Persistent pain is usually treated in the order it arrives: rest, an anti-inflammatory, a course of physical therapy, an injection, then the conversation about surgery. Each step can be right. What is often missing between them is a clear answer to a simple question: what exactly is damaged, and can it heal? These are the questions that get that answer.
Ask before an operation
- What structure, exactly, is the operation repairing or replacing?
- What does my imaging show, and how old is it?
- What happens if I wait six months? Does the joint get worse, or stay the same?
- What is the expected recovery, in weeks off work and weeks off training?
- What are the odds the pain is still there afterward?
- Is there anything that could delay or avoid this that we have not tried?
- Who follows me after the operation, and for how long?
Ask before another injection or prescription
- Is this treating the damage, or the pain from the damage?
- How many cortisone injections has this joint had, and is there a limit?
- How long did the last one work, and why did it stop?
- How long am I expected to stay on this medication?
- What is being measured to know whether it is working?
- What would a physical medicine physician add to this plan?
- Has anyone looked at how I move, not only where it hurts?
What a regenerative evaluation looks at
Regenerative medicine starts with the tissue rather than the prescription. The evaluation is meant to name the structure that hurts, how badly it is damaged, and what it can still do, before anything is injected.
| Step | What happens | Why it matters |
|---|---|---|
| Imaging review | Your MRI or ultrasound, read for the specific structure, not only the diagnosis on the report | Treatment goes where the damage is; a knee is not one thing |
| Functional exam | Range of motion, strength, stability and how you load the joint | Separates the tissue problem from the movement pattern that keeps re-injuring it |
| Labs where indicated | Inflammation and metabolic markers that affect healing capacity | A tissue heals in a body; the body's state decides how well |
| Protocol design | PRP, exosomes, peptides, prolotherapy and ozone, alone or combined, chosen for the condition and its severity | A template treats the diagnosis; a protocol treats you |
| Tracking | Function re-measured, imaging repeated when it will change the plan | Progress is measured, and the protocol adjusts to the response |
Which therapies exist, and where the evidence stands
Protocols at Aether Medicine may include platelet-rich plasma (PRP) injections, exosome therapy, peptide therapy, prolotherapy and ozone, and targeted biologics, guided by imaging and labs and combined with physical therapy, nutrition and lifestyle changes so the treatments work together. Regulatory status varies by modality: PRP is well established; others are emerging. We are transparent about the evidence base for each intervention we recommend, and about what is not yet known.
Most regenerative protocols involve a series of treatments rather than a single injection. Many patients notice early changes in pain and mobility within 4 to 8 weeks; deeper tissue repair and return of function typically become apparent over 3 to 6 months. Not every joint is a candidate. When the evaluation says surgery is the better answer, that is what you will hear.
What to bring to the visit
- Your most recent imaging (MRI, ultrasound, X-ray), with the report and the images themselves
- A list of what has been tried: medications, injections with dates, physical therapy and how long
- Any surgical recommendation you have received, and the surgeon's note if you have it
- The activities you have stopped, and the ones you want back
- This checklist, with your questions marked
The Regenerative Evaluation
Bring this checklist to a physician-led regenerative evaluation: imaging review, a functional exam, a plain-language account of what is damaged and what can heal, and a protocol written for you.
Schedule a ConsultationThis checklist is educational and does not constitute medical advice. It does not establish a physician-patient relationship. Only an evaluation by a licensed physician who has examined you and reviewed your imaging can determine whether a regenerative protocol is appropriate for your condition.