Case Study #2 – Female Patient with an Arm Injury

A young lady, 20 years old, came in to see Dr. Raj Singh of Barrow Neurological Institute with her dad. She had been away with some friends on a rock climbing adventure and upon return she began to notice some unusual ‘twinges’ around her wrist and elbow. She is not a die-hard athlete; more of a weekend warrior. She has never attempted rock climbing before and didn’t realize the extent of impact this would have on her body.

As she described it, she started to notice her wrists and elbows feeling “numb and tingly”. She doesn’t have a repetitive lifestyle that would impact her elbows and wrists and this sensation had not been there prior to her weekend expedition.

She initially went to see her primary care doctor. He tried steroid injections into the general area where she described her symptoms and sent her for physical therapy. Unfortunately, she had no relief.

After her PC had exhausted the extent of his care, he sent her to Dr.Singh. He knew that he would not only figure out the cause but actually understand her symptoms and what they meant. Dr. Singh proceeded to order a protocol-specific MRI and performed an EMG. He was able to rule out any type of ‘syndromes’ such as carpal or cubical tunnel. He reviewed the MRI films until he was unequivocally certain of his diagnosis and conferred with the Neuroradiologist until he was confident she was dealing with a case of median/ ulnar neuritis.

Now the question was, what is the most effective method for treating this type of case? This is a young lady with a lifetime of weekend expeditions ahead of her; Dr. Singh wanted to be sure to treat her issue as SPECIFICALLY and EFFECTIVELY as possible.

Dr. Singh decided regenerative therapy using amniotic allograft was the absolute best treatment method because of the high level of anti-inflammatory markers in the liquid amnion. In addition, there are a high volume of growth factors, cytokines, collagen and hyloronic acid. The goal was to reduce inflammation, prevent scar tissue formation, lubricate the joint and strengthen soft tissue support structures around the nerve. He wanted to create an environment for healing and that’s exactly what he did.

Using MSK Ultrasound guidance, Dr. Singh was able to clearly isolate the ‘starry night’ appearance of the nerve and used power Doppler to assure there were no vessels in his path. He then proceeded to bathe around the irritated nerves with the amnion as the patient (and her dad) watched on the ultrasound screen. Both he and the patient had the utmost confident that the pathologic area was being treated as it was clearly visualized on the ultrasound screen.

The patient began her customized Physical Therapy sessions two weeks post injection to rebuild strength and mobility. At her 4 week follow up she reported that she is 85% improved since her first visit.

There are so many options available for patients who want to treat their symptoms. Dr. Singh’s approach is a little different; he prefers to treat the problem that creates the symptoms.

Best of health,

Rachel O’Grady, RMST
President and Founder, MSK GUIDE

For more information on Dr. Raj Singh visit:
480 – 767 – 0555
Barrow Neurological Institute