Frequently Asked Questions

Todd Koppel, MD earned his medical degree from Cornell University Medical College and his fellowship training at The Hospital for Special Surgery and The New York Hospital. He is board certified from the American Board of Anesthesiology in both Anesthesiology and Pain Management.

Todd Koppel, MD has been practicing in the field of interventional pain management for the last twenty years. He has performed thousands of interventions throughout the body, and has successfully treatment thousands of patients suffering from a wide range of ailments.

Todd Koppel, MD is a member of the following organizations:

• American Society of Anesthesiologists
• New York State Society of Anesthesiologists
• International Spine Injection Society
• American Society of Interventional Pain Management Physicians (ASIPP)
• ASIPP-New Jersey Chapter: Board Member (2013-present)

The answer to this question depends upon the nature of the pain you are experiencing, the source of your pain, and the severity of the symptoms. Some conditions may be relatively simple, while others can be quite complex. Some can be eliminated easily and with only one treatment, but others may require a more thorough approach utilizing a combination of multiple procedures. This is why Todd Koppel, MD places the greatest importance in diagnosing the source of the pain, before embarking upon a treatment plan.

Regenerative medicine is a rapidly growing field which utilizes the bodies own regenerative capacity to help heal injured tissue, and reverse degeneration. This involves utilizing various cells, growth factors, and other products to enable the body to produce healthy tissue to replace or regenerate injured tissue. There are various sources to obtain these cells. Regenerative Cells may be obtained from bone marrow or abdominal adipose (fat) tissue, and Platelet Rich Plasma is obtained from the blood. There are also external sources of regenerative products, such as Exosomes, and Amniotic and Placental derived products. Lastly, Prolotherapy is a different but nonetheless useful therapy available for specific conditions in the body.

Unlike traditional treatment options, regenerative therapy offers the ability of the body to heal and restore itself to how it was in an earlier state, such as before the injury occurred or before the chronic condition became symptomatic. While there is certainly a role for corticosteroid injections in pain medicine, these medications are not without side affects, and may only temporarily reduce the inflammation. Surgery involves removing some tissue, which can lead to future degeneration, weakening of the structure, and scar tissue formation. Regenerative therapies have none of these untoward negative affects, and can only result in healing the injury, reducing the inflammation and restoring normal functioning.

Regenerative cells are cells which have the ability to become any other type of cell within the body. Regenerative cells derived from ones own body is called mesenchymal regenerative cells. These cells may be obtained from either bone marrow, usually extracted from the hip (Iliac) bone, or from abdominal fat tissue. After the bone marrow or fat is obtained, it is processed in a centrifuge whereby the cells and growth factors are highly concentrated. It is then simply injected into the abnormal structure. The injected cells then transform themselves into the same tissue, whether it be a ligament, cartilage in a knee, or even new disk material in the spine.

Plalelet Rich Plasma, or PRP, is a preparation of concentrated blood platelets in a small volume of plasma. The blood contains three cellular components: red blood cells, white blood cells, and platelets. Platelets are known to be involved in clotting, but studies have shown that they can also reduce inflammation and aid in healing of injured tissue. Platelets are also known to secrete various growth factors. To obtain PRP is quite simple; you just withdraw usually 30 to 60 cc of blood and prepare it in a centrifuge whereby the concentration of both platelets and growth factors are substantially enhanced. Studies have shown PRP to be effective for a great variety of injuries including muscle and tendon tears, intra-articular joint abnormalities such as that of the shoulder and knee, and tennis elbow. However it has also been used to speed healing of orthopedic injuries, such as foot and ankle fractures.

Prolotherapy involves injecting a solution of glucose or other solutions into a specific tendon or ligament to aid in healing and reduce laxity. When such structures are injured, it places a great amount of stress on the joint associated with it. This can lead to mal-alignment or laxity acutely producing pain, and chronically leads to inflammation, erosion of the normal cartilage, and joint calcification. Prolotherapy works by created a localized irritation, causing the body to utilize its own nature healing and promote growth of new tissue.

Everyone has heard of Regenerative Cells, but what are Exosomes? Exosomes are vesicles much smaller than cells (approx 1000x smaller), that cells generate to communicate with one another. They contain proteins, cytokines (molecules which aid in inflammation, and trauma), and nuclear material). Exosomes have been shown to have anti-inflammatory properties, and aid in the deterioration, healing, and regeneration of injured tissues.

There are many benefits of utilizing Exosomes over Regenerative Cells in regenerative injection therapy. First, they are externally derived, so bone marrow aspiration is unnecessary. This avoids an additional, potentially uncomfortable component of the therapy. Second, as the quantity and quality of regenerative cells decrease in people with age, they become less effective over time. Lastly, they may function better, being able to cross cellular barriers more easily, and adapt into the inflammatory environment better than regenerative cells.