FAQs

There may be some discomfort and pressure at the injection site as well as
soreness in the days following the procedure. Providing you with a comfortable experience is a priority. During your evaluation, we will discuss performing an ultrasound guided nerve block, which is dependent on injury location. We also give the option to take a mild oral sedation during the procedure.

These procedures are not covered by health insurance. We take FSA/HSA and offer financing to help assist with the initial cost. A variety of different financing options exist, and we can help you find the best one for you.
-The total cost will vary based on:
-severity and extent of injury
-how long you have had this problem
-number of joints/areas that need to be treated
-how many types of cells or other regenerative strategies such as shockwave therapy are necessary to achieve the results you desire.
-Each patient’s requirement is unique and we strive on individualizing treatment specifically for you. Therefore a consultation with our physician is needed to determine the best strategy and treatment options. After the consultation, we will give you a plan and exact cost.

All of the procedures performed at Elevated are allowed under Section 361 of the Public Health Service Act. All of our orthobiologic processing equipment and kits are FDA approved.

You will likely be sore and stiff after the injection, which can last for a few days after the treatment. This can vary depending on the cells in in the injection and site of injury. After the local anesthetic or nerve block wears off, we suggest refraining from activities that increase discomfort. It is also important to refrain from taking NSAID’s for at least 2 weeks after the procedure. Tylenol can be helpful in reducing pain and will not impact your treatment. We also suggest applying heat opposed to ice to the treatment site. For most injuries, physical therapy should be started 1-2 weeks after the procedure.

Patients with active cancers or infections.
Patients with severe anemia or thrombocytopenia (low platelets).

Yes. Platelet concentrations, mesenchymal stem cells, and growth factors will naturally decline with age. However, we have compensatory techniques to achieve appropriate concentrations for the best outcomes in all of our patients.

Yes, there is evolving research showing significant increases in platelet concentration with endurance activity prior to the procedure. If you’re able, we recommend doing at least 30 minutes of endurance exercise on the day of the procedure. Appropriate hydration and a well-rounded, nutrient dense diet are also important.

Heat can be helpful in reducing stiffness/soreness and aiding in the recovery process. We suggest waiting for about 2-3 days to allow the needle track sites to heal before soaking in the hot springs or hot tub.

After we inject regenerative cells, they go to work immediately. This repair process may continue for up to a year. Unlike steroid injections, tissue regeneration takes longer and often times it can take 4-6 weeks before noticing improvement. The trade off of delayed relief is often more longstanding improvements of function and pain.

We use the highest quality orthobiologic processing equipment to achieve a high concentration of regenerative cells and growth factors. Therefore, the vast majority of our patients have successful improvement after a single injection. Depending on the severity of injury, age, and other underlying medical conditions some patients may benefit from subsequent injections, which will be discussed at your initial evaluation.

Since you are the donor of regenerative cells and growth factors, we suggest a well- rounded, nutrient dense diet before and after the procedure. Some foods that may be helpful in promoting healthy blood product production include: dark, leafy vegetables, vegetables rich in color, whole grain rice, quinoa, kidney beans, black-eyed peas, orange juice, fresh oranges, eggs, lentils, dark chocolate. We also suggest targeting a health protein intake of at least 1 gram per pound of body weight.
-If you do not regularly eat a diet rich in colorful vegetables, fruits, whole grains it may be beneficial to start a multivitamin 2 weeks prior to the procedure to ensure optimal results.
-What should I avoid before an orthobiologic procedure?
-NSAIDS, alcohol, and tobacco should avoided for at least 1 week before and 2 weeks following the procedure.
-Some foods may reduce platelet counts such as quinine in tonic water, cranberry juice, cow’s milk, and garlic. The overall impact is not clear and more research is needed, however for best results it may be worthwhile avoiding these.

Absolutely. A comprehensive diagnostic ultrasound is performed during your initial visit to evaluate the site of injury and surrounding structures. There are occasions injuries are found that are not seen on MRI or Xray, when a dynamic (adding tension with range of motion to ligament, tendon, or joint) ultrasound is performed. Likewise, Dr. Vivolo uses live ultrasound guidance with every procedure to ensure the regenerative cells are precisely placed directly into the site of injury

Extracorporeal Shockwave Therapy (ESWT) is a non-invasive treatment that uses high- energy acoustic waves to stimulate healing in musculoskeletal conditions. It is commonly used to treat chronic pain and promote tissue regeneration.

ESWT is effective in treating conditions such as:
– Plantar fasciitis
– Achilles tendinopathy
– Tennis elbow (lateral epicondylitis)
– Golfer’s elbow (medial epicondylitis)
– Calcific tendinitis of the shoulder
– Patellar tendinopathy (jumper’s knee)
– Myofascial trigger points
– Stress fractures and delayed bone healing

ESWT delivers focused shockwaves that carries energy and can propagate through tissue. This physical force acts as a mechanical stimulus in the affected area, which stimulates increased blood circulation, bone remodeling, and promotes the body’s natural healing response. This process can help reduce pain and improve function over time.

Patients may experience mild discomfort during the treatment, depending on the intensity of the shockwaves. However, the procedure is generally well-tolerated, and any discomfort typically subsides shortly after the session.

The number of sessions required varies depending on the condition being treated. Most patients need between 3 to 5 sessions, spaced about a week apart, for optimal results.

Each ESWT session typically lasts between 15 to 30 minutes, depending on the treatment area and severity of the condition.

Some patients experience immediate pain relief, while others may notice gradual improvement over several weeks. Mild swelling, redness, or soreness in the treated area may occur but should resolve within a few days.

ESWT is generally safe with minimal side effects. Temporary redness, swelling, bruising, or mild discomfort in the treated area may occur but usually resolve quickly. Serious complications are rare.

 – Are pregnant
– Have a bleeding disorder or are on blood thinners
– Have a pacemaker or other implanted electronic device
– Have an active infection or tumor at the treatment site

Most patients can resume their daily activities immediately after treatment. However, it Is recommended to avoid high-impact activities or strenuous exercise for 48 hours following the session.

A consultation with a healthcare provider is necessary to determine if ESWT is an appropriate treatment for your condition. If you have been experiencing chronic pain and have not responded well to conventional treatments, ESWT may be a viable option for you.