TREATMENTS

Regenerative Protein Array (RPA) and MUSE-Infused RPA

Now available at Nivens Spine Medicine, the next step beyond stem cells and exosomes.

Regenerative Protein Array (RPA) and MUSE-Infused RPA, are an acellular regenerative therapy built to support your body’s own healing process, without the cellular or DNA transfer risk that comes with some other regenerative options.

What is RPA?

RPA is an array of proteins, growth factors, and cytokines pulled from donated placental tissue. Third-party proteomic and PCR testing verifies more than 300 healing proteins in it, drawn from all three layers of the placenta: the endoderm (soft tissue and organs), the ectoderm (brain and nerve), and the mesoderm (musculoskeletal). That’s a broader biologic profile than most regenerative products on the market today.

What’s different about MUSE-Infused RPA?

It adds a concentrated dose of Multilineage-differentiating Stress Enduring (MUSE) proteins. These are naturally stress-resistant and carry more endoderm and ectoderm bioactive components, which may give patients who need extra biologic support a stronger signal to work with.

Donated placental tissue goes into a specialized bioreactor that stimulates it to release cytokines and growth factors. What comes out the other end is a concentrated, acellular source of the components tied to tissue healing. Donors are U.S.-based, come from scheduled and healthy C-section births, and have a 20-year history clear of cancer, autoimmune disease, and genetic disease. After processing, the product goes through a quad-filtering step that strips out cellular and DNA matter, then passes third-party endotoxin and 14-day sterility testing.

RPA is categorized by the FDA as “cell factors,” acellular products without DNA. The FDA regulates how it’s manufactured, processed, and distributed, and leaves use and care decisions to licensed clinicians like Dr. Nivens, working with the patient. It’s produced in an FDA-registered facility under Human Cellular Therapy/Tissue Product standards. It is not an FDA-approved drug or treatment for any specific condition.

Our approach: assess, repair, maintain

Every patient starts with a real assessment, moves into a repair plan built around them, and gets a maintenance plan meant to protect whatever progress they’ve made.

Could this be right for you?

Maybe you want back on the pickleball court. Maybe it’s keeping up with grandkids, or just getting through a Tuesday without your knee complaining. Dr. Nivens can walk through whether RPA or MUSE-Infused RPA makes sense as part of your care. Results vary from patient to patient, and RPA isn’t intended to diagnose, treat, cure, or prevent any disease.

Other Information

Epidural Steroid Injections (ESI)

At Nivens Spine Medicine, Epidural Steroid Injections (ESI) are a trusted, non-surgical way to calm that inflammation and relieve pain caused by conditions like herniated discs, sciatica, spinal stenosis, or degenerative disc disease.

These injections deliver a powerful anti-inflammatory medication directly into the epidural space—the area surrounding the spinal nerves. By reducing swelling and irritation, patients often experience significant pain relief, improved mobility, and a better ability to participate in physical therapy or return to normal daily activity.

There are two main types of ESI we perform at Nivens Spine Medicine:

Interlaminar Epidural Steroid Injection (IL ESI)

This technique is image guided for accuracy and delivers medication into the epidural space, allowing it to spread across several affected nerves. These injections are commonly used for spine and extremity pain.

Transforaminal Epidural Steroid Injection (TF ESI)

This approach targets a specific nerve root as it exits the spine. Using precise, image-guided techniques, Dr. Nivens directs the medication exactly where the inflammation is occurring. TF ESI is particularly effective for focused pain, such as sciatica or nerve compression on one side of the body.

Both injections are minimally invasive, performed under X-ray guidance for accuracy and safety, and typically completed in an outpatient setting.

Our dedication to providing cutting-edge, non-surgical treatment options brings us to the forefront of spinal health innovations. We look forward to serving your needs.

MILD® (Minimally Invasive Lumbar Decompression)

Chronic back or neck pain often starts with inflammation around the spinal nerves. Epidural Steroid Injections (ESI) are a trusted, non-surgical way to calm that inflammation and relieve pain caused by conditions like herniated discs, sciatica, spinal stenosis, or degenerative disc disease.

These injections deliver a powerful anti-inflammatory medication directly into the epidural space, the area surrounding the spinal nerves. By reducing swelling and irritation, patients often experience significant pain relief, improved mobility, and a better ability to participate in physical therapy or return to normal daily activity. For patients suffering from lumbar spinal stenosis (LSS), a narrowing of the spinal canal that puts pressure on nerves, the MILD® Procedure offers lasting relief without the need for traditional surgery.

Dr. Charles Nivens is the only certified MILD® Procedure specialist in the Lowcountry, providing this advanced, minimally invasive treatment to help patients stand longer, walk farther, and live with less pain.

The MILD® Procedure removes small pieces of bone and excess ligament tissue that cause pressure in the lower spine. This is done through a tiny incision, about the size of a baby aspirin, using specialized imaging guidance to ensure precision and safety. Because no general anesthesia, implants, or stitches are required, most patients return home the same day.

The goal of MILD® is to restore space in the spinal canal, allowing nerves to move freely again, relieving pain, numbness, and heaviness in the legs. Most patients notice gradual improvement in mobility and comfort over the following weeks, with little to no downtime.

Every MILD® treatment is part of a personalized care plan. Dr. Nivens carefully evaluates each patient’s spine condition and overall health to ensure the MILD® Procedure is the right fit. The result is real relief, faster recovery, and a return to the activities you love without major surgery.

Peripheral Nerve Stimulator (PNS)

The PNS system uses high frequency-electro magnetic Coupling technology to power an implanted neurostimulator. A small, external rechargeable transmitter supplies power and data through the skin. The device uses pulsed electric current to create an electrical field that acts on nerves to inhibit the transmission of pain signals to the brain.

Radiofrequency Ablation (RFA)

Radiofrequency Abalation of the Medial Branch Nerves is used to create a scar around the Medial Branch Nerves that supply the Facet Joints.This can significantly reduce pain from the joints for 6-12 months. Watch below as Dr. Charles Nivens shares more on this treatment.

Additional Treatments Available

Spinal Cord Stimulator (SCS)

Your solution for targeted pain relief. We offer the Freedom® Spinal Cord Stimulator System that helps relieve chronic intractable pain with placement of an implanted stimulator in the epidural space of the spinal column. This system utilizes pulsed electrical current to create an energy field that acts on nerves near the spinal column. The energy field generated intercepts the pain signals originating from nerves around the spine from traveling to the brain, functionally blocking the pain signal.

Genicular Nerve Block to the Knee

This procedure is used to treat patients with knee pain that cannot have knee replacement or have had knee replacement and are still having pain. Targeting the nerves that supply sensation to the knee, Dr. Nivens will try to block the sensation to the joint and therefore pain is reduced or resolved.

Electromyography (EMG) and Nerve Conduction Studies (NCS)

NCS evaluates the nerves electrically. The only way we can truly evaluate the functioning of our nerves is to apply electricity and evaluate the response. It does not cause significant pain but can be bothersome and tedious for some. The EMG is where we use a very small needle (similar to an acupuncturist’s needle) to directly evaluate the muscle cell of specific muscles and indirectly evaluate the corresponding nerve to that muscle.

Various Joint Injections

We can inject most orthopedic joints with the extremities for synovitis or bursitis. We perform X-ray guided Hip Joint, Sacroiliac (SI) joint, and Greater Trochanteric Bursal injections due to the depth in which these joints are found. We inject Carpal Tunnels for relief of pain and numbness due to Carpal Tunnel Syndrome. We also perform Viscosupplement (i.e. Synvisc, Hyalgan) knee joint injections.

What our clients are saying

This is an amazing office I had gotten the runaround from my primary for weeks about the pain. I was in the office which was extremely busy but they somehow slipped me in and taken care of my problem. I highly recommend him.

- Crystabel

Charles J Nivens, M.D. has helped me get my life back. I've suffered from debilitating back pain for years and thought the only solution was pain medication or surgery. I tried injections in the past with little success, but I'm so thankful I came to Dr. Nivens, I finally feel like myself again!

- Jordan