Before I recommend an orthobiologic treatment, I want to know more than what the MRI shows. Tissue repair happens in the environment your whole body creates — and that environment is measurable.
Three markers worth knowing CRP — C-reactive protein — is an acute-phase reactant that rises sharply with inflammation. The high-sensitivity version (hs-CRP) picks up the low-grade, chronic inflammation that quietly interferes with healing.
ESR — the erythrocyte sedimentation rate — rises more slowly and stays elevated longer. An elevated ESR suggests chronicity: inflammation that has been simmering for a while, driven in part by fibrinogen.
Fibrinogen is both an inflammatory marker and a clotting factor. Elevated levels reflect inflammation and a pro-coagulant tendency — relevant when we are asking small vessels to deliver healing factors to a tendon or joint.
Why this matters for your outcome Two patients with identical MRIs can have completely different outcomes from the same treatment, and systemic inflammation is a big reason why. The encouraging part: these markers are genuinely modifiable. Exercise, sleep, diet, and weight all move them measurably.
When labs show a high inflammatory burden, we address it — sometimes before, sometimes alongside the injection. Treating the person, not just the picture, is not a slogan. It is how outcomes improve.