Services Provided

Dr. Dieguez as the innovator that he is, and using his background and expertise in anesthesia, interventional pain management and surgery, has brought to St. Augustine the most advanced and up to date techniques for the treatment of painful musculoskeletal orthopedic conditions, and sport injuries using when indicated the most natural ingredients and minimally invasive techniques.


Having worked for the Florida Department of Health as an expert witness for the prosecution services unit, reviewing pill mills type of operations, and being very aware of the addiction problem we have in our country, Dr. Dieguez avoids at all cost the use of powerful narcotics and other controlled addictive medications. With that been said, if what you are looking for are narcotics don’t expect to get them in this office.


At his office Dr. Dieguez uses mainly Regenerative Medicine/Interventional Orthopedics. This includes Prolotherapy, Platelet Rich Plasma (PRP), Autologous Adult Stem Cell Therapy with Liposuction, Fat transfer and bone marrow concentrate (BMC). All the injection procedures Dr. Dieguez performs are precision guided either using Fluoroscopy or Ultrasound.


Additionally for those interested he also offers Medical Acupuncture also called Traditional Chinese Medicine (TCM), and some

Regenerative Medicine

The purpose of regenerative medicine is to regenerate and promote healing of damaged tissues. Among the techniques that fall under this category that are used in our office we have Autologus Stem Cell Therapy, PRP or Platelet Rich Plasma and Prolotherapy. I will describe each one separately.


I. Autologus Stem Cell Therapy.


Autologous Stem Cell Therapy is a new minimally invasive treatment that enhances tissue repair and provides an alternative option for orthopedic conditions and sport injuries that have traditionally required invasive surgery. Of all the modalities of regenerative medicine approved in the USA this is the most advanced and the most sophisticated of all. It is also the most involved and the most expensive. But still, if you compare it with a joint replacement surgical procedure, its cost, risks, suffering and also down time involved, it is minimal when compared to the surgery. This procedure is done strictly under local anesthesia, at our office and you walk in and out in one hour.


A joint replacement surgery is a traumatic major surgical procedure that requires the risk of a major anesthetic with all its possible complications and also requires a long rehabilitation period. Additionally and what is even worse, after surgery you may still suffer from pain. Just ask around to friends that have has a joint replacement and get them to tell you about their experience.



II. PRP or Platelet Rich Plasma Injections.


PRP Injection is another Regenerative Medicine technique but with this technique you actually do not inject any Stem Cell. PRP stands with Platelet Rich Plasma. The characteristic of PRP is that it contains natural stimulating and nutritive factor that basically stimulate the stem cells that exist in the tissues we inject it into. This modality works well in tendon and ligament tears where there is no retraction of the ends of the torn tendon or ligament. It also works well for muscle tears.


Some recipients of PRP therapy are Kobe Bryant, Bartolo Colon and Tiger Woods to name a few. The response to platelet rich plasma PRP treatment varies. Most patients require two PRP treatments and some patients require more. For severe problems, additional PRP injections may be necessary. Some people experience immediate improvement, but most of the time it takes approximately six weeks to respond to platelet rich plasma treatment. Emcyte Corporation has recently come out with a top of the line system to use for this procedure.



III. Prolotherapy.


Prolotherapy is a technique which consists of injecting certain tissue irritating substances, such as, for example, hypertonic glucose (sugar water) among others, that when injected into precise points, stimulates healing and tissue regeneration and repair. It stimulates tissue to proliferate (therefore the name of prolotherapy) and heal. This may not sound like a cutting-edge medical technique, but a growing number of doctors are now following the teachings of the father of prolotherapy, Dr. George Hackett, MD from Canton, Ohio. He is considered the father of prolotherapy because he brought this technique to mainstream medicine. His research was published in some of the main medical journals of his time and presented at the prestigious American Medical Association meetings starting in June of 1955. Some of the statistics on his research include: 1) Sample size: 1,656 patients, 2) Patient age range: 15 to 88 years old, 3) Duration of the discomfort: three months to 65 years, 4) Average duration of symptoms: four and a half years, 5) Duration of study: 19 years, 6) Number of injections given: 18,000


There is, to say the least, an amazing amount of convincing evidence that the technique can provide long lasting results. A more familiar name to you, former United Stated Surgeon General, C. Everett Koop MD, himself a patient treated with prolotherapy, wrote the Preface of the book “PROLO YOUR PAIN AWAY!” and consider it “A MUST READ FOR ANYONE EXPERIENCING CHRONIC MUSCULOSKELETAL PAIN.”


In Dr. Hackett's study twelve years after treatment, an impressive 82 percent of the patients considered themselves cured. Dr. Hackett also proved in the laboratory that prolotherapy induces the growth of ligament and tendon tissue and is especially effective at strengthening the weld of these structures to the bone, by proliferating their fibro-osseous junction. Dr. Gustav Hemwall from Oak Park, Illinois continued the studies of Dr. Hackett after his retirement and again he found that the great majority of patient who completed treatment with prolotherapy obtained relief.



Among the conditions treated at Dr. Dieguez Office with some of the above techniques we have:

1.- Spine and other back, head and neck conditions. (enumerate al in each group)

2.- Hip conditions.

3.- Knee conditions.

4.- Lower leg and foot conditions.

5.- Shoulder and arm and wrist and hand conditions.

6.- Other conditions