Single injection of platelet-rich plasma as a novel treatment of carpal tunnel syndrome



Both in vitro and in vivo experiments have confirmed that platelet-rich plasma has therapeutic effects on many neuropathies, but its effects on carpal tunnel syndrome remain poorly understood. We aimed to investigate whether single injection of platelet-rich plasma can improve the clinical symptoms of carpal tunnel syndrome. Fourteen patients presenting with median nerve injury who had suffered from mild carpal tunnel syndrome for over 3 months were included in this study. Under ultrasound guidance, 1–2 mL of platelet-rich plasma was injected into the region around the median nerve at the proximal edge of the carpal tunnel. At 1 month after single injection of platelet-rich plasma, Visual Analogue Scale results showed that pain almost disappeared in eight patients and it was obviously alleviated in three patients. Simultaneously, the disabilities of the arm, shoulder and hand questionnaire showed that upper limb function was obviously improved. In addition, no ultrasonographic manifestation of the carpal tunnel syndrome was found in five patients during ultrasonographic measurement of the width of the median nerve. During 3-month follow-up, the pain was not greatly alleviated in three patients. These findings show very encouraging mid-term outcomes regarding use of platelet-rich plasma for the treatment of carpal tunnel syndrome.


Carpal tunnel syndrome (CTS) can be treated by both conservative (Klauser et al., 2009) and surgical interventions. Surgical decompression of the median nerve through the incision of the transverse carpal ligament (either open or mini-open or under ultrasound guidance) is the most cost-effective therapeutic option (Hui et al., 2005). However, mild to moderate CTS can be treated by conservative interventions, like functional braces and local infiltrations (Prime et al., 2010) in the carpal tunnel, mainly with corticosteroids. Local infiltration of corticosteroids easily leads to atrophy of the median nerve, subcutaneous fat, and systematic complications, such as hair loss and Cushing syndrome (Lambru et al., 2012). This treatment option is clearly inferior to surgical intervention despite the fact that it can improve clinical condition. There is evidence that local infiltration of corticosteroids is not superior to local injection of anesthetic (Karadas et al., 2012). To the best of our knowledgement, use of corticosteroids in the clinical practice has not been studied. However, a surgical treatment decision is always taken by the patient who sometimes wants to delay or avoid the surgery because of psychological or medical concerns including allergy to local anesthetic and immune deficiency and prefers a conservative treatment in the initial stage. A conservative treatment has been considered insufficient for CTS. In vitro and in vivo clinical and laboratory studies (Allampallam et al., 2000; Farrag et al., 2007; Cho et al., 2010; Anjayani et al., 2014; Park and Kwon, 2014) have demonstrated that platelet-rich plasma (PRP) has therapeutic action in several neuropathies. It would be interesting if a PPP injection is used as an alternative conservative treatment of CTS. The purpose of this study was to investigate if, and to what extent, a PPP injection, under ultrasound guidance, can improve the clinical condition of patients with CTS.

Materials and Methods

Fourteen patients were selected from initial 32 patients who received treatment in the Department of Orthopedics of “Konstantopouleio” General Hospital, Greece because of mild to moderate CTS, with a minimum of 3-month duration of symptoms, regardless of age and gender. Patients were rejected if they had one of the following items: thrombopenia, platelet dysfunction, local infection, NSAID use (less than 48 hours prior to injury), recent illness, malignancy, hemoglobin (Hb) level < 100 g/L, pregnancy, rheumatologic disease, uncontrolled hormonal disorder, vibrating caused neuropathy, systematic inflammatory disease, polyneuropathy, inability to complete questionnaires (due to language unawareness or mental disability), addicted to alcohol or drugs, total loss of sensation in the fingers, prior corticosteroid injection in the same wrist, had undergone a surgical intervention for CTS in the same hand, neurological deficit, cervical radiculopathy and/or cervical spinal stenosis and/or intervertebral disc herniation, nerve entrapment syndrome in the same hand.


PRP injection proved to be well tolerated, with no side effects, infections or complaints for persistent pain. We achieved well defined ultrasonographic mobilization, hydrodissection and hydrodisolution (Figure 2B) of the compressed median nerve through PRP simple injection.

At the end of the first month after PRP injection, the mean reduction in VAS (%) was 48.6 mm out of 100 mm in comparison to rates prior to injection. At that time, we found eight patients with full or almost full recovery (VAS: 0 – 20 mm) and three patients with great improvement (VAS decline: more than 30 mm). The mean decline of the Q-DASH score was calculated just a little less than 70% compared to the pre-injection rates (from mean Q-DASH 56.42 prior to injection to mean Q-DASH17.5 one month after). These rates slightly more improved 3 months later (Table 1).

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A Comparison of Health Outcomes in the Use of Stem Cells, Surgical, and Nonsurgical Approaches to Treat Degenerative Disk Disease: A Systematic Review

Systematic literature review.

This study provided a systematic review of randomized controlled trials which assessed the therapeutic effects of stem cell treatments, surgical interventions, and nonsurgical treatments on the outcomes of patients diagnoses with intervertebral disk degeneration (IDD).

A MEDLINE (2000-2017), PubMed (2000-2017), and Google scholar (1995-2000) database search was performed to identify published articles reporting on patient-reported clinical outcomes. A total of 12 articles were identified and met the inclusion criteria.

Literature evaluating the comparative treatment outcomes between patients who underwent surgical versus nonsurgical interventions demonstrated mixed findings in treatment efficacy. Although studies involving the manipulation of endogenous stem cells in fibrocartilage suggested that this application could be a potentially noninvasive, stem cell–based strategy to treat fibrocartilage degeneration, especially in patients with IDD.

The reviewed literature suggested that no clinical significance exists between surgical and nonsurgical treatment for IDD. The decision to undergo surgical or conservative treatment should depend on the patient’s state of health at the time of surgery, as well as any other potentially alarming factors (altered mental status, level of consciousness, comorbidities, etc) that could be exacerbated with the proposed treatment. Mesenchymal stem cells and fibrocartilage stem cells may also be an effective therapeutic option for the regeneration of a degenerated intervertebral disk. To move forward in finding an effective therapeutic treatment protocol for IDD, further research needs to be implemented that minimizes the limitation discussed in this review.

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Suffering with hair loss? New Regenerative Medicine treatments can help!


Premature hair loss may cause a decrease in self-esteem and self-confidence. Consequently, there is a growing interest in innovative technology and science that helps not only prevent excessive hair loss but also regenerates healthy hair follicles and restore hair growth.

In the past, the only limited options for hair loss prevention have been mostly the use of topical products, such as Rogaine or Minoxidil and even the use a low-level laser light shown to stimulate hair follicles. However, at Miami Stem Cell® we have new and exciting options to treat baldness via Regenerative Medicine using the patient’s own plasma and /or stem cells. These amazing new treatments use the body’s own natural power to self-repair, restore and regenerate aging tissues, as well as tissue damage, as well as a myriad of other chronic conditions.

Over the last decade, we have treated thousands of patients at our Miami institute, validating several published clinical studies indicating that using Autologous Stem Cells (for more severe cases) as well as Platelet-Rich Plasma, or PRP, can help restore hair follicles, prevent hair loss and increase hair growth by significantly increasing the body’s own regenerative potential.

Stem Cell Therapy has expanded greatly over the past few years, not only in treating many diseases but also to restore aging tissues. These cells are extracted from the patient’s own bone marrow and are extremely rich in multiple growth factors. These stem cells (or PRP which is collected from the patient’s blood) are then re-injected into the affected areas and have been shown to possess tremendous regenerative potential in the process of re-growing hair follicles.

After the initial consultation with one of our Team of Medical Experts, we then conduct a series of blood tests, which depending on the severity of each case, may include hormonal imbalance and Micro-Nutrient testing. This is a comprehensive type of nutritional analysis that measures functional deficiencies at the cellular level. This simple blood test delivers a total assessment of how well your body processes 33 vitamins, minerals, amino/fatty acids, antioxidants, and metabolites, while conveying the body’s need for these micronutrients, which allow the body to produce enzymes, hormones, and other substances which are essential for proper growth, development, and good health. This test will provide the basis of a personalized, functional approach in addressing a broad variety of clinical conditions, including premature hair loss, as well as many other ailments caused by micronutrient related deficiencies.

After reviewing the blood work results, our doctors will then recommend the ideal Regenerative Medicine treatment that would be most effective at tackling the hair loss situation at hand. The treatment with Stem Cells and/or PRP is performed right in our Coral Gables clinic, using minimal sedation and zero downtime for most patients. These innovative treatments are completed in about three hours and are performed by a board-certified physician, experienced and trained in this procedure.

At Miami Stem Cell® our top-of-the-line trademarked Stem Cell Treatment for hair-loss is called “Super Marrow” which has the most powerful concentration of Stem Cells available today. In this ground-breaking treatment, Autologous Stem Cells are extracted from the patient’s own bone marrow and re-injected into the affected area and has shown to be the most effective treatment at battling hair loss with no downtime and/or complications.

Ultimately, when compared to other more traditional hair loss non-surgical methods, we have extensive proof that validates the fact that Regenerative Medicine and particularly the use of Stem Cells and/or PRP, provides tremendous promise to help both men and women concerned about preventing future hair loss and in fact, actually also restoring hair growth.

In conclusion, hair loss can now be optional! However, you need to be evaluated by one of our experts as soon as possible, since the sooner you start treatment (once hair is noticeably thinning) the better. Unfortunately, once hair is completely gone from an area, it is basically impossible to treat and thus, if you are starting to see the signs of hair loss or the beginning of baldness, this is the ideal time to get started with one of our state-of-the-art Regenerative Medicine treatments!


For more information about our institute and the array of Regenerative Medicine Treatments that we provide for adult patients of every age, please call Miami Stem Cell® at (305) 598-7777 or visit:

You can also follow us on the social media networks of Facebook, Instagram and Twitter or watch multiple video-testimonials in our YouTube Channel.

Let Your Own Body Heal You at Miami Stem Cell®

Mesenchymal stem cells in osteoarthritis therapy: a review

Osteoarthritis (OA) is a chronic joint disease that generally occurs worldwide with pain and disability. The progression is slow, and it is mostly diagnosed midlife and often disturbs the knees, hips, feet, hands, and spine. Sex, age, obesity, occupation, and hereditary factors are risk factors that increase the opportunity for OA. Physical examinations involving X-rays and MRI, joint fluid analysis and blood tests are common tools for the diagnosis of OA. Interventions including exercise, manual therapy, lifestyle modification, and medication can help relieve pain and maintain mobility in the affected joints, yet none of the therapies enables the promotion of regeneration of degenerated tissues. Mesenchymal stem cells (MSCs) are a promising source for the treatment of OA due to their multipotency for differentiation into chondrocytes and their ability to modulate the immune system. Herein, we review the pathogenesis and treatment of OA and address the current status of MSCs as a novel potential therapeutic agent in OA treatment.

To read the entire published study, please click on the link below:



Stem Cell Transplant Trial Enrolls First MS Patient in Minnesota.

A clinical trial investigating patient-derived stem cell transplants for the treatment of people with severe relapsing forms of multiple sclerosis (MS) has enrolled a patient in Minnesota.

The patient was enrolled at the University of Minnesota Medical School, one of two trial sites in the state. An additional 18 sites in the U.S. and one in the U.K. also are, or soon will be, recruiting participants for the BEAT-MS Phase 3 trial (NCT04047628). More information is available here.

The prevalence of MS is greater in Midwestern states than in the general U.S. population. It is estimated that “about 309 people [of] every 100,000 in the United States have MS, but in the Midwest, … we rank second in prevalence — the numbers increase to 353 people out of every 100,000 that are affected by this disease,” Flavia Nelson, MD, a professor of neurology and the study’s lead investigator, said in a press release.

More than a dozen disease-modifying therapies have been approved for the treatment of MS. However, in addition to their elevated costs, some of these therapies are not very effective at treating severe forms of relapsing MS. A stem cell transplant has been explored as a treatment alternative for MS patients who failed to respond to conventional disease-modifying therapies (DMT). By reseting the immune system so that the central nervous system is no longer attacked, this would provide a more effective and longer-lasting alternative to patients.

However, whether a stem cell transplant — also known as an autologous (patient-derived) hematopoietic stem cell transplant — is more effective than conventional disease-modifying therapies remains unclear. Their safety and costs also have not been compared.

To read the entire article, please click on the link below:


Let Your Own Body Heal You at Miami Stem Cell®

Regenerative Medicine is the field of expertise at Miami Stem Cell® and our team of highly qualified medical professionals is devoted to the well-being of each one of our patients. Our mission is to provide all of our patients with top-quality healthcare in order to improve their overall quality of life.

We pride ourselves in offering innovative medical procedures and we make it our goal to try and solve the problem and alleviate the condition, not just attempt to treat it. We are committed to offering top-notch quality care, emphasizing that our patient’s safety is always our number one priority.

Miami Stem Cell® continues to be the leading institute in the clinical application of Stem Cell Treatments in America and we effectively treat a wide variety of conditions with minimally invasive procedures that include:

  • Arthritis (pain in the knee, shoulders, hips, spine, cervix and other joints).
  • Sports injuries (Tennis Player’s Elbow, Golfer’s Shoulder, etc.).
  • Degeneration of lumbar discs / Sciatica and pain in the lower back.
  • Fibromyalgia.
  • Tendinitis / Carpal Tunnel.


  • Sexual dysfunction in men and women.
  • Congestive Heart Disease.
  • Coronary artery disease.
  • Peripheral Vascular Condition.
  • Asthma / COPD / Respiratory problems.


  • Urinary incontinence.
  • Hair restoration.
  • Facial, neck and hand rejuvenation.
  • Intravenous Multi-Vitamin infusions.
  • Micro-Nutritional Testing / Micro-Nutrition.

In addition, Miami Stem Cell® conducts a comprehensive pre-procedure evaluation that encompasses a variety of medical tests that provide complete information about your overall health that even includes tumor marker screening. These medical tests help our team of experts identify any possible problems before your Stem Cell Procedure and avoid potential complications after your transplant, a series of extra precautions that many other Stem Cell Clinics do not perform.

For more information or to schedule a free evaluation with our team of experts, please call Miami Stem Cell® at (305) 598-7777 or 1 -855-598-CELL or via email:

You can visit our website: or follow us on Facebook, Instagram, Twitter and watch real patients tell their story in videos on our YouTube channel.

“Let Your Own Body Heal You”

Miami Stem Cell 475 Biltmore Way suite 307 Coral Gables, FL 33134