Frequently Asked Questions

Regenerative medicine uses your body's own healing mechanisms to repair damaged tissues. Rather than masking pain with medications or replacing joints with surgery, regenerative treatments stimulate your immune system to reduce inflammation and promote tissue repair. This approach addresses the root cause of pain and degeneration, not just the symptoms. At Triangle Regen Medicine, we offer multiple regenerative therapies including PRP, the Regenokine® Program, A2M protein concentrates, and nerve hydrodissection.

Most patients with osteoarthritis, tendon injuries, nerve compression, or chronic joint pain are potential candidates. Ideal candidates typically have mild to moderate joint degeneration, are looking for alternatives to surgery or long-term medication, and are otherwise healthy enough to mount a healing response. During your consultation, Dr. Buchheit will evaluate your condition, review imaging, discuss your goals, and determine which regenerative therapy is most appropriate for you. You can also take our online candidate assessment for an initial evaluation.

Cortisone (corticosteroid) injections suppress inflammation and provide temporary pain relief, but they don't address the underlying tissue damage. In fact, research shows that repeated cortisone injections may actually accelerate cartilage breakdown over time. Regenerative therapies work differently. They harness your body's healing mechanisms to promote tissue repair and reduce the destructive inflammation at its source. While cortisone offers quick but short-term relief, regenerative treatments aim for lasting improvement by supporting actual healing.

Results vary by treatment, condition severity, and individual factors. Many patients experience significant improvement lasting 1-3 years or longer. Some conditions may benefit from periodic maintenance treatments to sustain results. Because regenerative therapies promote actual tissue healing rather than just masking symptoms, the improvements tend to be more durable than those from corticosteroid injections. Dr. Buchheit will discuss expected outcomes for your specific situation during your consultation.

Absolutely. We welcome patients from throughout the Triangle region (Raleigh, Durham, Cary) and across North Carolina. We also see patients from out of state, particularly those seeking the Regenokine® Program, which is only available at a few locations in the United States. For out-of-town patients, we can often coordinate treatment schedules to minimize trips. Our office is conveniently located in Chapel Hill at 1440 Environ Way, with easy access from I-40.

Triangle Regen Medicine combines cutting-edge regenerative therapies with deep expertise in the science behind them. Dr. Buchheit brings over 20 years of clinical and research experience, including NIH and Department of Defense funded research at Duke University. He is one of the few U.S. physicians certified to offer the Regenokine® Program and has authored "Healing Joints and Nerves," a comprehensive guide to regenerative therapies. Here, you'll receive personalized care from a physician-scientist who understands both the research and the clinical application of these treatments.

Dr. Thomas Buchheit is a board-certified physician specializing in regenerative and biologic therapies. He served as Chief of Pain Medicine at Duke University's Department of Anesthesiology and remains an Adjunct Associate Professor at Duke. His research has been funded by the National Institutes of Health (NIH) and the Department of Defense. He has authored numerous peer-reviewed publications and the book "Healing Joints and Nerves: Immune Stimulation and the New Science of Regenerative Therapies." Dr. Buchheit is certified to offer the Regenokine® Program and has extensive training in ultrasound-guided procedures.

Dr. Buchheit served as Chief of Pain Medicine at Duke University's Department of Anesthesiology, where he led clinical care, research, and education in pain management. He co-directed Duke's Center for Translational Pain Medicine, focusing on understanding and treating chronic pain conditions. His research at Duke, funded by the NIH and Department of Defense, explored the mechanisms of nerve injury, pain, and healing. He continues to serve as an Adjunct Associate Professor, maintaining his connection to academic medicine while focusing on clinical care at Triangle Regen Medicine.

"Healing Joints and Nerves: Immune Stimulation and the New Science of Regenerative Therapies" provides a comprehensive guide to understanding how regenerative medicine works. The book explains the science behind treatments like PRP, the Regenokine® Program, and A2M therapy in accessible terms. It covers common conditions like osteoarthritis and nerve pain, discusses what to expect from treatments, and helps readers make informed decisions about their care. The book is available on Amazon and is an excellent resource for patients considering regenerative therapy. Learn more about the book.

After years of treating patients with chronic pain and seeing the limitations of traditional approaches, Dr. Buchheit became passionate about finding solutions that address root causes rather than just managing symptoms. His research into inflammation, nerve injury, and tissue healing led him to regenerative medicine, where the science aligned with his goal of helping patients achieve lasting improvement. He founded Triangle Regen Medicine to offer patients access to advanced treatments that weren't widely available, delivered by a physician who deeply understands the science behind them.

Platelet-Rich Plasma (PRP) is a concentration of your own platelets in a small volume of plasma. Platelets contain growth factors and signaling molecules that play a crucial role in tissue healing. By concentrating these platelets (typically 3-10 times normal levels) and injecting them into damaged tissue, we can enhance your body's natural repair processes. PRP is used to treat a wide range of conditions including osteoarthritis, tendon injuries, and muscle strains.

The process begins with a simple blood draw, similar to what you'd experience at a routine lab visit. We typically draw 30-60 mL of blood depending on the treatment area. The blood is then placed in a specialized centrifuge that separates the platelets from other blood components. This process takes about 15-20 minutes. The resulting platelet concentrate is then injected into the treatment area using ultrasound guidance to ensure precise placement.

The number of treatments depends on your condition and response to therapy. Many patients experience significant improvement after 1-2 treatments. Some conditions, particularly more severe arthritis, may benefit from a series of 2-3 treatments spaced several weeks apart. Dr. Buchheit will develop a personalized treatment plan based on your diagnosis and goals. Follow-up appointments allow us to assess your progress and determine if additional treatments would be beneficial.

PRP is very safe because it uses your own blood, eliminating the risk of allergic reaction or disease transmission. Common side effects include temporary soreness, swelling, or bruising at the injection site. These typically resolve within 2-5 days. Serious complications like infection are rare. Because PRP stimulates a controlled inflammatory response as part of the healing process, you should avoid anti-inflammatory medications (NSAIDs like ibuprofen) before and after treatment.

Unlike cortisone, which provides immediate but temporary relief, PRP works through tissue healing, which takes time. Most patients notice some improvement within 2-4 weeks, with continued improvement over 2-3 months as the healing process progresses. Maximum benefit is typically seen at 3-6 months. It's important to have realistic expectations and patience, as you're investing in actual tissue repair rather than just symptom suppression.

The Regenokine® Program (also known as Orthokine or Autologous Conditioned Serum) is an advanced regenerative therapy developed in Germany by Dr. Peter Wehling. Your blood is incubated under precisely controlled conditions for 24 hours, which stimulates white blood cells to produce high concentrations of interleukin-1 receptor antagonist (IL-1Ra). IL-1Ra is a natural protein that blocks interleukin-1, the inflammatory molecule primarily responsible for cartilage destruction in osteoarthritis. The serum is then harvested and injected over a series of 6 treatments.

While both use your own blood, they work through different mechanisms. PRP concentrates platelets and their growth factors to stimulate tissue repair. The Regenokine® Program specifically produces IL-1Ra to block the inflammatory cascade that drives cartilage destruction in arthritis. Think of PRP as promoting healing, while the Regenokine® Program directly inhibits the destructive inflammation. For osteoarthritis, the Regenokine® Program may be particularly effective because it targets the specific inflammatory pathway that degrades cartilage. For some conditions, one may be more appropriate than the other, or they may be used in combination.

The Regenokine® Program requires specialized equipment, proprietary incubation syringes, extensive training, and rigorous quality control protocols. Only a limited number of U.S. physicians are certified to offer this therapy. Previously, patients had to travel to Germany for treatment. Dr. Buchheit is one of the few providers in the United States trained and certified in the Regenokine® Program protocol, allowing Triangle region patients access to this advanced treatment without international travel.

The Regenokine® Program has been used by numerous professional athletes and celebrities, including Kobe Bryant, Alex Rodriguez, and Fred Couples, who famously traveled to Germany for treatment. Kobe Bryant credited the Regenokine® Program with extending his basketball career. While celebrity endorsements don't constitute medical evidence, the treatment is backed by clinical research showing superior outcomes compared to placebo and corticosteroid injections for knee osteoarthritis in randomized controlled trials.

The Regenokine® Program is particularly effective for osteoarthritis because it specifically targets the IL-1 inflammatory pathway that drives cartilage destruction. It's commonly used for knee, hip, and shoulder osteoarthritis, especially in patients with mild to moderate disease who want to avoid or delay joint replacement. It can also be effective for certain spine conditions where inflammation plays a key role. Dr. Buchheit will evaluate your specific condition to determine if the Regenokine® Program is the optimal choice for you.

Alpha-2-Macroglobulin (A2M) is a naturally occurring protein in your blood that acts as a powerful "protease inhibitor." In joints affected by arthritis, destructive enzymes called proteases break down cartilage. A2M captures and neutralizes these enzymes, essentially stopping the cartilage destruction process. By concentrating A2M from your own blood and injecting it into the affected joint, we can provide protection against further cartilage loss while allowing your body's natural repair processes to work.

A2M is prepared from your own blood through a specialized filtration and concentration process. A blood sample is drawn and processed using proprietary technology to isolate and concentrate the A2M protein. The concentrated A2M is then injected directly into the affected joint using ultrasound guidance. The procedure is typically performed in a single visit, similar to PRP treatment.

A2M therapy is particularly beneficial for patients with early to moderate osteoarthritis who want to slow or halt cartilage degradation. It may be especially useful for younger, active patients who want to preserve joint function for as long as possible. A2M can also be combined with other regenerative therapies for a comprehensive treatment approach. During your consultation, Dr. Buchheit will assess whether A2M alone or in combination with other treatments is right for your situation.

Nerve hydrodissection is an advanced ultrasound-guided technique that uses fluid injection to gently separate a compressed nerve from surrounding tissues. When nerves become entrapped in scar tissue, thickened fascia, or inflamed structures, they can cause pain, numbness, and weakness. Using precise ultrasound imaging, Dr. Buchheit injects a solution (often combined with PRP or other regenerative agents) around the nerve to release it from entrapment and promote healing. This non-surgical approach can provide relief similar to surgical nerve release for many patients.

For many patients with mild to moderate carpal tunnel syndrome, nerve hydrodissection can provide significant relief and may avoid the need for surgery. Studies have shown good outcomes comparable to surgical release in appropriate candidates. However, patients with severe nerve damage, muscle wasting, or those who haven't responded to conservative treatments may still benefit from surgery. Dr. Buchheit can evaluate your condition with clinical examination and diagnostic testing to determine the best approach for you.

Laser therapy, or photobiomodulation, uses specific wavelengths of light to stimulate cellular healing and reduce inflammation. The light energy is absorbed by cells, enhancing mitochondrial function and ATP production, which accelerates tissue repair. We use the MLS laser system, which delivers both continuous and pulsed wavelengths for optimal therapeutic effect. Laser therapy can complement other regenerative treatments and is particularly useful for superficial tissues, neuropathy, and chronic pain conditions.

Yes, we offer several approaches for peripheral neuropathy depending on the underlying cause. For neuropathy caused by nerve entrapment, hydrodissection can release the trapped nerve. Laser therapy can help with diabetic and other forms of neuropathy by improving nerve blood flow and reducing inflammation. PRP and other regenerative agents can support nerve healing. Dr. Buchheit will evaluate the type and cause of your neuropathy to develop an appropriate treatment strategy.

Knee osteoarthritis is one of the conditions we treat most frequently and successfully. We offer multiple treatment options including PRP, the Regenokine® Program, and A2M therapy, which can be tailored to the severity of your arthritis and your goals. Many patients with mild to moderate knee osteoarthritis can experience significant improvement and delay or avoid knee replacement surgery. Even patients with more advanced disease often achieve meaningful pain relief and improved function.

Yes, hip osteoarthritis responds well to regenerative treatments, though the hip joint is deeper and requires specialized ultrasound or fluoroscopic guidance for accurate injection. Dr. Buchheit has extensive experience with hip injections and uses advanced imaging to ensure precise delivery of regenerative therapies. PRP and the Regenokine® Program can both provide relief for hip arthritis, potentially delaying the need for hip replacement.

PRP is particularly effective for tendon injuries including rotator cuff tears. For partial tears and tendinopathy, PRP can stimulate healing and improve function, often avoiding the need for surgery. Even patients with full-thickness tears who are not surgical candidates can experience significant pain relief and functional improvement. We use ultrasound guidance to precisely target the damaged portion of the tendon for optimal results.

Regenerative medicine is not appropriate for all conditions. We generally don't treat acute fractures, infections, tumors, or inflammatory arthritis like rheumatoid arthritis (which requires systemic treatment). Very severe, end-stage arthritis with bone-on-bone degeneration may have limited response to regenerative therapy, though we can often still provide some relief. During your consultation, Dr. Buchheit will honestly assess whether regenerative treatment is appropriate for your condition.

Most regenerative therapies including PRP, the Regenokine® Program, and A2M are not covered by insurance. Insurance companies typically consider these treatments "experimental" or "investigational," despite substantial research supporting their effectiveness. Triangle Regen Medicine operates as a self-pay practice for regenerative treatments, which allows us to focus on providing the best possible care without insurance company interference. We're happy to provide documentation if you wish to submit to your insurance for possible reimbursement.

Treatment costs vary depending on the specific therapy and treatment areas. Dr. Buchheit believes patients deserve transparent pricing so they can make informed decisions. You'll receive detailed cost information during your consultation, before committing to any treatment. Contact our office at 919-752-3051 for current pricing information. We also offer package pricing for multi-treatment protocols like the Regenokine® Program.

Yes! Regenerative medicine treatments qualify as eligible medical expenses for both Health Savings Accounts (HSA) and Flexible Spending Accounts (FSA). This allows you to pay for treatment with pre-tax dollars, effectively reducing your out-of-pocket cost by your tax rate. We accept HSA and FSA debit cards. Check with your plan administrator for specific details about your account limits and eligible expenses.

Yes, we offer flexible payment options to make regenerative therapy accessible. We accept all major credit cards and can discuss payment arrangements during your visit. We want to ensure that financial considerations don't prevent patients from accessing treatments that could significantly improve their quality of life.

Regenerative treatments typically cost significantly less than surgical alternatives, even when comparing out-of-pocket costs. A knee replacement, for example, can cost $20,000-$50,000+ (and much more with complications), not including time off work and rehabilitation. Beyond direct costs, regenerative treatments have minimal downtime compared to surgery. Many patients can return to normal activities within days rather than months. Of course, the best treatment depends on your specific condition, not just cost.

Regenerative therapies work by stimulating a controlled inflammatory response that triggers tissue repair. NSAIDs (like ibuprofen, naproxen, and aspirin) suppress this inflammatory process and can significantly reduce the effectiveness of your treatment. For pain management before and after treatment, Tylenol (acetaminophen) is typically safe to use. We generally recommend avoiding NSAIDs for 1 week before and 2-4 weeks after treatment. Dr. Buchheit will provide specific guidance based on your situation.

Recovery varies by treatment and individual. Most patients can return to normal daily activities immediately, though you may experience soreness, swelling, or stiffness at the injection site for 2-5 days. This is actually a sign that the treatment is working and your body is mounting a healing response. We typically recommend avoiding strenuous activity for 1-2 weeks after treatment. Ice can be used for comfort. You should avoid anti-inflammatory medications during the initial healing period.

Light activity like walking is encouraged soon after treatment to promote healing. Higher-impact activities should be avoided for 1-2 weeks, then gradually reintroduced. The timeline depends on your treatment, the area treated, and your baseline activity level. Runners, for example, typically wait 2-3 weeks before returning to running. Dr. Buchheit may recommend physical therapy to optimize your recovery and long-term results. We'll provide specific guidance based on your treatment and goals.

Most patients find the injection tolerable. We use local anesthesia to numb the skin and superficial tissues before the injection. Joint injections typically cause brief pressure sensation. Tendon and nerve injections may cause momentary discomfort. Dr. Buchheit uses ultrasound guidance to ensure precise needle placement, which improves both effectiveness and comfort. Most patients report the procedure is less uncomfortable than they expected.

While most patients experience significant improvement, results aren't guaranteed and vary by individual. If you don't see adequate improvement at your follow-up visit (typically 6-8 weeks after treatment), Dr. Buchheit will reassess your condition. Options may include additional treatments, alternative regenerative approaches, or other recommendations. Our goal is your best possible outcome, and we'll work with you to achieve it. In some cases, referral for surgical consultation may be appropriate.

Physical therapy often complements regenerative treatments and can optimize your outcomes. After the initial healing period (usually 2-4 weeks), targeted exercises and manual therapy can improve strength, flexibility, and function. PT is particularly important for tendon injuries and post-treatment rehabilitation. Dr. Buchheit can recommend physical therapists who understand regenerative medicine and can tailor their approach accordingly. Not every patient needs PT, but many benefit from it.