Services
PRP
What is PRP?
Platelet-rich plasma is found naturally in your blood. This plasma contains a high concentration of growth factors that assist in the healing of damaged cells within the body. As new cells regenerate, they replace the old, injured cells to speed up the healing process from many different types of injuries, including:
Bone fractures
Ligament injuries
Damaged muscles
Tendon injuries
Dr. Waltrous can assess your injury and your overall health to determine if PRP treatments are right for you.
What can I expect during PRP treatment?
PRP treatments are relatively simple and require a two-step process. The first part involves drawing a sample of your own blood. Dr. Waltrous must prepare the blood in a centrifuge, a device that quickly spins the liquid to separate the platelet-rich plasma from the rest of the blood materials.
Once the plasma is ready, Dr. Waltrous injects it back into the area of your injury. The injected plasma contains a high concentration of growth factors that trigger the natural healing process.
What kind of results can I expect with PRP therapy?
While PRP is highly effective at improving your healing time and efficiency, it works gradually as the growth factors stimulate newer, healthier cells in the weeks after your treatment. Within four weeks of treatment, you should begin to see a noticeable improvement in your mobility and a reduction in your pain. As more cells grow, your healing continues to improve.
PRP therapy essentially helps your body heal naturally from the inside out, with the goal to reduce your reliance on pain medications and increase your overall functionality. Treatment with PRP can also reduce the likelihood you’ll need surgery in the future.
Is PRP therapy safe?
Because Dr. Waltrous uses your own blood for treatment, there is very minimal risk for side effects or complications.
Dr. Waltrous ensures you’re comfortable during your procedure and liberally uses numbing medication to decrease your pain. You may have slight bruising or mild swelling at the injection point, which resolves on its own in a day or two.
In many cases, you can achieve your desired results after your initial treatment, and Dr. Waltrous monitors your recovery closely to ensure the treatment is working well.
Find out if PRP therapy is right for you by calling Maryland Sports, Spine and Musculoskeletal Institute or requesting an appointment online today.
Concussion
What is a concussion?
A concussion is a brain injury that may cause a temporary loss of normal function in the brain. This type of injury is usually due to a direct blow to the head, even if there’s no sign of external damage. Concussions can occur with or without a loss of consciousness.
What are the signs of a concussion?
A concussion can affect many processes of the brain, even when the injury is minor. Because of this, there are a variety of symptoms that may occur along with a concussion.
Following an injury to the head, you may find it difficult to remember what just happened. You may also feel confused. Other common signs of a concussion include:
Dizziness
Speech issues
Poor reflexes
Loss of balance
Difficulty concentrating
Lack of muscle coordination
Nausea/vomiting
Sensitivity to light or sound
Even if symptoms appear mild, it’s important that you receive a thorough evaluation for a concussion as soon as possible to ensure there is not a more severe brain injury. This is especially true if you have a history of previous concussions.
How are concussions treated?
The primary treatment for a concussion is rest. You may need to restrict your activities, both physical and mental, to give your brain the rest it needs to heal.
Dr. Waltrous can monitor your condition and continuing symptoms to determine when it’s safe to return to sports, work, or your usual activities. To prevent future risk of concussions, Dr. Waltrous can provide resources to ensure you’re well protected, especially if you plan to return to your sports activity.
For some people, the effects of a concussion can last for weeks or months, a condition known as post-concussion syndrome (PCS). During this time, you may still struggle with your memory and ability to concentrate. It’s also possible to experience frequent headaches, difficulties with sleep, and chronic fatigue.
Dr. Waltrous is well versed in advanced management of concussion and post-concussion syndrome. He may recommend a variety of therapies and/or medications to help you to recover fully.
If you have symptoms of a concussion following a head injury, don’t delay treatment. Call Maryland Sports, Spine and Musculoskeletal Institute or requesting an appointment online today.
Prolotherapy
What is prolotherapy?
Prolotherapy is an alternative treatment for repairing injured ligaments, tendons, and joints. Treatment typically involves injection of a mixture of a local anesthetic, saline, and sugar water, into the affected tissue or joints, along with a numbing medication like lidocaine. By injecting these substances into the site of your injury, it stimulates your body’s natural healing process. This involves the regeneration of healthy cells to replace the damaged.
As a result of treatment, you can achieve a reduction in your pain and an improvement in the overall functionality and strength of the affected area.
What conditions can prolotherapy treat?
Prolotherapy can be effective on a number of degenerative diseases, such as arthritis or tendinitis. To achieve the optimal benefits of prolotherapy, Dr. Waltrous may recommend multiple treatments to continually stimulate new tissue growth. He bases your treatment on your injury type and the severity of your symptoms.
What can I expect during a prolotherapy procedure?
Using a custom treatment plan, Dr. Waltrous administers injections to very specific areas of your body. He will use image guidance, either ultrasound or fluoroscopy to guide the injections. The entire procedure takes less than 30 minutes and you only need to recover briefly before you can go home to rest.
Immediately after treatment, you may feel some soreness, stiffness and swelling in the treated area, which resolves on its own without further treatment. In many cases, you can expect to get back to your usual routine the next day.
You may still have soreness for as long as a week before you can notice a difference in the severity of your pain and your range of motion.
What are the benefits of prolotherapy?
Prolotherapy is a safe, effective treatment. It is helpful for long-term healing, especially when other treatments haven’t worked well for you.
Benefits of treatment include:
No incisions
No need for anesthesia
Fast treatment times
May prevent surgery
Prolotherapy can be used even if you’re already experiencing severe pain, and Dr. Waltrous uses a liberal amount of local anesthetic to keep you comfortable during the procedure.
If chronic joint pain is interfering with your life, you may be a good candidate for prolotherapy. Find out more about this innovative treatment by calling Maryland Sports, Spine and Musculoskeletal Institute or requesting an appointment online today..
Diagnostic Ultrasound Musculoskeletal
What is a diagnostic ultrasound?
Sound waves are used to create pictures of muscles, ligaments, tendons, and joints. These pictures allow Dr. Waltrous to better view your internal structures so he can identify the source of your pain or mobility issues.
Musculoskeletal ultrasounds are highly effective in diagnosing conditions like:
Tears
Tendinitis
Soft tissue damage
Nerve compression
Joint or nerve swelling
What can I expect during a diagnostic ultrasound?
This type of diagnostic testing is noninvasive and painless. A handheld transducer collects the sound waves that bounce back off your structures to create an image of your internal structures on an external monitor.
A gel is applied in order to ensure proper visualization of the painful area. Depending on the injury area, you may need to move into different positions to ensure Dr. Waltrous gets a visual of all areas of concern, and at times, to help with diagnosis.
You don’t need to do anything to prepare for your test, but you should wear comfortable clothing and leave your jewelry at home. You will not need to fast.
When can I expect results from a diagnostic ultrasound?
Because Dr. Waltrous can see the area of injury in real-time, he can often determine the root cause of your pain during your ultrasound examination. In some cases, further testing may be necessary to confirm a diagnosis. Once Dr. Waltrous has enough information about your injury, he can create a custom treatment plan to alleviate pain and improve your functionality.
Additional ultrasounds may be necessary to confirm treatment is working effectively and that your damaged tissues are healing properly.
Are diagnostic ultrasounds safe?
Ultrasound technology uses sound waves to create images. Unlike X-rays, this type of testing doesn’t expose you to radiation. Additionally, those with pacemakers or other implants that make MRIs and other diagnostic testing difficult to perform can safely undergo an ultrasound.
Many ultrasounds take only a few minutes to get enough information to make a diagnosis, and Dr. Waltrous ensures you’re comfortable throughout the procedure.
Request a consultation at Maryland Sports, Spine and Musculoskeletal Institute online or by phone today to learn more about on-site diagnostic testing.
Electromyography / Nerve Conduction Study (EMG/NCS)
What is an EMG/NCS?
Electromyography/nerve conduction study is a test that records the electrical impulses of your nerves and muscles. The test uses small sensors, known as electrodes, that collect the electrical signals and translate the data into graphs and numbers. This information can give information about any possible nerve or muscle disorders.
Why would I need an EMG/NCS?
You may need an EMG/NCS if you’re experiencing pain, weakness or other symptoms that may indicate a muscle or nerve disorder. These symptoms may include:
Tingling
Cramping
Numbness
Muscle weakness
Testing can determine if you have a disorder or disease that causes your pain, such as a herniated disc, carpal tunnel syndrome (CTS), or a muscle disorder.
What can I expect during an EMG/NCS?
An EMG/NCS involves two types of testing procedures. In NCS, Dr. Waltrous places electrodes on the surface of your skin and stimulates along the course of your nerves. This delivers a low electrical current, which can cause your muscles to spasm or twitch.
The EMG involves the insertion of a slender needle electrode into certain muscle tissues. This test allows Dr. Waltrous to assess the electrical activity in your muscle while it’s at rest. It also determines the level of activity during muscle contractions that you create. In the EMG, Dr. Waltrous asks you to contract or relax your muscle during different phases of the test.
What happens after an EMG?
Immediately after your EMG/NCS, you can expect to go home right afterwards. There may be some minor bruising in the area of needle insertion that goes away in a few days on its own, ice can be applied to these areas to help with healing.
Dr. Waltrous reviews the results of your test and may recommend additional testing procedures for diagnostic purposes. If he’s able to make a diagnosis after the EMG/NCS, he can discuss his ideas for treatment with you based on your condition.
If you have unexplained nerve pain that interferes with your ability to stay active, request a consultation at Maryland Sports, Spine and Musculoskeletal Institute online or by phone today to learn more about the diagnostic benefits of an EMG/NCS.
Epidural Injection
What is an epidural injection?
An epidural injection is an injection of some combination of anesthetic medicines, steroids, and saline that Dr. Waltrous injects into the epidural space, the outer part of the spinal canal.
Epidural injections can quickly reduce pain and inflammation around the spinal nerves. This reduction can aid in the healing of an injury and prevent the need for surgical intervention.
Why would I need an epidural injection?
There are a number of conditions that cause chronic pain and lead to mobility issues. Dr. Waltrous may recommend an epidural injection as part of your treatment plan for your injury.
Epidural injections may be beneficial for relieving pain and inflammation from conditions like:
Spinal bone spurs
Spinal stenosis
Herniated discs
After a review of your medical history and the severity of your condition, Dr. Waltrous can determine if epidural injections may be useful in managing your pain and aiding in the healing process.
What can I expect during an epidural injection?
To ensure the injections are going into the correct area of the spinal canal, Dr. Waltrous uses and image guidance modality called fluoroscopy, or live X-ray, during the injection procedure.
After the injection, the medications move quickly through the epidural space to cover the spinal nerves. You may experience immediate pain relief after the procedure, although it can take up to 48 hours to begin to feel relief. You should be able to return to work or your usual routine the next day.
Everyone experiences different degrees of pain relief after an injection. You may enjoy the benefits of the treatment for several weeks or several months after your injection, depending on the nature of your injury. Depending on the results of your initial treatment, Dr. Waltrous can provide additional injections to maximize pain relief in the long term.
To learn more about the benefits of epidural injection, request a consultation at Maryland Sports, Spine and Musculoskeletal Institute online or by phone today.
Sports Injuries
What are the most common sports injuries?
Regardless of the sport you play, you’re at risk for injury for a variety of reasons. Some of the most common sports-related injuries include:
Fractures
Dislocations
Knee injuries
Swollen muscles
Sprains and strains
Rotator cuff injuries
Whether you take a direct hit in a high-impact sport or perform repetitive motions as part of a low-impact sport, it’s important you get a comprehensive evaluation of your injury in order to help it to heal and to prevent additional complications.
What should I do if I get injured while playing sports?
As soon as you realize you’ve been injured, either due to pain or mobility issues, you should take yourself out of the game. Continuing to play with an existing injury can lead to permanent damage.
You can reduce swelling and pain using ice therapy. You should seek emergency room treatment to be looked at if there is concern for fractured or broken bones. If pain or swelling is intense, you should schedule an evaluation with Dr. Waltrous as soon as possible for an accurate diagnosis.
How are sports injuries diagnosed?
As an experienced Physiatrist, Dr. Waltrous specializes in the diagnosis and treatment of disabling conditions, primarily ones that occur due to neurological or musculoskeletal injury. He will do a review of the history behind your injury as well as a physical examination to determine your exact issue.
Dr. Waltrous may use an in office ultrasound to identify the root cause of your pain, if this is appropriate. From this information, he makes a custom treatment plan with the goal to alleviate your pain and ensure you heal effectively from your injury.
What treatments are available for sports injuries?
Depending on the nature of your injury, Dr. Waltrous may recommend continuing ice therapy for several days to control swelling and pain. You may also benefit from a compression bandage to reduce swelling. Elevating the area above your heart is also an effective way to reduce swelling and pain, and promote healing.
Dr. Waltrous offers many nonsurgical options to ease pain and treat sports injuries, such as epidural injections, nerve blocks, steroid injections, and prolotherapy/PRP. Often, his goal is to help you avoid surgery unless it is truly needed and promote efficient healing based on your specific needs.
To prevent your risk for future injury during sports participation, Dr. Waltrous can also recommend preventive options such as strengthening exercises and correction of any improper ergonomics to better support your performance.
Find out more about sports injury services available by calling Maryland Sports, Spine and Musculoskeletal Institute or requesting an appointment online today..
Tendinopathy
What is tendinopathy?
Your tendons are rope-like structures that connect your bones and muscles. These tissues contain a collagen protein, and when this protein breaks down due to injury, repetitive motions or overuse, it results in tendinopathy. Tendinopathy is a painful condition due to tendon injury. The condition differs from another common tendon condition, known as tendinitis. Tendinopathy occurs because of a degeneration of collagen protein that makes up the tendon, while tendinitis involves inflammation of the tendon.
Tendinopathy can affect any of your tendons but is more common in your:
Hamstrings
Rotator cuff
Patellar (Knee) tendon
Achilles tendon
While tendinopathy is a common sports-related injury, it can also occur due to aging. Without proper treatment, this condition can result in tendinitis.
How is tendinopathy diagnosed?
Dr. Waltrous performs a comprehensive review of your medical history and the symptoms you experience to determine the cause of your pain. Often, after a review of your history of the pain and a physical examination, he can determine if your pain relates to a tendon injury.
Dr. Waltrous may offer an on-site diagnostic ultrasound to help with diagnosis. He can get a closer look at the structure of your tendon to determine if your pain is due to tendinopathy or a different cause.
What treatment options are available for tendinopathy?
Because gross inflammation is rarely a factor in tendinopathy, common therapies like steroid injections aren’t effective in long-term treatment, and can potentially worsen the condition. Dr. Waltrous may initially recommend plenty of rest to avoid a worsening of your injury and pain.
For many, physical therapy is highly effective at rebuilding the strength in the muscle supporting your tendons. Dr. Walters may prescribe specific strengthening exercises that research has shown to help improve tendinopathy and help restore normal architecture of the tendon. Range-of-motion exercises can also improve your flexibility and overall functionality.
Dr. Waltrous also provides guidance for preventing your injury from worsening, especially if you play sports that require repetitive motions. He can give you resources to limit your risk for re-injuring the tendon and prevent new tendon-related injuries.
If you have pain surrounding a tendon, don’t delay treatment. Request a consultation online or by phone today at Maryland Sports, Spine and Musculoskeletal Institute.
Radiofrequency Ablation
What is radiofrequency ablation?
Radiofrequency ablation (RFA) is a minimally invasive, nonsurgical procedure that uses radiofrequency energy to disrupt the transmission of pain signals from nerves. The radiofrequency energy heats up targeted areas of nerve tissue, disrupting them and prevents them from sending pain signals.
Why would I need radiofrequency ablation?
As a fellowship-trained interventional pain management specialist, Dr. Waltrous offers radiofrequency ablation for lasting relief of chronic pain, especially in the lower back, neck, and arthritic joints.
He may recommend RFA as part of your individualized treatment plan if you have one arthritis of the spine that causes you chronic pain that interferes with your lifestyle.
RFA may provide longer-term pain relief than nerve blocks, lasting six to 12 months in many cases. This treatment may be right for you if other therapies, such as pain medications, don’t provide adequate relief.
What should I expect from radiofrequency ablation treatment?
First, Dr. Waltrous carefully reviews your medical history and performs a physical exam, in addition to any available imaging, to make sure you’re a good candidate for radiofrequency ablation. He will perform a series of diagnostic nerve blocks to identify the nerves responsible for your pain.
During RFA treatment, you lie on an X-ray table. Dr. Waltrous injects local anesthetic into your skin and deeper soft tissues to help improve your comfort during the procedure. Next, he inserts a fine needle through your numbed tissues and to the area of the nerves that are causing you pain. He uses a special X-ray called a fluoroscope to pinpoint the precise area for treatment.
Then, Dr. Waltrous inserts a microelectrode through the needle. The electrode delivers a controlled radiofrequency current that heats your nerve tissue, disabling its ability to transmit pain signals. RFA generally takes less than an hour and you should be able to go home within an hour after the procedure. You should arrange to have someone else drive you to and from the site of the procedure.
Most patients find RFA extremely effective at providing long-term pain relief. It’s common to experience relief for six to 12 months, but the effects of RFA can last for years in some patients.
To learn more about radiofrequency ablation, call Maryland Sports, Spine and Musculoskeletal Institute or requesting an appointment online today.
Spasticity
What is spasticity?
Spasticity is a condition that causes abnormal muscle contraction and stiffness. This muscle stiffness that can interfere with your ability to walk, move, or speak normally.
Ordinarily, a complex network of nerve impulses causes certain muscles to contract while others relax. This allows you to create movements such as brushing your teeth, bathing, getting out of a chair, and walking. Spasticity happens when damage to a part of your brain or spinal cord disrupts the signals between your nervous system and muscles, stopping the ability of certain muscles to relax.
What are the symptoms of spasticity?
Spasticity episodes can range in severity from mild to completely disabling. Common symptoms of spasticity include:
Abnormal posture
Muscle tightness
Muscle spasms
Joint stiffness
Involuntary jerky movements
Pain in the affected muscles and joints
Difficulty controlling muscles used to speak
What causes spasticity?
Spasticity usually results from damage to nerves in your central nervous system (brain and spinal cord). This occurs when the nerve damage takes away the signals that allow your muscles to relax. Numerous common medical conditions can cause this type of damage, including:
Traumatic brain injury
Spinal cord injury
Multiple sclerosis (MS)
Cerebral palsy
Stroke
Regardless of the cause, severity, and specific symptoms of your spasticity, Dr. Waltrous can develop an individualized treatment plan to help improve your quality of life.
How is spasticity diagnosed?
To diagnose spasticity, Dr. Waltrous thoroughly reviews your symptoms and medical history and performs a physical exam. Then, he recommends the best course of treatment based on factors such as:
Underlying condition causing your spasticity
Addressing episodes where your spasticity worsens
Severity of your spasticity pain and disability
Once he reaches a diagnosis, Dr. Waltrous can then develop an optimal treatment plan.
How is spasticity treated?
Treatment for spasticity focuses on improving your ability to function independently and relieving your pain or discomfort. Depending on your specific condition, Dr. Waltrous may recommend one or more of the following treatments:
Physical, occupational, and/or speech therapy
Ice therapy
Oral medications, such as muscle relaxers
Medicine injections, such as botulinum toxin (Botox®)
If your spasticity doesn’t improve with conservative treatments, Dr. Waltrous may recommend referral to a neurosurgeon for surgery. Surgical treatments for spasticity can include implanting an intrathecal pain pump or severing specific nerve roots if other conservative treatments do not provide complete relief of your spasticity.