Complementary Medical Services

Ear acupuncture, also known as auricular therapy is a powerful adjunct technique to treat various musculoskeletal conditions and to influence function of specific internal organs or the brain. The ear is a microsystem with the entire body represented on the auricle, the outer portion of the ear. Ailments of various joints or internal organs manifest in the form of tactile or electrical changes in the correspondent ear acupuncture points.

We do not use a blind approach in acupuncture: specific ear acupuncture points are precisely located by highly sensitive electronic tools. Upon detection, the points are stimulated with powerful sterile titanium needles which stay inserted for several days. Typically, patients who undergo auricular therapy are seen at IFSMED on a weekly basis. The number of treatments may vary from as few as three to up to twenty.

IFSMED utilizes medical acupuncture almost exclusively to treat local or regional musculoskeletal problems such as:

• Neck and shoulder pain
• Rotator cuff syndrome and frozen shoulder
• Tennis and golfer’s elbows
• Carpal tunnel syndrome
• Low back pain
• Knee pain
• Various forms of tendonitis and bursitis

To find more information about our integrative medicine in San Diego, call IFSMED at (858) 794-9192 or send us an e-mail at info@ifsmed.com

Humans conduct biofeedback naturally all the time.

The concept of biofeedback is based on the fact that a wide variety of ongoing functions occur in our body on an unconscious level.

The biofeedback process is designed to interface with select aspects of these “unconscious” processes.

Biofeedback is the process of monitoring these functions by using electronic technology.

The newest and most successful current technologies utilize highly sophisticated equipment that target various pathological processes.

After researching various biofeedback devices and the outcomes of biofeedback therapies; the clinic made a decision to introduce several biofeedback therapies to San Diego mainly operating on magnetic or electromagnetic principles.

Types of biofeedback therapy performed at IFSMED:

MAGNETIC RESONANCE BIOFEEDBACK

Because every single cell and tissue in our body carries a magnetic frequency, by analyzing the magnetic activity of our tissues, we can compare the results to normal and abnormal values to discover the functional status of the analyzed areas.

Based on individual results, we can apply specific magnetic frequencies to the damaged areas to correct or at least improve function.

The magnetic resonance biofeedback device operates as a scanning device that maps your body’s inner magnetic characteristics and creates a ranking functional system by indicating significantly depleted and overreacted problematic areas to target.

During a session, specific magnetic frequencies are applied to the body and functional correction is monitored in real time via computer. When the correct frequency is sent to a “mistuned” cell, the cell will take on the correct frequency and begin to regenerate and recover.

The magnetic resonance biofeedback can be used for:
• pain control
• therapy of functional gastrointestinal disorders
• adjunct therapy of chronic inflammatory processes
• adjunct therapy of endocrine and metabolic processes
• adjunct therapy of chronic infections
• adjunct therapy of chronic fatigue
• adjunct therapy of brain fog
• adjunct therapy of allergies and mast cell disorders
• adjunct therapy of various neurological problems (peripheral neuropathy, plexopathy, radiculopathy etc)
• adjunct therapy for chronic headaches
• adjunct therapy for autoimmune encephalopathy
• adjunct therapy for Parkinsons disease

SCALAR WAVE (SW) BIOFEEDBACK THERAPY

Scalar energy is formed when two identical frequencies from opposite directions come together and collide. This results in the creation of a stationary and static energy field with circles of energy that radiate outwards creating a field of live energy.

SW therapy utilizes non-contact means of transmitting biological information and energy through the air that can help you enhance, motivate, protect, and balance your autonomic nervous system as it reduces stress and anxiety.

SW provides us with a fresh canvas for healing purposes by reducing negative feelings that are associated with adverse habitual actions and eliminating waste that often accompanies illness.

The SW biofeedback therapy performed at IFSMED is performed using state-of-the-art equipment designed by the ‘father’ of SW technology, professor Konstantin Meyl.

The main indications for SW biofeedback therapy include:
• anxiety
• chronic fatigue
• chronic inflammatory and autoimmune processes
• depression
• detoxification problems
• emotional problems associated with chronic illnesses
• endocrine imbalance
• irritable bowel syndrome
• rehabilitation after strokes and heart attacks
• sympathetic and parasympathetic imbalance, including POTS syndrome

ELECTROMAGNETIC BIOFEEDBACK

During an electromagnetic biofeedback therapy session, the biofeedback device stimulates the body with gentle focused pulsed electromagnetic fields of various frequencies and intensities and identifies stressed areas in the body guided with the help of the patient’s pulse.

The identified stressed areas are stimulated with specific frequencies to facilitate repair and regeneration of specific body areas, which are potentially responsible for a patients’ symptoms and disease processes.

This therapy is especially helpful for:
• accelerating recovery after acute and chronic infections
• balancing parasympathetic and sympathetic nervous systems
• facilitating the detoxification processes
• improving bone regeneration and bone density
• optimizing immune responses
• recovering from physical and/or emotional stress

NONLINEAR SYSTEM (NLS) BIOFEEDBACK THERAPY

NLS biofeedback is designed to read, communicate with, and stimulate a change in the energy of the body. NLS begins by conducting a communication scan. During this scan, weak electrical signals are sent to the vagus nerve via headphones while the devices listens to the body’s response from those signals.

Once the communication scan is complete, the software returns a graphical representation of any located distortions in the body, as well as recommendations for nutritionals, homeopathics, etc. — including identified areas for NLS therapy that are recommended for rebalancing. These will then stimulate the body’s healing response and correct the noted distortions.

The information of the body is like the software of a computer, telling the body’s biochemistry how to organize and structure itself. If you have perfectly operating software, your body knows precisely what to do and can repair itself. Essentially the body is able to work off of a blueprint or set of information codes for optimal health and homeostasis.

By putting energy back into the specific area of the issue, the NLS device can then raise the electrical potential of those cells, restoring them over time to their normal, optimal behavior. Meta Therapy also stimulates the vagus nerve system, sending a signal to the brain to direct resources to that particular part of the body as part of the natural healing response.

The main indications for NLS biofeedback therapy include:
• adrenal insufficiency
• cardiovascular disease
• diseases of liver, gall bladder and bile ducts
• diseases of peripheral nerves
• diseases of thyroid gland
• neurological dysautonomia, including POTS

The following table represents many of the specific conditions biofeedback could benefit.

*Can be used, the outcome is variable

**Predominately beneficial outcome

***or****Predicted positive outcome

The main principle of our clinic is to utilize overlapping alternative and traditional diagnostic systems to obtain a definitive diagnosis and to define the causative root of the problem.

Things to note:

• Non-established patients need to have a brief 20 minute initial consultation to determine good candidacy 
• Length of sessions varies from 15 minutes to several hours
• Number of sessions depends on the nature and chronicity/duration of the medical problem

To find more information about our biofeedback therapy in San Diego, call IFSMED at (858) 794-9192 or send us an e-mail at info@ifsmed.com

Since ancient times, it has been very well recognized that the human body reacts positively to light and that light can influence a number of important physiological processes varying from wound healing to pain control and mood regulation. Biochemical research indicate that human tissues contain a protein, cryptochrome, which reacts positively to light.

The science behind light therapy is multi-fold—useful for skin and tissue healing, relieving pain, decreasing inflammation, and helping to restore function of the tissue and cells.1

As a part of our integrative approach, we offer corrective light therapy which harmonizes body functions via exposure of specific body areas to light. The procedure uses a light emitting diode therapy (LEDT) with incoherent polychromatic LED’s running at 480-780nm.

The machine we use has four different wavelength settings that are tailored to each patient’s needs.

Red light produces a wavelength that targets the cells in a way to promote aerobic activity, which works to increase metabolism of the cells to promote healing.3

Blue light is mainly used for cosmetic purposes, particularly inflammatory acne by disrupting the cell membrane of the bacteria.4

Infrared light is thought to penetrate deeper into the skin than color, so we use this in combination with other settings to promote uptake into deeper tissues.3

Green or yellow light is not employed as a primary light but are useful in conjunction with other wavelengths mentioned above.

A typical protocol incorporates 8-10 1-hour sessions 2-3 times a week. Protocols are designed and performed by our physician assistant, Neenah.

Applications of corrective light therapy include:

Reflex sympathetic dystrophy or regional pain syndrome
Peripheral neuropathy
Sport-related trauma or injuries
Pain due to shingles (post-herpetic neuralgia)
Poorly-healed wounds/skin and tissue healing
Decreasing inflammation
Chronic infections
Interstitial cystitis
Anxiety disorder

1. Avci P, Gupta A, Sadasivam M, et al. “Low-level laser (light) therapy (LLLT) in skin: stimulating, healing, restoring.” Semin Cutan Med Surg. 2013 Mar; 32(1): 41–52.
2. Cidral-Filho F, Mazzardo-Martins L, et al. “Light-Emitting Diode Therapy Induces Analgesia in a Mouse Model of Postoperative Pain through Activation of Peripheral Opioid Receptors and the l-Arginine/Nitric Oxide Pathway.” Lasers in Medical Science. 2013; 29(2): 695–702. doi: 10.1007/s10103-013-1385-3.
3. De Almeida P, Alvaro R, et al. “Red (660 nm) and infrared (830 nm) low-level laser therapy in skeletal muscle fatigue in humans: what is better?” Lasers Med Sci. 2012; 27: 453-458. Doi: 10.1007/s10103-011-0957-3.
4. Gold M, Sensing W, Biron J. “Clinical efficacy of home-use blue-light therapy for mild-to-moderate acne.” Journal of Cosmetic and Laser Therapy. 2011; 13: 308-314. DOI: 10.3109/14764172.2011.630081.

Energy kinesiology, also known as applied kinesiology, is a holistic technique that uses muscle testing to uncover hidden ailments and determines and corrects the root cause of illness on a biochemical, genetic, and emotional level.

While traditional medicine heals on a chemical level with drugs, applied kinesiology heals on an energy level. Energy healing effects your energy field on multiple levels, including chakras, acupressure meridians, tree of life, and higher self connection among others.

Energy kinesiology is not a solo diagnostic tool, but rather a part of a complete holistic treatment protocol. Energy healing empowers the body to remove blockages to health and heal itself.

What does energy kinesiology do?
Finds what is disturbing or blocking the path to healing
Corrects the disturbance
Tests if the correction is successful
Determines if the correction is sustainable. To reach a sustainable level, multiple sessions may be necessary.

How does energy kinesiology work?
Applied kinesiology works on the idea that our muscles weaken when we are under stress. Specific muscles are connected to specific organs and tissues. By testing how your muscles respond to resistance, we can tell if the corresponding organ is functioning properly. By correcting the weakened muscle, we can help heal the problem in the associated organ.

How is muscle testing done?
A minimal amount of pressure is applied to a muscle to assess your ability to meet the pressure and resist. We’re not analyzing your physical strength, but instead are evaluating the response the muscle gives. If the muscle stands up to pressure, it’s deemed “strong” or “locked”; those that give way to pressure are considered “weak” or “unlocked,” and are deemed indicative of a problem.

What can I expect from a session?
Your first session can last from 2-3 hours. The environment is much like a massage room, with music playing and soft lighting. Dress in comfortable clothing as you will be lying on a massage table for most of the session. You may need 2-4 sessions to achieve a lasting correction.

Some areas energy kinesiology can help with:

• Reverse disease processes
• Access and correct the cause of pain
• Alleviate chronic allergies
• Release past trauma stored in your memory
• Correct genetic predispositions to certain diseases
• Identify and match supplements to your individual needs
• Reduce chronic fatigue by finding underlying contributing factors
• Determine previously unsuspected food or chemical sensitivities
• Start treatment before an imbalance progresses to a disease
• Erase stress and raise focus
• Long-standing or difficult to diagnose health problems

One-on-One Interview with Dr. Shikhman and Steve

Dr. Shikhman interviews Steve to describe what applied kinesiology is and the various ways it goes beyond traditional medicine to find an underlying cause using techniques that simply aren’t available in a traditional medical evaluation.

You will get a better understanding of how it may enhance your treatment protocol, how Dr. Shikhman and Steve work together, what you can expect from a session, and see a sample of a session.

Steve describes the core of his process as discovering and removing areas of stress in the body and bringing you back to a healthy balance.

Topics in the interview include:
:38 What is energy kinesiology?
1:43 How energy kinesiology is used as a diagnostic tool
2:40 Correlation between energy kinesiology and standard blood work
3:01 The benefits of energy kinesiology in the therapy of autoimmune disease
4:44 How energy kinesiology works in concert with dietary supplements, drugs, and homeopathic remedies
6:40 What can you expect from an appointment?
8:52 How many sessions are needed?

The Interview. (10 mins)
Dr. Shikhman and Steve take a deep dive into energy kinesiology and how it can help autoimmune diseases.

Supplement Testing. (4 mins)
Evaluate if a supplement is helpful or hurtful to your body.

Sample Session. (1 min)
This is sped up by 4x.
Quick example of the types of muscle testing movements that can be done in a session.

Steve is one of a handful of people in the country who practice this unique skill and we have the privilege of offering his services to you.

Call us to see how Steve can help you 858-794-9192.

Adult (non-embryonic) mesenchymal stem cells are undifferentiated cells that have the ability to replace dying cells and regenerate damaged tissue. These special cells seek out areas of injury, disease, and destruction. Once there, they are capable of regenerating healthy cells and accelerating the natural healing process.

There is increasing evidence of using stem cells to treat autoimmune diseases, restore joint function, as well as an anti-aging therapy.

Mesenchymal stem cell therapy is preferred over the traditionally used embryonic stem cells and induced pluripotent stem cells because unlike the mesenchymal stem cell, they have the potential to form tumors.

At IFSMED our therapy uses exosomes excreted from msenchymal stem cells derived from the umbilical cord, not the actual stem cells, as research as shown greater beneficial outcomes from exosomes over stem cells with minimal risk.

Exosomes are membrane-enclosed nanovesicles that are facilitators of cell-to-cell communication. They facilitate the exchange of biological information between different cell types. They travel to the target area, which are then taken up by the target’s cells to facilitate healing.

Exosomes possess a strong regenerative potential and can normalize various pathological and inflammatory processes in chronic ailments. In addition, stem cell-derived exosomes are frequently used as a part of anti-aging therapy.

Beneficial uses of mesenchymal stem cell exosomes include but are not limited to:

• Chronic inflammatory and autoimmune diseases
• Chronic fatigue syndrome
• Neurodegenerative diseases including: Parkinson disease, multiple sclerosis, stroke, chronic demyelinating inflammatory neuropathies etc (exosomes penetrate through the blood brain barrier)
• Arthritis
• Acute and chronic tendinitis and tendinosis
• Muscle fatigue and muscle weakness
• Coronary artery disease and congestive heart failure
• Chronic hepatitis and other liver diseases
• Chronic kidney diseases

Q: What is the source of stem cell-derived exosomes? Exosomes used in our clinic are obtained from human umbilical cord stem cells. Prior to use, the donated cords are extensively tested for a number of viruses. Exosomes are produced in a FDA registered tissue facility that follows cGMP production procedures and holds both ISO 9001 and ISO 13485 quality control certification. The production of exosomes is regulated as a 351 tissue product by the Food and Drug Administration.

Q: How are exosomes administered?
For systemic illnesses and as a part of anti-aging therapy, exosomes are administered intravenously. As a part of joint regenerative therapy, exosomes are administered via intraarticular (joint) injections.

Q: How soon after administration of exosomes can a person can expect to see the benefits?
Every individual is different, but two key determinants for success are the severity of your condition and your body’s response to exosome therapy. Typically, early benefits of therapy are observed in 3-4 months. However, it is not uncommon, to see the benefits after 9 to 12 months.

Q: What Can I Expect After the Procedure? Are there any side effects?
Exosome transplantation is usually done on an outpatient basis; most patients should expect to walk out of the clinic without any major pain or problems. Generally speaking, aside from the initial pain at the injection site, the patient will not experience any discomfort. Less than 10% of (mostly lumbar puncture) patients have developed a minor fever, headache, nausea or vomiting. However, these side effects have never lasted more than three days and usually resolve within 24 hours. No long term negative side effects have been reported.

Q: When Can I Resume Physical Activity?
For the procedure to have the best chance of lasting benefit, we strongly recommend:
• Refraining from anti-inflammatory medication
• Resting for the first 24–48 hours, but do not lie sedentary
• Cardio is allowed after 3–4 weeks
• After four weeks, weight lifting and running are permitted

Q: Why are exosomes safer than stem cells?
Stem cells can proliferate and establish in the recipient’s body possessing a certain risk of undesirable complications such as new tumor growth. Exosomes do not proliferate but rather transfer valuable biological signals to the recipient’s tissues and facilitate the normalization of various pathological processes.

Q: How do exosomes benefit the inflammatory processes?
Stem cell-derived exosomes induce high levels of anti-inflammatory cytokines, in contrast to decreased levels of pro-inflammatory molecules. In addition, they can also inhibit abnormal macrophage activation. The macrophage is a large white blood cell that is an integral part of our immune system. Its job is to locate microscopic foreign bodies and ‘eat’ them. However, disproportional macrophage activation can induce undesirable inflammatory processes.

Q: How does exosome therapy benefit patients with chronic infections and autoimmune diseases?
Chronic infections have a lot in common with autoimmune diseases, including dysregulated immune response incapable of protecting our body from intruders (bacteria, viruses, molds etc) while attacking its own tissues and organs thus causing significant structural damage. One of the key mechanisms controlling the direction of immune responses is a balance between specific immune cells involved in protection vs autoimmune responses, the Th17/Treg ratio. This ratio is significantly abnormal in patients with both chronic infections and autoimmune diseases. Exosomes from mesenchymal stem cells normalize this ratio and bring the deviant immune response back to normal.

Q: How can exosomes benefit musculoskeletal disorders?
Experimental data show that stem cell-derived exosomes stimulate bone growth and skeletal muscle regeneration by directing the stem cells specifically into muscle and bone cell precursors.

Q: How can exosomes benefit neurodegenerative diseases?
They penetrate the blood-brain barrier and stimulate neuronal differentiation, neuronal growth, and suppress inflammatory processes within the brain tissue.

To find more information about our integrative medicine in San Diego, call IFSMED at (858) 794-9192 or send us an e-mail at info@ifsmed.com

Soft laser therapy (also known as cold laser therapy and laser biostimulation) is a cutting edge medical technique in which exposure to infrared laser light is used to elicit beneficial clinical effects. The Food and Drug Administration granted approval to market several infrared lasers “for temporary relief of minor muscle and joint pain, arthritis, muscle spasm, relieving stiffness and promoting relaxation of muscle tissue.”

Based on the power of generated energy, all lasers are divided into several classes from the least powerful class 1 to the most powerful class 4. Our clinic possesses several powerful therapeutic class 3B and class 4 lasers emitting both pulsed and continuous monochromatic light.

Laboratory studies suggest that infrared lasers stimulate collagen production, modify DNA synthesis, and normalize the function of damaged neurological tissue. Several mechanisms underlying therapeutic effects with low level laser therapy have been suggested.

These include:

• Increased ATP production by the mitochondria and increased oxygen consumption on the cellular level, which may result in muscle relaxation
• Increased serotonin and increased endorphins
• Increased anti-inflammatory effects through reduced prostaglandin synthesis
• Improved blood circulation to the skin in cases such as neuralgia and diabetes mellitus
• Decreases permeability of the membrane of the nerve cells for Na/K causing hyperpolarisation
• Increased lymphatic flow and decreased edema

Institute for Specialized Medicine utilizes acupuncture and soft lasers almost exclusively for regional musculoskeletal conditions such as:

• Cervicalgia / neck pain
• Low back pain
• Pelvic pain
• Rotator cuff syndrome
• Tennis and golfers elbows
• Carpal tunnel syndrome
• deQuervain tenosynovitis
• Hip osteoarthritis
• Knee osteoarthritis
• Patellar and quadriceps tendonitis
• Ankle and foot pain
• Achilles tendonitis
• Plantar fasciitis
• Tarsal tunnel syndrome
• Muscle spasms

Our advanced protocols combine acupuncture, auricular therapy, soft laser therapy and soft tissue and joint injections to optimize the outcome of therapy for chronic musculoskeletal diseases.

Acupuncture and soft laser therapy may take place over a period of several weeks or more before achieving desirable results.

To find more information about our integrative medicine in San Diego, call IFSMED at (858) 794-9192 or send us an e-mail at info@ifsmed.com

It is well recognized that traditional medical therapy has its limitations. These limitations are based on the limited selection of available therapeutic agents and barriers due to the potential drug side effects and drug interactions. The expansion of the therapeutic horizons is based on broader use of natural products and supplements.

Why natural products?
• The range of herbs and food supplements available for medicinal use is much larger than the range of prescription drugs
• In general (not always though), food supplements and herbs are considered safer than the prescription drugs
• Typically, food supplements and herbs are more affordable than drugs

How does IFSMED utilizes food supplements and herbs in the therapy of autoimmune and musculoskeletal diseases?

Once your diagnosis is established, we offer you a choice of traditional, alternative or integrative therapy when it’s appropriate. As a rule, acute conditions (e.g., acute joint pain, lupus flare up, etc.) are typically treated with traditional therapy. Once your condition is stabilized, we start introducing herbs and food supplements. In our personal view, the right choice of food supplements and herbs (in a combination with other modalities such as diet modification, acupuncture, physical therapy etc.) is an excellent way to maintain remission of chronic illnesses.

The individual selection of food supplements and herbs is based on:
• Scientific data regarding biological and therapeutic activity of individual ingredients / components of a given remedy
• Our personal clinical experience
• Your laboratory and instrumental diagnostic tests
• Your clinical history, including history of previous therapies and drug/supplement reactions

We provide our patients with very specific protocols for alternative therapies which include:
• The exact supplements and doses
• The exact time of their administration
• Potential side effects to watch
• Potential interactions with currently taken traditional drugs
• Timetable for drugs and supplements administration

Once the therapy with herbs and supplements is started, we perform a close surveillance of its efficacy utilizing clinical examination, laboratory testing and alternative diagnostic therapy.

Examples:

Case #1
A patient with osteoporosis (confirmed by DEXA) scan who could not tolerate traditional therapy with bisphosphonates (Actonel, Fosamax, Boniva) was evaluated in our clinic for alternative therapy. Several food supplements and the detail protocol of their use were implemented. One year after the administration of the therapy, the DEXA scan was performed. It demonstrated a 6.8% increase in the bone density in the femoral neck (hip). Subsequently, the patient was instructed in detail on how to continue his therapy for the next 6 to 12 months.

Case #2
A patient with systemic lupus erythematosus came to our clinic with an acute flareup of her illness. She was stabilized with prescription drugs. Once the remission was achieved, most of the medications with one exception were slowly tapered off and several herbs and a specific diet were administered. The patient has been monitored for lupus activity using several diagnostic tests. She has been in remission for almost two years which had not happened before since she was diagnosed with lupus.

Therapy can take a number of forms, but one of the most effective is Pilates, a mind/body integration and movement system offered by IFSMED.

Pilates is used to reestablish correct and effective motor function and muscle activation. It has seen a great deal of popularity in recent years as an exercise and toning program. In addition to its use in the gym, Pilates can also be used to achieve a greater capacity for physical exercise, and develop a stronger mind and body relationship, which will carry over to include a wide variety of whole-life benefits.

This type of physical corrective therapy is adaptable to any fitness level and focuses on developing core strength and improving posture. At IFSMED, we tailor every program to the needs of particular patients — what works for one arthritis sufferer will not work for all. We are dedicated to creating treatments that are specific to the individual and their needs.

We specialize in the following conditions:

Arthritis
Diastysis recti
Disc protrusions/bulge
Kyphosis
Lumbar lordosis
Osteoarthritis
Osteopenia
Osteoporosis
Post-partum rehabilitation
Sacroiliac dysfunction
Scoliosis
Spinal stenosis
Spine fusions
Spondylolisthesis

As part of our commitment to get you feeling better, we are committed to creating Pilates programs that are both safe and challenging and that can be adapted by our professionals at any time to increase their effectiveness for patients. With a wealth of knowledge, we are able to offer Pilates, mat classes, isometric exercises and orthopedic stretches in a clinical setting which provides a safe way to gain optimum health.

Our pilates specialist, Michelle, has been a member of IFSMED for four years. Michelle has taught more than 1500 Pilates mat classes and taught a combined 10,000 hours of Pilates in private and group sessions.

To find more information about our integrative medicine in San Diego, call IFSMED at (858) 794-9192 or send us an e-mail at info@ifsmed.com

View this prp handout to learn: how how to prepare for the procedure, what to expect during, and what to do after.

What is PRP?
PRP is an autologous therapy (meaning that the donor and recipient is the same person) that is based on injecting the platelet rich portion of a person’s blood directly into the arthritic or injured area. This catalyzes the body’s ability to repair damaged tendons, partially ruptured muscles, as well as heal bone and cartilage defects in arthritic joints.

How does PRP work?
Platelets, or thrombocytes, are small, irregularly shaped clear cell fragments (i.e. cells that do not have a nucleus containing DNA), which are derived from the fragmentation of precursor megakaryocytes. Platelets circulate in human blood and are involved in hemostasis, leading to the formation of blood clots. The premise of PRP therapy is based on the fact that upon injection, the platelets spread over injured tissues and release various growth factors (transforming growth factor beta (TGFbeta), vascular endothelial growth factor (VEGF), platelet-derived growth factor (PDGF), epithelial growth factor (EGF), and fibroblast growth factor (FGF)) and other biologically active molecules (for example, vitronectin and fibronectin), which stimulate regenerative and healing processes as well as bone mineralization.

Why does PRP work?
In chronic wounds and other tissues where blood supply may be low, the delivery of platelets is often impeded so adequate concentrations of growth factors, cytokines and chemokines are not released and wound healing stalls. In these cases, a patients’ own platelet rich plasma can be activated to generate a fibrin rich gel that serves as a rich source of growth factors, cytokines and chemokines to re-establish balance in the wound bed. The PRP System harnesses the patient’s natural healing processes to providing growth factors, chemokines and cytokines known to promote angiogenesis and to regulate cell growth and formation of new tissue. PRP technology restores the balance in the wound environment to transform a non-healing wound to a wound that heals naturally.

What conditions is PRP good for?
Typical indications for PRP therapy in humans include chronic tennis elbow, chronic rotator cuff syndrome of the shoulder, knee/patellar tendinitis and meniscal tears, achilles tendinitis as well as chronic low back pain and spine instability. The latest expanded indications for PRP therapy also include knee, hip and shoulder osteoarthritis and even chronic pain after joint replacement surgery.

What is the process?
PRP therapy starts with platelet separation from the whole blood via spinning/centrifugation incorporating the most advanced techniques in laser-guided platelet separation. Subsequently, PRP is harvested into a syringe for injection. Using ultrasound guidance, the physician can precisely deliver PRP to the arthritic or injured site.

What is the technology?
We use the latest advanced techology, Angel PRP system by Cytomedix. Many platelet concentrate systems are rigid in how much whole blood they are able to process, the quantity of platelet rich plasma produced and how the clinician is able to operate the device. With the Cytomedix Angel, blood separation has more possibilities.

Watch a video of Dr. Shikhman performing the procedure

How many treatments will I need?
Depending on the nature and duration of the injury, the satisfactory healing process may require between one to six treatments.

Why is PRP beneficial?
It can provide pain relief and healing without the need for surgery and prolonged recovery time
Low-risk minimally invasive procedure
Because your own blood is used, there is no risk of a transmitting infection and a very low risk of allergic reaction

View this PRP handout to learn: how how to prepare for the procedure, what to expect during, and what to do after.

PRP Testimonial

Issue
Thumbs

Symptoms
I was in excruciating pain that brought me to tears. I couldn’t hold a fork to eat or sign my name. I couldn’t pinch or pull anything, I couldn’t put on my clothes or hold items. The smaller the object, the worse the pain.

Treatment
I started out with physical therapy, but did not get the results I wanted—there was no noticeable improvement. I was totally non-functioning and PRP sounded like the best treatment. I had 3 treatments on my right hand and 5 on my left as it was always worse than my right.

Did you experience any side effects from PRP?
It was painful for 3 days. The first 1-2 days I would just sit still and not do anything. By day 3 I was feeling better, doing more for myself. By day 4 I was out and about.

Results
After my first treatment I felt about 10% better, after the second it was up to 30%, after the third it was up to 80%. PRP is the first thing I’ve ever experienced where there was such a big improvement between treatments.

Would you consider PRP a success?
YES! I am getting the procedure done on my knees as well. Dr. Shikhman really goes above and beyond to see what what the cause is and treats it appropriately—I call it my miracle treatment by a genius doctor.

To find more information about our integrative medicine in San Diego, call IFSMED at (858) 794-9192 or send us an e-mail at info@ifsmed.com

Prolotherapy in San Diego has been gaining ground in recent years as a viable modality to treat joint pain.

It is well recognized that musculoskeletal pain is often triggered by unstable and hypermobile joints due to the laxity of ligaments and tendons. The principle of prolotherapy is based on induction of fine scar tissue containing collagen fibers via dextrose (or similar solutions) injections which stabilizes damaged or weakened tendons or ligaments.

We use prolotherapy for the following indications:
• unstable ankles
• unstable knees
• meniscal tears
• chronic hip pain due to trochanteric bursitis
• low back pain due to instability of sacroiliac joints
• low back / thoracic pain due to instability of facet joints
• tennis elbow
• chronic shoulder pain due to rotator cuff syndrome
• chronic neck pain

In our clinic, prolotherapy is performed exclusively under ultrasound guidance which significantly increases efficacy of the procedure due to the precise accuracy of the dextrose delivery. Long-term prolotherapy is much safer than continuous steroid injections.

Although prolotherapy received mixed reviews in medical literature, those who use this technique routinely and easily identify appropriate indications and successfully treat the problem. Success rate of prolotherapy in our clinic varies from 70–90% depending on anatomy of the affected joints and chronicity of the problem. Since 2005, prolotherapy is supported by Mayo clinic physicians.

We’re proud to be a leader in the field and will continue to ensure that our prolotherapy options deliver the most effective treatment.

To find more information about our integrative medicine in San Diego, call IFSMED at (858) 794-9192 or send us an e-mail at info@ifsmed.com