Essential Sports and Spine Solutions

09/25/2026

Pain that occurs primarily with stairs does not necessarily mean the knee is seriously damaged. However, recurring or worsening pain can indicate an underlying condition that deserves evaluation.

Knee pain when climbing or descending stairs is a common complaint, but the reason is not always obvious. Stair climbing places greater demands on the knee joint than walking on level ground, which can make underlying problems more noticeable. Pain may be related to the kneecap, cartilage, tendons,....

09/24/2026

My buddy tore his Achilles. First question we talked through: does he actually need surgery? 🤔

He chose not to. He went the regenerative route with PRP and bone marrow concentrate, plus the rehab work that nobody gets to skip. Two years later he's running triathlons. 🏊‍♂️🚴‍♂️🏃‍♂️

And Aaron Rodgers? He did have surgery. But he didn't stop there. He's talked publicly about adding stem cells, hyperbaric oxygen, a dialed-in diet, and up to eight hours a day of rehab, with PRP reportedly part of the mix too. Surgery was one piece. Everything around it is what sped up his return.

Now, let me be honest. A full tear with a big gap is a different conversation, and I said that on the podcast too. You can't inject a complete rupture back together. But a lot of people get handed a surgery date before anyone asks the real question: what does YOUR tear look like, and what are YOUR goals?

That's the whole philosophy of my field, physical medicine and rehabilitation. What can we do to prevent or put off surgery, and when surgery is the right call, how do we help you recover better?

The injection is one piece. The protocol is the point. 💪

Clip from my conversation on (Down To Health Podcast).

📍 Columbus, OH | Book a consult, link in bio
📲 Follow for more of the nuance

This is not medical advice. This is for educational purposes.

09/23/2026

If a clinic tells you they can inject you with millions of live stem cells, that claim is not true.

Wharton's jelly. Cord blood. Amniotic products. Multiple studies have shown these contain no functional living stem cells by the time they reach you.

Period. It's marketing.

And people are paying five figures for it.

I'm a regenerative medicine specialist. So what does that actually mean? Are we really regenerating things? Yeah, maybe. Maybe not. It depends entirely on what we're treating and what we mean by the word.

I'd rather say that up front than have you find out later.

Here's what I can stand behind. These therapies do not regrow cartilage. They do not reverse advanced structural disease. What they can do is calm a joint, reduce pain, and improve how you move, sometimes for a long stretch.

For a lot of people that's the difference between sitting out their life and getting back into it.

That's enough. It doesn't need to be oversold.

Part 12 is live. PRP, BMAC, micronized adipose, why dose and precision decide everything, who isn't a candidate, and seven questions to ask any clinic before you hand them money.

Those questions work on me too.

Link in bio 🔗

This is for educational purposes only and does not constitute medical advice.

09/22/2026

Cortisone keeps wearing off for a reason. 💉

In a randomized trial published in JAMA, knee steroid injections every three months for two years led to more cartilage loss than saline, with no better pain relief.
The new ACR arthritis guideline still gives steroid injections a strong recommendation.

I rarely use them, and never as a reflex. One injection isn't a catastrophe. A cycle of them isn't a strategy.
If you've had two or three cortisone shots and you're wondering what's next, that's exactly the conversation I have every week.

💬 Comment STEROID and I'll send you my write up on this topic
📍 Columbus and Central Ohio: link in bio.

This is for educational purposes only and does not constitute medical advice.

CortisoneShot AlternativeToCortisone KneePain KneeArthritis Osteoarthritis PRP RegenerativeMedicine SportsMedicine

09/21/2026

09/18/2026

The 2026 ACR guideline recommends against PRP for knee arthritis. Dr. Verma breaks down the evidence grading, NSAIDs, steroids, laser, and shockwave.

By Nikhil Verma, MD. Board-certified in Physical Medicine and Rehabilitation and Interventional Spine, fellowship-trained in Interventional Spine and Sports Medicine. Essential Sports and Spine Solutions, Columbus, OH. This week the same graphic kept showing up in my feed. The 2026 update to the Ame...

09/14/2026

Understanding how menopause affects joint pain can help women recognize potential contributing factors and determine when professional evaluation may be appropriate.

Menopause brings a range of physical changes, and joint pain is a common concern for many women during the transition. Aching knees, stiff fingers, sore hips, and discomfort in the back or shoulders may become more noticeable as hormone levels change. Understanding how menopause affects joint pain c...

09/10/2026

Who's doing your PRP matters more than you think. 🩸

A lot of the regenerative medicine failures I see weren't a biology problem. They were a setup problem. A clinic where PRP is a side service, no image guidance, a low-dose prep, and no plan for what happens after the injection.

That's how the whole field gets a bad name.

Before you book, ask these 4 questions:
1️⃣ Is every injection guided by ultrasound or fluoroscopy?
2️⃣ What platelet dose does your system actually deliver?
3️⃣ Who performs the procedure, and how often do they do it?
4️⃣ Is there a protocol around the injection, or just the shot?

If the answers are vague, keep looking.

The injection is one piece. The protocol is the point.

📍 Columbus | Dublin | Westerville | Upper Arlington | Gahanna
📅 Request a consult: link in bio
👉 Follow Nikhil Verma, MD for more of this
💾 Save this for the next time someone asks you about PRP

This is for educational purposes only and does not constitute medical advice. I may be a doctor, but I am not your doctor.

09/09/2026

For years these got lumped together as "modalities."

Passive care. Something a tech did to you for fifteen minutes while the doctor was in another room.

Honestly, a lot of that criticism was earned. Some of the older equipment was underpowered to the point of being biologically irrelevant, and it got used on everybody who walked in the door.

So when a colleague raises an eyebrow at me for using laser, I understand where the eyebrow comes from.

Here's what changed.

Laser calms tissue. Shockwave provokes it. Those are opposite jobs, and using the wrong one at the wrong moment doesn't just fail, it can make things worse.

Most of my patients aren't limited by weakness when they first come in. They're limited by sensitivity. The nerves are overactive, so the muscles guard, so movement feels threatening, so rehab becomes intolerable. And rehab is the thing that actually builds durable tissue.

Laser turns the volume down enough that the door opens.

The laser is not the treatment. The laser is what makes the treatment possible.

Part 11 is live. MLS laser, shockwave, EMTT, and scrambler therapy. What each one actually does, when to use which, and an honest section on where the evidence is thinner than I'd like.

Link in bio 🔗

This is for educational purposes only and does not constitute medical advice.

09/08/2026

A patient told me last week that PRP "didn't work" for his knee. Before I agreed with him, I asked two questions. What was the platelet dose, and was the injection guided?

He didn't know the dose. And it was done by feel, no ultrasound.

Here's why that matters. Landmark-guided knee injections land in the joint roughly 77 to 82 percent of the time. That's about one in five that miss. Add image guidance and accuracy climbs to around 95 percent.

So we don't actually know that PRP failed him. We know a shot happened somewhere near his knee.

Every procedure I do is guided. Joints and soft tissue under ultrasound so I can watch the needle in real time. Deeper spinal targets under fluoroscopy, often with contrast to confirm placement before anything therapeutic goes in.

When you've done the work to prepare a high quality, correctly dosed biologic, delivering it precisely isn't an upgrade. It's the whole point.

If you were told PRP doesn't work, it's worth asking what was actually in the syringe and where it went. Link in bio to request an evaluation.

This is for educational purposes only and does not constitute medical advice. I may be a doctor, but I am not your doctor.