Using various cutting edge injection therapies and techniques, Dr. Miles provides non-surgical approaches and procedures to assist in the treatment of certain musculoskeletal (MSK) ailments.
We provide these services with advanced ultrasound technology to eliminate the guess work associated with traditional "blind" injections and therapy. Dr. Miles was one of the first doctors in the state of Georgia credentialed in musculoskeletal ultrasound by the ARDMS and formally Registered in Musculoskeletal Sonography (RMSK.) In addition to therapeutic interventions, MSK ultrasound offers certain real-time diagnostic visualization that cannot be seen with X-ray, CT, or MRI.
Dr. Miles was tutored by orthopedists and sports medicine physicians in the art and science of joint and tendon injections and has been performing some of these injections for two decades. He is also experienced and trained in the newer procedures and techniques. Recent advances in musculoskeletal ultrasound imaging have made the procedures vastly more accurate and easy to provide in a comfortable office setting. This setting avoids exorbitant costs of surgery centers and operating suites.
Specific joints we inject include the: shoulder, elbow, wrist, hand, fingers, hip, knee, ankle, foot, toes, as well as the sacroiliac joint (SI joint.) At this time we are not injecting the spine.
Some of the various syndromes we treat include Rotator Cuff Syndromes, Lateral Epicondylitis (tennis elbow,) Medial Epicondylitis (golfer's elbow,) DeQuervain's tenosynovitis, Greater Trochanteric Bursitis, SI Joint Pain Syndrome, Piriformis Syndrome, Plantar Fasciitis, Carpal Tunnel Syndrome, and many various other Tendinitis and Bursitis and Arthritis conditions.
Depending on the type of procedure you need we may be able to perform the procedure on the same day. We may instead have to set you up for a separate procedure time or have you complete further evaluation steps first.
Platelet Rich Plasma, known more simply as PRP, is the small fraction of your blood that contains the platelets, the tiny blood cells that help to clot and heal the body in response to injury. The platelets (the small light blue cells in the photo) have this ability because they store and release many growth factors including PDGF, TGFb, EGF, bFGF, VEGF, and IGF. The "GF" stand for growth factors so you can see there is a wide variety of growth factors available for healing.
All of these growth factors have specific roles within the body including stimulating healthy cell replication, helping to form the extracellular matrix of tissues, proliferating endothelial cells and fibroblasts, and stimulating angiogenesis where more tiny blood vessels are formed. All of theses things occur to foster healing of tissues and promote more youthful and normal structure and function.
While steroid (aka, Cortisone) injections are helpful with the pain syndromes, they do not really alter the course or improve the long term outcome of your joints and tendons. This is why PRP is so different. PRP may actually improve the function and slow down the degeneration we see with age and injuries.
Dr. Miles has used PRP to treat tendon and ligament injuries for years at Miles Family Medicine located in Newnan, GA. We also commonly treat patients from Metro Atlanta, Peachtree City, LaGrange, Fayetteville and others.
We processes your own blood on site to remove the platelet rich plasma and inject it back into the affected joint, tendon, or ligament. Because PRP is your own blood and blood cells, there is essentially no risk of allergic reactions or other medication side effects. PRP therapy is not as well known to the public because no Pharmaceutical company can promote and profit from something you make yourself.
Despite all the decades of evidence of PRP's usefulness, most insurance companies (who just don't want to pay for procedures) still consider it experimental and therefore do not consider it a covered benefit. So for most joint and tendons we charge a flat rate of $299 which includes processing of your blood, and injecting the PRP into your joint or tendon using ultrasound guidance when needed. The visit for your pain is usually covered by the insurance company and is therefore a separate charge.
Dr. Miles is a residency trained, board certified medical doctor who practices Evidence-Based Medicine. This means he uses proven science, doctor reviewed medical studies, and consensus guidelines, along with his vast experience to guide his practice of medicine.
Included here is a brief list of some of the medical studies and reviews on knee osteoarthritis, plantar fasciitis, tennis elbow and thumb arthritis if you would like to learn more of the science of PRP Injections. There are many other studies for other joint, tendon, and ligment issues.
Does Intra-articular Platelet-Rich Plasma Injection Provide Clinically Superior Outcomes Compared With Other Therapies in the Treatment of Knee Osteoarthritis? A Systematic Review of Overlapping Meta-analyses. Campbell, et al. Arthroscopy. 2015 Nov;31(11):2213-21.
Hyaluronic Acid Versus Platelet-Rich Plasma: A Prospective, Double-Blind Randomized Controlled Trial Comparing Clinical Outcomes and Effects on Intra-articular Biology for the Treatment of Knee Osteoarthritis. Cole, et al. Am J Sports Med. 2017 Feb;45(2):339-346.
Efficacy of platelet-rich plasma for chronic tennis elbow: a double-blind, prospective, multicenter, randomized controlled trial of 230 patients. Mishra, et al. Am J Sports Med. 2014 Feb;42(2):463-71.
Platelet-Rich Plasma versus Corticosteroid Intra-Articular Injections for the Treatment of Trapeziometacarpal [Thumb] Arthritis: A Prospective Randomized Controlled Clinical Trial. Malahias, et al. Cartilage. 2018 Oct 20:1947603518805230.
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