Patient Edition Jun 2026 Doc 005 · Ed. 01

§ 005 · Free patient resource

The aftercare guide.

Medically reviewed by the Celva medical team · June 2026

How to recover after MSC therapy, across every condition we treat. The universal first 72 hours, then the specifics for joint, systemic IV, and neurologic care, including the cases where protocols stack.

§ What's inside

01The recovery curve and the universal first 72 hours
02The golden rules: medication, hydration, load
03Joint and orthopedic, every region we treat
04IV and systemic: longevity, recovery, post-event
05Neurologic and complex conditions
06Combined protocols, follow-up, and when to call

§ 00 · Orientation

Read first · 3 min

About this guide

Two layers to every recovery.

Whatever brought you to Celva, a worn knee, a systemic IV program, or a neurologic condition, recovery has two layers. The first is universal: the same biological response follows a broadly predictable curve for everyone. The second is specific to your track, with its own rules, protected window, and timeline.

Read the universal pages first (§ 01 and § 02), then turn to the section for your track. If your case combines protocols (bilateral, multi-region, or an IV add-on), the combined-protocols page (§ 06) tells you what stacks.

Find your track

03 Joint and orthopedic. An image-guided injection to a knee, hip, shoulder, spine, hand, or foot, with or without a systemic IV adjunct. § 03
04 IV and systemic. A systemic infusion for longevity, athletic recovery, or recovery after surgery, illness, or a post-viral event. § 04
05 Neurologic and complex. A measured, evaluation-first program tracked over twelve months, with your own specialists kept informed. § 05

§ The one rule above all others

"Your written discharge instructions are specific to you and always take precedence over this guide. Where the two ever differ, follow the discharge sheet and call your coordinator."

Medical disclaimer

This guide is for informational purposes only. It does not constitute medical advice, diagnosis, or treatment recommendations. All aftercare decisions are made by licensed physicians at Hospital Angeles, Tijuana. Individual recovery varies by indication, baseline severity, and biology.

Section one

01

§ The shape of recovery

§ 01 · Applies to all tracks

The curve, and the first 72 hours.

Response is neither linear nor immediate. The first weeks often feel quiet on the validated scores even while sleep and energy are already shifting. That early stretch is part of how the cells work, not a sign that they aren't.

Fig. 01 · Typical outcome trajectory over time The same broad shape across tracks

Typical post-MSC response Untreated trajectory (flat baseline)

Wk 1 · Settle

The early days

For IV, sleep often improves first, then energy. For an injection, the site is usually sore before it is better. A smaller group feels a brief flu-like reaction in the first 24 to 72 hours. All of it is physiology settling.

Wk 2 – Mo 2 · Build

The quiet stretch

Sleep and energy keep improving, but the validated scores have not moved yet. The hardest phase psychologically. The work is happening at tissue level.

Mo 2 – 4 · Signal

First real change

The first genuine change on validated scores. Pain falls, function and sleep improve. Subtle, then unmistakable. The steepest gains usually land in the two-to-five-month range.

Mo 4 – 9 + · Durable

Gains consolidate

The trajectory settles at a new, higher level and many patients keep building gently past month nine. This is your durable response window.

The first 72 hours, hour by hour

0–6 hTake it easy and hydrate. For an injection, rest the treated area; a mild ache or pressure at the site is normal. Do not test the joint's range.Protect
6–24 hHydrate heavily, eat normally. Light, gentle movement is fine and helpful. A pull toward rest by evening is common and expected.Hydrate
24–48 hStay light. Short walks and normal daily tasks. No loaded or repetitive use of a treated joint. Acetaminophen only if you need pain relief.Easy
48–72 hMost patients are back to baseline. Begin gentle, pain-free range of motion. Hold off on real loading until your region's window opens.Ease in

Section two

02

§ Protect the signal

§ 02 · Medication, load, and habits

Five rules that protect the result.

The cells work by signaling, and a handful of common habits quietly blunt it. These five rules apply no matter what we treated.

Rule 01 · The single most important one

No NSAIDs for at least the first two weeks. Ibuprofen, naproxen, aspirin, and the rest blunt exactly the inflammatory signaling the cells rely on. Use acetaminophen for pain. Your discharge sheet gives the exact window for your case; when in doubt, call before you take anything.

Load and movement

Rules 02 – 03

Protect, do not immobilize. Gentle pain-free motion beats total rest. Stiff joints recover worse.
No loaded or high-impact use of a treated joint until its window opens (see your region).
Let pain be the governor. If a movement hurts the joint, it is too soon. Back off and try again in a few days.

Hydration and habits

Rules 04 – 05

Hydrate hard for the first 48 to 72 hours. It measurably eases the early fatigue.
No alcohol for 72 hours, and no strenuous exercise for 48 to 72 hours.
Smoking dampens the response. If you smoke, this is a good window to ease off.
Keep a brief daily journal. The contrast between week 8 and week 14 tells you more than any single day.

For pain and swelling, in order of preference

1stAcetaminophen (Tylenol). The preferred analgesic. It does not interfere with cell signaling. Stay within the labeled daily limit.Preferred
2ndBrief ice, for comfort. Ten to fifteen minutes at a time is fine for swelling. Avoid prolonged, aggressive icing.As needed
AvoidNSAIDs and systemic steroids. Both suppress the response. Do not restart a daily anti-inflammatory without clearing it with your physician.2 weeks +

Supplements

Some anti-inflammatory supplements (for example high-dose fish oil or turmeric and curcumin) act on the same pathway as NSAIDs. Tell your physician about everything you take so they can advise you on what to pause and when.

Section three

03

§ Knee · Hip · Foot

§ 03 · Weight-bearing joints

The joints that carry you.

Lower-body joints take your weight with every step, so the protected window is about load, not rest. Walk early and often; defer impact, depth, and distance. These windows assume the universal rules on § 02 are being followed, especially no NSAIDs.

KKneeIntra-articular OA · meniscus · post-injury

Protected: 48–72 h off your feet beyond light walking. No deep squats, kneeling, or unnecessary stairs.
Green-lit: Flat walking, gentle pain-free bend and straighten, stationary cycling without resistance after day 3.
Hold off: Running, jumping, deep squats and lunges, and downhill loading for 2 to 4 weeks.
Back to normal: Strengthening around week 2; impact and sport reintroduced gradually from week 4 to 6.

HHipIntra-articular OA · labrum · image-guided

Protected: 48–72 h light only. The hip is deep; give it the same respect as the knee even if it feels fine.
Green-lit: Level walking, easy standing, gentle hip flexion to a pain-free range. Change position often.
Hold off: Prolonged sitting over 45 minutes, end-range stretching, running and impact for 2 to 4 weeks.
Back to normal: Light work around week 2; longer walks build through weeks 3 to 4; fuller activity by week 6 for most.

FFoot & ankleAnkle OA · plantar fascia · Achilles

Protected: 48–72 h, weight-bearing as tolerated in supportive shoes. Tendon cases protect longer.
Green-lit: Short flat walks in cushioned, supportive footwear; gentle ankle circles within comfort.
Hold off: Barefoot walking, high heels, running and jumping. Achilles and plantar cases: 4 to 6 weeks before impact.
Back to normal: Progressive loading is the goal for tendons. A slow, graded return guided by symptoms, not the calendar.

Read together

The single biggest mistake in weight-bearing recovery is doing too much, too soon, on a joint that feels fine in week one before the quiet stretch has fully passed. Your written discharge instructions set the exact limits for your case.

Section three · cont.

03

§ Shoulder · Hand · Spine

§ 03 · Upper-body and axial joints

Reach, grip, and the spine.

These joints are not carrying your weight, so the protected window is about leverage and reach: overhead load, hard gripping, twisting and lifting, rather than standing or walking.

SShoulderRotator cuff · glenohumeral OA · biceps

Protected: 48–72 h with the arm relaxed at your side. A sling is usually not needed; gentle motion is better.
Green-lit: Pendulum swings, elbow and wrist movement, pain-free reaching below shoulder height.
Hold off: Overhead reaching and lifting, heavy pushing or pulling, sleeping on the side for 2 to 4 weeks.
Back to normal: Guided range of motion around week 2; strengthening from week 4; overhead load last, only once pain-free.

WHand & wristThumb CMC · finger OA · tendinopathy

Protected: The hand is functional in 24 to 48 h. Mild soreness at the injection site is normal. Splint only if instructed.
Green-lit: Typing, light daily tasks, gentle open and close of the fingers within comfort.
Hold off: Hard pinch and grip, jar-opening, heavy or repetitive gripping for 1 to 2 weeks.
Back to normal: Grip-strengthening from around week 2; pinch and grip dynamometry tracked at follow-up.

BSpine, neck & backFacet · disc · post-surgical

Protected: 48–72 h easy. No bed rest; gentle walking is the single best thing for the spine.
Green-lit: Frequent short walks, good posture, changing position often, pain-free gentle mobility.
Hold off: Heavy lifting, twisting under load, end-range bending, and prolonged sitting for 2 to 4 weeks.
Back to normal: Core and posture work from around week 2; graded return to lifting once symptoms are settled.

Nerve note

Nerve-driven pain is different. If your symptoms are radiating numbness, tingling, or weakness down an arm or leg rather than joint pain, flag it at follow-up. That pattern may need a different tool, and it changes what counts as a normal recovery.

Section four

04

§ Longevity · Recovery · Post-event

§ 04 · IV and systemic infusion

The infusion that works everywhere.

There is no procedure site to protect and no recovery room. IV recovery is entirely systemic. You walk out the same day, and the whole job of aftercare is to protect the signal and let the early days pass.

LLongevityProactive maintenance · 45–70

Expect: Mild fatigue the same evening for some; sleep often improves first. Back to yourself by day 2. Nothing to immobilize.
Green-lit: Resume normal life immediately: work, travel, light movement, gentle exercise.
Hold off: Strenuous training and alcohol for 48 to 72 h; NSAIDs and anti-inflammatory supplements for two weeks.
Re-test: CRP, HOMA-IR, and ApoB re-drawn at follow-up. Sleep and recovery tend to shift first, around weeks 2 to 4.

RRecoveryAthlete · operator · high load

Expect: A heavier pull toward rest is common at high training load. Legs may feel flat for 2 to 3 days.
Green-lit: Easy movement, mobility, sleep. Hydrate aggressively; it eases the early fatigue measurably.
Hold off: Hard sessions, PR attempts, and contact for 3 to 5 days. Do not mask soreness with NSAIDs.
Return: Graded back to full volume across weeks 1 to 2. Let recovery markers, not the calendar, lead.

PPost-eventAfter surgery · illness · long COVID

Expect: The gentlest curve. Fatigue can linger; watch for post-exertional malaise.
Green-lit: Pace and rest. Gentle daily activity kept inside a comfortable energy envelope.
Hold off: Pushing through fatigue, over-scheduling, and alcohol for several days. Do not chase a fast rebound.
Return: Slow and symptom-led. Coordinate any medication changes with your treating physician.

The systemic difference

With no joint to guard, hydration is your single biggest lever in the first 72 hours. If your IV was paired with a joint injection, follow your region's loading window too. See § 06 for how the two stack.

Section five

05

§ MS · dysautonomia · post-viral · post-stroke

§ 05 · Neurologic and complex conditions

A different rhythm entirely.

Neurologic care is not a single procedure with a curve. It is an evaluation-first, systemic IV program measured against structured scales and tracked in writing over a full year. Response is slower, subtler, and never assumed.

What to expect between reads

Mo 3First structured check-in. We re-run your scales and a functional measure such as a six-minute walk. Subtle change at most this early is expected, not a failure.Read 01
Mo 6Mid-window read. Scales tracked again at 180 days, with labs re-checked. We compare honestly against your baseline.Read 02
Mo 9–12Definitive read. Scales at 360 days drive the decision: maintenance, a trial, or stopping. A further dose is never automatic, and often the honest answer is no.Decision

Medications and your specialists

§ Keep your own doctors in the loop

Keep every neuro medication and disease-modifying therapy exactly as prescribed.
Change nothing without your treating specialist, not even on a good week.
We do not require your specialist's sign-off, and we give you your full records to share with them.
Dysautonomia: hold your hydration, salt, and compression routine; expect some transient fluctuation.

The first days after an IV

§ Same systemic care as § 01

Hydrate well and rest. A pull toward rest in the first 24 to 72 hours is common.
The universal rules still apply: no NSAIDs, easy movement, no alcohol for 72 hours.
Track symptoms in a simple daily line. Patterns over weeks matter more than any single day.

§ The line that matters most

MSC therapy here is an adjunct, not a replacement. Do not stop your disease-modifying therapy or neuro medications. The cells work alongside your existing care, never instead of it.

Section six

06

§ Bilateral · multi-region · IV

§ 06 · Combined and layered protocols

When your case is more than one thing.

Many patients are treated on both sides, in more than one place, or with a systemic IV the same day. The rules do not change. They stack.

01
Bilateral, both sides treated.
Both joints are in their protected window at once, so you have no good side to lean on. Plan for slower mobility, more help at home, and a deeper fatigue dip in week one.
02
Multi-region, for example knee plus shoulder.
Follow the most conservative window that applies to any joint treated. Stage your return; bring back one region at a time rather than testing everything at once.
03
Combined IV and joint injection.
The local rules for your joint still apply, and the IV adds a stronger systemic response. Expect more fatigue and a flu-like feeling for 24 to 48 hours. Hydrate harder than a joint-only patient.
04
Autoimmune or inflammatory overlay.
If you have an autoimmune condition such as rheumatoid arthritis or lupus, adjust immunomodulators only as your physician directs and watch for flare patterns. Report changes promptly; these cases are followed more closely.
05
Previously operated joints.
Hardware, scar tissue, and altered anatomy mean a more conservative window and a slower, gentler return.

What stacks up

§ More treated, more response

Bigger fatigue dip. More cells and more sites means a stronger week-one systemic response.
Slower mobility. Two protected joints take longer to move around than one.
More at-home support for the first 48 to 72 hours is worth arranging in advance.

What does not change

§ The rules still hold

No NSAIDs, still the rule, across every site treated.
No pushing through joint pain; pain is still the governor on each joint.
No second program elsewhere during the quiet stretch.

§ The simple heuristic

When more than one thing was treated, follow the strictest window of all of them, give yourself an extra day of rest, and bring activity back one joint at a time.

Section seven

07

§ The schedule and the safety net

§ 07 · Follow-up and when to call

Follow-up, and when to call us.

Follow-up, by track

JointStandardized scoring at 4, 8, and 12 months (6 and 12 for the slower-responding spine and foot), using scales such as KOOS, QuickDASH, VAS, and pinch and grip. Imaging is repeated about annually.4 / 8 / 12 mo
IVBiomarkers re-checked at six and twelve months (CRP, HOMA-IR, ApoB). Most patients maintain with one to two infusions a year.1–2× / yr
NeuroStructured scales at 90, 180, and 360 days, with reads at month 3, month 6, and month 9 to 12, plus labs at 6 and 12 months. A second dose is discretionary, never automatic.12-month arc

§ You are not on your own

Every patient gets a coordinator check-in during the first week. The after-hours line goes to a real person, not a queue.

What is normal, and what isn't

§ Call your physician if any of these appear. They are not part of the curve.

High fever

Over 38.5 °C / 101.3 °F. A mild low-grade temperature in week one is normal; a true fever is not.

Chest pain or breathlessness

Any chest pain or new shortness of breath, especially in the first 72 hours. Emergency care first, then us.

Hot, spreading redness

Expanding redness, warmth, or discharge at an injection or IV site past day three needs evaluation.

Severe joint swelling

Marked swelling, heat, and pain in a treated joint that escalates rather than settling after day 3 to 4.

Worsening past week 4

Real, escalating decline into month two, not the quiet stretch. Rare, but worth a call.

New neurological signs

Numbness, weakness, vision change, or confusion at any point. Almost certainly unrelated, worth ruling out.

How to reach us

For anything urgent, call local emergency services first, then notify Celva once you are stable. Your aftercare packet has your case physician's number and the 24/7 clinical line. For non-urgent questions, your coordinator is the fastest route.

§ Keep going

The recovery is yours to protect.

Follow the universal rules, respect your track's window, and let the curve do its work. The patients who get the best result are almost always the ones who knew the shape of recovery before it started.

01 · Track

Keep the journal.

A line a day. The contrast between week 8 and week 14 is the clearest read on whether the cells are working.

The recovery timeline →

02 · Ask

Call, don't guess.

If something feels off, or you are simply unsure whether it is normal, the clinical line is there for exactly that.

Contact us →

03 · Return

Keep your follow-ups.

The scheduled assessments are how we know it worked, and how we time any maintenance dose.

Plan your follow-up →

celva.com Recovery: the timeline Questions: contact us

Celva · Hospital Angeles, Tijuana · Physician-led regenerative medicine

This guide is for informational purposes only and does not constitute medical advice, diagnosis, or treatment recommendation. Your written discharge instructions take precedence. Individual results may vary. These therapies are not FDA-approved. All treatment is performed in Mexico by licensed physicians at Hospital Angeles, Tijuana, regulated by COFEPRIS. © 2026 Celva.