Patient Safety

Epidural Steroid Side Effects: Repeated Injections Cause Diminishing Relief

On the surface, as a nonsurgical way to relieve pain and inflammation, epidural steroid injections seem like a great idea. However, when we dive beneath the surface, we find that epidural steroid side effects are pretty awful. I’ve observed many times, that for some patients, that while that first shot seems nothing short of miraculous,…read more

Is Injecting Bupivacaine or Lidocaine into a Joint Malpractice?

This week a patient sent a note that her mom was to undergo surgery and the anesthesia crew was planning on using the local anesthetic bupivacaine. She knew from reading the blog that this wasn’t a  good idea, so let’s explore just how nasty this drug is to joints and why doctors are still using…read more

Prolotherapy for CCJ Instability: Keeping Patients Safe

Patients with craniocervical joint (CCJ) instability will often be offered prolotherapy injections. While much of this is performed blind, some physicians will use guidance. However, while guidance is used, many times it’s not used with contrast. Why is this an issue? Let me explain. What Is Prolotherapy? Prolotherapy is one of the earliest regenerative-medicine procedures. It…read more

Cyplexinol Review 2: More of the BMP Shuffle…

Last year I was contacted by a marketing agent on Twitter about the “research” supporting a new supplement called Cyplexinol. When I dug into this supplement, what I found was very disturbing. Yesterday a physician who uses stem cells sent me a copy of the company’s most recent e-mail ad campaign which looks as factually…read more

The Research: Steroids Hammer Stem Cells!

Steroids are widely used in Orthopedic care like water, sprinkled here and there for good measure in arthritis and surgical procedures alike. We’ve known for sometime that these high dose steroids are horrible for cartilage and other cells, but there hasn’t been much published on how they impact stem cells. A recent study adds to the…read more

My Hip X-ray is Bad so this Means I Need My Hip Replaced, Right? Not So Much…

Almost all patients and many physicians still treat x-ray and MRI images like the Oracle of Delphi, yet study after study continues to show that there isn’t great correlation between what we see on these images and pain. The most recent entry in this debate was just published last month and it shows how few…read more

Knee Steroid Injection Side Effects

We’ve known for awhile that local anesthetic and steroid shots can produce side effects for stem cells and cartilage cells. Local anesthetics are a common component of knee steroid shots. We’ve been amazed at the toxicity of one commonly used numbing agent in knee steroid shots called Bupivicane (also known as Marcaine). A recent literature review on the topic I performed…read more