Living Pain-Free with Marc Darrow, MD

Complete Radio Transcript

Five caller issues discussed

  • Kevin reports that prolotherapy successfully treated his frozen right shoulder approximately 12 years ago.
  • Kevin asks how stem cells and platelet-rich plasma (PRP) work and whether they may help osteoarthritis in his left hip.
  • Marc Darrow, MD, discusses the importance of a physical examination and cautions against making treatment decisions from imaging alone.
  • Kevin asks how many PRP or stem-cell treatments his hip might require and why ultrasound guidance matters for joint injections.
  • Dena Lee describes intermittent knee problems and asks how stem cells work and how the treatment process is performed.

ANNOUNCER: Are you living in pain? Is it joint pain or muscle pain? If so, stay tuned. Welcome to Living Pain-Free with Marc Darrow, MD, from the Stem Cell Institute in West Los Angeles.

This is the program that can give you effective solutions for the pain you have been living with. Dr. Darrow is a medical doctor who completed his residency at UCLA. He uses stem cells and platelet-rich plasma and teaches about stem cells, PRP, and prolotherapy.

Today’s program could open up a new life without pain for you. To speak with Dr. Darrow, call 866-870-KRLA—that’s 866-870-5752. Ask for a copy of Dr. Darrow’s book, Stem Cell and Platelet Therapy: Regenerate, Don’t Operate. Now, here is Marc Darrow, MD.

MARC DARROW, MD: Hello there. I’m Marc Darrow, MD. I completed my residency at UCLA and then taught there for 20 years. I taught about stem cell and platelet therapy.

For anyone who wants to call now, I’m going to give you a free copy of my book, Stem Cell and Platelet Therapy. The byline is “Regenerate, Don’t Operate.”

We use PRP and stem cells to regrow tissue in the body that is either injured or worn out—arthritic tissue and problems involving joints, ligaments, tendons, muscles, and tears from the top of the head to the bottom of the feet.

If you have an emergency, go to the orthopedic surgeon. Most surgeries, however, do not need to be done immediately. Be careful if you are going to have surgery unless it is an emergency. Elective means you get to choose. That is not the doctor’s choice; it is your choice.

Many people make the wrong decision, and we see many patients with failed surgeries. They ask why a surgeon performed an operation that did not need to be done. I do not have the answer.

I did a lot of orthopedic surgery during my training. I never became board-certified in it because I had shoulder surgery that failed, and I changed course. My wrist was initially treated after a golf injury and then my shoulder after a weightlifting injury. I performed these injections on myself.

I have been doing this work for almost 30 years. At age 78, I am still active in athletics. People who know me wonder how I can be my age because I’m so active, and I’m told that I look pretty young. This is something I think you ought to consider.

Regenerative medicine is the term, and the most prevalent treatments today are stem cells and PRP—platelet-rich plasma—for healing. I hope you will give it a shot. That is a pun.

It is an injection. Instead of cutting tissue open, we can palpate the area with our hands, find the pain generator, and inject that area with the hope of relieving the pain. I say “hope” because there are no guarantees. People who have been helped sometimes call this work a miracle.

I have treated probably 10 different areas of my body. Having been a gymnast when I was young, I was pretty beat up. I also participated in physically demanding sports, including high-speed water skiing, regular skiing, tennis, and golf. If I play golf, I want to hit the ball as far and as hard as I can.

It does not matter to me what my age is. I do not believe in age. I hope you do not either, because focusing on age can bring you down. When people ask how old I am, I tell them I am 16. Do I believe it? Yes, I do, because that is my belief and what I have always been.

I’m not changing that. I do not care what my chronological or physical age is. That is irrelevant to me. Everything to me is more on the spiritual and mental level, and I am here to demonstrate that to people. Anyone who wants to come in and meet me, I would love to see you.

We have a caller coming in. Before we take the call, I want to give you the studio number because I want to talk to everybody about their musculoskeletal complaints, questions about stem cells or PRP, injuries, and arthritis. The question could be about you, a friend, or a family member. The studio number is 866-870-5752.

If you want a free phone consultation and a free book, call our staff at 800-300-9300. If you want to watch videos of me performing these procedures, visit stemcellinstitute.com. Every page has a place where you can email me. I answer my emails every day and get right back to people.

We have Kevin from Los Angeles. Kevin, what is going on with you? Can you hear me?

KEVIN: Yes. Hi, Dr. Darrow. Can you hear me?

MARC DARROW, MD: You’re good, man.

KEVIN: Okay, cool. I have a question about stem cells. I do not know if you remember, but probably 12 years ago I had a frozen right shoulder, and you treated it with prolotherapy.

MARC DARROW, MD: Okay.

KEVIN: It really fixed it. My shoulder became completely free again after being seized up for a year.

MARC DARROW, MD: Wow.

KEVIN: Now I have been diagnosed with osteoarthritis in my left hip. I have heard a lot about stem cells. Could you give a simple explanation of how stem cells work and whether they could be useful for my left hip osteoarthritis?

MARC DARROW, MD: Sure. I’m glad you called with that question, and I’m glad we were able to help your shoulder. You said that about 12 years ago you had prolotherapy, a form of regenerative medicine that has been used for approximately 130 years.

Two doctors in Chicago, Hemwall and Hackett, treated thousands of patients with it. It fell out of favor for some reason; I’m not sure why. It was a simple procedure using concentrated dextrose with lidocaine.

That would produce an inflammatory reaction similar to a small injury. Fibroblasts from the blood would then be drawn to the injection area, where they grow new collagen. Collagen is found throughout the body. Most importantly for you, it is in your cartilage, muscles, tendons, and ligaments.

When I treated you 12 years ago, how many treatments did it take for your frozen shoulder to improve?

KEVIN: I think it was four or five.

MARC DARROW, MD: That is a good segue into what we are doing now. When PRP came out, I adopted it because, in my experience, it worked more efficiently than old-school prolotherapy, which I had performed for years on thousands of patients because that was what we had available.

When PRP came to the forefront, I started using it immediately. Please turn down your radio because we’re getting feedback.

What I found from treating my own body when I was injured was that PRP worked more efficiently for me than prolotherapy. Some physicians still use prolotherapy. One possible reason is that they do not have to draw blood; they use dextrose and lidocaine from a bottle.

From my personal experience, prolotherapy did not work as well for me as what we have now. I have had injuries for which I used prolotherapy without getting the result I wanted, and then PRP worked very well. If PRP did not achieve what I wanted, I moved to stem cells mixed with PRP to get the benefits of both.

KEVIN: What does PRP stand for again?

MARC DARROW, MD: Platelet-rich plasma. It is a simple procedure. We draw your blood and spin it in a centrifuge. The heavier red blood cells go to the bottom, while the platelets remain toward the top. We can then aspirate the platelet-containing plasma and not use the red cells.

Whole blood could theoretically be used, and I know physicians who used it in the past, but it is more painful. Red blood cells in the tissue can be more painful and are not necessary. Whole blood has been used over many years, but it is not commonly used for this purpose today.

KEVIN: Does the plasma contain white cells and other things that promote healing?

MARC DARROW, MD: Yes. Platelets are among the first cells to go to an injury. If you cut yourself and we examined the tissue, we would find platelets going there. They are part of the initial response to injury and begin a healing cascade.

PRP can also contain leukocytes, or white blood cells, which are inflammatory. We value an appropriate inflammatory response because it can bring fibroblasts from the blood into the area, where they also lay down new tissue.

We also combine PRP with stem cells. The PRP acts more like scaffolding—a ladder for the stem cells to grow on. To me, it is better to use different things together than only one or the other, although they all work differently. It is a question of efficacy.

Now let’s discuss your hip. Your shoulder did well, and your hip has arthritis. Are you able to walk? Do you have a limp?

KEVIN: Occasionally, but not very often.

MARC DARROW, MD: You probably have fairly good range of motion. I’m guessing you had imaging and a doctor told you that you have hip arthritis. Is that correct?

KEVIN: Yes. The doctor said it was bone-on-bone. I saw the image. One hip appears to have some joint space, and the other does not seem to have space.

MARC DARROW, MD: Please do not let the term “bone-on-bone” automatically convince you that you must have joint replacement surgery. That terminology can create a psychological state in which a patient believes healing or improvement is impossible.

I see people described as having bone-on-bone changes who remain functional. If you still have range of motion, that matters. Do you participate in any sports?

KEVIN: I swim.

MARC DARROW, MD: If you’re swimming, you are still moving that joint. True loss of cartilage can severely restrict movement. Cartilage is the slippery surface over the ends of bones that permits a joint to move.

I have seen patients over the years whose joints moved very little. In my experience, we can sometimes still help by injecting PRP and stem cells into the joint. I’m not saying you would receive a brand-new hip like a 15-year-old, but the goal would be some pain relief and perhaps increased range of motion.

KEVIN: That sounds great.

MARC DARROW, MD: Kevin, if you want to speak with my staff for a free phone consultation, call 800-300-9300. You can also visit stemcellinstitute.com to watch videos of me performing procedures on shoulders, hips, elbows, and other areas.

I treat the whole body rather than limiting treatment to knees or shoulders. Another important consideration is to choose a doctor who knows how to use ultrasound to guide the needle and confirm where it is going.

Ultrasound does not have to be used on every part of the body, but it is important for joints, especially when the target is small. The same applies to the hip. Much of my continuing education involves ultrasound training with cadavers because this is important to maintain.

The hip joint is difficult to access accurately without ultrasound. Years ago, before ultrasound guidance became common, regenerative-medicine meetings included discussions about why hips did not seem to heal as well as other areas. We learned that injections were not always reaching the hip joint.

KEVIN: Is there an approximation of how many injections or PRP and stem-cell procedures it would take to get the hip moving?

MARC DARROW, MD: Not until I examine you. That is the important point. Imaging can be useful because it may reveal conditions such as a cyst or cancer, but an image does not always identify the source of a person’s pain.

An image is useful for a surgeon to identify an anatomical area, but that does not necessarily mean the operation will address the pain generator. When I ask patients with failed surgeries whether the surgeon physically examined them, many say the decision was based primarily on an X-ray or MRI. When I examine them and touch another area, they sometimes say, “That’s the spot that causes the pain.”

Be careful about undergoing surgery you may not need. It is possible that something other than the hip joint is contributing to your pain. Many anatomical structures around the hip can create pain. A person could undergo a hip replacement and still experience pain if the hip joint was not the primary pain generator.

KEVIN: Right. Over the last few months, especially after hernia surgery, I have felt out of it and have spent a lot of time on the couch. I keep hearing internally that I have to change my lifestyle, stop watching television, and do all of that.

MARC DARROW, MD: Have the problem evaluated and learn about the options available to you. Look at stemcellinstitute.com and watch the procedures. The process can involve drawing blood, spinning it, and mixing the PRP with stem cells. Bone marrow may also be an option. There are different ways of obtaining stem cells.

You owe it to yourself to find out what is available. In my view, surgery is sometimes necessary for musculoskeletal emergencies, and surgery is also necessary for many other conditions, including cancers and bowel problems. In my opinion, however, many elective musculoskeletal operations should be approached carefully. My office sees patients whose surgeries did not relieve their pain.

Kevin, we’re going to Dena Lee in Monrovia. Thank you so much. God bless you.

If you want a free phone consultation with the staff and a free copy of my book, Stem Cell and Platelet Therapy: Regenerate, Don’t Operate, call 800-300-9300.

For listeners who want to call me live in the studio, the number is 866-870-5752.

Dena Lee, can you hear me?

DENA LEE: Yes. Can you hear me?

MARC DARROW, MD: Yes. How are you today, Dena?

DENA LEE: I’m doing well, Dr. Darrow. How are you?

MARC DARROW, MD: I’m always living it up. Patients ask, “How come you’re always so happy?” I say, “I’m living it up.” I have already told my wife that I want my gravestone to say, “Living it up.”

DENA LEE: That is a great thing to put on your tombstone.

MARC DARROW, MD: Why not? Do you remember W. C. Fields, the actor and comedian?

DENA LEE: Yes.

MARC DARROW, MD: His gravestone said, “All things considered, I’d rather be in Philadelphia.” I do not believe in death anyway, so what is the difference? When it is time for my ashes to go somewhere, spread them around. Everybody who wants them can take a piece. My motto is, “When God wants me, I’m ready to go.”

Anyway, Dena, what is going on? Do you have any musculoskeletal injuries or problems?

DENA LEE: My knees are something that comes and goes. I have been looking at the information about stem cells. I want to know what you can tell me about them and how you perform the process.

MARC DARROW, MD: Those are very good questions. Do you want to know how they work, how we obtain them, or what they do?

How they work is simple: they can form colonies of tissue. They grow into tissue, and wherever you put them, they seem to know where to go.

There was a study many years ago involving rats with retinal damage. The researchers administered stem cells intravenously and marked them with an isotope so they could observe where they went. Guess where the stem cells went?

DENA LEE: To the eye?

MARC DARROW, MD: Yes, they went to the retina. Ding, ding—you get a prize.

DENA LEE: I get a prize, right?

MARC DARROW, MD: You get a free retina.

Based on studies I have read, stem cells are released from our bone marrow throughout our lives. They help keep processes regenerating in the body. Stem cells are present throughout the body, and many are dormant, or asleep. When we inject stem cells, we aim to activate regenerative processes.

The injection also creates a degree of inflammation. After injections, patients usually experience some stiffness. The inflammatory response can bring fibroblasts from the blood into the area. Those cells lay down new collagen, which is a major component of cartilage.

We have about 20 seconds until the break, Dena. We’ll pause and take you again after the break. Dena, stay with me. Adam Pontrelli, stay with me if you can.

We’re going to a short break. Anyone who wants a free phone consultation with my staff can call the office at 800-300-9300. To watch videos of me performing these procedures, visit stemcellinstitute.com.

Hang on, everybody. We’re going to the break, and we’ll be right back. Thank you so much.

ANNOUNCER: You’re listening to Living Pain-Free with Marc Darrow, MD, at the Stem Cell Institute in West Los Angeles. To schedule an appointment, call 800-300-9300. That’s 800-300-9300.

MARC DARROW, MD: Marc Darrow, MD, here. I trained at UCLA, where I learned about regenerative medicine. In the old days, it was prolotherapy. Today, it is PRP and stem cells, which I have found more effective.

If anyone wants to call the show, I would love to talk with you at 866-870-5752. You can also visit stemcellinstitute.com and email me there. I get back to everybody the same day.

For a free phone consultation with my staff, call 800-300-9300. We would also love to send you a free copy of my book, Stem Cell and Platelet Therapy: Regenerate, Don’t Operate. It contains 250 studies on stem cells and PRP, and the foreword is by Suzanne Somers.

Dena, I’m going to let you go. Come in and get your knees evaluated. I would love to take care of you.

I’m going to Adam, who has been waiting for quite some time. Adam, are you still with me?

ADAM: Yes. Thank you so much for taking my call. I have some tears in my shoulder, and I feel as though I’m getting the runaround. My physical therapist and everybody else are pushing me toward an orthopedist, and that is the last place I want to go.

MARC DARROW, MD: When you say they are pushing you toward an orthopedist, do you mean an orthopedic surgeon to have surgery?

ADAM: Yes.

MARC DARROW, MD: How long has this been going on?

ADAM: Probably about six months. I think I keep reinjuring it, and it is becoming increasingly painful. It is time to take care of it.

MARC DARROW, MD: I assume you are athletic and do not give it much opportunity to heal.

ADAM: Guilty as charged.

MARC DARROW, MD: That is difficult for active athletes. They do not give injuries a chance to heal. I’m raising my hand, too, because I push myself after an injury, even if it hurts, until I cannot use the area anymore. Then I go into the office and inject myself. We athletes are all a little crazy.

One of the biggest issues I have with patients is that they do not let the treated area heal after we inject platelets or stem cells. Did you have an MRI of your shoulder?

ADAM: Yes. I have a full-thickness tear of the supraspinatus and another tear in the labrum. I feel the one in the front near the biceps tendon, but I do not necessarily feel the one in the back as much.

MARC DARROW, MD: The labrum is deep within the joint. It is the fibrocartilage surrounding the head of the humerus that helps hold the upper arm bone in the glenoid, or shoulder socket.

I have similar MRI findings and no pain. I have treated myself and improved. My MRI shows a supraspinatus tear, a labral tear, and a subscapularis tear, but I do not have pain.

Do not get lost in the diagnosis. A finding described by another doctor may not identify the area generating the pain. The important question is whether the structure on the image is actually the pain generator.

If you want to come in for an examination, call the office at 800-300-9300. I can use my hands and ultrasound to determine where the pain appears to be coming from. People ask, “Don’t you want an MRI?” I tell them, “My hands are my MRI and my X-ray.” A physical examination can be more useful for identifying the painful structure.

ADAM: What could stem cells do for me?

MARC DARROW, MD: If you are fortunate and respond as I did, the goal would be to make you feel much better.

ADAM: Perfect is okay, right?

MARC DARROW, MD: I’m not promising anything. If you decide to have treatment, you will sign a consent form stating that there are no guarantees. In my experience, it often works, but you have to follow my directions. It can take more than one treatment to achieve what you want.

ADAM: I appreciate that. Thank you so much.

MARC DARROW, MD: God bless you, Adam. I appreciate your call.

We’re going to Raphael in Venice. Raphael, are you with us?

RAPHAEL: Hi, Dr. Darrow. How are you today?

MARC DARROW, MD: I’m living it up, man. I’m a happy camper.

RAPHAEL: Amazing. I’m one of the patients at your Joint Rehab and Sports Medical Center in Brentwood. Dr. Grove gave me PRP injections last year, and they definitely helped with my hip bursitis. They took away a lot of the pain, which makes me very happy.

MARC DARROW, MD: Before you continue, I have a question so I understand what you are describing. I do not think we have met. Did you say hip bursitis?

RAPHAEL: Yes.

MARC DARROW, MD: Can you describe where that is on your body for everyone listening?

RAPHAEL: If you run your hand down the outside of the hip, you can feel a bony prominence—the greater trochanter. In the area around it, I had swelling, inflammation, and considerable pain. My right hip was trying to become another support mechanism because my left leg was so weak.

MARC DARROW, MD: I have not examined you, but the area you are describing is not necessarily the hip joint. People often call any pain in that region “hip pain.” The bony prominence on the side of the femur is the greater trochanter. There are numerous muscle and tendon attachments in that area, as well as bursae.

Bursae are small, fluid-filled sacs that cushion areas where tendons attach or move over bone. Problems involving these tissues may be treatable and are different from disease inside the hip joint.

We see patients who have undergone hip replacement but still have pain around the greater trochanter. When I palpate the area, it may become apparent that the operation did not address the original pain generator.

RAPHAEL: Right. When I was in your clinic, one of the doctors examined my left knee with ultrasound and found a lateral collateral ligament tear. Could that have anything to do with the hip-area problem?

MARC DARROW, MD: Not directly. It could be related indirectly through posture, mobility, or favoring one side. Compensating for the knee could place additional stress on the greater trochanter and the tendons attached there.

RAPHAEL: My main question about the stem-cell treatment is whether it actually regenerates cartilage, discs, tendons, or ligaments, or whether it mainly reduces inflammation and pain.

MARC DARROW, MD: The intention is tissue repair as well as relief of pain and inflammation. It is not given merely as a pain shot. It is given with the goal of repairing tissue so the pain improves.

RAPHAEL: Does that include discs, tendons, and ligaments?

MARC DARROW, MD: I do not generally inject spinal discs. MRI findings involving discs often do not identify the source of the person’s pain.

I do not want to criticize surgeons. I think they perform some of the hardest work in medicine. I simply believe surgery should be reserved for situations in which it is needed. If you break a bone and have bone protruding, for example, you need a surgeon to repair it.

In my experience, many elective musculoskeletal operations do not need to be performed. I have done this work for almost 30 years. New patients come in every day after being told they have bone-on-bone arthritis, require surgery, or have a herniated disc. We often treat them without surgery. I have herniated discs and no pain.

RAPHAEL: That is amazing. May I ask one more question?

MARC DARROW, MD: Absolutely.

RAPHAEL: What is the difference between bone marrow stem cells, fat-derived cells, and products from umbilical cord or birth tissue?

MARC DARROW, MD: That is a great question. In my clinical experience, I have not observed a meaningful difference in efficacy. I have used them all. They can all work when used by an experienced physician in the right situation.

RAPHAEL: Do you do anything differently at your clinic?

MARC DARROW, MD: Yes, we do many things differently, but they are trade secrets.

RAPHAEL: All right. That sounds good, Dr. Darrow.

MARC DARROW, MD: God bless you, Raphael. Thank you so much.

We have a few more people to get to. If you want to talk to me live, the studio number is 866-870-5752.

For a free phone consultation with my staff and a free copy of our book, which contains approximately 250 scientific studies on stem cells and PRP, call 800-300-9300. To watch the videos, visit stemcellinstitute.com.

Next is Doug in Orange County, who has been waiting quite some time. Sorry to keep you waiting. Doug, do you have a question for me?

DOUG: No problem, Dr. Darrow. It is great to speak with you. I’m an avid tennis player.

MARC DARROW, MD: Good.

DOUG: I love to hit a hard serve. Recently, when I extend upward to serve, I have been experiencing increasing shoulder pain. Could stem-cell therapy potentially help this situation?

MARC DARROW, MD: Great question. People who play tennis, swim, or repeatedly perform similar overhead movements often develop shoulder problems from overuse. You might have a shoulder tear, but the pathology shown on an image is not the only important consideration. You need an examination so someone can palpate the area and determine where the pain is being generated.

I played a lot of tennis when I was younger. After a weightlifting injury and years of tennis, I had shoulder surgery that failed. When I discovered regenerative injections, I treated myself and experienced rapid relief. Based on that experience, I believe there is reason to consider whether this approach might help your shoulder.

I also learned to modify my serve to avoid jolting the shoulder. Instead of a hard topspin serve, I learned a slice serve in which my arm remained more connected with my body. I pulled my body and arm down together while cutting across the ball. It was effective and placed less demand on my shoulder. You might consider modifying your serve as well.

DOUG: That is a great idea. Thank you so much.

MARC DARROW, MD: God bless you, Doug. I appreciate your call.

We’re going to Larry in Palos Verdes, and then we’ll get to Stephen. Larry, how are you today?

LARRY: I’m good. How is it going, doctor?

MARC DARROW, MD: I’m living it up, man. How about you?

LARRY: I have a 17-year-old daughter who is an avid soccer player. A couple of years ago, she tore her meniscus.

MARC DARROW, MD: Meniscal tears are common among soccer players. The sport can be hard on the knees. I have meniscal tears in both knees, but I do not have pain. I have already treated them.

LARRY: Her doctor recommended repairing the meniscus, so she had surgery. Afterward, she could not participate in activities for approximately two months. Now, a couple of years later, she is coming home from soccer practice with knee pain. I do not think the repair worked. At age 17, would stem cells be a viable option for her?

MARC DARROW, MD: Age alone does not determine whether someone may be treated. In my practice, I have treated people ranging from adolescents to 100 years old. I also do not agree with the assumption that a person’s stem cells are automatically ineffective simply because the person is older. That is my clinical opinion based on my experience.

One concern after meniscal surgery is that tissue may be removed even when the procedure is described as a repair. Removing tissue can affect knee stability. If she came in, I would examine the knee with ultrasound to see what condition the tissues are in after surgery.

Many patients I see with knee pain have either undergone meniscal surgery or have an untreated meniscal tear. In my experience, regenerative treatment may sometimes help even after prior surgery.

LARRY: What would the downtime be after treatment?

MARC DARROW, MD: That is difficult to predict because it depends on the person and the injury. Some areas of my body improved rapidly, while others took longer. I generally ask patients to avoid stressing the treated joint for at least a couple of weeks. That does not mean lying in bed; it means not participating in the sport and allowing the early healing response to develop. Then we reexamine the patient and assess progress.

LARRY: The number of treatments would also depend on the patient?

MARC DARROW, MD: Absolutely. Everybody is different, everybody heals differently, and every injury is different. The first step is an examination to locate the pain generator. I like to review imaging, but imaging alone does not decide what I will do. Then we discuss what the patient wants to do.

LARRY: Where would the stem cells come from? Would they be umbilical-cord-derived cells, or would you obtain them from her?

MARC DARROW, MD: That would be a choice made after discussing the options. There are several approaches.

LARRY: She may be skittish about needles. How many injections would she need?

MARC DARROW, MD: If someone is concerned about needles, we can apply numbing cream to the treatment area to numb the skin. We can also use a cold spray.

Patients often do not know how many injections they receive. They may feel the first one, and then the brain seems to reduce its awareness of the area. On rare occasions, I have treated broad areas with 20 or more injections, and patients have told me afterward that they felt only one or two.

God bless you, Larry. I have Stephen, who has been waiting quite a while. I would love to evaluate your daughter. For a free phone consultation and more information, call the office at 800-300-9300.

Stephen, are you still with me?

STEPHEN: Yes. Thanks, Dr. Darrow. I have heard a lot of good things about you, and I appreciate you taking the call.

I run quite a bit. I was wondering about your perspective on stem cells for runner’s knee or more chronic knee pain.

MARC DARROW, MD: “Runner’s knee” could describe several conditions. I would need to examine you to determine what it is. Often, the pain involves the patellar tendon or nearby tissues between the bottom of the patella and the tibial tuberosity.

The patellar tendon is a band of collagen connecting the kneecap to the tibia. If that is the source of your pain, I have found it can respond well to PRP and stem cells. Before giving you a diagnosis, however, I would need to examine the knee and see what is happening.

How many miles do you usually run per day or per week?

STEPHEN: Approximately 30 or more miles per week.

MARC DARROW, MD: That may not be too much for some runners, but it might be too much for your body right now. How old are you?

STEPHEN: I’m in my early 30s.

MARC DARROW, MD: It is something to address now so it does not progress. How long has it been going on?

STEPHEN: On and off for a few years.

MARC DARROW, MD: It is worth evaluating. Based on what you have described, it may not be a severe problem, but it can certainly be painful.

A related problem commonly seen in adolescent boys who run and jump extensively is Osgood-Schlatter disease. The tibial tuberosity, the area below the kneecap where the patellar tendon attaches, can become prominent and painful. If you have a painful bump there, that can also be evaluated.

STEPHEN: Thank you. I appreciate all the information.

MARC DARROW, MD: With any repetitive sport, it is helpful to allow a day of rest between sessions when possible. We all want to do our sport every day. If I had my preference, I would work out all day because it is fun and makes me feel great. It is still important to rest one body area and exercise another when you can.

STEPHEN: That sounds good. Thank you, Dr. Darrow. I appreciate it.

MARC DARROW, MD: I appreciate you, Stephen. God bless you. Stop in sometime. I would love to examine you and determine what the issue is.

I’m going to answer an interesting question that just arrived through the website. If you want to ask me a question, visit stemcellinstitute.com. Every page has a place to email me, and I answer quickly.

This question concerns Bertolotti syndrome. Very simply, this is a congenital anatomical variation in which an enlarged transverse process of the lowest lumbar vertebra, usually L5, forms a joint or fuses with the sacrum or pelvis. The transverse processes are the parts of a vertebra that project outward. The sacrum is the wedge-shaped bone beneath the lower back, in the middle of the pelvis.

The person writes: “I have Bertolotti syndrome and pain. I have undergone 15 acupuncture sessions, which helped a little. I cannot stand or sit for too long. Should I have surgery? What should I do? Am I a good candidate for stem cells?”

First, an anatomical finding associated with Bertolotti syndrome does not automatically prove that it is the source of the pain. If a surgeon says you should have surgery solely because the variation appears on imaging, research the diagnosis and seek a careful evaluation. The key question is whether that structure is actually generating the symptoms.

I’m a conservative doctor. I prefer to consider less-invasive options such as PRP or stem cells when appropriate. These are injection procedures performed without general anesthesia.

I hear that we’re at the end of the show. God bless you all. It has been a pleasure talking with you. I appreciate your calls and everyone listening.

For a free copy of my book, call the office at 800-300-9300, and we will send it to you. God bless you all. It has been fun.

ANNOUNCER: You have been listening to Living Pain-Free with Marc Darrow, MD. To schedule an appointment, call 800-300-9300. Ask for a copy of Dr. Darrow’s book, Stem Cell and Platelet Therapy: Regenerate, Don’t Operate, or visit stemcellinstitute.com.

Living Pain-Free with Marc Darrow, MD is heard Saturdays at 10:00 a.m., 1:00 p.m., and 5:00 p.m. on AM 870 The Answer.

Take the first step toward a pain-free life. Call 800-300-9300. Live long and pain-free.