Sports Injury Treatment
Sports Injury Treatment for Active Palm Beach Lifestyles
Whether it is a golf swing, a tennis serve, or a morning run along the water, an active Florida lifestyle puts real demands on your joints, tendons, ligaments, and muscles. At Palm Beach Regenerative Sport and Spine, Dr. Ghattas offers image-guided orthobiologic treatments designed to support your body’s natural healing response after a sports-related injury, with the goal of helping many patients explore alternatives to surgery and extended time away from the activities they love.
Results vary. Not all patients are candidates. Dr. Ghattas will discuss realistic expectations for your specific condition.
What Sports Injuries Can Be Addressed?
Dr. Ghattas evaluates and treats a wide range of sports-related injuries, including:
- Ligament sprains, including knee ligament injuries
- Tendon injuries and tendinopathy, such as tennis elbow, golfer’s elbow, Achilles tendinopathy, and rotator cuff irritation
- Muscle strains, including hamstring and calf strains
- Meniscus and labral tears
- Overuse injuries, such as plantar fasciitis and joint irritation from repetitive motion
How We Approach Sports Injuries
After reviewing your imaging and discussing your activity goals, Dr. Ghattas may recommend an image-guided orthobiologic injection, such as platelet-rich plasma (PRP) or bone marrow concentrate, targeted precisely to the injured structure using real-time ultrasound or fluoroscopic guidance. The goal of these treatments is to support your body’s natural healing response and help manage inflammation. Because sports injuries vary widely in type and severity, Dr. Ghattas will develop a plan customized to your imaging findings and the specific demands of your sport.
Who May Be a Candidate?
Many patients with ligament sprains, tendon injuries, muscle strains, or overuse injuries may be candidates for orthobiologic treatment, though this depends on the severity and location of the injury. More severe injuries, such as complete ligament or tendon ruptures, may require surgical evaluation. Dr. Ghattas will provide an honest assessment of whether orthobiologic treatment, surgery, or a combination approach is right for you.
What to Expect
- Consultation: Review of your imaging and a discussion of your sport, activity level, and recovery goals.
- Treatment: Image-guided orthobiologic injection targeted to the specific injured structure.
- Recovery and return to activity: An individualized timeline based on the injury treated, generally with a gradual return to higher-impact activity.
- Follow-up: Structured tracking of your recovery and function over time.
Like all medical procedures, orthobiologic treatments have potential risks and benefits. Results vary by individual. Not all patients are candidates. Dr. Ghattas will discuss your specific situation, realistic expectations, and all treatment options, including when surgery may be more appropriate.
Frequently Asked Questions
Recovery timelines vary widely depending on the injury treated and its severity. Many patients gradually resume light activity within days to weeks, with a structured return-to-play plan for higher-impact sports. Dr. Ghattas will give you a timeline specific to your injury.
PRP uses a concentration of your own platelets, while bone marrow concentrate contains a broader mix of cells drawn from bone marrow. Dr. Ghattas will recommend the option, or combination, best suited to your specific injury and imaging findings.
For some patients, exploring orthobiologic treatment before considering surgery may be an option worth discussing. This depends heavily on the specific injury and its severity. Dr. Ghattas will discuss all of your options, including when surgery may be the more appropriate path.
Quick Appointments Available
Don't wait in pain. We can see you within 1-2 weeks. Get the orthopedic care you need, fast.
●PATIENT OUTCOMES
Real Patients. Real Results.
No medical procedure can guarantee an outcome. What you should expect is an honest discussion of the evidence, a careful assessment of candidacy, and a recommendation based on your condition.
"Honestly one of the best experiences, I’ve had a really stiff neck for a couple weeks I tried seeing a chiropractor for and it helped marginally but the real jump in relief was coming to see Dr. Ghattas! He has been incredible, wonderful staff, and minimally invasive technique for my pain relief which was super important to me! Thank you Dr. Ghattas recommending to anyone with pain!"Monica A
"Ghattas was instrumental in helping my torn rotator cuff. I did Barbotage for the stone, and then PRP. Great experience. Been about a month or 2 since and I feel great."Ahmet B
"I had severe knee pain and was looking for proper knee pain treatment, which is how I found Dr. Ghattas on Instagram. I was a bit hesitant at first, but it turned out to be one of the best decisions I’ve made for my health. Francia was amazing at coordinating all my consultations and making the whole process easy and stress-free. If you’re dealing with knee pain and looking for a reliable doctor and team, I highly recommend them."Roger L
"Over a year ago, both my daughter and I underwent PRP treatment with Dr. Ghattas—PRP for my left knee and PRP for my daughter’s L4-L5 and sacral region. We wanted to wait long enough to truly evaluate the results before sharing our experience. I am pleased to say that the outcomes have been outstanding. My daughter’s improvement has been remarkable, and the treatment has made a significant difference in her quality of life. I have also experienced excellent results with my knee. Dr. Ghattas is an exceptional physician who combines expertise, professionalism, and genuine care for his patients. We are incredibly grateful for the treatment we received and the positive impact it has had on our lives. Thank you, Dr. Ghattas. We are truly grateful for everything you have done. You are simply the best."Dr Jorge A
"Dr. Ghattas is very knowledgable and a sympathetic doctor. Hard to find in America. All questions answered, my procedure went very smoothly, very little pain. Follow up is excellent, I highly recommend his practice."Luciana D
“ I had severe knee pain and was looking for proper knee pain treatment, which is how I found Dr. Ghattas on Instagram. I was a bit hesitant at first, but it turned out to be one of the best decisions I’ve made for my health. Francia was amazing at coordinating all my consultations and making the whole process easy and stress-free. If you’re dealing with knee pain and looking for a reliable doctor and team, I highly recommend them. ”Roger L
“Dr. Ghattas was terrific today. He spent a good amount of time examining me and explaining the regenerative process which I intend to have done next month. More to come after the procedure.”Louie R
“I found Dr Ghattas and his staff very welcoming and informative. The process was well explained and gave me encouragement about the potential for fully restoring my knee joint integrity.”Eric C
“I received two treatments from Dr. Ghattas With excellent results, he takes great care in his assessment and in his treatment you couldn’t be in better hands. I highly recommend his work.”Gisela S
“Apart from the exemplary personal service by the reception and the staff that makes us feel we're at home at the clinic, I have experienced remarkable healing in several episodes from shoulder issue to knee injuries and hip pain. The doctor is so thorough in the diagnosis phase that he administered exactly what was needed, no more no less! Thank you folks for a wonderful experience.”RG G
“Went to Dr. Ghattas for chronic knee and neck issue. I’ve already had multiple procedures done on my neck and multiple epidurals with minimal success. My knee I was told needed surgery to fix. I already had surgery in the past with minimal difference. I ended up getting stem cells in my knee and neck and could t be happier with the outcome. Anyone considering surgery I recommend checking out Regenex first. Next I’m doing the ganglion block and look forward to the results.”Logan H
“Dr. James Ghattas and his team are truly top-notch. His office is equipped with state-of-the-art technology and a staff that's exceptional in their fields. I've referred several clients to him, and they've all been incredibly satisfied. Dr. Ghattas is absolutely ahead of the curve, and I wholeheartedly endorse his work.”Ron H
“I am quite active and go to pilates 3-4 times per week. I was having left knee pain and which was treated with PRP. It took about 3 months for me to feel better but then the pain completely subsided. I now am able to exercise without the fear that I will tear a ligament and am pain free.”Ellipsis P
“Transparency, thoroughness, attention to detail, immediate, high quality, follow ups and follow through are just a few words that come to mind throughout my experiences with Palm Beach Regenerative Sport and Spine.”Milton L
Peripheral Neuropathy Treatment
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Peripheral Neuropathy Treatment Without Surgery
Peripheral Neuropathy and Nerve Pain Treatment
Peripheral neuropathy is a broad term that covers many different causes of nerve pain, numbness, tingling, and weakness. Because the underlying cause varies so widely from patient to patient, not every form of neuropathy responds to the same type of treatment. At Palm Beach Regenerative Sport and Spine, Dr. Ghattas focuses on nerve pain caused by localized entrapment or compression, and will help you understand honestly whether this approach may be appropriate for your specific type of neuropathy.
Results vary. Not all types of neuropathy respond to this approach. Dr. Ghattas will discuss whether your condition is a good match during your evaluation.
What Is Peripheral Neuropathy?
Peripheral neuropathy refers to damage or dysfunction affecting the nerves outside the brain and spinal cord. It can cause pain, burning, numbness, tingling, or weakness, often in the hands and feet. There are many potential causes, including diabetes, chemotherapy, autoimmune conditions, and direct injury or compression of a nerve, and in some cases a specific cause cannot be identified.
Which Types of Neuropathy May Respond to Our Treatment Approach?
Our image-guided approach is focused specifically on nerve pain caused by entrapment or compression, meaning a nerve that is being irritated or restricted at a particular point along its path. Examples include carpal tunnel syndrome (compression of the median nerve at the wrist), tarsal tunnel syndrome (compression of a nerve at the ankle), ulnar nerve entrapment at the elbow, and nerve irritation related to spine conditions such as sciatica.
Diffuse, widespread forms of neuropathy, including diabetic peripheral neuropathy and chemotherapy-induced neuropathy, affect nerves throughout the body rather than at a single point of compression. These conditions are generally not good candidates for our image-guided injection approach. Dr. Ghattas will review your history, perform a physical examination, and consider results from nerve testing, such as EMG or nerve conduction studies, when available, to help determine whether entrapment or compression is contributing to your symptoms.
How We Approach Nerve Entrapment and Compression
For appropriately selected patients, we use ultrasound-guided hydrodissection, an injection technique that separates the nerve from surrounding scar tissue or adhesions using an injectate that may include orthobiologic material such as platelet lysate. This approach is intended to reduce irritation around the nerve and support its natural healing and function.
These treatments do not regenerate nerve tissue that has been severed or severely damaged, and they are not intended for diffuse polyneuropathy. Dr. Ghattas will discuss honestly whether your presentation is consistent with a localized, treatable source of nerve compression, or whether other management strategies or specialist referral would be more appropriate.
What to Expect
- Consultation: A detailed history and physical examination, with review of any prior nerve testing, to assess whether entrapment or compression is likely contributing to your symptoms.
- Treatment: If you are a candidate, ultrasound-guided hydrodissection targeted to the affected nerve.
- Recovery: Most patients resume normal activities quickly, with specific guidance based on the nerve treated.
- Follow-up: Structured follow-up to monitor your symptoms and function over time.
Like all medical procedures, orthobiologic treatments have potential risks and benefits. Results vary by individual. Not all patients are candidates. Dr. Ghattas will discuss your specific situation, realistic expectations, and all treatment options, including when surgery may be more appropriate.
Frequently Asked Questions
Diabetic peripheral neuropathy is a diffuse condition affecting nerves broadly rather than at a single compression point, so it is generally not a good match for our image-guided injection approach. Dr. Ghattas can discuss other management strategies and, where appropriate, refer you to the right specialist.
Nerve hydrodissection is an ultrasound-guided injection technique used to help separate an irritated or entrapped nerve from surrounding scar tissue or adhesions, with the goal of reducing compression and supporting nerve function.
Common symptoms include localized numbness, tingling, burning, or weakness along the path of a specific nerve, which can worsen with certain positions or repetitive movements. This differs from diffuse neuropathy, which tends to affect both feet or both hands more symmetrically.
Quick Appointments Available
Don't wait in pain. We can see you within 1-2 weeks. Get the orthopedic care you need, fast.
●PATIENT OUTCOMES
Real Patients. Real Results.
No medical procedure can guarantee an outcome. What you should expect is an honest discussion of the evidence, a careful assessment of candidacy, and a recommendation based on your condition.
"Honestly one of the best experiences, I’ve had a really stiff neck for a couple weeks I tried seeing a chiropractor for and it helped marginally but the real jump in relief was coming to see Dr. Ghattas! He has been incredible, wonderful staff, and minimally invasive technique for my pain relief which was super important to me! Thank you Dr. Ghattas recommending to anyone with pain!"Monica A
"Ghattas was instrumental in helping my torn rotator cuff. I did Barbotage for the stone, and then PRP. Great experience. Been about a month or 2 since and I feel great."Ahmet B
"I had severe knee pain and was looking for proper knee pain treatment, which is how I found Dr. Ghattas on Instagram. I was a bit hesitant at first, but it turned out to be one of the best decisions I’ve made for my health. Francia was amazing at coordinating all my consultations and making the whole process easy and stress-free. If you’re dealing with knee pain and looking for a reliable doctor and team, I highly recommend them."Roger L
"Over a year ago, both my daughter and I underwent PRP treatment with Dr. Ghattas—PRP for my left knee and PRP for my daughter’s L4-L5 and sacral region. We wanted to wait long enough to truly evaluate the results before sharing our experience. I am pleased to say that the outcomes have been outstanding. My daughter’s improvement has been remarkable, and the treatment has made a significant difference in her quality of life. I have also experienced excellent results with my knee. Dr. Ghattas is an exceptional physician who combines expertise, professionalism, and genuine care for his patients. We are incredibly grateful for the treatment we received and the positive impact it has had on our lives. Thank you, Dr. Ghattas. We are truly grateful for everything you have done. You are simply the best."Dr Jorge A
"Dr. Ghattas is very knowledgable and a sympathetic doctor. Hard to find in America. All questions answered, my procedure went very smoothly, very little pain. Follow up is excellent, I highly recommend his practice."Luciana D
“ I had severe knee pain and was looking for proper knee pain treatment, which is how I found Dr. Ghattas on Instagram. I was a bit hesitant at first, but it turned out to be one of the best decisions I’ve made for my health. Francia was amazing at coordinating all my consultations and making the whole process easy and stress-free. If you’re dealing with knee pain and looking for a reliable doctor and team, I highly recommend them. ”Roger L
“Dr. Ghattas was terrific today. He spent a good amount of time examining me and explaining the regenerative process which I intend to have done next month. More to come after the procedure.”Louie R
“I found Dr Ghattas and his staff very welcoming and informative. The process was well explained and gave me encouragement about the potential for fully restoring my knee joint integrity.”Eric C
“I received two treatments from Dr. Ghattas With excellent results, he takes great care in his assessment and in his treatment you couldn’t be in better hands. I highly recommend his work.”Gisela S
“Apart from the exemplary personal service by the reception and the staff that makes us feel we're at home at the clinic, I have experienced remarkable healing in several episodes from shoulder issue to knee injuries and hip pain. The doctor is so thorough in the diagnosis phase that he administered exactly what was needed, no more no less! Thank you folks for a wonderful experience.”RG G
“Went to Dr. Ghattas for chronic knee and neck issue. I’ve already had multiple procedures done on my neck and multiple epidurals with minimal success. My knee I was told needed surgery to fix. I already had surgery in the past with minimal difference. I ended up getting stem cells in my knee and neck and could t be happier with the outcome. Anyone considering surgery I recommend checking out Regenex first. Next I’m doing the ganglion block and look forward to the results.”Logan H
“Dr. James Ghattas and his team are truly top-notch. His office is equipped with state-of-the-art technology and a staff that's exceptional in their fields. I've referred several clients to him, and they've all been incredibly satisfied. Dr. Ghattas is absolutely ahead of the curve, and I wholeheartedly endorse his work.”Ron H
“I am quite active and go to pilates 3-4 times per week. I was having left knee pain and which was treated with PRP. It took about 3 months for me to feel better but then the pain completely subsided. I now am able to exercise without the fear that I will tear a ligament and am pain free.”Ellipsis P
“Transparency, thoroughness, attention to detail, immediate, high quality, follow ups and follow through are just a few words that come to mind throughout my experiences with Palm Beach Regenerative Sport and Spine.”Milton L
Ankle Arthritis Treatment
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Ankle Arthritis Treatment Without Surgery
Non-Surgical Treatment for Ankle Osteoarthritis
Ankle arthritis often develops years after a significant ankle injury, such as a fracture or a severe sprain, though it can also result from general wear and tear over time. At Palm Beach Regenerative Sport and Spine, Dr. Ghattas offers image-guided orthobiologic treatments for appropriately selected patients with ankle arthritis, with the goal of reducing inflammation and supporting joint function.
Results vary. Not all patients are candidates. Dr. Ghattas will discuss realistic expectations for your specific condition.
What Causes Ankle Arthritis?
Unlike the knee or hip, ankle arthritis is frequently linked to a specific past injury. Prior fractures, severe or repeated ankle sprains, and joint instability can all change the way the ankle bears weight, gradually wearing down the cartilage that cushions the joint. Age-related wear, repetitive stress from activity, and structural misalignment can also contribute.
What Are the Symptoms of Ankle Arthritis?
- Swelling and tenderness around the ankle joint
- Stiffness, especially after periods of rest
- A feeling of instability or the ankle giving way
- Clicking, popping, or grinding sensations with movement
- Difficulty walking, running, or standing for extended periods
How We Approach Ankle Arthritis
Our image-guided orthobiologic treatments for ankle arthritis are designed to reduce inflammation, manage symptoms, and support healthy tissue function in the joint. Many patients experience meaningful improvement in pain and mobility, though results vary based on arthritis severity and individual factors.
Important: these treatments do not regenerate cartilage. For patients with advanced, bone-on-bone ankle arthritis, surgical options such as ankle fusion or ankle replacement may be more appropriate. Dr. Ghattas will review your imaging and discuss realistic expectations for your specific degree of arthritis.
Who May Be a Candidate?
Patients with mild to moderate ankle arthritis, who still have retained joint space on imaging, tend to be the best candidates for orthobiologic treatment. Patients with advanced, bone-on-bone arthritis are often better served by a surgical consultation, and Dr. Ghattas will provide an honest assessment of whether treatment is likely to benefit your specific situation.
What to Expect
- Consultation: Review of your ankle imaging and history, including any prior fractures or sprains, to assess candidacy.
- Treatment: Image-guided injection into the ankle joint under ultrasound or fluoroscopic guidance.
- Recovery: Most patients resume normal activities within days, with high-impact activity limited for several weeks.
- Follow-up: Structured tracking of your symptoms and function over time.
Like all medical procedures, orthobiologic treatments have potential risks and benefits. Results vary by individual. Not all patients are candidates. Dr. Ghattas will discuss your specific situation, realistic expectations, and all treatment options, including when surgery may be more appropriate.
Frequently Asked Questions
For patients with mild to moderate arthritis, non-surgical approaches, including orthobiologic injections, may be worth exploring. Advanced, bone-on-bone arthritis is often better addressed with surgery, and Dr. Ghattas will help you understand where you fall on that spectrum.
A sprain is an acute injury to the ligaments of the ankle. Ankle arthritis is a separate, typically longer-term condition involving breakdown of the joint's cartilage, though a serious sprain or fracture earlier in life can increase the risk of developing arthritis later on.
This varies by patient and by the severity of arthritis. Based on Regenexx registry data, many patients with joint arthritis report improvement in pain and function following treatment, though individual results vary and are not guaranteed.
Quick Appointments Available
Don't wait in pain. We can see you within 1-2 weeks. Get the orthopedic care you need, fast.
●PATIENT OUTCOMES
Real Patients. Real Results.
No medical procedure can guarantee an outcome. What you should expect is an honest discussion of the evidence, a careful assessment of candidacy, and a recommendation based on your condition.
"Honestly one of the best experiences, I’ve had a really stiff neck for a couple weeks I tried seeing a chiropractor for and it helped marginally but the real jump in relief was coming to see Dr. Ghattas! He has been incredible, wonderful staff, and minimally invasive technique for my pain relief which was super important to me! Thank you Dr. Ghattas recommending to anyone with pain!"Monica A
"Ghattas was instrumental in helping my torn rotator cuff. I did Barbotage for the stone, and then PRP. Great experience. Been about a month or 2 since and I feel great."Ahmet B
"I had severe knee pain and was looking for proper knee pain treatment, which is how I found Dr. Ghattas on Instagram. I was a bit hesitant at first, but it turned out to be one of the best decisions I’ve made for my health. Francia was amazing at coordinating all my consultations and making the whole process easy and stress-free. If you’re dealing with knee pain and looking for a reliable doctor and team, I highly recommend them."Roger L
"Over a year ago, both my daughter and I underwent PRP treatment with Dr. Ghattas—PRP for my left knee and PRP for my daughter’s L4-L5 and sacral region. We wanted to wait long enough to truly evaluate the results before sharing our experience. I am pleased to say that the outcomes have been outstanding. My daughter’s improvement has been remarkable, and the treatment has made a significant difference in her quality of life. I have also experienced excellent results with my knee. Dr. Ghattas is an exceptional physician who combines expertise, professionalism, and genuine care for his patients. We are incredibly grateful for the treatment we received and the positive impact it has had on our lives. Thank you, Dr. Ghattas. We are truly grateful for everything you have done. You are simply the best."Dr Jorge A
"Dr. Ghattas is very knowledgable and a sympathetic doctor. Hard to find in America. All questions answered, my procedure went very smoothly, very little pain. Follow up is excellent, I highly recommend his practice."Luciana D
“ I had severe knee pain and was looking for proper knee pain treatment, which is how I found Dr. Ghattas on Instagram. I was a bit hesitant at first, but it turned out to be one of the best decisions I’ve made for my health. Francia was amazing at coordinating all my consultations and making the whole process easy and stress-free. If you’re dealing with knee pain and looking for a reliable doctor and team, I highly recommend them. ”Roger L
“Dr. Ghattas was terrific today. He spent a good amount of time examining me and explaining the regenerative process which I intend to have done next month. More to come after the procedure.”Louie R
“I found Dr Ghattas and his staff very welcoming and informative. The process was well explained and gave me encouragement about the potential for fully restoring my knee joint integrity.”Eric C
“I received two treatments from Dr. Ghattas With excellent results, he takes great care in his assessment and in his treatment you couldn’t be in better hands. I highly recommend his work.”Gisela S
“Apart from the exemplary personal service by the reception and the staff that makes us feel we're at home at the clinic, I have experienced remarkable healing in several episodes from shoulder issue to knee injuries and hip pain. The doctor is so thorough in the diagnosis phase that he administered exactly what was needed, no more no less! Thank you folks for a wonderful experience.”RG G
“Went to Dr. Ghattas for chronic knee and neck issue. I’ve already had multiple procedures done on my neck and multiple epidurals with minimal success. My knee I was told needed surgery to fix. I already had surgery in the past with minimal difference. I ended up getting stem cells in my knee and neck and could t be happier with the outcome. Anyone considering surgery I recommend checking out Regenex first. Next I’m doing the ganglion block and look forward to the results.”Logan H
“Dr. James Ghattas and his team are truly top-notch. His office is equipped with state-of-the-art technology and a staff that's exceptional in their fields. I've referred several clients to him, and they've all been incredibly satisfied. Dr. Ghattas is absolutely ahead of the curve, and I wholeheartedly endorse his work.”Ron H
“I am quite active and go to pilates 3-4 times per week. I was having left knee pain and which was treated with PRP. It took about 3 months for me to feel better but then the pain completely subsided. I now am able to exercise without the fear that I will tear a ligament and am pain free.”Ellipsis P
“Transparency, thoroughness, attention to detail, immediate, high quality, follow ups and follow through are just a few words that come to mind throughout my experiences with Palm Beach Regenerative Sport and Spine.”Milton L
Foot Arthritis Treatment
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Foot Arthritis Treatment Without Surgery
Non-Surgical Treatment for Foot Arthritis
The foot contains more than two dozen small joints, and arthritis can develop in any of them, most commonly at the base of the big toe, across the midfoot, or in the joint just below the ankle. At Palm Beach Regenerative Sport and Spine, Dr. Ghattas offers image-guided orthobiologic treatments aimed at reducing inflammation and supporting healthy joint function in appropriately selected patients with foot arthritis.
Results vary. Not all patients are candidates. Dr. Ghattas will discuss realistic expectations for your specific condition.
What Causes Foot Arthritis?
Foot arthritis develops when the cartilage that cushions the small joints of the foot breaks down over time. Common contributors include prior injury or fracture, years of repetitive stress, structural issues such as bunions or flat feet that change how weight moves through the foot, and inflammatory forms of arthritis. The big toe joint (a condition often called hallux rigidus), the midfoot joints, and the subtalar joint beneath the ankle are among the most frequently affected areas.
What Are the Symptoms of Foot Arthritis?
- Pain with standing, walking, or push-off during activity
- Stiffness, especially first thing in the morning or after rest
- Swelling around the affected joint
- Reduced range of motion in the toe or midfoot
- Difficulty finding comfortable, well-fitting shoes
- Visible bone spurs in more advanced cases
How We Approach Foot Arthritis
Our image-guided orthobiologic treatments for foot arthritis focus on reducing inflammation, managing symptoms, and supporting healthy tissue function in the affected joint. Many patients experience meaningful improvement in pain and mobility, though results vary based on the severity of arthritis and individual factors.
Important: these treatments do not regenerate cartilage. They work by reducing inflammation and supporting your body’s natural healing processes. For patients with severe, bone-on-bone arthritis, surgical options such as joint fusion may be more appropriate. Dr. Ghattas will review your imaging and provide an honest assessment of all your options.
Who May Be a Candidate?
Patients with mild to moderate foot arthritis, who still have retained joint space on imaging, tend to be the best candidates for orthobiologic treatment. Patients with advanced, bone-on-bone arthritis are often better served by a surgical consultation, and Dr. Ghattas will discuss this honestly during your evaluation.
What to Expect
- Consultation: Comprehensive review of your imaging and a physical examination to identify which joint or joints are involved.
- Treatment: Image-guided injection of orthobiologic material into the affected joint under ultrasound or fluoroscopic guidance.
- Recovery: Most patients resume normal activities within days and are asked to avoid high-impact activity for a period of weeks.
- Follow-up: Systematic tracking of your symptoms and function over time.
Like all medical procedures, orthobiologic treatments have potential risks and benefits. Results vary by individual. Not all patients are candidates. Dr. Ghattas will discuss your specific situation, realistic expectations, and all treatment options, including when surgery may be more appropriate.
Frequently Asked Questions
The right treatment depends on which joint is affected and how severe the arthritis is. Options range from bracing and physical therapy to orthobiologic injections or, for advanced cases, surgery. Dr. Ghattas will help you understand which approach fits your situation.
Many patients with mild to moderate foot arthritis explore non-surgical options first, including orthobiologic treatment. Results vary, and not everyone is a candidate.
Most patients are back to normal daily activities within a few days, though higher-impact activity is typically limited for several weeks while the treated area recovers.
Quick Appointments Available
Don't wait in pain. We can see you within 1-2 weeks. Get the orthopedic care you need, fast.
●PATIENT OUTCOMES
Real Patients. Real Results.
No medical procedure can guarantee an outcome. What you should expect is an honest discussion of the evidence, a careful assessment of candidacy, and a recommendation based on your condition.
"Honestly one of the best experiences, I’ve had a really stiff neck for a couple weeks I tried seeing a chiropractor for and it helped marginally but the real jump in relief was coming to see Dr. Ghattas! He has been incredible, wonderful staff, and minimally invasive technique for my pain relief which was super important to me! Thank you Dr. Ghattas recommending to anyone with pain!"Monica A
"Ghattas was instrumental in helping my torn rotator cuff. I did Barbotage for the stone, and then PRP. Great experience. Been about a month or 2 since and I feel great."Ahmet B
"I had severe knee pain and was looking for proper knee pain treatment, which is how I found Dr. Ghattas on Instagram. I was a bit hesitant at first, but it turned out to be one of the best decisions I’ve made for my health. Francia was amazing at coordinating all my consultations and making the whole process easy and stress-free. If you’re dealing with knee pain and looking for a reliable doctor and team, I highly recommend them."Roger L
"Over a year ago, both my daughter and I underwent PRP treatment with Dr. Ghattas—PRP for my left knee and PRP for my daughter’s L4-L5 and sacral region. We wanted to wait long enough to truly evaluate the results before sharing our experience. I am pleased to say that the outcomes have been outstanding. My daughter’s improvement has been remarkable, and the treatment has made a significant difference in her quality of life. I have also experienced excellent results with my knee. Dr. Ghattas is an exceptional physician who combines expertise, professionalism, and genuine care for his patients. We are incredibly grateful for the treatment we received and the positive impact it has had on our lives. Thank you, Dr. Ghattas. We are truly grateful for everything you have done. You are simply the best."Dr Jorge A
"Dr. Ghattas is very knowledgable and a sympathetic doctor. Hard to find in America. All questions answered, my procedure went very smoothly, very little pain. Follow up is excellent, I highly recommend his practice."Luciana D
“ I had severe knee pain and was looking for proper knee pain treatment, which is how I found Dr. Ghattas on Instagram. I was a bit hesitant at first, but it turned out to be one of the best decisions I’ve made for my health. Francia was amazing at coordinating all my consultations and making the whole process easy and stress-free. If you’re dealing with knee pain and looking for a reliable doctor and team, I highly recommend them. ”Roger L
“Dr. Ghattas was terrific today. He spent a good amount of time examining me and explaining the regenerative process which I intend to have done next month. More to come after the procedure.”Louie R
“I found Dr Ghattas and his staff very welcoming and informative. The process was well explained and gave me encouragement about the potential for fully restoring my knee joint integrity.”Eric C
“I received two treatments from Dr. Ghattas With excellent results, he takes great care in his assessment and in his treatment you couldn’t be in better hands. I highly recommend his work.”Gisela S
“Apart from the exemplary personal service by the reception and the staff that makes us feel we're at home at the clinic, I have experienced remarkable healing in several episodes from shoulder issue to knee injuries and hip pain. The doctor is so thorough in the diagnosis phase that he administered exactly what was needed, no more no less! Thank you folks for a wonderful experience.”RG G
“Went to Dr. Ghattas for chronic knee and neck issue. I’ve already had multiple procedures done on my neck and multiple epidurals with minimal success. My knee I was told needed surgery to fix. I already had surgery in the past with minimal difference. I ended up getting stem cells in my knee and neck and could t be happier with the outcome. Anyone considering surgery I recommend checking out Regenex first. Next I’m doing the ganglion block and look forward to the results.”Logan H
“Dr. James Ghattas and his team are truly top-notch. His office is equipped with state-of-the-art technology and a staff that's exceptional in their fields. I've referred several clients to him, and they've all been incredibly satisfied. Dr. Ghattas is absolutely ahead of the curve, and I wholeheartedly endorse his work.”Ron H
“I am quite active and go to pilates 3-4 times per week. I was having left knee pain and which was treated with PRP. It took about 3 months for me to feel better but then the pain completely subsided. I now am able to exercise without the fear that I will tear a ligament and am pain free.”Ellipsis P
“Transparency, thoroughness, attention to detail, immediate, high quality, follow ups and follow through are just a few words that come to mind throughout my experiences with Palm Beach Regenerative Sport and Spine.”Milton L
Kienbock's Disease Treatment
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Kienbock's Disease Treatment Without Surgery
Kienbock's Disease Treatment in West Palm Beach
Kienbock’s disease is an uncommon wrist condition that can be difficult to diagnose and confusing to research on your own. At Palm Beach Regenerative Sport and Spine, Dr. James Ghattas offers a thorough evaluation of your wrist, including a review of your imaging, to help you understand your stage of disease and the full range of options available to you.
For appropriately selected, earlier-stage patients, image-guided orthobiologic injections may be considered as part of a broader treatment plan focused on supporting your body’s natural healing response and managing symptoms.
Results vary. Not all patients are candidates. Dr. Ghattas will discuss realistic expectations for your specific stage of Kienbock’s disease.
What Is Kienbock's Disease?
Kienbock’s disease is a condition in which the lunate, a small bone near the center of the wrist, gradually loses its blood supply. Over time, this can cause the bone to harden, weaken, and in advanced cases, collapse or fragment. The exact cause is not fully understood, but it is generally associated with a disruption in blood flow to the lunate. Contributing factors may include prior wrist trauma, unequal length between the two forearm bones (the radius and ulna), or a naturally occurring variation in the shape of the lunate itself.
What Are the Symptoms of Kienbock's Disease?
- Wrist pain that tends to worsen with gripping, lifting, or weight-bearing activities
- Swelling and tenderness, usually centered over the back of the wrist
- Stiffness and a gradual loss of wrist motion
- Decreased grip strength
- In later stages, a clicking or grinding sensation with wrist movement
How Is Kienbock's Disease Staged, and Why Does It Matter?
Kienbock’s disease is generally described in four progressive stages, ranging from early changes in blood flow to eventual bone collapse and, in the most advanced cases, arthritis of the surrounding wrist joints. Because the disease can behave very differently depending on how far it has progressed, staging plays a central role in deciding which treatments are worth considering. Dr. Ghattas will use X-ray and, when appropriate, MRI imaging to determine your stage before discussing treatment options.
How We Approach Kienbock's Disease
For carefully selected patients in the earlier stages of Kienbock’s disease, before significant bone collapse has occurred, image-guided orthobiologic injections, such as bone marrow concentrate, may be considered. These treatments are performed under ultrasound or fluoroscopic guidance and are intended to help address inflammation and support your body’s natural healing processes in and around the affected bone.
These treatments do not reverse bone collapse that has already occurred, and they are not a substitute for surgical evaluation in more advanced disease. Kienbock’s disease can progress over time, and patients in later stages, or those who do not respond to conservative measures, are often better served by surgical options such as joint leveling, revascularization procedures, or wrist salvage surgery. Dr. Ghattas will provide an honest assessment of where you fall on that spectrum.
Who May Be a Candidate for Orthobiologic Treatment?
Kienbock’s disease treatment with orthobiologics is generally best suited to patients who:
- Are in an earlier stage of disease, before significant bone collapse or fragmentation
- Have not yet developed secondary wrist arthritis
- Have a clear diagnosis confirmed by imaging (X-ray and/or MRI)
- Are interested in exploring non-surgical options before considering surgery
When Surgery May Be More Appropriate
For patients with advanced-stage Kienbock’s disease, including bone fragmentation, collapse, or established wrist arthritis, surgical intervention often provides more reliable, longer-term results. Dr. Ghattas will refer you to a hand and wrist surgeon when surgery is the more appropriate path.
What to Expect
- Consultation: A detailed history, physical examination, and review of your wrist imaging to confirm diagnosis and stage.
- Treatment: If you are a candidate, an image-guided injection performed under ultrasound or fluoroscopic guidance.
- Recovery: Most patients resume light activities within days, with a period of activity modification recommended for the wrist.
- Follow-up: Structured follow-up to monitor your symptoms and, when appropriate, repeat imaging to track the condition over time.
Like all medical procedures, orthobiologic treatments have potential risks and benefits. Results vary by individual. Not all patients are candidates. Dr. Ghattas will discuss your specific situation, realistic expectations, and all treatment options, including when surgery may be more appropriate.
Frequently Asked Questions
For some patients in the earlier stages, non-surgical approaches, including orthobiologic injections, may be part of a broader treatment plan. Whether this is appropriate depends on your specific stage of disease, which Dr. Ghattas will determine through imaging.
Kienbock's disease tends to progress over time without intervention, and the timeline can vary significantly from patient to patient, ranging from months to years. Because of this, an early evaluation is recommended.
No. Kienbock's disease begins as a disruption in blood supply to the lunate bone, though it can eventually lead to wrist arthritis if it progresses without treatment.
Quick Appointments Available
Don't wait in pain. We can see you within 1-2 weeks. Get the orthopedic care you need, fast.
●PATIENT OUTCOMES
Real Patients. Real Results.
No medical procedure can guarantee an outcome. What you should expect is an honest discussion of the evidence, a careful assessment of candidacy, and a recommendation based on your condition.
"Honestly one of the best experiences, I’ve had a really stiff neck for a couple weeks I tried seeing a chiropractor for and it helped marginally but the real jump in relief was coming to see Dr. Ghattas! He has been incredible, wonderful staff, and minimally invasive technique for my pain relief which was super important to me! Thank you Dr. Ghattas recommending to anyone with pain!"Monica A
"Ghattas was instrumental in helping my torn rotator cuff. I did Barbotage for the stone, and then PRP. Great experience. Been about a month or 2 since and I feel great."Ahmet B
"I had severe knee pain and was looking for proper knee pain treatment, which is how I found Dr. Ghattas on Instagram. I was a bit hesitant at first, but it turned out to be one of the best decisions I’ve made for my health. Francia was amazing at coordinating all my consultations and making the whole process easy and stress-free. If you’re dealing with knee pain and looking for a reliable doctor and team, I highly recommend them."Roger L
"Over a year ago, both my daughter and I underwent PRP treatment with Dr. Ghattas—PRP for my left knee and PRP for my daughter’s L4-L5 and sacral region. We wanted to wait long enough to truly evaluate the results before sharing our experience. I am pleased to say that the outcomes have been outstanding. My daughter’s improvement has been remarkable, and the treatment has made a significant difference in her quality of life. I have also experienced excellent results with my knee. Dr. Ghattas is an exceptional physician who combines expertise, professionalism, and genuine care for his patients. We are incredibly grateful for the treatment we received and the positive impact it has had on our lives. Thank you, Dr. Ghattas. We are truly grateful for everything you have done. You are simply the best."Dr Jorge A
"Dr. Ghattas is very knowledgable and a sympathetic doctor. Hard to find in America. All questions answered, my procedure went very smoothly, very little pain. Follow up is excellent, I highly recommend his practice."Luciana D
“ I had severe knee pain and was looking for proper knee pain treatment, which is how I found Dr. Ghattas on Instagram. I was a bit hesitant at first, but it turned out to be one of the best decisions I’ve made for my health. Francia was amazing at coordinating all my consultations and making the whole process easy and stress-free. If you’re dealing with knee pain and looking for a reliable doctor and team, I highly recommend them. ”Roger L
“Dr. Ghattas was terrific today. He spent a good amount of time examining me and explaining the regenerative process which I intend to have done next month. More to come after the procedure.”Louie R
“I found Dr Ghattas and his staff very welcoming and informative. The process was well explained and gave me encouragement about the potential for fully restoring my knee joint integrity.”Eric C
“I received two treatments from Dr. Ghattas With excellent results, he takes great care in his assessment and in his treatment you couldn’t be in better hands. I highly recommend his work.”Gisela S
“Apart from the exemplary personal service by the reception and the staff that makes us feel we're at home at the clinic, I have experienced remarkable healing in several episodes from shoulder issue to knee injuries and hip pain. The doctor is so thorough in the diagnosis phase that he administered exactly what was needed, no more no less! Thank you folks for a wonderful experience.”RG G
“Went to Dr. Ghattas for chronic knee and neck issue. I’ve already had multiple procedures done on my neck and multiple epidurals with minimal success. My knee I was told needed surgery to fix. I already had surgery in the past with minimal difference. I ended up getting stem cells in my knee and neck and could t be happier with the outcome. Anyone considering surgery I recommend checking out Regenex first. Next I’m doing the ganglion block and look forward to the results.”Logan H
“Dr. James Ghattas and his team are truly top-notch. His office is equipped with state-of-the-art technology and a staff that's exceptional in their fields. I've referred several clients to him, and they've all been incredibly satisfied. Dr. Ghattas is absolutely ahead of the curve, and I wholeheartedly endorse his work.”Ron H
“I am quite active and go to pilates 3-4 times per week. I was having left knee pain and which was treated with PRP. It took about 3 months for me to feel better but then the pain completely subsided. I now am able to exercise without the fear that I will tear a ligament and am pain free.”Ellipsis P
“Transparency, thoroughness, attention to detail, immediate, high quality, follow ups and follow through are just a few words that come to mind throughout my experiences with Palm Beach Regenerative Sport and Spine.”Milton L
Regenexx
Why Regenexx? The Evidence-Based Standard in Regenerative Orthopedics
Not all regenerative medicine is created equal. The marketplace has become flooded with clinics offering unproven ‘stem cell’ treatments using birth tissue products (umbilical cord, amniotic fluid) that have been repeatedly challenged by the FDA. Regenexx is different — in how treatments are prepared, how they are performed, and how outcomes are measured.
- Your Own Cells — Not Birth Tissue Products
Regenexx procedures exclusively use your own blood or bone marrow as the source of orthobiologic material. This is a fundamental distinction from clinics advertising ‘stem cell’ injections from umbilical cord or amniotic tissue — products the FDA has taken enforcement action against repeatedly for making unsubstantiated claims. When we use your own cells, there is no risk of rejection and a well-established safety profile. - Proprietary Preparation Protocols
Regenexx uses proprietary preparation methods developed and refined over nearly two decades. The result is consistently higher platelet concentrations and more controlled preparations than what is achievable with standard, off-the-shelf PRP kits. This is not standard PRP — it is a specialized, lab-controlled process performed in our on-site BioMod Lab. - Mandatory Image Guidance on Every Injection
Every Regenexx injection is performed under real-time ultrasound or fluoroscopic guidance. Image guidance confirms that the orthobiologic material reaches the intended target — a joint, tendon, ligament, disc, or nerve — not the surrounding tissue. This is not standard practice at most PRP clinics, where injections are often performed “blind.” - Outcomes Registry and Peer-Reviewed Research
Regenexx maintains one of the largest databases of orthobiologic procedure outcomes in the world. The organization has published peer-reviewed research, including evidence of MRI-confirmed ACL healing and condition-specific outcome data. This commitment to evidence distinguishes Regenexx from the broader “stem cell” industry, which is largely unregulated and unmonitored. - Strict Candidacy Standards
Regenexx trains its providers to apply honest candidacy criteria — including clearly defined situations where these treatments are not appropriate. We will tell you honestly if regenerative treatment is unlikely to help your specific situation. This is not universal in the regenerative medicine marketplace.
Regenexx vs. Standard PRP: What's the Difference?
PRP (platelet-rich plasma) has become widely available at orthopedic offices, sports medicine clinics, and even medical spas. But not all PRP is the same — and the differences matter. Regenexx uses a fundamentally different approach to platelet preparation, delivery, and outcome tracking compared to standard PRP offered in most clinical settings.
| Factor | Standard PRP | Regenexx (at PBR) |
|---|---|---|
| Preparation | Standard commercial kits; concentration varies widely | Proprietary lab-controlled protocol; consistently high concentration |
| Image Guidance | Often performed ‘blind’ without imaging | Every injection under real-time ultrasound or fluoroscopy — always |
| Customization | One-size-fits-all preparation | Custom formulation based on condition and imaging findings |
| Outcomes Tracking | Rarely tracked systematically | Active participation in Regenexx national outcomes registry |
| Provider Training | Minimal specialized training required | Formal Regenexx physician training and certification required |
| Published Evidence | General PRP literature; variable quality | Regenexx-specific peer-reviewed publications, including ACL and knee OA data |
| Cell Source | Your blood only (platelet layer) | Blood or bone marrow — customized to condition |
Regenerative Medicine vs. Surgery: Understanding Your Options
One of the most common questions patients bring to their consultation is: “Should I try regenerative medicine before surgery, or go straight to surgery?” There is no single answer — and anyone who tells you otherwise isn’t being honest. The right choice depends entirely on your specific diagnosis, the severity of your condition, your goals, and what the evidence shows for your situation.
Dr. Ghattas will always present both options transparently and will recommend surgery when it is the more appropriate path.
When Regenerative Medicine May Be Worth Exploring First
- Mild to moderate arthritis with remaining joint space
- Partial tendon or ligament tears (as opposed to complete ruptures)
- Conditions where surgery has significant recovery burden or risk
- Patients who have not yet tried conservative non-surgical options
- Patients who are not ideal surgical candidates for health reasons
- Conditions with published evidence supporting orthobiologic outcomes (ACL, rotator cuff, knee OA)
When Surgery Is Often the More Appropriate Choice
- Severe bone-on-bone arthritis — particularly hip arthritis in patients over 55
- Complete tendon ruptures requiring structural repair
- Spinal instability that requires structural surgical correction
- Conditions where regenerative medicine has not provided adequate relief after appropriate treatment
- When imaging shows pathology that requires direct surgical intervention
Regenerative medicine is not a replacement for surgery in all cases, and surgery is not appropriate for all patients. Dr. Ghattas will always provide an honest assessment of your options based on your specific imaging, symptoms, and health status. Many patients who were surgical candidates chose to explore regenerative medicine first and experienced meaningful improvement — but this is not a guarantee, and surgery remains the better option for some conditions.
Quick Appointments Available
Don't wait in pain. We can see you within 1-2 weeks. Get the orthopedic care you need, fast.
●PATIENT OUTCOMES
Real Patients. Real Results.
No medical procedure can guarantee an outcome. What you should expect is an honest discussion of the evidence, a careful assessment of candidacy, and a recommendation based on your condition.
"Honestly one of the best experiences, I’ve had a really stiff neck for a couple weeks I tried seeing a chiropractor for and it helped marginally but the real jump in relief was coming to see Dr. Ghattas! He has been incredible, wonderful staff, and minimally invasive technique for my pain relief which was super important to me! Thank you Dr. Ghattas recommending to anyone with pain!"Monica A
"Ghattas was instrumental in helping my torn rotator cuff. I did Barbotage for the stone, and then PRP. Great experience. Been about a month or 2 since and I feel great."Ahmet B
"I had severe knee pain and was looking for proper knee pain treatment, which is how I found Dr. Ghattas on Instagram. I was a bit hesitant at first, but it turned out to be one of the best decisions I’ve made for my health. Francia was amazing at coordinating all my consultations and making the whole process easy and stress-free. If you’re dealing with knee pain and looking for a reliable doctor and team, I highly recommend them."Roger L
"Over a year ago, both my daughter and I underwent PRP treatment with Dr. Ghattas—PRP for my left knee and PRP for my daughter’s L4-L5 and sacral region. We wanted to wait long enough to truly evaluate the results before sharing our experience. I am pleased to say that the outcomes have been outstanding. My daughter’s improvement has been remarkable, and the treatment has made a significant difference in her quality of life. I have also experienced excellent results with my knee. Dr. Ghattas is an exceptional physician who combines expertise, professionalism, and genuine care for his patients. We are incredibly grateful for the treatment we received and the positive impact it has had on our lives. Thank you, Dr. Ghattas. We are truly grateful for everything you have done. You are simply the best."Dr Jorge A
"Dr. Ghattas is very knowledgable and a sympathetic doctor. Hard to find in America. All questions answered, my procedure went very smoothly, very little pain. Follow up is excellent, I highly recommend his practice."Luciana D
“ I had severe knee pain and was looking for proper knee pain treatment, which is how I found Dr. Ghattas on Instagram. I was a bit hesitant at first, but it turned out to be one of the best decisions I’ve made for my health. Francia was amazing at coordinating all my consultations and making the whole process easy and stress-free. If you’re dealing with knee pain and looking for a reliable doctor and team, I highly recommend them. ”Roger L
“Dr. Ghattas was terrific today. He spent a good amount of time examining me and explaining the regenerative process which I intend to have done next month. More to come after the procedure.”Louie R
“I found Dr Ghattas and his staff very welcoming and informative. The process was well explained and gave me encouragement about the potential for fully restoring my knee joint integrity.”Eric C
“I received two treatments from Dr. Ghattas With excellent results, he takes great care in his assessment and in his treatment you couldn’t be in better hands. I highly recommend his work.”Gisela S
“Apart from the exemplary personal service by the reception and the staff that makes us feel we're at home at the clinic, I have experienced remarkable healing in several episodes from shoulder issue to knee injuries and hip pain. The doctor is so thorough in the diagnosis phase that he administered exactly what was needed, no more no less! Thank you folks for a wonderful experience.”RG G
“Went to Dr. Ghattas for chronic knee and neck issue. I’ve already had multiple procedures done on my neck and multiple epidurals with minimal success. My knee I was told needed surgery to fix. I already had surgery in the past with minimal difference. I ended up getting stem cells in my knee and neck and could t be happier with the outcome. Anyone considering surgery I recommend checking out Regenex first. Next I’m doing the ganglion block and look forward to the results.”Logan H
“Dr. James Ghattas and his team are truly top-notch. His office is equipped with state-of-the-art technology and a staff that's exceptional in their fields. I've referred several clients to him, and they've all been incredibly satisfied. Dr. Ghattas is absolutely ahead of the curve, and I wholeheartedly endorse his work.”Ron H
“I am quite active and go to pilates 3-4 times per week. I was having left knee pain and which was treated with PRP. It took about 3 months for me to feel better but then the pain completely subsided. I now am able to exercise without the fear that I will tear a ligament and am pain free.”Ellipsis P
“Transparency, thoroughness, attention to detail, immediate, high quality, follow ups and follow through are just a few words that come to mind throughout my experiences with Palm Beach Regenerative Sport and Spine.”Milton L
Trigeminal Neuralgia Treatment
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Trigeminal Neuralgia Treatment Without Surgery
Trigeminal Neuralgia: A Non-Surgical Approach to One of Medicine's Most Painful Conditions
If you’ve been told your only options are nerve-destroying procedures or lifelong medication, there may be another path worth exploring. Dr. Ghattas brings a rare combination of board-certified neurology and interventional orthobiologics to the evaluation and management of trigeminal neuralgia.
Results vary. Not all patients are candidates. Dr. Ghattas will discuss realistic expectations for your specific condition.
What is trigeminal neuralgia?
Trigeminal neuralgia (TN) is widely considered one of the most severe pain conditions in medicine. It affects the trigeminal nerve — one of the largest cranial nerves in the body — which is responsible for sensation across the face and motor functions like chewing.
When the trigeminal nerve is compressed, irritated, or damaged, the result is sudden, intense facial pain triggered by the most ordinary activities: eating, speaking, brushing your teeth, or even a light touch of the cheek.
The three branches of the trigeminal nerve
| Nerve Branch | Area Innervated |
|---|---|
| V1 — Ophthalmic | Forehead, scalp, upper eyelid |
| V2 — Maxillary | Cheek, upper lip, upper teeth, nose |
| V3 — Mandibular | Jaw, lower lip, lower teeth, chin |
What does trigeminal neuralgia feel like?
TN is often described as the worst pain a human being can experience. Episodes are typically sudden and intense, often described as electric shock-like or stabbing facial pain. Common characteristics include:
- Sudden, severe pain on one side of the face lasting seconds to minutes
- Pain triggered by everyday actions — eating, talking, brushing teeth, even wind on the face
- Episodes that may cluster in bursts, separated by pain-free periods
- A constant aching or burning sensation between acute episodes (in some patients)
- Pain so severe it can interfere with eating, sleeping, and daily function
Important: If you are experiencing severe uncontrolled facial pain, please seek immediate medical evaluation. This page is for informational purposes and does not replace a clinical assessment.
Standard treatments and their limitations
Traditional treatment approaches for TN generally fall into two categories: medications that dampen pain signals, and procedures that intentionally damage or destroy the nerve to stop pain transmission. While these may provide relief, each comes with important trade-offs.
| Treatment | Description |
|---|---|
| Anticonvulsants | Carbamazepine, gabapentin, and similar drugs stabilize nerve signals. Often effective early but may lose efficacy over time and carry significant side effects. |
| Muscle relaxants | Baclofen and similar agents may help certain patients, often used in combination with anticonvulsants. |
| Gamma Knife / Radiosurgery | Focused radiation targets the nerve root to disrupt pain signals. May cause permanent facial numbness. |
| Rhizotomy procedures | Glycerol injection, balloon compression, or radiofrequency ablation — all work by intentionally damaging the nerve. Facial numbness is a common outcome. |
| Microvascular decompression | Open skull surgery to relocate blood vessels compressing the nerve. Most invasive option; carries risks including hearing loss, facial weakness, and stroke. |
The core problem with destructive procedures: Most conventional interventional options work by damaging or destroying the nerve itself to block pain. This trades pain for numbness — and does nothing to address the underlying nerve dysfunction. For some patients, pain can return when the nerve attempts to recover.
A different question: can we support the nerve instead of destroying it?
At Palm Beach Regenerative Sport and Spine, we approach TN from a different angle. Rather than targeting the nerve for destruction, our image-guided orthobiologic approach aims to deliver concentrated platelet-derived growth factors precisely around the trigeminal nerve — reducing inflammation and addressing nerve dysfunction while supporting your body’s own natural processes.
The majority of our nerve-related procedures use platelet-rich plasma (PRP). These are image-guided injections of your own concentrated blood platelets — no foreign substances, no systemic medications.
| Feature | Description |
|---|---|
| Comprehensive consultation | Dr. Ghattas reviews your full history, imaging, and prior treatments. Not every patient is a candidate — honest assessment comes first. |
| Precision image guidance | Using ultrasound and/or fluoroscopy, treatment is delivered to the exact nerve target — not approximated. |
| Structured follow-up | We track your response at defined intervals — 6 weeks, 3 months, 6 months. Data-driven care, not guesswork. |
| Honest reassessment | If orthobiologics aren’t the right fit for your situation, Dr. Ghattas will tell you — and refer you to the appropriate specialist. |
The PBRSS difference for nerve conditions
Trigeminal neuralgia sits at the intersection of neurology and interventional pain — a combination few regenerative practices can address with genuine clinical depth. Dr. Ghattas’s background makes Palm Beach Regenerative uniquely positioned for this condition.
| Feature | Description |
|---|---|
| Board-certified neurologist | TN is a neurological condition. Dr. Ghattas’s neurology board certification means your nerve condition is evaluated by someone who trained specifically in this space — not just a pain specialist working by protocol. |
| Official Regenexx network provider | Access to the most rigorously developed orthobiologic protocols in the field, backed by the largest regenerative medicine outcomes registry in existence. |
| Every injection image-guided | Real-time ultrasound and fluoroscopy guidance ensures accurate delivery to the intended nerve target. Not approximate — precise. |
| Outcome tracking | Structured follow-up at 6 weeks, 3 months, 6 months, and beyond. We measure what we do and adjust based on your individual response. |
Candidacy for orthobiologic TN treatment
Not every TN patient is a candidate for this approach. During your consultation, Dr. Ghattas will evaluate your specific situation honestly — including whether orthobiologics are appropriate or whether a different path would serve you better.
May be appropriate (Grade I–II) if you:
- Have not responded adequately to medications or are experiencing significant side effects
- Want to explore options before pursuing destructive nerve procedures
- Have a confirmed diagnosis of trigeminal neuralgia with appropriate imaging
- Are in generally good health without contraindications to injections
May not be appropriate if you:
- Have a vascular cause of TN clearly identified where surgical decompression is indicated
- Have secondary TN related to a tumor or lesion requiring direct intervention
- Have active infection or contraindications to injection-based procedures
- Are in crisis and require immediate pain control — this is not an emergency treatment
Like all medical procedures, orthobiologic treatments have potential risks and benefits. Results vary by individual. Not all patients are candidates. Orthobiologic treatment for trigeminal neuralgia represents an off-label application based on clinical evidence and physician discretion. Dr. Ghattas will discuss your specific situation, realistic expectations, and all treatment options — including when referral to a neurologist or neurosurgeon is more appropriate. This page is for informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment.
Explore your options with a specialist who understands both sides
Trigeminal neuralgia requires careful evaluation. Schedule a consultation to discuss whether an orthobiologic approach is appropriate for your situation — or what the best next step is if it isn't.
●PATIENT OUTCOMES
Real Patients. Real Results.
No medical procedure can guarantee an outcome. What you should expect is an honest discussion of the evidence, a careful assessment of candidacy, and a recommendation based on your condition.
"Honestly one of the best experiences, I’ve had a really stiff neck for a couple weeks I tried seeing a chiropractor for and it helped marginally but the real jump in relief was coming to see Dr. Ghattas! He has been incredible, wonderful staff, and minimally invasive technique for my pain relief which was super important to me! Thank you Dr. Ghattas recommending to anyone with pain!"Monica A
"Ghattas was instrumental in helping my torn rotator cuff. I did Barbotage for the stone, and then PRP. Great experience. Been about a month or 2 since and I feel great."Ahmet B
"I had severe knee pain and was looking for proper knee pain treatment, which is how I found Dr. Ghattas on Instagram. I was a bit hesitant at first, but it turned out to be one of the best decisions I’ve made for my health. Francia was amazing at coordinating all my consultations and making the whole process easy and stress-free. If you’re dealing with knee pain and looking for a reliable doctor and team, I highly recommend them."Roger L
"Over a year ago, both my daughter and I underwent PRP treatment with Dr. Ghattas—PRP for my left knee and PRP for my daughter’s L4-L5 and sacral region. We wanted to wait long enough to truly evaluate the results before sharing our experience. I am pleased to say that the outcomes have been outstanding. My daughter’s improvement has been remarkable, and the treatment has made a significant difference in her quality of life. I have also experienced excellent results with my knee. Dr. Ghattas is an exceptional physician who combines expertise, professionalism, and genuine care for his patients. We are incredibly grateful for the treatment we received and the positive impact it has had on our lives. Thank you, Dr. Ghattas. We are truly grateful for everything you have done. You are simply the best."Dr Jorge A
"Dr. Ghattas is very knowledgable and a sympathetic doctor. Hard to find in America. All questions answered, my procedure went very smoothly, very little pain. Follow up is excellent, I highly recommend his practice."Luciana D
“ I had severe knee pain and was looking for proper knee pain treatment, which is how I found Dr. Ghattas on Instagram. I was a bit hesitant at first, but it turned out to be one of the best decisions I’ve made for my health. Francia was amazing at coordinating all my consultations and making the whole process easy and stress-free. If you’re dealing with knee pain and looking for a reliable doctor and team, I highly recommend them. ”Roger L
“Dr. Ghattas was terrific today. He spent a good amount of time examining me and explaining the regenerative process which I intend to have done next month. More to come after the procedure.”Louie R
“I found Dr Ghattas and his staff very welcoming and informative. The process was well explained and gave me encouragement about the potential for fully restoring my knee joint integrity.”Eric C
“I received two treatments from Dr. Ghattas With excellent results, he takes great care in his assessment and in his treatment you couldn’t be in better hands. I highly recommend his work.”Gisela S
“Apart from the exemplary personal service by the reception and the staff that makes us feel we're at home at the clinic, I have experienced remarkable healing in several episodes from shoulder issue to knee injuries and hip pain. The doctor is so thorough in the diagnosis phase that he administered exactly what was needed, no more no less! Thank you folks for a wonderful experience.”RG G
“Went to Dr. Ghattas for chronic knee and neck issue. I’ve already had multiple procedures done on my neck and multiple epidurals with minimal success. My knee I was told needed surgery to fix. I already had surgery in the past with minimal difference. I ended up getting stem cells in my knee and neck and could t be happier with the outcome. Anyone considering surgery I recommend checking out Regenex first. Next I’m doing the ganglion block and look forward to the results.”Logan H
“Dr. James Ghattas and his team are truly top-notch. His office is equipped with state-of-the-art technology and a staff that's exceptional in their fields. I've referred several clients to him, and they've all been incredibly satisfied. Dr. Ghattas is absolutely ahead of the curve, and I wholeheartedly endorse his work.”Ron H
“I am quite active and go to pilates 3-4 times per week. I was having left knee pain and which was treated with PRP. It took about 3 months for me to feel better but then the pain completely subsided. I now am able to exercise without the fear that I will tear a ligament and am pain free.”Ellipsis P
“Transparency, thoroughness, attention to detail, immediate, high quality, follow ups and follow through are just a few words that come to mind throughout my experiences with Palm Beach Regenerative Sport and Spine.”Milton L
Herniated Disc Treatment
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Herniated Disc Treatment Without Surgery
Herniated Disc, Bulging Disc, Degenerative Disc Disease: What's the Difference — and Does It Matter?
Patients are often given three different labels — bulging disc, herniated disc, degenerative disc disease — as if they are three different conditions requiring three different treatments. In practice, they represent a spectrum of the same underlying process: disc breakdown. At Palm Beach Regenerative, we treat the whole Functional Spinal Unit around the affected disc — because the disc is rarely the only structure involved.
This condition is treated as part of the Lumbar Functional Spinal Unit (FSU). Dr. Ghattas evaluates every contributing structure — not just the affected segment.
Herniated disc, bulging disc, DDD — one spectrum
The intervertebral disc is a fibrocartilaginous shock absorber between each pair of vertebrae. It consists of a tough outer ring (annulus fibrosus) and a gel-like inner core (nucleus pulposus). Disc pathology exists on a continuum: a bulging disc occurs when the outer ring weakens and the disc expands beyond its normal boundary. A herniated disc occurs when the inner nucleus pushes through a tear in the outer ring—potentially contacting a nerve root. Degenerative disc disease describes the age- or injury-related loss of disc height, hydration, and structural integrity that underlies both.
The important clinical point: many people with significant disc findings on MRI have no pain, while others with modest disc changes have severe symptoms. This is because disc pathology alone does not determine pain—the facet joints, ligaments, and nerve environment around the disc are equally important. This is why the FSU approach, rather than disc-isolated treatment, produces more comprehensive results in appropriate candidates.
How does disc disease present?
| Symptom | Typical Pattern | Likely Structure |
|---|---|---|
| Symptom | Central or bilateral back pain; worse with prolonged sitting or standing | Disc, facet joints, ligaments |
| Sciatica | Radiating pain, numbness, or tingling down one leg | Compressed nerve root |
| Morning stiffness | Stiffness easing after 30–60 min of movement | Disc dehydration, facet arthritis |
| Pain with bending forward | Increased disc pressure worsens symptoms with flexion | Disc (anterior) |
| Pain with extension | Pain worse leaning back; may ease bending forward | Facet joints (posterior) |
| Muscle weakness or foot drop | Weakness in a specific leg muscle group | Significant nerve root compression |
How we treat disc disease through the FSU
Our treatment protocol for disc disease addresses the full FSU — not just the disc. In most cases, the facet joints, ligaments, and nerve environment are treated first or concurrently, as they are often equally responsible for the pain. Direct disc injection is reserved for carefully selected cases only.
- Lumbar facet joint PRP or prolotherapy
Facet joint degeneration accelerates as disc height decreases — the joints bear more load as the disc loses its shock-absorbing function. Image-guided PRP or prolotherapy to the facet joint capsules addresses this component and is typically the primary treatment target. - Lumbar ligament prolotherapy
Spinal ligament laxity at the affected level allows excessive segmental motion — a key driver of ongoing pain and disc stress. Prolotherapy to the interspinous and iliolumbar ligaments supports your body’s natural stabilizing response. - Lumbar ligament prolotherapy
When disc herniation is causing nerve root inflammation and radicular symptoms, image-guided epidural PRP targets the inflammatory environment around the affected root — distinct from traditional corticosteroid epidurals in its mechanism and intent. - Direct disc treatment (selected cases)
In carefully selected patients with clear discogenic pain, image-guided injection of orthobiologic material adjacent to or within the disc may be appropriate. This is not offered routinely — it carries additional procedural considerations and is discussed in full during consultation. These treatments do not regenerate or rebuild the disc.
Candidacy for disc disease treatment
May be appropriate if you:
- Have confirmed disc pathology on MRI (herniation, DDD, annular tear)
- Have not responded adequately to physical therapy or conservative care
- Want to explore non-surgical options before considering microdiscectomy or fusion
- Have axial back pain, radiculopathy, or both
- Do not have severe neurological deficits requiring urgent surgical decompression
May not be appropriate if you:
- Have severe or progressive neurological deficit(foot drop, bowel/bladder changes)
- Have cauda equina syndrome — requiresemergency surgical evaluation
- Have spinal instability requiring surgicalstabilization
- Have infection, tumor, or fracture as the causeof disc pathology
- Have not yet had a current MRI reviewed by Dr.Ghattas
FDA/FTC Compliance Note: Per Regenexx guidelines: never claim to regenerate or rebuild discs. Majority of spine procedures use PRP, not BMC. Direct disc injection only in carefully selected cases. Always qualify outcomes (‘many patients experience improvement’). Acknowledge when surgery is more appropriate.
Like all medical procedures, orthobiologic treatments have potential risks and benefits. Results vary by individual. Not all patients are candidates. The majority of spine procedures use platelet-rich plasma (PRP) rather than bone marrow concentrate. These treatments do not regenerate or rebuild damaged discs or spinal structures. Dr. Ghattas will discuss your specific situation, realistic expectations, and all options — including when surgical referral is more appropriate. This content is for informational purposes only and does not constitute medical advice, diagnosis, or treatment.
Ready to understand the real source of your back pain?
Dr. Ghattas will review your imaging and assess your lumbar spine as a complete system — then discuss which structures are contributing and whether orthobiologic treatment is appropriate for your specific case.
●PATIENT OUTCOMES
Real Patients. Real Results.
No medical procedure can guarantee an outcome. What you should expect is an honest discussion of the evidence, a careful assessment of candidacy, and a recommendation based on your condition.
"Honestly one of the best experiences, I’ve had a really stiff neck for a couple weeks I tried seeing a chiropractor for and it helped marginally but the real jump in relief was coming to see Dr. Ghattas! He has been incredible, wonderful staff, and minimally invasive technique for my pain relief which was super important to me! Thank you Dr. Ghattas recommending to anyone with pain!"Monica A
"Ghattas was instrumental in helping my torn rotator cuff. I did Barbotage for the stone, and then PRP. Great experience. Been about a month or 2 since and I feel great."Ahmet B
"I had severe knee pain and was looking for proper knee pain treatment, which is how I found Dr. Ghattas on Instagram. I was a bit hesitant at first, but it turned out to be one of the best decisions I’ve made for my health. Francia was amazing at coordinating all my consultations and making the whole process easy and stress-free. If you’re dealing with knee pain and looking for a reliable doctor and team, I highly recommend them."Roger L
"Over a year ago, both my daughter and I underwent PRP treatment with Dr. Ghattas—PRP for my left knee and PRP for my daughter’s L4-L5 and sacral region. We wanted to wait long enough to truly evaluate the results before sharing our experience. I am pleased to say that the outcomes have been outstanding. My daughter’s improvement has been remarkable, and the treatment has made a significant difference in her quality of life. I have also experienced excellent results with my knee. Dr. Ghattas is an exceptional physician who combines expertise, professionalism, and genuine care for his patients. We are incredibly grateful for the treatment we received and the positive impact it has had on our lives. Thank you, Dr. Ghattas. We are truly grateful for everything you have done. You are simply the best."Dr Jorge A
"Dr. Ghattas is very knowledgable and a sympathetic doctor. Hard to find in America. All questions answered, my procedure went very smoothly, very little pain. Follow up is excellent, I highly recommend his practice."Luciana D
“ I had severe knee pain and was looking for proper knee pain treatment, which is how I found Dr. Ghattas on Instagram. I was a bit hesitant at first, but it turned out to be one of the best decisions I’ve made for my health. Francia was amazing at coordinating all my consultations and making the whole process easy and stress-free. If you’re dealing with knee pain and looking for a reliable doctor and team, I highly recommend them. ”Roger L
“Dr. Ghattas was terrific today. He spent a good amount of time examining me and explaining the regenerative process which I intend to have done next month. More to come after the procedure.”Louie R
“I found Dr Ghattas and his staff very welcoming and informative. The process was well explained and gave me encouragement about the potential for fully restoring my knee joint integrity.”Eric C
“I received two treatments from Dr. Ghattas With excellent results, he takes great care in his assessment and in his treatment you couldn’t be in better hands. I highly recommend his work.”Gisela S
“Apart from the exemplary personal service by the reception and the staff that makes us feel we're at home at the clinic, I have experienced remarkable healing in several episodes from shoulder issue to knee injuries and hip pain. The doctor is so thorough in the diagnosis phase that he administered exactly what was needed, no more no less! Thank you folks for a wonderful experience.”RG G
“Went to Dr. Ghattas for chronic knee and neck issue. I’ve already had multiple procedures done on my neck and multiple epidurals with minimal success. My knee I was told needed surgery to fix. I already had surgery in the past with minimal difference. I ended up getting stem cells in my knee and neck and could t be happier with the outcome. Anyone considering surgery I recommend checking out Regenex first. Next I’m doing the ganglion block and look forward to the results.”Logan H
“Dr. James Ghattas and his team are truly top-notch. His office is equipped with state-of-the-art technology and a staff that's exceptional in their fields. I've referred several clients to him, and they've all been incredibly satisfied. Dr. Ghattas is absolutely ahead of the curve, and I wholeheartedly endorse his work.”Ron H
“I am quite active and go to pilates 3-4 times per week. I was having left knee pain and which was treated with PRP. It took about 3 months for me to feel better but then the pain completely subsided. I now am able to exercise without the fear that I will tear a ligament and am pain free.”Ellipsis P
“Transparency, thoroughness, attention to detail, immediate, high quality, follow ups and follow through are just a few words that come to mind throughout my experiences with Palm Beach Regenerative Sport and Spine.”Milton L
Robotic MLS Laser Therapy
What is MLS Laser Therapy?
MLS (Multiwave Locked System) Laser Therapy is an advanced, FDA-cleared treatment that uses specific wavelengths of light to energize cells, reduce inflammation, and support accelerated healing. At Palm Beach Regenerative, our state-of-the-art BioModulation Lab features robotic MLS Laser technology.
Unlike older laser technologies, MLS combines continuous and pulsed emissions in a synchronized pattern, allowing deeper tissue penetration without thermal damage. Dr. Ghattas uses MLS Laser as a powerful adjunct to interventional orthobiologics, enhancing overall results and supporting your body’s healing response.
MLS Laser delivers targeted photobiomodulation energy to tissues for enhanced cellular function and healing.
How MLS Laser Works
The Science of Photobiomodulation:
- Cellular Energy Boost:
Light wavelengths are absorbed by mitochondria (the cell’s powerhouses), boosting ATP production – the energy currency cells use for healing and function. More cellular energy means faster, more effective healing. - Inflammation Reduction:
Laser energy decreases pro-inflammatory mediators and increases anti-inflammatory cytokines, reducing swelling and pain at the cellular level. - Enhanced Circulation:
Promotes microcirculation, bringing oxygen and nutrients to damaged tissues while removing waste products and inflammatory debris. - Nerve Modulation:
Reduces pain signal transmission by affecting nerve cell membranes, providing symptomatic relief while healing occurs.
What Makes MLS Different:
- Synchronized wavelengths (808nm and 905nm in precise timing)
- Deeper penetration (reaches tissues up to 3-5cm deep)
- No thermal damage (pulsed delivery prevents overheating)
- Robotic precision (consistent delivery to exact treatment area)
- FDA-cleared for pain relief and inflammation reduction
Total Treatment Time: 10-20 minutes per session
Conditions Treated with MLS Laser
MLS Laser may benefit most musculoskeletal conditions:
Tendon Conditions:
- Tennis/golfer’s elbow
- Achilles tendinitis
- Patellar tendinitis
- Rotator cuff tendinopathy
- Any tendinitis or tendinosis
Arthritis:
- Knee osteoarthritis
- Hip osteoarthritis
- Shoulder arthritis
- Hand/wrist arthritis
- Spine arthritis (facet joints)
Acute Injuries:
- Ligament sprains
- Muscle strains
- Post-injury inflammation
- Bruising and swelling
- Delayed healing
Chronic Pain Conditions:
- Nerve pain (sciatica, neuropathy)
- Chronic regional pain
- Fibromyalgia
- Myofascial pain
- Post-surgical pain
MLS Laser + Orthobiologics: A Powerful Combination
At Palm Beach Regenerative, we often combine MLS Laser with Regenexx procedures:
Pre-Treatment Protocol:
Reducing inflammation before orthobiologic injections can:
- Improve cell engraftment and survival
- Optimize healing environment
- Reduce post-procedure discomfort
- Enhance overall treatment response
Post-Treatment Protocol:
Using MLS Laser after injections:
- Accelerates tissue response to biologics
- May shorten recovery time
- Reduces post-procedure inflammation
- Supports tissue remodeling
Standalone Treatment:
For conditions not requiring injections:
- Conservative management of arthritis or tendinitis
- Bridge therapy while planning interventional orthobiologics
- Maintenance therapy between biologic treatments
- Acute injury management
What to Expect During MLS Laser Treatment
The Experience:
- No pain – most patients feel gentle warmth or tingling
- Remain clothed – laser applied over treatment area
- Quick sessions (10-20 minutes depending on area)
- No downtime – return to all activities immediately
- Relaxing – many patients find treatment soothing
Treatment Protocol:
- Typical course: 6-12 sessions over 2-4 weeks
- Frequency: Usually 2-3 times per week initially
- Maintenance: Some patients continue periodic treatments
- Same-day combination: Can be performed same day as orthobiologic procedures
What Patients Notice:
- Many feel improvement within first few sessions
- Cumulative effects build over treatment course
- Pain relief often precedes functional improvement
- Some experience temporary increase in circulation (warmth, redness)
- Effects continue after treatment course ends
Success Rates and Outcomes
Many patients with musculoskeletal conditions report:
- Significant pain reduction (often 30-70% improvement)
- Improved range of motion and function
- Reduced inflammation and swelling
- Faster recovery from injury or procedure
- Enhanced response to other treatments
- Reduced need for pain medications
Response Factors:
- Acuity vs. chronicity of condition
- Severity of inflammation or tissue damage
- Number of treatments completed
- Concurrent treatments
- Overall health and healing capacity
Timeline for Results:
- Acute conditions: Often respond within 3-6 sessions
- Chronic conditions: May need 8-12+ sessions for optimal benefit
- Post-procedure: Enhances healing over 2-4 weeks
- Maintenance: Some continue periodic treatments
The Science Behind MLS Laser
Multiple peer-reviewed studies demonstrate MLS Laser effectiveness:
- Significant pain reduction vs. placebo in multiple studies
- Accelerated healing visible on ultrasound imaging
- Better function scores in arthritis patients
- Enhanced outcomes when combined with regenerative treatments
Research Highlights:
- Studies on knee osteoarthritis show meaningful pain and function improvement
- Tendinitis research demonstrates accelerated healing
- Post-surgical studies show faster recovery and less pain
- Combination studies suggest synergy with biologics
Safety Profile
MLS Laser is extremely safe with no known serious adverse effects when used properly.
Contraindications Include:
- Active cancer in treatment area
- Pregnancy (over abdomen/pelvis)
- Photosensitizing medications (discuss with Dr. Ghattas)
- Directly over eyes (protective eyewear worn)
- Over thyroid gland
Side Effects (Rare):
- Temporary warmth or redness (normal response)
- Mild increased circulation
- Temporary symptom increase (rare)
FDA Status:
MLS Laser is FDA-cleared for:
- Temporary relief of minor muscle and joint pain
- Temporary relief of muscle spasm
- Temporary increase in local blood circulation
Is MLS Laser Right for You?
May be appropriate when:
- You have musculoskeletal pain or inflammation
- You want to enhance interventional orthobiologics outcomes
- You have acute injury requiring faster healing
- You prefer non-invasive treatment approach
- You want to reduce medication use
Often combined with:
- Any orthobiologic injection (before or after)
- Physical therapy for enhanced results
- Conservative management of arthritis
- Sports injury rehabilitation
Standalone option when:
- Conservative management of mild-moderate conditions
- Acute injury not requiring injections
- Maintenance between biologic treatments
- Optimizing tissue health before procedures
Why Choose Palm Beach Regenerative for MLS Laser?
- Part of comprehensive BioModulation Lab
- Robotic precision delivery
- Can be combined same-day with interventional orthobiologics
- Fellowship-trained physician oversight
- Systematic outcome tracking
- Evidence-based protocols
Cost and Insurance
Most insurance plans do not cover laser therapy. We provide:
- Affordable single-session pricing
- Discounted multi-session packages
- Often included/discounted with orthobiologic procedures
- HSA/FSA eligible
- No hidden fees
Required Disclaimer
MLS Laser Therapy is FDA-cleared for temporary relief of minor muscle and joint pain, muscle spasm, and temporary increase in local blood circulation. Results vary by individual. Not all patients achieve the same level of benefit. Dr. Ghattas will discuss realistic expectations during consultation.
Schedule a consultation to discuss MLS laser therapy. Ask about same-day laser when scheduling orthobiologic procedures for enhanced results!
Quick Appointments Available
Don't wait in pain. We can see you within 1-2 weeks. Get the orthopedic care you need, fast.
●PATIENT OUTCOMES
Real Patients. Real Results.
No medical procedure can guarantee an outcome. What you should expect is an honest discussion of the evidence, a careful assessment of candidacy, and a recommendation based on your condition.
"Honestly one of the best experiences, I’ve had a really stiff neck for a couple weeks I tried seeing a chiropractor for and it helped marginally but the real jump in relief was coming to see Dr. Ghattas! He has been incredible, wonderful staff, and minimally invasive technique for my pain relief which was super important to me! Thank you Dr. Ghattas recommending to anyone with pain!"Monica A
"Ghattas was instrumental in helping my torn rotator cuff. I did Barbotage for the stone, and then PRP. Great experience. Been about a month or 2 since and I feel great."Ahmet B
"I had severe knee pain and was looking for proper knee pain treatment, which is how I found Dr. Ghattas on Instagram. I was a bit hesitant at first, but it turned out to be one of the best decisions I’ve made for my health. Francia was amazing at coordinating all my consultations and making the whole process easy and stress-free. If you’re dealing with knee pain and looking for a reliable doctor and team, I highly recommend them."Roger L
"Over a year ago, both my daughter and I underwent PRP treatment with Dr. Ghattas—PRP for my left knee and PRP for my daughter’s L4-L5 and sacral region. We wanted to wait long enough to truly evaluate the results before sharing our experience. I am pleased to say that the outcomes have been outstanding. My daughter’s improvement has been remarkable, and the treatment has made a significant difference in her quality of life. I have also experienced excellent results with my knee. Dr. Ghattas is an exceptional physician who combines expertise, professionalism, and genuine care for his patients. We are incredibly grateful for the treatment we received and the positive impact it has had on our lives. Thank you, Dr. Ghattas. We are truly grateful for everything you have done. You are simply the best."Dr Jorge A
"Dr. Ghattas is very knowledgable and a sympathetic doctor. Hard to find in America. All questions answered, my procedure went very smoothly, very little pain. Follow up is excellent, I highly recommend his practice."Luciana D
“ I had severe knee pain and was looking for proper knee pain treatment, which is how I found Dr. Ghattas on Instagram. I was a bit hesitant at first, but it turned out to be one of the best decisions I’ve made for my health. Francia was amazing at coordinating all my consultations and making the whole process easy and stress-free. If you’re dealing with knee pain and looking for a reliable doctor and team, I highly recommend them. ”Roger L
“Dr. Ghattas was terrific today. He spent a good amount of time examining me and explaining the regenerative process which I intend to have done next month. More to come after the procedure.”Louie R
“I found Dr Ghattas and his staff very welcoming and informative. The process was well explained and gave me encouragement about the potential for fully restoring my knee joint integrity.”Eric C
“I received two treatments from Dr. Ghattas With excellent results, he takes great care in his assessment and in his treatment you couldn’t be in better hands. I highly recommend his work.”Gisela S
“Apart from the exemplary personal service by the reception and the staff that makes us feel we're at home at the clinic, I have experienced remarkable healing in several episodes from shoulder issue to knee injuries and hip pain. The doctor is so thorough in the diagnosis phase that he administered exactly what was needed, no more no less! Thank you folks for a wonderful experience.”RG G
“Went to Dr. Ghattas for chronic knee and neck issue. I’ve already had multiple procedures done on my neck and multiple epidurals with minimal success. My knee I was told needed surgery to fix. I already had surgery in the past with minimal difference. I ended up getting stem cells in my knee and neck and could t be happier with the outcome. Anyone considering surgery I recommend checking out Regenex first. Next I’m doing the ganglion block and look forward to the results.”Logan H
“Dr. James Ghattas and his team are truly top-notch. His office is equipped with state-of-the-art technology and a staff that's exceptional in their fields. I've referred several clients to him, and they've all been incredibly satisfied. Dr. Ghattas is absolutely ahead of the curve, and I wholeheartedly endorse his work.”Ron H
“I am quite active and go to pilates 3-4 times per week. I was having left knee pain and which was treated with PRP. It took about 3 months for me to feel better but then the pain completely subsided. I now am able to exercise without the fear that I will tear a ligament and am pain free.”Ellipsis P
“Transparency, thoroughness, attention to detail, immediate, high quality, follow ups and follow through are just a few words that come to mind throughout my experiences with Palm Beach Regenerative Sport and Spine.”Milton L
Nerve Hydrodissection
What is Nerve Hydrodissection?
Nerve hydrodissection is a specialized technique that uses image-guided injection to free compressed or entrapped nerves from surrounding scar tissue, adhesions, or inflammation.
By precisely delivering fluid solution around the affected nerve under real-time ultrasound guidance, Dr. Ghattas can mechanically separate the nerve from structures causing compression while simultaneously delivering healing factors to support nerve health and function.
Hydrodissection literally means “separating with fluid” – the technique provides both immediate mechanical relief and long-term healing support.
How Nerve Hydrodissection Works
Understanding Bone Marrow Lesions:
MRI imaging may reveal areas of bone marrow swelling and inflammation (bone marrow lesions or BMLs) in joints affected by:
- Osteoarthritis
- Stress reactions
- Avascular necrosis (early stages)
- Post-traumatic changes
- Overload and repetitive stress
The Procedure:
- Ultrasound Evaluation
Real-time ultrasound identifies the exact location where the nerve is compressed or entrapped. - Precise Needle Placement
Under continuous ultrasound visualization, Dr. Ghattas guides a small needle to the precise location of nerve compression, avoiding surrounding blood vessels and structures. - Controlled Fluid Injection
Sterile solution (often containing Platelet Lysate or other healing preparations) is injected in controlled manner to:- Mechanically separate nerve from adhesions or scar tissue
- Reduce inflammation around irritated nerve tissue
- Deliver healing factors to support nerve recovery
- Restore nerve’s normal gliding motion
Conditions Treated with Nerve Hydrodissection
Upper Extremity Nerve Compression:
- Carpal tunnel syndrome (median nerve compression)
- Cubital tunnel syndrome (ulnar nerve at elbow)
- Radial tunnel syndrome
- Thoracic outlet syndrome
- Suprascapular nerve entrapment
Lower Extremity Nerve Compression:
- Tarsal tunnel syndrome (tibial nerve)
- Morton’s neuroma
- Peroneal nerve entrapment
- Sural nerve entrapment
- Saphenous nerve entrapment
Other Applications:
- Scar tissue around nerves after surgery or injury
- Chronic nerve compression not responding to conservative care
- Nerve pain from repetitive motion
- Failed previous nerve treatments
What Makes Nerve Hydrodissection Different?
Non-Surgical Nerve Release:
Provides mechanical freeing of nerve without surgery, avoiding surgical risks, recovery time, scarring, and general anesthesia.
Precision Targeting:
Real-time ultrasound ensures treatment is delivered exactly where needed, unlike blind injections or systemic medications.
Enhanced with Biologics:
Combining hydrodissection with Platelet Lysate or other preparations may offer both immediate mechanical relief and long-term healing support.
Diagnostic and Therapeutic:
The procedure provides information about the nerve’s response, helping confirm diagnosis and guide further treatment.
What to Expect During Nerve Hydrodissection
Pre-Procedure:
- Detailed nerve examination
- Ultrasound evaluation of nerve compression site
- Discussion of expected outcomes
Treatment (30-45 minutes):
- Patient positioned for optimal access
- Real-time ultrasound locates compressed nerve
- Skin cleaned and prepared
- Fine needle advanced under ultrasound guidance
- Precise placement confirmed adjacent to nerve
- Controlled injection of hydrodissection solution
- Observation of nerve separation on ultrasound
- May include Platelet Lysate or other healing solutions
Total Time: Approximately 1 hour
Recovery and Timeline
Immediate (Day 0-3):
- May notice immediate improvement in symptoms (from mechanical release)
- Some patients experience temporary increased sensitivity
- Mild soreness at injection site
- Ice and gentle movement as directed
Early Response (Week 1-2):
- Nerve symptoms often begin improving
- Reduced numbness, tingling, or pain
- Improved function in affected area
- May combine with therapy or splinting
Continued Improvement (Week 2-8):
- Progressive reduction in nerve symptoms
- Enhanced nerve function and sensation
- May require repeat treatment for optimal results
- Some conditions need series of treatments (2-3 sessions)
Long-Term (2-6 months):
- Sustained improvement in most responsive cases
- Nerve healing continues over months
- Lifestyle modifications may be needed to prevent recurrence
Success Rates and Outcomes
Many patients with nerve compression report:
- Significant reduction in nerve pain
- Decreased numbness and tingling
- Improved grip strength or function
- Avoided or delayed surgical intervention
- Reduced need for medications
Response varies based on:
- Severity and duration of compression
- Degree of nerve damage
- Presence of underlying conditions (diabetes, etc.)
- Adherence to post-procedure recommendations
Is Nerve Hydrodissection Right for You?
May be appropriate when:
- You have confirmed nerve compression on imaging or testing
- Conservative treatments (splinting, therapy) haven’t provided relief
- You want to avoid or delay nerve release surgery
- You have nerve symptoms affecting quality of life or function
May NOT be best choice when:
- You have complete nerve transection (requires surgical repair)
- You have severe, chronic nerve damage with muscle wasting
- Underlying structural problems require surgical correction
Compared to Surgery:
- Less invasive with faster recovery
- Can be repeated if needed
- Avoids surgical risks and scarring
- Surgery remains option if hydrodissection insufficient
Why Choose Palm Beach Regenerative for Nerve Hydrodissection?
- Real-time ultrasound guidance for precision
- Fellowship-trained in interventional techniques
- Enhanced with Platelet Lysate preparations
- Nerve-specific expertise
- Systematic outcome tracking
- Non-surgical alternative
Cost and Insurance
Insurance coverage varies by plan and diagnosis. We provide:
- Pre-authorization assistance
- Transparent cost estimates
- Superbills for submission
- HSA/FSA eligible
- CareCredit financing available
Required Disclaimer
Like all medical procedures, nerve hydrodissection has potential risks and benefits. Results vary by individual. Not all patients achieve complete symptom resolution. Dr. Ghattas will discuss realistic expectations and all treatment options during consultation.
Schedule a consultation to discuss nerve hydrodissection.
Quick Appointments Available
Don't wait in pain. We can see you within 1-2 weeks. Get the orthopedic care you need, fast.
●PATIENT OUTCOMES
Real Patients. Real Results.
No medical procedure can guarantee an outcome. What you should expect is an honest discussion of the evidence, a careful assessment of candidacy, and a recommendation based on your condition.
"Honestly one of the best experiences, I’ve had a really stiff neck for a couple weeks I tried seeing a chiropractor for and it helped marginally but the real jump in relief was coming to see Dr. Ghattas! He has been incredible, wonderful staff, and minimally invasive technique for my pain relief which was super important to me! Thank you Dr. Ghattas recommending to anyone with pain!"Monica A
"Ghattas was instrumental in helping my torn rotator cuff. I did Barbotage for the stone, and then PRP. Great experience. Been about a month or 2 since and I feel great."Ahmet B
"I had severe knee pain and was looking for proper knee pain treatment, which is how I found Dr. Ghattas on Instagram. I was a bit hesitant at first, but it turned out to be one of the best decisions I’ve made for my health. Francia was amazing at coordinating all my consultations and making the whole process easy and stress-free. If you’re dealing with knee pain and looking for a reliable doctor and team, I highly recommend them."Roger L
"Over a year ago, both my daughter and I underwent PRP treatment with Dr. Ghattas—PRP for my left knee and PRP for my daughter’s L4-L5 and sacral region. We wanted to wait long enough to truly evaluate the results before sharing our experience. I am pleased to say that the outcomes have been outstanding. My daughter’s improvement has been remarkable, and the treatment has made a significant difference in her quality of life. I have also experienced excellent results with my knee. Dr. Ghattas is an exceptional physician who combines expertise, professionalism, and genuine care for his patients. We are incredibly grateful for the treatment we received and the positive impact it has had on our lives. Thank you, Dr. Ghattas. We are truly grateful for everything you have done. You are simply the best."Dr Jorge A
"Dr. Ghattas is very knowledgable and a sympathetic doctor. Hard to find in America. All questions answered, my procedure went very smoothly, very little pain. Follow up is excellent, I highly recommend his practice."Luciana D
“ I had severe knee pain and was looking for proper knee pain treatment, which is how I found Dr. Ghattas on Instagram. I was a bit hesitant at first, but it turned out to be one of the best decisions I’ve made for my health. Francia was amazing at coordinating all my consultations and making the whole process easy and stress-free. If you’re dealing with knee pain and looking for a reliable doctor and team, I highly recommend them. ”Roger L
“Dr. Ghattas was terrific today. He spent a good amount of time examining me and explaining the regenerative process which I intend to have done next month. More to come after the procedure.”Louie R
“I found Dr Ghattas and his staff very welcoming and informative. The process was well explained and gave me encouragement about the potential for fully restoring my knee joint integrity.”Eric C
“I received two treatments from Dr. Ghattas With excellent results, he takes great care in his assessment and in his treatment you couldn’t be in better hands. I highly recommend his work.”Gisela S
“Apart from the exemplary personal service by the reception and the staff that makes us feel we're at home at the clinic, I have experienced remarkable healing in several episodes from shoulder issue to knee injuries and hip pain. The doctor is so thorough in the diagnosis phase that he administered exactly what was needed, no more no less! Thank you folks for a wonderful experience.”RG G
“Went to Dr. Ghattas for chronic knee and neck issue. I’ve already had multiple procedures done on my neck and multiple epidurals with minimal success. My knee I was told needed surgery to fix. I already had surgery in the past with minimal difference. I ended up getting stem cells in my knee and neck and could t be happier with the outcome. Anyone considering surgery I recommend checking out Regenex first. Next I’m doing the ganglion block and look forward to the results.”Logan H
“Dr. James Ghattas and his team are truly top-notch. His office is equipped with state-of-the-art technology and a staff that's exceptional in their fields. I've referred several clients to him, and they've all been incredibly satisfied. Dr. Ghattas is absolutely ahead of the curve, and I wholeheartedly endorse his work.”Ron H
“I am quite active and go to pilates 3-4 times per week. I was having left knee pain and which was treated with PRP. It took about 3 months for me to feel better but then the pain completely subsided. I now am able to exercise without the fear that I will tear a ligament and am pain free.”Ellipsis P
“Transparency, thoroughness, attention to detail, immediate, high quality, follow ups and follow through are just a few words that come to mind throughout my experiences with Palm Beach Regenerative Sport and Spine.”Milton L