients are able to return to work after a procedure. Office procedures usually only require you to take part of the day off in order to have the procedure performed. The only exception is if you have a spine or joint procedure and you have a job involving physical exertion such as heavy lifting. In that scenario, Dr. Bleiweiss will advise you when it is appropriate to return to work.

Yes. There are usually no restrictions of daily activities. The only restrictions are on certain types of exercise activities. These restrictions depend on the type of procedure and the type of exercise that you are engaged in. For example, if you lift heavy weights and you had a spinal disc procedure, or you are a long distance runner and you just had a knee procedure. Dr. Bleiweiss will advise you when it is appropriate to resume your normal exercise routine after a procedure.

Very few patients complain about significant pain and it’s usually very well tolerated.

Minor discomfort is usually experienced for a few days after a procedure. Significant temporary discomfort after a procedure can occur, but it is rare. There can, however, be varying degrees of regenerative discomfort for a day or two after the procedure as your body is in the initial healing phase.

Yes you can drive home after the procedure. However, we don’t recommend that you drive if you received a procedure of the knee, ankle or hip purely for mechanical reasons. For example, if you need to suddenly slam on the break to stop the car, it’s not helpful to your post procedure recovery. If you have sedation for a spinal disc procedure, you have to have someone drive you home.

All stem cell and other regenerative medicine injection procedures are outpatient office procedures that are performed under local anesthesia. The only exception is a spinal disc regenerative procedure.  This procedure requires fluoroscopic guidance and is therefore performed at an outpatient surgery center.

PRP

PRP stands for platelet-rich plasma. PRP is a blood fraction that contains mostly platelets. It is produced by withdrawing a small amount of your own blood and processing it in the office.  However, not all PRP processing is equal.  We use the latest techniques to properly process PRP and activate it with 3 separate frequencies of light. 

In regenerative medicine, the platelets are the “good stuff” because they are packed with growth factors and many other valuable healing compounds. PRP has many applications and can be used alone or in combination with other regenerative medicine such as stem cell and ozone treatments to enhance their effectiveness.

All PRP procedures are outpatient office procedures that are performed under local anesthesia. The only exception is if PRP is used as part of a spinal disc regenerative procedure. All spinal disc procedures, since they require fluoroscopic guidance, are performed as an outpatient procedure at a surgery center with local anesthesia or with a combination of intravenous sedation and local anesthesia.

No. Most patients are able to return to work the day after a procedure. Office procedures usually only require you to take part of the day off in order to have the procedure performed. The only exception is if you are having a spine or joint procedure and you have a job that requires heavy lifting, such as construction work. In that scenario, Dr. Bleiweiss will advise you when it is appropriate to return to work.

As stated above, not all PRP preparations are the same.  PRP preparations can vary widely, depending on the equipment used and the way it is processed.  Dr. Bleiweiss has extensively studied this process and uses the most effective PRP treatment, which includes photo activation of the platelet granules. Using the proper PRP assures that the best possible treatment and outcome can be obtained from the procedure. 

Yes, all PRP procedures are outpatient office procedures.

All PRP procedures are office procedures that are performed under local anesthesia. The only exception is when PRP is used as part of a spinal disc regenerative procedure. All spinal disc procedures, since they require fluoroscopic guidance, are performed at an outpatient surgery center with local anesthesia or with a combination of intravenous sedation and local anesthesia.

PRP injections have been performed for many years. PRP is considered to be very safe, however, in all of medical practice, there is no zero risk procedures. Steps should be taken to ensure a safe and effective procedure. Your blood should be drawn under sterile conditions and your injection site should be prepared with appropriate antiseptics to assure that the infection or other complications risk is very low.

No. Most patients are able to return to work after a procedure. Office procedures usually only require you to take part of the day off in order to have the procedure performed. The only exception is if you have a spine or joint procedure and you have a job involving physical exertion such as heavy lifting. In that scenario, Dr. Bleiweiss will advise you when it is appropriate to return to work.

Yes. There are usually no restrictions of daily activities. The only restrictions are on certain types of exercise activities. These restrictions depend on the type of procedure and the type of exercise that you are engaged in. For example, if you lift heavy weights and you had a spinal disc procedure, or you are a long distance runner and you just had a knee procedure. Dr. Bleiweiss will advise you when it is appropriate to resume your normal exercise routine after a procedure.

PRP works by producing a certain amount of inflammation which focuses the healing and regenerative properties of the body. Therefore, there can be regenerative discomfort after the local anesthetic wears off.  As stated above, we use the most advanced PRP processing technique which includes photo activation.  Photo activation creates a PRP product that causes less pain.  Some patients do, however, complain of significant pain after the procedure for a few days which is controlled with anti inflammatory medications, Tylenol, or ice.  Some patients noted regenerative discomfort for a day or two after the procedure.  This can also be controlled with anti-inflammatories, Tylenol, and ice. 

Discomfort can be experienced for a few days after a procedure while healing is in process. This is known as regenerative discomfort.

As stated in the answer above, we use photo activation which tends to lessen the regenerative discomfort that is seen after the procedure.  The discomfort that is noted after the procedure can easily be controlled with anti-inflammatories such as Advil, ice, or pain relievers such as Tylenol.

No, there isn’t. All procedures are done as either an office procedure or at an outpatient surgical center.

Yes you can drive home after the procedure. However, we don’t recommend that you drive if you received a procedure for the knee, ankle or hip purely for mechanical reasons. For example, if you need to suddenly slam on the break to stop the car, it’s not helpful to your post procedure recovery.