pain-management

Coastal Virginia
Spine and Pain Center

prp

Reducing PAIN

Returning FUNCTION 

Restoring QUALITY OF LIFE

Coastal Virginia Spine and Pain Center

Dedicated and Skilled Professionals
Treating  Spinal and Musculoskeletal Pain
Providing Quality Care
Using Cutting-Edge Technology
Utilizing over 30 Years of Experience
Covering the Coastal Virginia Region
Centrally Located in Virginia Beach

REGENERATIVE MEDICINE

regenerative therapy

Regenerative Medicine, (commonly referred to as "Biologic Healing" or "Stem Cell Therapy") describes a process by which an intervention is performed in order to initiate regeneration of injured or damaged sites within the body. This cutting-edge treatment has been shown to improve both pain and function in many painful conditions such as osteoarthritis, tendonitis, partial tendon tears and ligament injuries.

Our provider team at Coastal Virginia Spine and Pain Center will assess the cause of your pain, and then decide which Regenerative Treatment method would be best to heal your condition.

We currently offer Platelet-Rich Plasma and Prolotherapy.

PLATELET-RICH PLASMA

Platelet Rich Plasma (PRP) Injection Therapy is a cutting-edge technique that uses the patient’s own blood as the source of the solution that is being injected. This technique is well documented, because of the facilitation of healing and the reduced risk of infection, and is now showing success with treating chronic pain in:

  • Tennis Elbow
  • Plantar Fasciitis
  • Rotator Cuff Tears
  • Osteoarthritis
  • Bursitis
PRP-injections

Research is being performed on an ongoing basis to determine which type of Platelet-Rich Plasma is best for individual pain conditions, as Not ALL Platelet-Rich Plasma is EQUAL…

Platelet-Rich Plasma is classified into 2 categories:

  • Leukocyte-Rich (LR-PRP)
  • Leukocyte-Poor (LP-PRP) - has been shown to stimulate cartilage cells improving knee osteoarthritis compared to the effects of LR-PRP.

Platelet-Rich Plasma (PRP) is plasma that is very concentrated with platelets. These platelets have high levels of growth factors that help to facilitate connective and soft tissue healing.

In addition to understanding which PRP type is right,  concentrations have been shown to matter significantly, and are considered when planning a Platlet-Rich treatment plan.

platelet-rich-plasma

Platelet-Rich Plasma with Red blood cells with platelets.  

At Coastal Virginia Spine and Pain Center, we strive to provide you with  the most up-to-date, evidence-based research to formulate a plan to help you heal your injury to its full potential.  

Properties of Blood

Platelets

Platelets are fragments of a much larger cell, the megakaryocyte, which stays in the bone marrow after it differentiates and matures from the stem cell. Stem cells are cells that retain the ability to renew themselves and can differentiate into a diverse range of specialized cell types.

Platelets leave the bone marrow and circulate throughout the body in the plasma. When stimulated by substances from damaged tissue, they:

  • Facilitate clotting of the blood after an injury.
  • Bring white blood cells to the injured area. The white blood cells then clean up the dead and injured cells.
  • Release growth factors that facilitate tissue regeneration.
stem-cells

Blood is made up of Plasma, White and Red Blood Cells, and Platelets.  

Plasma

Plasma is the “river” in which the blood cells travel. It carries blood cells, nutrients (sugars, amino acids, fats, salts, minerals, etc.), waste products (CO2, lactic acid, urea, etc.), antibodies, clotting proteins (called clotting factors), chemical messengers such as hormones, and proteins that help maintain the body's fluid balance.

Platelet-rich-plasma-3

Growth Factors

Growth factors are proteins that assist the body in repairing itself by stimulating stem cells to regenerate new tissue. The more growth factors released; the more stem cells stimulated to produce new collagen. Because of this, the body is able to help itself heal. The growth factors include:

  • Platelet-derived growth factors PGDF
  • Platelet-derived growth factors PGDF
  • Insulin-like growth factor ILGF

BENEFITS OF PLATELET-RICH PLASMA (PRP)

Platelets are responsible for clotting during the healing phase of injury within the body. The platelets circulate normally throughout the body and once an injury occurs the platelets aggregate around the injured site and concentrate growth and repair factors that stimulate organ/tissue repair.

Once the Platelet-Rich Plasma (PRP) is injected into the affected areas, it triggers inflammation, which then facilitates the healing process to begin. New collagen starts to develop, and then it starts to shrink. As the collagen tightens, it strengthens the ligaments and tendons that were injected. This then helps the areas to become more stable. As a result, pain levels will decrease and mobility will increase.

Collagen is the main protein of connective tissue and the most abundant protein in our bodies. It is the “glue” that holds the body together, and it makes up about 25% of the total protein content. It is fibrous in nature, and it connects and supports other bodily tissues, such as skin, bone, tendons, muscles, and cartilage.

PLATELET-RICH PLASMA vs CORTISONE INJECTIONS

Cortisone injections are used to temporarily stop inflammation and provide pain relief. They do not provide long-term healing, and studies have shown that they may actually weaken the tissue. PRP injections are used to promote healing and strengthening of ligaments and tendons to promote long-term benefits.

Platelet-Rich Plasma Injections

In our clinic PRP is made by first extracting a patient’s own blood (about 20 cc) through a simple venipuncture similar to a typical lab draw. The blood is then spun to a specific setting within a centrifuge which effectively separates the blood into layers where the platelet-rich and platelet poor samples can then be extracted for PRP injection.

prp

A PRP injection is performed in our clinic similar to our other injection procedures. Every PRP procedure at Coastal Virginia Spine and Pain Center is guided either by Fluoroscopy or Musculoskeletal Ultrasound (MSKUS). A local anesthetic is used to make the procedure as comfortable as possible.

Post procedure there is most commonly injection site soreness that may last anywhere from 1-10days. This is perfectly normal and goes in line with a mild inflammatory reaction which is exactly the purpose of undergoing PRP- stimulate cellular repair and healing.

Then entire procedure generally takes about one hour.

PRP PREP AND INJECTION

Post-Regenerative Treatment Instructions

Congratulations! You have taken your first step in a process to heal your chronic condition through regenerative therapy.  After your Regenerative Procedure, whether it is Prolotherapy, Platelet-rich Plasma or Stem Cell Injections; there is very little downtime, as opposed to a surgical procedure, and the healing process goes on for the next 4-6 months.  The first 1-2 weeks, however, are when you may feel the most discomfort.  It is advisable to plan for a few days of rest post-procedure to  accommodate the expected soreness.  Please follow the following guidelines to make sure your healing progresses and in order to optimize your outcome.  If you have any questions or problems, please contact this office at 757-227-3820

DO's

  • DO REST. Plan to rest the treated area for the next 1-3 days.
  • DO use Tylenol to control the pain. There is now more inflammation as the healing cascade is starting and an increase in pain is expected as with any medical procedure.   A typical regimen is to take 500mg OTC        Tylenol 3 x daily
  • DO MONITOR the injection site for increasing redness or discharge. Increased  tenderness, mild swelling, and even warmth is to be expected after these treatments. However given the rather simple and more natural approach with regenerative treatments,  reactions and infection risk is rather low.
  • DO stay hydrated, well nourished, active,  and get plenty of sleep. The healing is just beginning with this treatment and using the affected area with normal movements such as walking will help increase the blood flow and healing.

DON'TS

  • DON’T ICE the affected area for 72 hours; this is to allow the repair process to maximize potential.
  • DON’T take any NSAID medications, vitamins,  or supplements unless approved by your clinician. This includes nutritional supplements, herbs, NSAIDs, and even marijuana and CBD for the week following your treatment.
  • DON’T apply creams, lotions, oils, or makeups to the injection sites for at least 8 hours.
  • DON’T EXERCISE or perform strenuous activity with the affected area. The procedure  is trying to stimulate healing and the injured area or site needs to go through this repair process fully. You may perform ROM stretches as tolerated though.
  • Don't bathe, shower or swim for eight hours after treatment. Doing so may increase the risk of infection or a reaction.
  • DON’T SMOKE or drink Alcohol for 72 hours post injection. These items increase BAD inflammation and free radicals in our body and can delay or interfere with the healing process. Ideally minimize the use of these substances for a few weeks after your procedure.

Frequently Asked Question About Platelet-Rich PlasmaTherapy Injections

Can I take Medications after having PRP Injections?

You are not allowed to use any non-steroid anti-inflammatory medications (NSAIDs) one week prior to the procedure, nor will you be able to use them throughout the course of treatment.

What can I expect after the treatment?

After the treatment, you can expect soreness in the area that was treated for about one to two days, and then some pain relief should begin within the first week, continuing over a period of three months.

How long does it take to see results from the PRP Injections?

The amount of time it will take to see significant improvement is patient dependent and several factors play a role to provide estimation including pathology treated, and case severity

How many treatments are needed?

Responses to PRP injections vary, but most patients will require 3-6 sets of injections. The treatments are usually spaced between four and six weeks apart. There are no limits to the number of treatments you can have.

Who should not have PRP Injection Therapy?

Patients with bleeding disorders or hematological diseases do not qualify for this procedure. Check with your physician to determine if Platelet-Rich Plasma Injections are right for you.

When Can I return to regular activity?

PRP injections are stimulating the growth and repair of ligaments and tendons, which requires time. Because of this, the process is slow, so there is no immediate fix. Your provider will determine what activity level is best for you throughout the course of this treatment.

Are there any risks or side effects?

As with any technique that is invasive to the body, there is a slight risk of infection, but this is rare. The technique is safe, because the patient’s own blood is being used for the source of the growth factors and there is no risk of transmission of blood-borne diseases, side effects or allergic reactions from steroids or other injectable medications.

Am I a candidate for PRP?

Now is the time to schedule a PRP consultation with one of our providers to find out.     

Call 757-227-3820 or visit  E-mail us to schedule an appointment

Does Insurance Cover Stem Cell Therapy Injections?

At the moment, most insurances do not cover Platelet-Rich Plasma Injections or Regenerative Therapies .  We will assist you in determining if your insurance will cover the costs for these procedures.   The costs can sometimes be paid with an HSA or FSA, so you will need  to check with your Plan Administrator.

What is the cost?

At Coastal Virginia Spine and Pain Center, we believe that the cost to achieve pain relief should be affordable.   We will  make  every attempt to minimize the out of pocket cost to all of our patients.

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OUR SERVICES

INTERVENTIONAL PAIN MANAGEMENT

  • Fluoroscopically-Guided Spinal Injections
  • Musculoskeletal Ultrasound (MSKUS)
  • MSKUS-Guided Joint Injections
  • Trigger Point Injections
  • Scar Tissue Injections
  • Spinal Cord Stimulator Trials

REGENERATIVE MEDICINE

  • Platelet-Rich Plasma Therapy (PRP)
  • Prolotherapy

DIAGNOSTIC STUDIES

  • Electromyography
  • Nerve Conduction Studies
  • Spinal Medial Branch Blocks

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pain-management

PHYSICAL THERAPY

  • One-On-One Care
  • Same Therapist for Each Visit
  • Individualized Care Plans
  • Spinal Stabilization and Strengthening
  • Postural Retraining
  • Restoration of Breathing Mechanics

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pain-management

MEDICAL WEIGHT MANAGEMENT PROGRAM

This program is for patients who....

  • Want or need to lose weight 
  • Cannot have spinal or joint surgery because of weight
  • Have been unsuccessful in weight loss or other diet programs
  • Cannot tolerate regular exercise

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Medication for Management of Pain

MEDICATION FOR  MANAGEMENT OF PAIN

Coastal Virginia Spine and Pain Center use of medication for pain management places an emphasis on a multimodal approach, patient education and clinical decision making to achieve pain relief while reducing opioid-related risks.

Our priority is placed upon the identification of the source of the pain and then consider the best treatment approach for your care. We start with non-opioid medications, Physical Therapy, and potentially, interventional techniques.

When using limited opioid-based medications, in addition to the current treatment plan, strict patient compliance is necessary to reduce potential risks and maximize functional return.

Coastal Virginia Spine and Pain Center adheres to State and Federal Guidelines, as well as our Opioid Prescribing Policy related to the prescribing of controlled medications.

WORKERS COMPENSATION CASE MANAGEMENT

Coastal-virginia -spine-and-pain-center

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Location

Coastal Virginia Spine and Pain Center

Southport Center Building

4525 South Boulevard

Suite 200

Virginia Beach, Virginia  23452

VIEW MAP

coastal-virginia-spine-and-pain-center

Hours

Monday-Thursday: 7:30AM - 5:00PM

Friday:  7:30AM - 4:00PM

cova-office-enter

Meet Our Providers

Dr. Robert Spear
Dr. Robert Spear
Dr. Bonnie Nock
Dr. Bonnie Nock
Abby Barney, PA-C
Abby Barney, PA-C
Claire Denny, PA-C
Claire Denny, PA-C
Kristi Nixon-Cartwright, NP-C
Kristi Nixon-Cartwright, NP-C
Kathryn Bragg, PT
Kathryn Bragg, PT
Scott Burch, PT
Scott Burch, PT
Robin Levine, PT
Robin Levine, PT

The physicians and staff at Coastal Virginia Spine and Pain Center have over 30 years of experience in Pain Management. 

We provide comprehensive treatment for spinal and musculoskeletal pain to help improve and manage acute or chronic pain.

The goal of treatment is to help our patients become empowered over their pain- to help reduce pain and increase function through intervention, therapy and education.

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Frequently Asked Questions

Schedule an Appointment

To make an appointment, you may call us at 757-227-3820 between 7:30 a.m. and 4:00 p.m. Monday – Friday, or you may stop by our office to schedule an appointment. 

You can also E-mail us, and we will reply as soon as possible.  If you wish to be called back, please include your name and preferred contact number in your e-mail. 

Patient Portal

You can access the Patient Portal after receiving a password from our office.  If you have any questions please contact us

Initial Evaluation

Patients are generally scheduled within two weeks for a new evaluation.

You will receive a welcome packet in the mail or e-mail, prior to your visit, or you can download the New Patient Packet. It is recommended that you arrive about 15 minutes prior to your initial evaluation if you have completed your paperwork, and 30 minutes before if you have not completed the paperwork.

After your initial evaluation, your provider will discuss with you the most effective treatment program and care plan for your problem.

First Appointment

To assist in making your first visit to COVA Spine and Pain Center more time efficient, please bring any relevant medical records as well as:

  • Photo ID
  • Insurance Card
  • Referrals from your Primary Care Physician
  • All completed New-Patient Paperwork
  • Co-Pay, if required

We will request any other medical records, MRI’s, CT scans, X-rays or laboratory results or MRIs be faxed to our office from your referring physician’s office. To expedite this process, you can download the Medical Records Request Form before your first visit.

Prescription Refills

You can call our office at 757-227-3820 for prescription refills, Monday through Friday between 7:30:00 a.m. and 4:00 p.m. Please allow three (3) business days to process your request.

 

If someone is picking up the prescription for you, an Authorization for Release of Prescription has to be completed in order for the prescription to be released.

prescription-refills

Pre-Authorization

You should check with your insurance to determine if a referral is necessary prior to receiving treatment.

 

If your insurance requires a pre-authorization to see a specialist, then you must get a referral from a Primary Care Physician or OB/GYN to see a pain specialist for an initial appointment.

 

After the initial consultation, our office will obtain any future authorizations, sometimes with the assistance of your referring doctor.

Medical Records Request

We will be happy to provide you with a copy of your medical records. You will need to fill out a copy of the Medical Records Release Form.

Insurance Questions

Insurances We Accept• OPTIMA - Physician Services Only, Not Physical Therapy
• Anthem/Blue Cross/Blue Shield - Effective 3/7/2025, COVA PHYSICAL THERAPY will no longer be In-Network with Anthem/Blue Cross.  Read More.
• Medicare
• Tricare
• Cigna
• Aetna
• United Healthcare
• Most Commercial Insurances
Insurances that Require Referral• Tricare Prime
Insurances We DO NOT Accept
Plans which we DO NOT accept:
• HealthKeepers Plus
• Optima Family Care
• Optimum Choice
• Virginia Premier
• MAMSI
• Alliance
Worker's Comp Guidelines• Case manager or adjuster must call and schedule the first appointment
• The following information must be provided
• Date of injury
• State of injury
• Body part injured
• Case manager or adjuster’s name and number
• Insurance name, number, address and adjuster
No Health InsuranceThe costs vary depending on what type of treatment is needed. We will try to work with you to help you obtain the care you need.

Please contact our office at 757-227-3820 to see how we can hellp you.
Difference Between a Co-Pay and Co-InsuranceA co-pay is the amount designated by your carrier that identifies a set amount for the office visit. Typically, there is one for your primary care provider and a different amount due a specialty provider.

Co-insurance is a percentage due, determined by your benefit plan and the contract with your carrier and your provider.
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