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Functional milestones Functional improvements often tell you more than pain scores alone: Walking distance without symptom increase Sitting tolerance (minutes before symptoms worsen) Ability to perform previously limited activities Sleep quality (reduced nighttime symptoms indicate improvement) Medication usage (decreasing NSAID use is a positive sign) When to adjust the protocol If there is no improvement after 3 to 4 weeks on a BPC-157 only protocol, consider adding TB-500 for systemic support

Conflict of interest The authors declare that there is no conflict of interest

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