Non-Operative
Non-operative treatment modalities make up greater than 80% of Dr. Driesman's practice. It is his philosophy that surgery should only be used as a last resort, when all non-operative treatments have been exhausted.
Physical Therapy
Dr. Driesman works closely with physical therapy colleagues to return to regain maximal functionality. He believes strongly that manipulations and strengthening exercises can help individuals restore normal biomechanics, so they are no longer in pain. If identified correctly in the office exam, these poor habits can be quickly remedied in therapy without extensive treatment.
Corticosteroid Injection
Corticosteroid injections have been used for decades to temporarily relieve pain and inflammation in joints and soft tissues, and to relieve systemic inflammatory reactions. The advantage to injecting corticosteroid medication rather than taking it orally is that it is delivered more quickly to the affected area and often has more effective results. Corticosteroid injections are routinely used to reduce the pain and swelling of bursitis, tendonitis and arthritis.
Corticosteroid injections are often given as part of rehabilitation program to help a patient perform physical therapy exercises with less discomfort. Relief from a single injection typically lasts from 1 week up to 1 year. A typical positive response may last for 3 months. Corticosteroid injections can also be of diagnostic value in pinpointing the regional source of the pain.
Corticosteroid injections are usually administered in an outpatient facility under the guidance of fluoroscopy or ultrasound to verify that the medication is reaching the inflamed location. Because the injection contains a local anesthetic as well as a corticosteroid, the injection is usually not painful, although the patient may feel pressure at the injection site. The injection procedure takes only a few minutes. Although the steroids themselves are not analgesics, they alleviate pain as a result of reducing inflammation.
In most cases, the patient experiences immediate pain relief from the anesthetic, but the relief is temporary and wears off in a few hours. During the next day or two, however, as the corticosteroid reduces inflammation, the patient should feel a significant, if not total, reduction in pain. The patient can usually resume normal activities the day following the procedure.
Viscosupplementation
Dr. Driesman frequently utilizes viscosupplementation, which refers to the injection of a hyaluronan preparation into the joint. This is a natural substance normally present in joint fluid to assist with lubrication. This allows for smooth movement of cartilage covering the joint spaces. A single injection directly into the joint can replenish diminished synovial fluid and enhance its lubricating properties.
Platelet Rich Plasma (PRP)
Platelet Rich Plasma is a relatively new method for the treatment of orthopedic conditions. It utilizes the patient's own growth factors and platelets to assist in healing. To perform, Dr. Driesman draws about 20 cc of blood and spins it down to create a mixture containing high concentrations of your own healing factors. This then can be injected into the affected area to provide an anti-inflammatory response and pain relief. This is not indicated for all patients, and Dr. Driesman will be quick to provide honest review of its efficacy in your condition.
Connective Tissue Progenitor Cells
Some providers like to call these "stem cells therapy", but the procedure actually uses tissue that can be isolated from the patient to proliferate into various connective tissues. It is still controversial whether this technique "restores, heal and regrow damage tissue", as touted by some. Dr. Driesman will have an honest conversation regarding the benefits and drawbacks of this therapy since it has been shown to improve symptoms in some patients, reducing inflammation and improving pain. Dr. Driesman can perform this therapy on select patients. The first step however is determining if you are a good candidate.
Additional Resources
Orthopaedic Specialty Group Milford Office
