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July 19, 2019 by Steve Coleman

Dr. Steve Coleman, D.O.

Founder of

Imagine the desperation and fear that grows unchecked, in a strong woman forced to live with chronic knee pain for two decades…when she realizes that she has little hope of relief from traditional medicine and traditional knee surgery?

Our courageous patient, Jane, has battled the scourge of aging and osteoarthritis, which gripped both her knee joints after a hundred falls since the age of 40.  Statistics suggest that you are 2.5 times more likely to suffer from a fall, if arthritis is present.

In Jane’s case, she was way above this statistic, partly due the fact that she had torn the meniscus in her left knee sometime in 1998.    This critical piece of cartilage acts as a cushion between your shin and thigh bones, governing both mobility and flexibility.  As previous articles have noted on this site, the knee meniscus takes a notoriously long time to heal when torn during exercise or a fall.

The Pain in Jane, Falls Mainly on the Knees

“I’ve literally fallen hundreds of times, on both knees, over the last 20 years,” Jane told me during her initial 100 Point Health Score (100 PHS) and Comprehensive Medical Assessment (CMA). See her video here.

Even the intervention of arthroscopic surgery sometime in 1995, could not remediate the throbbing pain, particularly pronounced while standing for long periods during her day job as a printing professional.   

Over 750,000 knee surgeries are performed each year to repair torn meniscus cartilage.  Sadly, most are ineffective, with new studies suggesting that 66% of arthroscopic surgeries fail to heal the delicate cartilage or provide much pain relief. 

While insurance does cover it – mostly – it’s $10,000 or more price tag is a burden on our healthcare system and does not include insurance deductibles, lost work days, or further risks that come with any surgery.  The true costs are obviously much higher.

Is Cortisone Worth the Risk?

“Did the Cortisone injections help?” I asked Jane during her CMA. “It took some of the pain away, lasting about 3 to 4 months,” she replied visibly jaded by her multiple experiences in traditional medicine which tends to use lots of these corticosteroid shots.

While used primarily to temporarily relieve pain and inflammation, Cortisone does not promote joint healing and simply masks serious underlying issues related to disease and degeneration. It has virtually no positive influence over aging joints eroded by osteoarthritis and acute lateral meniscus tears.  It is often chosen mainly because it covered by insurance due to historical reasons.

Patients and Doctors should consider the potential side effects of cortisone, ranging from nerve damage, to decreased healing, to osteoporosis (thinning of the bone) when used for primary joint injections. Osteoporosis is especially of concern for post-menopausal women prone to bone density loss during the aging process.  Any falls or ligament tears in knee joints exacerbate issues as well as causing more pain and discomfort.

In some instances, cortisone injections may actually cause further cartilage erosion and joint degeneration making it a poor rival to the options available in modern-day regenerative medicine, including Stem Cell Therapy, PRP and Laser Therapies.

In fact, corticosteroid shots carry several additional risks. Especially when used to target sensitive joint areas such as the spine’s epidural space.   At one point the FDA issued a letter warning that this approach may result in serious adverse side-effects including but not limited to ‘loss of vision, stroke, paralysis, and even death’.  These facts are not meant to scare you, but to illustrate the current limitations of pharmaceutical approaches to dealing with chronic pain, especially in the delicate joints of the body.

Exploring Alternatives to Knee Surgery

Prior to contacting for a cellular medicine consult, Jane had done her homework on alternatives to further knee surgery or pain medication.

“I did a lot of reading on the benefits for PRP and Stem Cell Therapy. In particular, my sister-in-law had successfully undergone the procedures and said she has ‘no pain’ whatsoever.  She did say her movement was a bit restricted but absolutely no pain,” Jane said. “I just want be able to stand at Church and not hurt.”

Jane openly expressed her concern and frustration at virtually being unable to walk more than a few steps at a time.   Unbearable pain had stopped her enjoying relaxing pastimes like scuba diving or even swimming in the pool.  By the time Jane came to see me for her initial consult she scored her pain levels at a whopping nine out of ten for both knees

This is a massive amount of pain and discomfort to live with at the young age of 65, especially while still working.

The worst expression of this pain appeared while going up and down stairs, an activity that led to several falls.  The one single step at work was now a terrifying experience: She was convinced she would fall over unless she held tightly to the guard rail.

“I literally don’t know what leg to use when attempting to climb stairs. I am so scared I will fall.”

You can imagine how this fear radiates through her while walking down steps, a direction which creates even more imbalance and pressure on the knees. 

“I’ve fallen three times in the last year at work missing the step. The pain races down the side of my leg and has become unbearable over the last six months,” she said.   

It had reached the point where she would carefully descend tall steps sideways to compensate for the pain and further fear of falling.  Like other patients we have seen over the years, Jane had tried to reprogram her brain to deal with the chronic pain and instability of bad knees. It is not easy to do.

Comprehensive Medical Exam (CMA)

To really understand the context of Jane’s pain, I had to build a map of her musculoskeletal issues and physiological timeline. This diagnostic evaluation includes an assessment of her past medical treatments plus a rigorous physical exam to determine pain thresholds, mobility and flexibility issues.

Knee Pain Chart

The physical exam confirmed several musculoskeletal issues including severely reduced flexion. Extending the legs did not cause much discomfort but bending them triggered a cascade of pain. 

A routine McMurray procedure to test for knee tears (using a series of orthopedic leg rotations and joint manipulation) confirmed the presence of advanced osteoarthritis.   As I manipulated and palpated her knee through several range of motions, I detected joint grinding and crepitus. Further tests revealed joint-line tenderness, all confirming a final diagnosis of degenerative arthritis stemming from decades of injuries and the lingering effects of arthroscopic surgery.

Treating Jane’s Knee Pain

Based on the Jane’s age, condition and the findings of her CMA, our Naples stem cell clinic concluded that a hybrid approach to tackling her chronic pain was called for.  To reduce inflammation and trigger a powerful molecular healing cascade in both her knees, three cellular modalities were carefully prepared and calibrated to meet this objective: Prolotherapy, Platelet Rich Plasma (PRP) and Stem Cell Therapy.    


Prolotherapy is an Injection Technique and Strategy which has been taught since 1938. See the article here. Who knows how long it was performed before professors began teaching it?  Probably quite some time.  This is a healing approach to ligament and joint repair, as opposed to just cutting and replacing with artificial joints.  It involves sterilely injecting a mild irritant, usually a dextrose or glucose-based compound, into carefully selected intraarticular areas of the inflamed knee joint.  Its use has been well documented since the early part of the 20th Century but in actuality it has been used successfully by medical practitioners since the time of Greek antiquity, including Hippocrates.      The therapeutic solution administered by a trained prolotherapy physician can treat a range of conditions including lower back pain, osteoarthritis and general tendinopathy. The solution is injected into the affected areas around the ligaments and tendons, including the adjacent joint spaces. It’s a specialist procedure that demands years of training and musculoskeletal understanding to administer precisely, safely and effectively.  The local irritation stimulates inflammation and tissue healing which ultimately enlarges and strengthens the microscopic fibers that make up your intra-articular joints.   In Jane’s case, it was an important component in helping to reduce knee pain and increase overall mobility.

As reported elsewhere on, studies show that those patients who underwent prolotherapy experienced  remarkable strengthening of joint ligaments, tendon and tissue. In fact, they were 31% stronger, 47% larger, and 28% thicker than those in the control group.

Platelet Rich Plasma

While our clinic has had tremendous success in using only prolotherapy to treat chronic knee pain, successful patient outcomes are amplified by the addition of Platelet Rich Plasma (PRP) to accelerate molecular healing.      The wonderful aspect of this treatment modality is that it’s entirely composed of the patient’s own blood, making it completely FDA-compliant and entirely safe for treating joint pain.   In Jane’s case, her blood was extracted and centrifugally enhanced according to FDA guidelines.   This allowed our team to amplify the natural-healing platelets, cytokines and interleukins that naturally swam through her bloodstream.    

With low red blood cells and neutrophils, we triggered a powerful healing cascade in Jane’s knees, boosting the proliferation and remodeling of her joint cells. uses a specialized ortho-biological PRP kit to accommodate this process that emphasizes quality and a high concentration of cells when processing.  These approved and validated kits are part of our proprietary cellular treatment modalities that will not be found in every regenerative clinic.  

The combination of prolotherapy with PRP, helps our physicians enhance both bone and soft tissue with a minimum PRP platelet count of 1,000,000 platelets per microliter of blood (or roughly one billion platelets per milliliter). 

The approaches described above allow to harness cytokines, hormones, white blood cell mediators and platelets to signal to the knee joint to re-start the healing process. Often this is Jolt to the Joint to get it Out of Chronic inflammation and back In to Acute inflammation that can lead to healing.  The combination of monocytes, lymphocytes and macrophages mix together to spearhead an antimicrobial effect in the knees while also strengthening a general immune response.  The end result is a potent cocktail of growth factors that help the knee heal faster and ultimately work to minimize pain.

Side note:  Our clinic is deeply focused on maintaining a sterile work zone for aseptic techniques, including prolotherapy, PRP and Stem Cells. One of the ways we achieve this is by using state-of-the-art laminar flow hoods designed to protect work surfaces, products and materials from particulate contamination. These incredible machines draw ordinary room air through HEPA filters and then through the cabinet interior to purify the interior from dirty, dusty unfiltered air.  This system protects materials inside the cabinet from particulates. This is exactly how big Pharmaceutical Companies make pure products with good manufacturing processes. We learn from the best.

Stem Cell Injections

While the benefits of both prolotherapy and PRP described previously should be clearly obvious, its’s the addition of stem cell therapy that takes this regenerative approach to an entirely new level and helped Jane achieve a remarkable reduction in knee pain.   Stem cell therapy – along with PRP and Prolotherapy – is classified as a safe level 1 office procedure which extracts the patient’s own stem cells to accelerate joint healing in the knee.   

As long as the patient’s knee is not yet bone-on-bone, stem cell therapy is a powerful alternative to invasive orthopedic surgery or the risky symptomatic approach of using cortisone injections.

Our clinic established that Jane was an excellent candidate for stem cell therapy. Her previous surgery and long litany of falls gradually resulted in an escalation in pain and reduced mobility. 

By extracting stem cells contained in her fat and bone marrow, mixing them together with prolotherapy and PRP, a powerful injectional therapeutic could be formulated for re-injection into the maligned knee.    To increase the chances of success, our clinic also supplemented the stem cell injections with a powerful family of messenger proteins called cytokines.  These proteins are involved in nearly all human biological processes and help regulate and control the effects of inflammation in the knee.    In a nutshell, cytokines mimic the effects of  “icing” a painful joint and play a role in tissue repair. They enhance healing while decreasing Chronic or Bad inflammation as opposed to acute inflammation. Acute inflammation is how your body naturally heals itself after any injury or severe work out.

Reaching Back Up

“Falling down is part of life.  Getting back up, proves you are alive.”

Immediately after the stem cell procedure, Jane was able to move haltingly out of the office and begin to re-enter her normal life after 24 hours of rest. Amazingly her pain was not unbearable and she did not use any of the Narcotic Pain medication prescribed to her “Just In Case”.

Over the following 21-30 days Jane experienced dramatic and long-last lasting results : After two decades of pain, she reported that both knees – including the trouble right-knee joint – were virtually pain free.  

“My right knee barely hurts at all – it’s about a 1/10,’ said Jane. “My left knee has zero pain.”

This treatment strategy is a powerful testament to the hope of cellular medicine to both minimize pain, and to help to remodel bone, ligaments and tendons.   After decades of falling, interspersed with episodes of surgery, had taken their toll on her body, Jane now had a new lease on life no longer bracketed by chronic pain.

While not every patient will experience a 90% reduction in pain like Jane, many of my other patients attest to just that including Jorge G, an athletic 54-year construction worker.  In most cases, however, patients should experience mild to moderate improvements in knee mobility with lower pain levels.  These remarkable patient success stories are available on for your review. These are actual live video proofs of the power of regenerative medicine. Any of these patients will tell you their truth if you ask them.


Jane’s story shows all of us that even baby boomers have hope in treating knee pain without surgery.  These minimally invasive, Non-Surgical, orthopedic procedures composed of Prolotherapy, PRP and stem cell therapy are providing proof positive results for patients who experience knee pain. Whether from falls, sports injuries or work-related incidents which damage the intricate workings of many patient’s joints.

We would also like to remind readers that ancillary treatments like laser therapy for shoulder and knee pain also exist to supplement the healing process.  These trigger positive cellular responses that cumulatively work together to heal the body at a molecular level.

Our team would like to commend Jane for getting back up and fighting osteoarthritis.  She took matters into her own hands by educating herself, and looking for alternatives to surgery.  Her grit and perseverance paid off when she found our clinic and went ahead with stem cell therapy. It may work as well for you.

One major battle with knee pain has been won.  There are many more that may benefit. Thanks for helping wage the war against Degenerative Joint Disease. We are humbled by your courage.

We have won it. Things are better now.