I had this exact procedure done with this exact doctor and the results have been incredible. Hands down best decision I have ever made. Thank you to the amazing staff and to the facility for helping me along this journey. It has been eight weeks and my recovery is 80-90% right now. I am two PRP injection rounds in and will never look back. Incredible.
I severed both of my Rotator Cuffs in a Heavy Equipment Accident and I had PRP done on both in 2015 and I only had to have 1 treatment , I keep my pH up and I believe that helps too.
1. How much was the cost for this procedure? Was any of it covered by insurance? 2. How much blood was drawn and how much PRP was produced for the injections? Thank you
I have had multiple PRP and stem cell procedures, all with outstanding results. Dr. Sebastian truly worked to discover the source of my pain and offered multiple solutions. I feel amazing and thank Dr. Sebastian and his wonderful staff for my pain free life! Gwen
Thank you Gwen, I find that PRP and prolotherapy injections for lower back pain are a great alternative to surgery for spinal arthritis, bulging and herniated discs. Using PRP - platelet lysate for the epidural injections is also a great option for herniated discs, lumbar radiculopathy and sciatica as it can quickly eliminate leg pain, decrease inflammation and stimulate nerve healing.
@@sebastianklisiewiczintegra9805 love your videos doctor! I am scheduled for Prp & prolothesrpy but I seen another doctor and he mention Prp is absolutely useless! He said he may help the ligaments but it doesn’t treat the disc. He said this machine called the DRX 9000 will bring fluid back to my disc by stretching my lower back for about 20-30 sessions. Wanted to pick your brain on that, any suggestions doctor?
@@bridgetown2076 PRP injections (with a prolotherapy approach, treating the whole spinal segment) is a proven and effective treatment for back pain, sciatica (and inability, muscle spasms, spinal arthritis, and disc bulge). You can do a literature search on google scholar and you will find medical literature supporting its use. In my clinic, we see pain relief and return in function, PRP is a great alternative to steroids, pain medications and surgery. Your doctor must be a chiropractor and has his own beliefs and favorites (as we all do), DRX is a spinal decompression unit, works in some cases, but it will not strengthen your spine nor help heal the muscles, ligaments and joints.
I live in Thailand and tomorrow I start these injections at Srinagarind Hospital in Khon Kean. I am looking forward to this after 30 plus years of physical therapies, chiropractors, neurologists, and orthopedics. They never once suggested any type of injections. I sure hope this works.
I’m in my second week after performing PRP on my lower back. I have minimal degenerative disc, bulging disc in L5 and S1 and also I have nerve damage, and I’m starting to notice major improvement and I’m not in a serious pain anymore!! I really hope this improvement is going to continue. My doctor said I will start to notice the pain will fade away gradually at the 3rd week . I will do another treatment to enhance the process 🙌🏼
The healing continues for 6-8 weeks after the PRP, so your back should be getting better. Best results are usually with a series of treatments (~ 2-3 treatments spaced 4-8 weeks apart). Good luck, keep us posted :)
@@kerimbalaban610 my burning sensation is localized “ symptoms only appear in my lower back “ I asked my doctor why I always have burning sensation and she said I probably had nerve damage, but anyway, I still have symptoms but not as bad as before and haven’t had the burning sensation in a while.
@@sebastianklisiewiczintegra9805 Thank you, Dr...I have L5 S1 for 9 months and I suffer from pain and difficulty moving. I do not have problems with footfall or urination. I use Tildene. My question is, is it possible to recover permanently through injections, or is injection a temporary treatment? Will injections spare me from surgery? I will be happy to answer my question.
Dr Klisiewicz, I was lucky enough to find your video. I started my own research to find a Pain Center near me to look for treatment. I have bulging L4L5 and L5S1 with spine instability on both. I can't seat down for long, laid on my back or function. I can't carry weight on my back or my hands. I'm in constant pain. Also sciatica on both legs. Life came to a complete holt. It's been a year What questions do you think I should ask the Dr who would perform PRP treatment? Thank you again for this video.
For a procedure that actually cures the problem, it appears to be getting low amount of publicity compared to other treatment options that don't help as much. These other options only help to manage the condition like physiotherapy, chiropractic sessions, engronomic chairs, pain killers, all sorts of exercises etc. I believe the reason is the there's more money to be made in treating an ailment rather than curing it.
@B. L. Hello sir, have you tried any stem cell or PRP therapy related to the back area? My MRI shows a L5-S1 DDD, causing left foot drop, was wondering if these treatments along with core exercises can alleviate the pain.
It does not cure the problem, it's only a temporary relief in most cases (except for tendon problems, where it can cure the problem), it can fail like any other treatment if your condition is too advanced. It's not covered by insurance companies because it is still experimental, so you have to pay out of pocket between 1-3 thousand USD per injection, most of the time, more than 1 injection is needed, so, PRP treatment or stem cells can end up being as expensive as surgery.
How many injections are needed? Is it safe to do it for cervical spine at c4-c5 level? Is this a permanent remedy. I have a mild disc protrusion but i do have nerve compression hence my doc has aske me to get tgis done.
Thank you for valuable content. Doctor, does literature support PRP administration for chronic backache or disc prolapse? If yes, please share the link, would love to read more about it. 🙂
PRP for the spine is a safe, effective and proven treatment for low back pain, sciatica and herniated discs. There is ample of research articles that support it effectiveness in all areas of the spine. The best PRP treatment for back pain includes several treatments of the whole spinal unit (facet joints and ligaments, muscles, SI joint, epidural space and spinal nerves). Here is just a few of the studies showing the individual benefits of PRP for back pain and sciatica. There are many more, hope this helps. Transforaminal Epidural with PRP provided significant relief from sciatica (radiculopathy) for greater than 1 year in 25 patients. www.sciencedirect.com/science/article/pii/S1015958422005929 PRP of the lumbar spine and PRP lysate epidural augmented with resoprtion of herniated discs, case series www.degruyter.com/document/doi/10.7556/jaoa.2020.032/html PRP caudal epidural injection provided better relief that steroids at 6 month follow up in a controlled randomized study onlinelibrary.wiley.com/doi/abs/10.1111/papr.12893 Lumbar facet injections with PRP were superior to steroids for chronic low back pain from facet arthritis inovomedical.ca/wp-content/uploads/2017/07/Wu_et_al-2017-Pain_Practice.pdf PRP was superior to steroids for treatments of low back pain from SI joint pain www.prolotherapy.com/pdf-spine-pelvis/SP-012-Steroid-versus-platelet-rich-plasma-in-ultrasound-guided-sacroiliac-joint-injection-for-chronic-low-back-pain-(2017).pdf
@@sebastianklisiewiczintegra9805 no doctor,I do not agree with this procedure and if you could be so kind to reply to me I would love to explain You why.
For any disc injection (discseel, PRP, stem cells), we use nitrous gas, pain medications and anesthetics. These keep the procedure very tolerable, pain is not severe. Nobody has complained :)
I'm looking for PRP treatment near me, i am just wondering has there been a time that something has went wrong for you? And if there has been, what is the worse one of them all and how many times has it happened?
PRP is typically considered a safe and effective nonsurgical treatment for back pain when done by an experience physician. It is best to have it done with ultrasound or X-ray guidance for accuracy and safety. I have not had any complications and I have done hundreds of these treatments. The worse we get is increased pain for a few weeks, some headaches and a few allergic reactions. Consider flying out to Fort Myers for a treatment with us. integrativerehabmedicine.com/SouthWest-Fl-Arthritis-pain-treatment-Orthopedic-care-Naples-Sports-Medicine
I really would love to start PRP but with the negative side effects of back surgery I’m a bit nervous has there been any negative feedback from these injections I do construction can’t really mess my back up or I’ll be jobless
PRP is a safe and effective treatment for back pain and sciatica. It uses your own plasma and immune system to improve the health of your spine. Please watch some of my testimonial videos on this channel and follow the link below for more information: integrativerehabmedicine.com/naples-fort-myers-bonita-springs-spine-pain-treatment
PRP injections of the lumbar spine (lower back) are a great nonsurgical alternative for bulging discs as this can stimulate healing and stability of the whole spinal unit. Not everyone is a candidate, it is important to have a consultation to go over the symptoms, physical exam and imaging to evaluate if you are a candidate, you can call my office for more information (we have patients from all over the US and Canada): integrativerehabmedicine.com/contact
Thank you, Dr...I have L5 S1 for 9 months and I suffer from pain and difficulty moving. I do not have problems with footfall or urination. I use Tildene. My question is, is it possible to recover permanently through injections, or is injection a temporary treatment? Will injections spare me from surgery? I will be happy to answer my question.
PRP injections can be a very effective treatment lumbar spine injuries (such ad for L5-S1 disc injury). When done correctly with guidance (ultrasound and X-ray), PRP can be injected in all the supporting structures and the lumbar disc to stimulate healing of the whole functional unit. When combined with proper therapy and nutritional support, this can heal the injury and provide long term relief. see for more detail: integrativerehabmedicine.com/a-deep-dive-into-low-back-pain
Thank you dr. Just quick question, can prp injection be used for degeneration/dehydration of Thoracis spine discs. I have issue from T1 to T6 on my MRI. Plz keep up the videos and Thank you so much
PRP / Prolotherapy can be an effective treatment for thoracic spine pain (upper back pain) from degenerated discs and weak muscles/ligaments. The PRP / Prolotherapy can strengthen the ligaments that support your thoracic spine and offload the vertebral discs, thus improving the spinal segment health and treating thoracic pain, see more details: integrativerehabmedicine.com/treatments-prolotherapy
After years of having these procedures I ended up having surgery , I had spondylolisthesis. 5 years ago had Lumber Fusion L5 S1. i was totaly incapacitated. Lumber crisis keep me in bed for days. The most important thing is to get the right diagnosis and do your homework research the best doctor for your operation I'm doing great .
I have L3L4 bulge and stenosis at this point, with Sciatic pain. I will let you know after my procedure in a week. I've already had my Achilles fixed using PRP. Its amazing
@@jasonhughes3152 OK... Be great if you could let me know I'm in the middle of my prolotherapy.. 3 months in.. No difference so far but a lot of bruising.... Its important for us all as patience to get as much feed back on these injections as possible.. And not just take the doctors word for it that it works...
Yes, PRP for low back pain can help patients of all ages as long as they are healthy enough to mount the healing response. To maximize results, we combine PRP injections with Pilates therapy, laser therapy and specific diet and supplement regimen. Also, you can improve you PRP quality by intermittent fasting and performing high intensity exercise prior to your procedure. Such an Integrative approach provides the best PRP in the Fort Myers, Estero and Bonita Springs area.
PRP seems to be very effective when treating the spine, stems cells are not a whole lot better for the spinal ligaments and joints. Stem cells are more effective when treating knee arthritis or large rotator cuff tears. integrativerehabmedicine.com/treatments-bone-marrow-stem-cells
Naseer. We have patients come from all over the country for prolotherapy and prp treatments of the spine. We treat herniated discs, back sprains, arthritis, stenosis. It is difficult to give you advice without a consultation. You can schedule a virtual (telehealth) consultation to discuss. Contact our clinic: integrativerehabmedicine.com/contact
I had leg pain in October last year and had again in March but I got injection and eat medicine i can't do the therapy bc of my board exam , my pain only last 1 week in October but 2 weeks March will my sciatica come back
The procedure takes ~ 20-30 minutes, depending on you condition, it can help for months to years. Best to schedule a consultation for a full evaluation and treatment plan. Our PRP treatments are combined with specific regenerative physical therapy, nutrition and lasers. please visit our website www.iRehabMed.com for more information.
PRP can be used for back pain with sciatica (radiculopathy) and lumbar stenosis injected as an epidural (caudal or other). It is typically further processed to release the growth factors (platelet lysate or releasate), this can be safely injected into the epidural space. It does not cause inflammations, it is anti-inflammatory. There are multiple medical papers outlining the beneficial effects of PRP on sciatica, neuropathy, carpal tunnel, spinal stenosis.
Spinal PRP and prolotherapy is offered in the US. We recommend the patient waits ~ 6 weeks after any steroid injection as steroids weaken the muscles and tendons and can dampen the healing response. for more info, please read this blog article: integrativerehabmedicine.com/healing-back-pain-with-platelet-rich-plasma-prp
Doing a PRP lysate epidural can help with radiculopathy due to scaring. It may take a series of treatments for best results. See our video on PRP lysate epidural: ua-cam.com/video/qGMGLVXeqPQ/v-deo.html
I offer nonsurgical back pain and sciatica treatment with PRP injections in my clinic in Estero (southwest florida, between Naples and fort myers). I am a back pain specialist with extensive training in PRP, stem cells and other regenerative treatments of the spine. check out my website: integrativerehabmedicine.com/naples-fort-myers-bonita-springs-spine-pain-treatment/
Bone marrow stem cells and high concentration PRP injections into the spinal disc are a safe and effective treatment for degenerated discs. In clinical studies, ~ 40% of patients had improvement on MRI images ~ 12 months after bone marrow stem cell injections into the disc, yet most patients showed significant improvement in pain and function. See link to one study below. link.springer.com/article/10.1007/s00264-017-3560-9
Prolotherapy and PRP of the spine actually heal the injured ligaments, joint capsules and muscles. They increase spinal stability (often the root cause of chronic back pain). We find that with a series of treatments combined with therapy, patients can achieve full recovery and long term results. get more info here: integrativerehabmedicine.com/healing-back-pain-with-platelet-rich-plasma-prp
I have a minor slipped disc in my lower spine and painful sciatica for 5+ months. Ive done physio and RMT massages. I stopped taking pain killers as i dont want them. Ive been told i can try steroid shots. Any thoughts?
Steroid injections can provide temporary relief, but may not give you long term results. PRP of the lumbar spine along with PRP lysate epidural injection can help the body heal the injured spinal segment and provide long term relief. Sometime we need to inject the disc to help it heal from within, see for more details: integrativerehabmedicine.com/a-deep-dive-into-low-back-pain
PRP injections of the spine are effective and safe when done under image guidance by an experienced doctor. The spinal cord ends at ~ L1, so there is no chance of hitting the spinal cord when treating low back pain. When this is done under ultrasound or X-ray, it can be done safely anywhere in the spine, above L1. :)
We are located in Estero FL (just south of Fort Myers FL), a short flight away from Las Vegas. We have many patients travel to Florida from all over the US for PRP treatment of the spine and other areas. Contact our office for more details: integrativerehabmedicine.com/contact
PRP and Prolotherapy injections (as shown here, in Estero FL) are not typical pain management procedures to temporarily take away the pain. They are meant to heal and stabilize ligaments and other injured tissues thus potentially healing the condition. A series of 2-5 procedures can typically provide longterm relief .
I have two herniated discs been in pain for almost 3 years and I'm considering this in the future only if it would help because I have seen some comments in here with horror stories and it's starting to scare me off
We offer non-surgical treatments of the spine, for back pain and degenerated spinal discs. I do inject PRP or bone marrow stem cells into the discs with careful X-ray guidance. We also use PRP epidurals to treat the nerves and PRP to treat all the supporting ligaments and joints of the spine. It is a very comprehensive treatment of the spine. We are located in Estero FL (southwest florida), we have patient come from all over he US for treatments. Schedule a telehealth consultation: integrativerehabmedicine.com/back-pain-relief-treatment-naples-fort-myers-fl
I saw your technic injection without aspiration before injected your medication (lokal anestetic), how if the needle tip intra vascularly? Local anestetic intravascular can made intoxication, heart stop working. 🤔
For prolotherapy and PRP of the spine, the needle tip is placed on bone, therefore not intravascular, the ultrasound also helps identify and concerning vessels and nerves. The dosages of lidocaine and ropivacaine we use in the area will not affect the heart nor other organs.
This treatments is combined with therapy (therapy is covered by insurance). The PRP injections for the spine are in the ~$1,000 range, depending on size of area and PRP used.
When doing prolotherapy or PRP for back pain, the pre-numbing does not reduce the results, it make the procedure more tolerable. Lidocaine can be used in the skin, but for the deeper numbing, we use ropivacaine. When injected deep, lidocaine can be inhibitory to stem cells and possibly platelets, but ropivacaine is safe and does not exitbit any negative effects.
When PRP and prolotherapy of the spine is done correctly under image guidance (such as ultrasound or X-ray), it is very unlikely to injure the dura and cause a leak. Only have this done by someone who has a lot of experience with treating the spine.
Everyone responds differently to PRP injections for back pain and sciatica. The pre-numbing and the caudal epidural helps decrease the discomfort. At times, we also use pre-procedure medications to calm the patient and decrease the discomfort. When I do prolotherapy and PRP of the spine, I try to be very gentle with each injection.
My clinic Integrative Rehab Medicine is located in Estero FL (between Fort Myers and Naples FL). PRP of the spine and platelet lysate epidural can help lumbar herniated discs heal faster as it stimulates the immune system to degrade the herniated disc. It also stabilizes the spinal ligaments and strengthens the back muscles, making this a more healthy healing environment. see this case report published in the Journal of Osteopathic medicine: www.degruyter.com/document/doi/10.7556/jaoa.2020.032/html Although, if you have significant weakness of the leg (foot drop), surgery may be needed. Call you clinic for a telehealth consultation: integrativerehabmedicine.com/contact/
PRP of the spine can stabilize the ligaments and strengthen the tendons and muscles that support the spine. This decreases the stress on the discs and allows the body to heal the disc. Platelet lysate (growth factors from PRP) can be injected into the epidural space, this can help the body to heal the discs and ligaments from etc inside. Sometimes, PRP can be injected into the disc, this may provide additional benefit, but often this is not necessary.
@@davoncci the first 3 days it was painful from the injection site. I can say it helped but you have to still do some type of back stretching and remember to sit up straight and I am getting a bed that supports the spine while I sleep
PRP and prolotherapy injections of the spine can provide long term relief from chronic back pain because they are meant to heal and strengthen the area, not just block the pain like steroid injections. Healing depends on many factors such as the health, strength and commitment of the person. Some patients only need 1 spinal PRP and Prolotherapy procedure while others may need ~ 2-3 procedures (usually 4-6 weeks apart). We always combine our Prolotherapy and PRP procedures with physical therapy, nutrition optimization and other modalities such as bracing, taping or cold laser. Non-surgical treatment of back pain is truly a healing journey. integrativerehabmedicine.com/conditions-back-pain/
@@mysteryman123able This particular patient had a chronic lumbosacral injury from many years of abusing his back. He received 1 spinal PRP procedure and 3 spinal prolotherapy injections over a course of 8 months along with some Pilates therapy. His last prolotherapy was in June, currently his back and leg symptoms are fully resolved and he is back to full activity without restrictions. integrativerehabmedicine.com/conditions-back-pain
@@edwardgongsky8540 Ultrasound guidance for spine PRP injections allows us to clearly see and distinguish the lumbar facet joints, lamina, spinous process and all the surrounding muscles. This makes PRP a very powerful treatment for chronic back pain. These spine structures may not show up the clearest on the video, but regardless it takes a lot of practice to be able to distinguish the grays, whites and blacks on the ultrasound monitor.
Do you think this could help,? I got a L5/S1 bulge/extrusion and my coordination is all screwed up i feel like im walking on a trampoline a lot i believe thr disc is causing this. I also have ligament damage all throughout neck
Prolotherapy and PRP is a great treatment and alternative to surgery for back pain and sciatic caused by a bulging disc. This treatment can help stabilize your spine and allow the body to heal the bulge. The coordination and walking issue is more likely coming from your neck (consider getting evaluated for cervical stenosis) and possibly cervical instability. see this video ua-cam.com/video/t8L1TnDCFc4/v-deo.html
PRP injections can help stabilize the spine and also help your body deal with the bulging disc. This may provide an improved feeling of stability. You would need a full evaluation. Please contact us for a consultation to discuss your case and to see if you would be a candidate: integrativerehabmedicine.com/contact
Is every syringe about a 1000 dollars, or is the 1000 dollars for the treating the entire lower back? For example, if I need to have like 2-3 syringes of PPR, how much would that cost?
This is a very comprehensive treatment of the low back that requires plenty of PRP. The cost can be ~ $1500-$2500 for the entire procedure, depending on the extent of the treatment and if we include the epidurals, nitrous gas or other. We make very high quality PRP in our lab, and we can process large amounts of blood to give us as much PRP as needed for the spinal procedure (can be 2-6 syringes). Contact our clinic to schedule a consultation (live or virtual): integrativerehabmedicine.com/contact
This is a chronic illness,and Medicare should cover at least some of the money… But unfortunately they don’t 😞 a bit costly if your in too much pain to work,and pay for it.
Unfortunately, Medicare does not pay for prolotherapy and PRP, it is a great treatment for chronic pain, an alternative to pain medications and surgery. There are ways to arrange payment plans and make it possible.
Medical doctors such as DOs and MDs can perform prolotherapy and prp injections (such as this one for low back pain and sciatica). Best to work with someone who has plenty of experience in prolotherapy and other nerve treatments (such a perineural injections and nerve hydrodissections. integrativerehabmedicine.com/treatments-prolotherapy/
Prolotherapy and prp for back pain and sciatica does not harm the kidneys. The injections are guided under ultrasound, away from the kidney. PRP and Dextrose for the prolotherapy are not toxic to the kidney nor any other organs. Steroid injections and NSAID medications on the other hand, can have more harmful effects on the body and organs.
FYI - More recent research shows that actually some red in the PRP is good, this also allows us to capture more platelets, I have changed my protocol since.
PRP of the spine is different then steroids. Steroids just decrease the inflammation but do not heal nor stabilize the spine. Steroids also have short and long term side effects. Prolotherapy and PRP for back pain actually heal the tissue without the degenerative side effects of steroids. See our article for more details: integrativerehabmedicine.com/healing-back-pain-with-platelet-rich-plasma-prp
Yeah screw that. I’m so glad I’m going under sedation for this on Monday. I don’t care what people think. I’m getting my right hip & shoulder done, under sedation.
I had this exact procedure done with this exact doctor and the results have been incredible. Hands down best decision I have ever made. Thank you to the amazing staff and to the facility for helping me along this journey. It has been eight weeks and my recovery is 80-90% right now. I am two PRP injection rounds in and will never look back. Incredible.
May I ask what was wrong with you? I have a disc bulge
How u doing now cody
may I ask how much this costed you as I am looking to get this done too
I severed both of my Rotator Cuffs in a Heavy Equipment Accident and I had PRP done on both in 2015 and I only had to have 1 treatment , I keep my pH up and I believe that helps too.
Can we talk a little bit? Im debating getting it. Have you been pain free for a while??
1. How much was the cost for this procedure?
Was any of it covered by insurance?
2. How much blood was drawn and how much PRP was produced for the injections?
Thank you
I had this done for chronic back pain and other issues caused by an incompetent chiropractor, its worth every pennies, and it saved my life
I have had multiple PRP and stem cell procedures, all with outstanding results. Dr. Sebastian truly worked to discover the source of my pain and offered multiple solutions. I feel amazing and thank Dr. Sebastian and his wonderful staff for my pain free life! Gwen
Thank you Gwen, I find that PRP and prolotherapy injections for lower back pain are a great alternative to surgery for spinal arthritis, bulging and herniated discs. Using PRP - platelet lysate for the epidural injections is also a great option for herniated discs, lumbar radiculopathy and sciatica as it can quickly eliminate leg pain, decrease inflammation and stimulate nerve healing.
@@sebastianklisiewiczintegra9805 love your videos doctor! I am scheduled for Prp & prolothesrpy but I seen another doctor and he mention Prp is absolutely useless! He said he may help the ligaments but it doesn’t treat the disc. He said this machine called the DRX 9000 will bring fluid back to my disc by stretching my lower back for about 20-30 sessions. Wanted to pick your brain on that, any suggestions doctor?
@@bridgetown2076 PRP injections (with a prolotherapy approach, treating the whole spinal segment) is a proven and effective treatment for back pain, sciatica (and inability, muscle spasms, spinal arthritis, and disc bulge). You can do a literature search on google scholar and you will find medical literature supporting its use. In my clinic, we see pain relief and return in function, PRP is a great alternative to steroids, pain medications and surgery. Your doctor must be a chiropractor and has his own beliefs and favorites (as we all do), DRX is a spinal decompression unit, works in some cases, but it will not strengthen your spine nor help heal the muscles, ligaments and joints.
I live in Thailand and tomorrow I start these injections at Srinagarind Hospital in Khon Kean. I am looking forward to this after 30 plus years of physical therapies, chiropractors, neurologists, and orthopedics. They never once suggested any type of injections. I sure hope this works.
Hey Kenneth did it work ? Please share.
Pls tell me if it works because I am in pain sciatica for over 2 years try everything already none it works. Thanks
Let us know how it goes.. We all need honest feedback
How did it go
I guess it didnt
I’m in my second week after performing PRP on my lower back. I have minimal degenerative disc, bulging disc in L5 and S1 and also I have nerve damage, and I’m starting to notice major improvement and I’m not in a serious pain anymore!! I really hope this improvement is going to continue. My doctor said I will start to notice the pain will fade away gradually at the 3rd week . I will do another treatment to enhance the process 🙌🏼
The healing continues for 6-8 weeks after the PRP, so your back should be getting better. Best results are usually with a series of treatments (~ 2-3 treatments spaced 4-8 weeks apart). Good luck, keep us posted :)
Do you mean to say that you have burning sensation in feet? This is the case for me. Or what do you mean by nerve damage? Thank you
@@kerimbalaban610 my burning sensation is localized “ symptoms only appear in my lower back “ I asked my doctor why I always have burning sensation and she said I probably had nerve damage, but anyway, I still have symptoms but not as bad as before and haven’t had the burning sensation in a while.
@@sebastianklisiewiczintegra9805 Thank you, Dr...I have L5 S1 for 9 months and I suffer from pain and difficulty moving. I do not have problems with footfall or urination. I use Tildene. My question is, is it possible to recover permanently through injections, or is injection a temporary treatment? Will injections spare me from surgery? I will be happy to answer my question.
@@sebastianklisiewiczintegra9805 does this treatment cause temporary relief or permenet relief?
This surgeon knows what he is doing, would like to have him working on me if needed. A top man.
Dr Klisiewicz, I was lucky enough to find your video. I started my own research to find a Pain Center near me to look for treatment.
I have bulging L4L5 and L5S1 with spine instability on both. I can't seat down for long, laid on my back or function. I can't carry weight on my back or my hands. I'm in constant pain. Also sciatica on both legs. Life came to a complete holt. It's been a year
What questions do you think I should ask the Dr who would perform PRP treatment?
Thank you again for this video.
If you go ahead with it let me know how you get on?
Plz, share your experience with me after you're done. I have same issue 4yrs ago
For a procedure that actually cures the problem, it appears to be getting low amount of publicity compared to other treatment options that don't help as much. These other options only help to manage the condition like physiotherapy, chiropractic sessions, engronomic chairs, pain killers, all sorts of exercises etc. I believe the reason is the there's more money to be made in treating an ailment rather than curing it.
You're spot on on the accessment. Have you tried PRP on the spine area?
@B. L. Hello sir, have you tried any stem cell or PRP therapy related to the back area? My MRI shows a L5-S1 DDD, causing left foot drop, was wondering if these treatments along with core exercises can alleviate the pain.
It does not cure the problem, it's only a temporary relief in most cases (except for tendon problems, where it can cure the problem), it can fail like any other treatment if your condition is too advanced. It's not covered by insurance companies because it is still experimental, so you have to pay out of pocket between 1-3 thousand USD per injection, most of the time, more than 1 injection is needed, so, PRP treatment or stem cells can end up being as expensive as surgery.
@@DrCantinero Is your assessment from experience?
@B. L. There is its 500 a shot.. I'm op to 2000 and no relief yet after 10 weeks
I need this injection because I suffer from sciatica.
What part of the disc is the PRP injected into? And does the healing take place in the entirety of the disc?
I had PRP three weeks ago and I am 90% better it worked for me.
May I ask what was wrong with you?
How many injections are needed? Is it safe to do it for cervical spine at c4-c5 level?
Is this a permanent remedy. I have a mild disc protrusion but i do have nerve compression hence my doc has aske me to get tgis done.
Is it okay to use red light therapy and PEMF right after the procedure or should there be any gap?
That ultrasound screen should work on voice command
Thank you for valuable content. Doctor, does literature support PRP administration for chronic backache or disc prolapse? If yes, please share the link, would love to read more about it. 🙂
PRP for the spine is a safe, effective and proven treatment for low back pain, sciatica and herniated discs. There is ample of research articles that support it effectiveness in all areas of the spine. The best PRP treatment for back pain includes several treatments of the whole spinal unit (facet joints and ligaments, muscles, SI joint, epidural space and spinal nerves). Here is just a few of the studies showing the individual benefits of PRP for back pain and sciatica. There are many more, hope this helps.
Transforaminal Epidural with PRP provided significant relief from sciatica (radiculopathy) for greater than 1 year in 25 patients.
www.sciencedirect.com/science/article/pii/S1015958422005929
PRP of the lumbar spine and PRP lysate epidural augmented with resoprtion of herniated discs, case series
www.degruyter.com/document/doi/10.7556/jaoa.2020.032/html
PRP caudal epidural injection provided better relief that steroids at 6 month follow up in a controlled randomized study
onlinelibrary.wiley.com/doi/abs/10.1111/papr.12893
Lumbar facet injections with PRP were superior to steroids for chronic low back pain from facet arthritis
inovomedical.ca/wp-content/uploads/2017/07/Wu_et_al-2017-Pain_Practice.pdf
PRP was superior to steroids for treatments of low back pain from SI joint pain
www.prolotherapy.com/pdf-spine-pelvis/SP-012-Steroid-versus-platelet-rich-plasma-in-ultrasound-guided-sacroiliac-joint-injection-for-chronic-low-back-pain-(2017).pdf
@@sebastianklisiewiczintegra9805 no doctor,I do not agree with this procedure and if you could be so kind to reply to me I would love to explain You why.
@@eeerrr5966I’m curious as to why? I’m considering getting it done soon. Thanks
How painful is the Intradiscal Injection?
For any disc injection (discseel, PRP, stem cells), we use nitrous gas, pain medications and anesthetics. These keep the procedure very tolerable, pain is not severe. Nobody has complained :)
I'm looking for PRP treatment near me, i am just wondering has there been a time that something has went wrong for you? And if there has been, what is the worse one of them all and how many times has it happened?
PRP is typically considered a safe and effective nonsurgical treatment for back pain when done by an experience physician. It is best to have it done with ultrasound or X-ray guidance for accuracy and safety. I have not had any complications and I have done hundreds of these treatments. The worse we get is increased pain for a few weeks, some headaches and a few allergic reactions.
Consider flying out to Fort Myers for a treatment with us.
integrativerehabmedicine.com/SouthWest-Fl-Arthritis-pain-treatment-Orthopedic-care-Naples-Sports-Medicine
I really would love to start PRP but with the negative side effects of back surgery I’m a bit nervous has there been any negative feedback from these injections I do construction can’t really mess my back up or I’ll be jobless
PRP is a safe and effective treatment for back pain and sciatica. It uses your own plasma and immune system to improve the health of your spine. Please watch some of my testimonial videos on this channel and follow the link below for more information: integrativerehabmedicine.com/naples-fort-myers-bonita-springs-spine-pain-treatment
I have L5/S1 bulge/extrusion im wondering if this is why my balance is screwed up so bad! Do you think prp would help?
PRP injections of the lumbar spine (lower back) are a great nonsurgical alternative for bulging discs as this can stimulate healing and stability of the whole spinal unit. Not everyone is a candidate, it is important to have a consultation to go over the symptoms, physical exam and imaging to evaluate if you are a candidate, you can call my office for more information (we have patients from all over the US and Canada): integrativerehabmedicine.com/contact
You haven't injected cortisone then,what was the indication ,was there any motor deficits? ,or only radicular pain
Thank you, Dr...I have L5 S1 for 9 months and I suffer from pain and difficulty moving. I do not have problems with footfall or urination. I use Tildene. My question is, is it possible to recover permanently through injections, or is injection a temporary treatment? Will injections spare me from surgery? I will be happy to answer my question.
PRP injections can be a very effective treatment lumbar spine injuries (such ad for L5-S1 disc injury). When done correctly with guidance (ultrasound and X-ray), PRP can be injected in all the supporting structures and the lumbar disc to stimulate healing of the whole functional unit. When combined with proper therapy and nutritional support, this can heal the injury and provide long term relief. see for more detail: integrativerehabmedicine.com/a-deep-dive-into-low-back-pain
Ddd is such a general term. Does prp heal facet joint osteoarthritis on lumbar and cervical spine?
May I ask, what size and length needle do you use to inject? Thank you
Thank you dr. Just quick question, can prp injection be used for degeneration/dehydration of Thoracis spine discs. I have issue from T1 to T6 on my MRI. Plz keep up the videos and Thank you so much
PRP / Prolotherapy can be an effective treatment for thoracic spine pain (upper back pain) from degenerated discs and weak muscles/ligaments. The PRP / Prolotherapy can strengthen the ligaments that support your thoracic spine and offload the vertebral discs, thus improving the spinal segment health and treating thoracic pain, see more details: integrativerehabmedicine.com/treatments-prolotherapy
I wonder if this would work for spondololysthesis in my lumbar. I had it done on my left meniscus and it was good for 4 months, and that's it.
After years of having these procedures I ended up having surgery , I had spondylolisthesis. 5 years ago had Lumber Fusion L5 S1. i was totaly incapacitated. Lumber crisis keep me in bed for days. The most important thing is to get the right diagnosis and do your homework research the best doctor for your operation I'm doing great .
hi I have L4 L5 disk bulge and spinal stenosis. i have scitica pain. Does PRP can heal these things?
I have L3L4 bulge and stenosis at this point, with Sciatic pain. I will let you know after my procedure in a week.
I've already had my Achilles fixed using PRP. Its amazing
@@jasonhughes3152 any good?
@@mysteryman123able Sorry, the procedure did not get set up right away, so I'm still waiting.
@@jasonhughes3152 OK... Be great if you could let me know I'm in the middle of my prolotherapy.. 3 months in.. No difference so far but a lot of bruising.... Its important for us all as patience to get as much feed back on these injections as possible.. And not just take the doctors word for it that it works...
@@mysteryman123able No doubt. My intentions are to let everyone know my results.
Can PRP for lower back pain be performed on a otherwise healthy 84 year old man?
Yes, PRP for low back pain can help patients of all ages as long as they are healthy enough to mount the healing response. To maximize results, we combine PRP injections with Pilates therapy, laser therapy and specific diet and supplement regimen. Also, you can improve you PRP quality by intermittent fasting and performing high intensity exercise prior to your procedure. Such an Integrative approach provides the best PRP in the Fort Myers, Estero and Bonita Springs area.
Dr, when would you recommend stem cell instead of prp?
PRP seems to be very effective when treating the spine, stems cells are not a whole lot better for the spinal ligaments and joints. Stem cells are more effective when treating knee arthritis or large rotator cuff tears. integrativerehabmedicine.com/treatments-bone-marrow-stem-cells
Dr. How much will it cost me PRP tx for my lower back?
Hlo hi how are you
I have a problem in L5 S1
Please give me advise
I saw your video of spine injection
Naseer. We have patients come from all over the country for prolotherapy and prp treatments of the spine. We treat herniated discs, back sprains, arthritis, stenosis. It is difficult to give you advice without a consultation. You can schedule a virtual (telehealth) consultation to discuss. Contact our clinic:
integrativerehabmedicine.com/contact
I had leg pain in October last year and had again in March but I got injection and eat medicine i can't do the therapy bc of my board exam , my pain only last 1 week in October but 2 weeks March will my sciatica come back
How long will this treatment last
The procedure takes ~ 20-30 minutes, depending on you condition, it can help for months to years. Best to schedule a consultation for a full evaluation and treatment plan. Our PRP treatments are combined with specific regenerative physical therapy, nutrition and lasers. please visit our website www.iRehabMed.com for more information.
@@sebastianklisiewiczintegra9805 Thank you. I don't want surgery. So i will make an appointment.
@@daltonvoss7693 PRP and Prolotherapy is a great alternative to spine surgery. We will do our best to help you avoid surgery :)
Can PRP be injected epidurally? Caudal route....will it cause inflammation/pain?
PRP can be used for back pain with sciatica (radiculopathy) and lumbar stenosis injected as an epidural (caudal or other). It is typically further processed to release the growth factors (platelet lysate or releasate), this can be safely injected into the epidural space. It does not cause inflammations, it is anti-inflammatory. There are multiple medical papers outlining the beneficial effects of PRP on sciatica, neuropathy, carpal tunnel, spinal stenosis.
what about PRF? will be better ?
Is this offered in the states (CT) and how long should I give after my first cortisone shot to give this a try? Look for a way to be me again
Spinal PRP and prolotherapy is offered in the US. We recommend the patient waits ~ 6 weeks after any steroid injection as steroids weaken the muscles and tendons and can dampen the healing response. for more info, please read this blog article: integrativerehabmedicine.com/healing-back-pain-with-platelet-rich-plasma-prp
Does PRP improve neuraxial radiculopathy secondary to surgical scarring post laminectomy?
Doing a PRP lysate epidural can help with radiculopathy due to scaring. It may take a series of treatments for best results. See our video on PRP lysate epidural: ua-cam.com/video/qGMGLVXeqPQ/v-deo.html
Where are you located?
I offer nonsurgical back pain and sciatica treatment with PRP injections in my clinic in Estero (southwest florida, between Naples and fort myers). I am a back pain specialist with extensive training in PRP, stem cells and other regenerative treatments of the spine. check out my website: integrativerehabmedicine.com/naples-fort-myers-bonita-springs-spine-pain-treatment/
Dr, how much volume you drawn the blood patient? so, you get to much number of PRP? I recognized any spuit 10 cc full of PRP. Thank a lot
May i ask, after intradiscal prp injection, will the dessicated disc regenerate / rehydrate?
Bone marrow stem cells and high concentration PRP injections into the spinal disc are a safe and effective treatment for degenerated discs. In clinical studies, ~ 40% of patients had improvement on MRI images ~ 12 months after bone marrow stem cell injections into the disc, yet most patients showed significant improvement in pain and function.
See link to one study below.
link.springer.com/article/10.1007/s00264-017-3560-9
Thank you so much for this information.
Does this only mask the pain? Or actually heals the injury??
Prolotherapy and PRP of the spine actually heal the injured ligaments, joint capsules and muscles. They increase spinal stability (often the root cause of chronic back pain). We find that with a series of treatments combined with therapy, patients can achieve full recovery and long term results. get more info here: integrativerehabmedicine.com/healing-back-pain-with-platelet-rich-plasma-prp
I have a minor slipped disc in my lower spine and painful sciatica for 5+ months. Ive done physio and RMT massages. I stopped taking pain killers as i dont want them. Ive been told i can try steroid shots. Any thoughts?
Steroid injections can provide temporary relief, but may not give you long term results. PRP of the lumbar spine along with PRP lysate epidural injection can help the body heal the injured spinal segment and provide long term relief. Sometime we need to inject the disc to help it heal from within, see for more details: integrativerehabmedicine.com/a-deep-dive-into-low-back-pain
I'm interested but what are the chances of accidently injecting into the spinal cord?
PRP injections of the spine are effective and safe when done under image guidance by an experienced doctor. The spinal cord ends at ~ L1, so there is no chance of hitting the spinal cord when treating low back pain. When this is done under ultrasound or X-ray, it can be done safely anywhere in the spine, above L1. :)
Any recommendations for a dr who does prp in las vegas
We are located in Estero FL (just south of Fort Myers FL), a short flight away from Las Vegas. We have many patients travel to Florida from all over the US for PRP treatment of the spine and other areas. Contact our office for more details: integrativerehabmedicine.com/contact
How long will he be pain free
PRP and Prolotherapy injections (as shown here, in Estero FL) are not typical pain management procedures to temporarily take away the pain. They are meant to heal and stabilize ligaments and other injured tissues thus potentially healing the condition. A series of 2-5 procedures can typically provide longterm relief .
@@sebastianklisiewiczintegra9805 OK doctors how come hardly any comments saying how it helps..
How much relief can you get from the first injection and how long should you wait for the second
I have two herniated discs been in pain for almost 3 years and I'm considering this in the future only if it would help because I have seen some comments in here with horror stories and it's starting to scare me off
DO you also inject prp intradiscal for dessicated disc ?
We offer non-surgical treatments of the spine, for back pain and degenerated spinal discs. I do inject PRP or bone marrow stem cells into the discs with careful X-ray guidance. We also use PRP epidurals to treat the nerves and PRP to treat all the supporting ligaments and joints of the spine. It is a very comprehensive treatment of the spine. We are located in Estero FL (southwest florida), we have patient come from all over he US for treatments. Schedule a telehealth consultation: integrativerehabmedicine.com/back-pain-relief-treatment-naples-fort-myers-fl
I saw your technic injection without aspiration before injected your medication (lokal anestetic), how if the needle tip intra vascularly? Local anestetic intravascular can made intoxication, heart stop working. 🤔
For prolotherapy and PRP of the spine, the needle tip is placed on bone, therefore not intravascular, the ultrasound also helps identify and concerning vessels and nerves. The dosages of lidocaine and ropivacaine we use in the area will not affect the heart nor other organs.
how much is this treatment?
This treatments is combined with therapy (therapy is covered by insurance). The PRP injections for the spine are in the ~$1,000 range, depending on size of area and PRP used.
does the pre-numbing injections reduce the results of PRP?...should i just have skin numbing cream applied?!
When doing prolotherapy or PRP for back pain, the pre-numbing does not reduce the results, it make the procedure more tolerable. Lidocaine can be used in the skin, but for the deeper numbing, we use ropivacaine. When injected deep, lidocaine can be inhibitory to stem cells and possibly platelets, but ropivacaine is safe and does not exitbit any negative effects.
Does this puncture the dura or risk a csf leak?
When PRP and prolotherapy of the spine is done correctly under image guidance (such as ultrasound or X-ray), it is very unlikely to injure the dura and cause a leak. Only have this done by someone who has a lot of experience with treating the spine.
How is the patient so calm? I was on Being electrocuted and on fire when I got mine done in Texas
Everyone responds differently to PRP injections for back pain and sciatica. The pre-numbing and the caudal epidural helps decrease the discomfort. At times, we also use pre-procedure medications to calm the patient and decrease the discomfort. When I do prolotherapy and PRP of the spine, I try to be very gentle with each injection.
😳😳😳
Where in Texas did you have your done??
Where are you located? Can this help for 7MM Herniated Disc?
My clinic Integrative Rehab Medicine is located in Estero FL (between Fort Myers and Naples FL). PRP of the spine and platelet lysate epidural can help lumbar herniated discs heal faster as it stimulates the immune system to degrade the herniated disc. It also stabilizes the spinal ligaments and strengthens the back muscles, making this a more healthy healing environment. see this case report published in the Journal of Osteopathic medicine: www.degruyter.com/document/doi/10.7556/jaoa.2020.032/html
Although, if you have significant weakness of the leg (foot drop), surgery may be needed.
Call you clinic for a telehealth consultation: integrativerehabmedicine.com/contact/
Does PRP work for degenerative disc disease?
PRP of the spine can stabilize the ligaments and strengthen the tendons and muscles that support the spine. This decreases the stress on the discs and allows the body to heal the disc. Platelet lysate (growth factors from PRP) can be injected into the epidural space, this can help the body to heal the discs and ligaments from etc inside. Sometimes, PRP can be injected into the disc, this may provide additional benefit, but often this is not necessary.
@@sebastianklisiewiczintegra9805 thanks. I just need to find a good Doctor in Ga.
Does insurance cover this?
I'm having mines tomorrow morning I'm getting put to sleep. My insurance approved it. I'm from Philadelphia
@@arlenerobertspittsburghste3136 Hello, how are you? Did it work for you? I am from New York
@@davoncci the first 3 days it was painful from the injection site. I can say it helped but you have to still do some type of back stretching and remember to sit up straight and I am getting a bed that supports the spine while I sleep
after this injection pain never happened again ln l4 l5 s1 ?
PRP and prolotherapy injections of the spine can provide long term relief from chronic back pain because they are meant to heal and strengthen the area, not just block the pain like steroid injections. Healing depends on many factors such as the health, strength and commitment of the person. Some patients only need 1 spinal PRP and Prolotherapy procedure while others may need ~ 2-3 procedures (usually 4-6 weeks apart). We always combine our Prolotherapy and PRP procedures with physical therapy, nutrition optimization and other modalities such as bracing, taping or cold laser. Non-surgical treatment of back pain is truly a healing journey.
integrativerehabmedicine.com/conditions-back-pain/
@@sebastianklisiewiczintegra9805 you didn't answer.. Was this patient pain free for good... Did it work... It didnt did it
@@mysteryman123able This particular patient had a chronic lumbosacral injury from many years of abusing his back. He received 1 spinal PRP procedure and 3 spinal prolotherapy injections over a course of 8 months along with some Pilates therapy. His last prolotherapy was in June, currently his back and leg symptoms are fully resolved and he is back to full activity without restrictions.
integrativerehabmedicine.com/conditions-back-pain
No frigen way will a needle be any where near my spine.
How does the doc know exactly where that needle is poking? Asking because the image guidance doesn't seem to clear, just a blob
@@edwardgongsky8540 Ultrasound guidance for spine PRP injections allows us to clearly see and distinguish the lumbar facet joints, lamina, spinous process and all the surrounding muscles. This makes PRP a very powerful treatment for chronic back pain. These spine structures may not show up the clearest on the video, but regardless it takes a lot of practice to be able to distinguish the grays, whites and blacks on the ultrasound monitor.
That hurts a lot I did 2 times
Do you think this could help,? I got a L5/S1 bulge/extrusion and my coordination is all screwed up i feel like im walking on a trampoline a lot i believe thr disc is causing this. I also have ligament damage all throughout neck
Prolotherapy and PRP is a great treatment and alternative to surgery for back pain and sciatic caused by a bulging disc. This treatment can help stabilize your spine and allow the body to heal the bulge. The coordination and walking issue is more likely coming from your neck (consider getting evaluated for cervical stenosis) and possibly cervical instability. see this video ua-cam.com/video/t8L1TnDCFc4/v-deo.html
PRP injections can help stabilize the spine and also help your body deal with the bulging disc. This may provide an improved feeling of stability. You would need a full evaluation. Please contact us for a consultation to discuss your case and to see if you would be a candidate: integrativerehabmedicine.com/contact
@@sebastianklisiewiczintegra9805: Is it okay to use red light therapy and PEMF right after the procedure or should there be any gap?
Is every syringe about a 1000 dollars, or is the 1000 dollars for the treating the entire lower back? For example, if I need to have like 2-3 syringes of PPR, how much would that cost?
This is a very comprehensive treatment of the low back that requires plenty of PRP. The cost can be ~ $1500-$2500 for the entire procedure, depending on the extent of the treatment and if we include the epidurals, nitrous gas or other. We make very high quality PRP in our lab, and we can process large amounts of blood to give us as much PRP as needed for the spinal procedure (can be 2-6 syringes). Contact our clinic to schedule a consultation (live or virtual): integrativerehabmedicine.com/contact
educational.
Doctor, do you know a good doctor in Los Angeles Area for referral?
Doctor Peter Fields out of a Santa Monica. Great doctor. Did 3 prp treatments on my lower spine. Healed me in 2-3 months.
@@imfrom63rd-n4l5 Thanks a lot, Doctor. You're doing a great job. Many success to your life.
@@imfrom63rd-n4l5 do you know if this prp really works to heal annular tears?
candacejanine I do not know the answer to that
@@imfrom63rd-n4l5 ok what did you use prp to heal specifically?
This is a chronic illness,and Medicare should cover at least some of the money…
But unfortunately they don’t 😞 a bit costly if your in too much pain to work,and pay for it.
Unfortunately, Medicare does not pay for prolotherapy and PRP, it is a great treatment for chronic pain, an alternative to pain medications and surgery. There are ways to arrange payment plans and make it possible.
What kind of doctors are allowed to do this treatment?
Medical doctors such as DOs and MDs can perform prolotherapy and prp injections (such as this one for low back pain and sciatica). Best to work with someone who has plenty of experience in prolotherapy and other nerve treatments (such a perineural injections and nerve hydrodissections. integrativerehabmedicine.com/treatments-prolotherapy/
@@sebastianklisiewiczintegra9805 hi
Why do you say stem cells? I thought you were giving him PRP?
PRP is filled with growth factors that activate the local and other stem cells to come to the injection site and start the healing process.
How many day is reslat
most people need to rest ~ 1 week after spinal PRP, the rest is shorter after prolotherapy with dextrose, typically ~ 3 days
Is this injection harm for kidney?
Prolotherapy and prp for back pain and sciatica does not harm the kidneys. The injections are guided under ultrasound, away from the kidney. PRP and Dextrose for the prolotherapy are not toxic to the kidney nor any other organs. Steroid injections and NSAID medications on the other hand, can have more harmful effects on the body and organs.
ya that red sucks says Dr Chris Centero from Regenexx. He said he is godfather of PRP.
FYI - More recent research shows that actually some red in the PRP is good, this also allows us to capture more platelets, I have changed my protocol since.
PRP injection AND STEROID injection ARE SAME ?
PRP of the spine is different then steroids. Steroids just decrease the inflammation but do not heal nor stabilize the spine. Steroids also have short and long term side effects. Prolotherapy and PRP for back pain actually heal the tissue without the degenerative side effects of steroids. See our article for more details: integrativerehabmedicine.com/healing-back-pain-with-platelet-rich-plasma-prp
Yeah screw that. I’m so glad I’m going under sedation for this on Monday. I don’t care what people think. I’m getting my right hip & shoulder done, under sedation.
App ka naber