What we treat

Shoulders, Elbows, Wrists & Ankles

Shoulder, elbow, wrist, and ankle pain is where regenerative medicine is most frequently requested. Rather than suppressing the inflammatory signal the way cortisone does, regenerative injections deliver cells and growth factors to the tissue itself.

Why do cortisone injections stop working?

Cortisone suppresses inflammation, which reduces pain, but the underlying tissue is unchanged. Research demonstrates that intra-articular corticosteroid (cortisone) injections can accelerate bone degradation, cartilage loss, and joint destruction over time, and many patients arrive here after the interval between injections has shortened.

Regenerative injections take the opposite approach: deliver signaling and repair capacity to the tissue and support the body’s own repair process.

What is treated in these joints?

Rotator cuff and shoulder tissue, tennis and golfer’s elbow, wrist tendon and ligament injuries, and ankle instability are among the most common. Treatment is targeted injection, sometimes alongside systemic therapy where inflammatory load is a factor.

Where imaging shows damage beyond what regenerative therapy addresses, Dr. Southern will tell you that directly and refer you appropriately.

The workup

What gets evaluated before an upper-body joint is treated?

Injecting a joint without understanding it is how this category earned its reputation. Evaluation here means imaging review, functional assessment, and the systemic picture together.

Imaging

review of existing MRI or X-ray; referral for imaging where none exists

Functional

range of motion, strength, and provocation testing of the joint

Inflammatory

systemic inflammatory markers that shape healing capacity

Hormonal

testosterone and sex hormones, which drive musculoskeletal repair

Panels are tailored to your history at consultation; the groups above are representative, not exhaustive.

Dr. Ashley Southern working with patient records at her desk

What does treatment of a shoulder, elbow, wrist, or ankle involve?

Most upper-body protocols are a single targeted injection visit inside a structured course: evaluation before, defined follow-up after.

01
Consultation, imaging review, and exam
Dr. Southern reviews your imaging and examines the joint. If the structural damage is beyond what regenerative therapy addresses, you hear that now and get a surgical referral instead of a sales pitch.
02
Protocol design
Cell or exosome therapy selected for the tissue involved, with systemic therapy added only where inflammatory load justifies it.
03
Injection visit
The injection is performed in-clinic. Most patients are in and out the same day with specific activity guidance.
04
Structured follow-up
Function and symptoms are reassessed at defined intervals against the baseline exam, so the outcome is evaluated rather than assumed.

Signals

Signals that bring patients in

These are the patterns we hear most often from patients who end up being good candidates.

Shoulder pain that limits overhead movement
Tennis or golfer’s elbow that keeps returning
Wrist or ankle pain and instability that limit daily use
Pickleball and racquet-sport injuries
Cortisone that is wearing off faster each time

Younger hands holding an older patient’s hands

Treatments

Therapies used for this

Stem Cell Therapy

Umbilical cord-derived mesenchymal cell therapy

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Exosome Therapy

Next-generation cell-signaling therapy

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Where we draw the line

When is injection the wrong answer for an upper-body joint?

A regenerative injection cannot rebuild what is structurally gone, and pretending otherwise costs patients a surgical window.

Full-thickness rotator cuff tears with retraction, which need a surgical opinion first
Advanced joint destruction where replacement is the realistic path
Active infection in the joint
Numbness or weakness suggesting nerve involvement, which needs its own workup

The honest read

Where does the evidence stand for these joints?

Musculoskeletal application is the most-studied corner of regenerative medicine, with the shoulder and elbow literature growing but thinner than the knee literature. Results vary by tissue and severity, and none of these therapies is FDA-approved for orthopedic use.

What that means practically: candidacy assessment carries most of the weight. The published signal is meaningfully better in the patients these therapies suit, which is why we spend our effort on the evaluation rather than on promising.

Dr. Ashley Southern, NMDNaturopathic Medical Doctor · On where the evidence stands

Google reviews

What patients say

★★★★★

Dr. Southern was very thorough in her approach to my health issues and resolved a chronic pain issue I had been dealing with for at least 3 years. No other doctor I had dealt with could provide me the long term relief that she has. She is amazing and researches your entire health picture for the answers. Can’t recommend her enough!

Jessie BowmanVerified Google review

★★★★★

This has been a great experience! This practice offers a wholistic health model and I’m learning so much about how my body actually works, the best fuel for it, as well as creative ways to heal old injuries and keep me young and active as long as possible!

Angus ScottVerified Google review

★★★★★

I had such a wonderful experience seeing Dr. Southern today. My new patient visit was better than I anticipated. Dr. Southern is knowledgeable and thorough and talks with you rather than to you.

Crystal ShahVerified Google review

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Answers