Regenerative Medicine FAQs

Most treatments focus on managing symptoms. Regenerative medicine focuses on helping your body heal the underlying injury. Instead of masking pain, we use your body's own healing cells and growth factors to support tissue repair, improve function, and potentially help you avoid more invasive treatments like surgery. The goal isn't just to feel better temporarily. It's to help the damaged area function better over the long term.

A cortisone injection is designed to reduce inflammation and pain, which can be very helpful in the right situation. It does not repair damaged tissue, though, and when used repeatedly it may even have negative effects on tissue health. Regenerative treatments work differently. They deliver concentrated growth factors and healing signals that help the body recruit repair cells, improve blood flow, and support healing within injured tissues.

Pain is often a symptom of tissue dysfunction. While cortisone can quiet the pain signal, regenerative medicine aims to improve the health of the tissue itself, which may lead to more durable improvements in pain and function.

Every patient is different, so the plan starts with understanding the diagnosis, the severity of tissue damage, your goals, and what you have already tried. PRP is often a great option for mild to moderate injuries and inflammation. Bone marrow derived stem cells may be more appropriate for advanced degeneration or complex cases. Shockwave therapy can help stimulate healing and improve blood flow, especially in chronic tendon injuries, while MLS laser therapy can reduce pain and inflammation and support recovery.

In many cases the best results come from combining treatments, because healing is multifaceted. The key is a personalized plan rather than the same approach for every patient.

PRP alone is often an excellent option for milder rotator cuff tendinopathy and small partial tears. For more significant tissue degeneration, larger partial tears, prior treatment failures, or high-demand patients looking to maximize healing potential, I may recommend adding bone marrow derived stem cells.

Age and activity level do play a role. An active athlete in their 40s with a substantial partial tear may benefit from a more robust biologic approach than a less active patient with mild tendinopathy. Ultimately the decision is based on the severity of tissue damage, healing goals, and your overall health and activity demands.

For many patients the confusion comes from marketing. Bone marrow derived stem cells are not a magic cure, and this is not about growing a brand-new shoulder. It is a concentration of your body's own repair cells, growth factors, and signaling molecules designed to support the natural healing process.

I encourage patients to be skeptical and to focus on the diagnosis, the quality of the procedure, and the available evidence rather than the advertising. The goal is not to regenerate an entirely new tendon or joint, but to improve the biologic environment, reduce pain, enhance function, and potentially delay or avoid more invasive treatments in the right candidate. Setting realistic expectations is one of the most important parts of the consultation.

Many patients hear terms like PRP, bone marrow derived stem cells, or regenerative medicine and assume they're all the same, but they're not. PRP uses your own blood, concentrates healing growth factors, and is often excellent for tendon injuries, ligament issues, and mild to moderate arthritis. Bone marrow derived stem cells offer a more advanced biologic approach that provides not just healing signals but additional cellular support, making them better suited for more complex degeneration or advanced cases.

The biggest difference in outcomes often comes down to patient selection, biologic quality, and precision in how and where the treatment is performed.

MLS laser therapy is a form of light-based treatment that works at the cellular level, not just by heating tissue. The goal is to stimulate the body's own repair and recovery systems using specific wavelengths of light energy.

MLS laser therapy is often most helpful when tissue is irritated, inflamed, overworked, or healing slowly, especially in muscles, tendons, ligaments, joints, and nerves. PRP helps provide biologic signaling and growth factors, while MLS laser may help optimize the tissue environment by improving circulation and calming inflammation. Shockwave stimulates the tissue mechanically, while MLS helps the tissue recover and respond more efficiently.

In our practices, shockwave is used to stimulate, and MLS is used to calm and support healing between sessions.

Pain is often a signal that tissue is irritated, inflamed, overloaded, or not healing properly. If we only numb the pain temporarily without improving the health of the tissue, the problem often keeps coming back. Cortisone can sometimes reduce inflammation quickly, but repeated use may not improve tissue quality long term. Anti-inflammatory medications may help symptoms temporarily, but they do not directly stimulate healing. Rest alone can calm things temporarily, but chronically injured tissue often becomes weaker and stiffer without active recovery.

MLS laser therapy works differently because it attempts to improve cellular energy production, enhance circulation and oxygen delivery, reduce inflammatory signaling, and support tissue recovery rather than simply masking pain. So instead of asking how we block the pain, the question becomes why the tissue is failing to recover.

The injection provides the biologic material and healing signals, while the MLS laser helps create a healthier environment for the tissue to respond and recover. PRP and bone marrow derived stem cells deliver growth factors and signaling cells, stimulate tissue repair, and support regeneration in damaged tendons, ligaments, joints, discs, and soft tissue.

But even after a regenerative injection, the surrounding tissue environment still matters. Many chronic injuries involve poor circulation, chronic inflammation, scar tissue, and a slowed healing response. That's where MLS laser therapy may complement the injection by helping improve microcirculation, increase cellular energy production, reduce inflammatory mediators, and support recovery.

Every shoulder pain patient undergoes a detailed evaluation, including a physical exam, diagnostic ultrasound, and imaging review when needed. The goal is to identify the exact source of pain before considering treatment. Ideal candidates have tendon, ligament, labral, or arthritic conditions that have not responded to conservative care.

Patients with complete tears requiring surgery, active infection, or severe joint destruction may not be appropriate candidates for regenerative treatment.

Regenerative injections help provide the biologic building blocks for healing, while MLS laser therapy creates a more favorable healing environment. In practice, we often perform the injection and then use MLS laser treatments over the following weeks to help reduce inflammation, improve circulation, support cellular metabolism, and enhance tissue recovery.

The goal isn't simply pain relief. It's to optimize the body's healing response. While an injection addresses the injured tissue directly, MLS laser can help accelerate and support recovery, which is why we frequently use them together in appropriate patients.

Recovery after regenerative treatment is generally much easier than recovery after surgery, but healing still takes time. Most patients experience some soreness or an increase in symptoms for several days after the procedure as the body's healing response begins. Over the first few weeks we focus on protecting the treatment area, restoring motion, and gradually increasing activity.

Unlike surgery, there are no incisions, no implants, and typically no prolonged immobilization. Most patients can continue many of their normal daily activities within days, while meaningful improvements often develop gradually over the following weeks to months as the tissue heals. Surgery often requires a long rehabilitation period to recover from the procedure itself, whereas regenerative treatments are designed to stimulate healing with significantly less downtime.

Ideal candidates are patients who are willing to actively invest time and effort into their recovery. Successful outcomes often require more than the procedure itself. They typically involve a comprehensive approach that includes optimized nutrition, appropriate rehabilitation, and adjunctive therapies such as laser therapy and shockwave treatment when clinically indicated.

That said, not every condition is best treated with regenerative approaches. If imaging demonstrates a full-thickness tear, or if the exam reveals concerning neurologic findings such as progressive weakness, significant numbness, or loss of function, the most appropriate next step may be prompt surgical consultation.

Treating chronic knee or hip degeneration is not about a one-time injection. It's a structured recovery process. We start with a detailed evaluation to identify the true pain source and determine whether regenerative treatment is the right fit. If appropriate, we create a personalized plan that may include precision image-guided treatment, pre- and post-procedure optimization with nutrition, shockwave, and laser therapy, and recovery support to help the tissue heal.

Recovery is actively monitored with weekly follow-up and adjustments focused on getting you back to moving better, hurting less, and avoiding surgery whenever possible.

Being a Regenexx Core Provider means I have completed advanced training in image-guided regenerative orthopedic procedures and follow strict protocols designed to maximize safety, accuracy, and consistency. Regenerative medicine is highly technique-dependent. The quality of the biologic product, the way it's processed, and most importantly the precision of where it's placed can significantly impact outcomes.

At Regenexx, procedures are performed using advanced imaging guidance to accurately target the structures causing pain rather than simply injecting a general area. Patients also benefit from protocols refined over many years, ongoing physician education, and participation in one of the largest regenerative medicine outcome databases. It's not just about what is injected. It's about how, where, and why it's done.

It changes the approach significantly, because it's not simply about offering PRP or adding regenerative medicine as another menu item. It's about following a structured, diagnosis-driven, precision-based treatment philosophy. A lot of clinics advertise PRP or even bone marrow derived stem cell treatments, but the term alone tells you very little about the quality of care.

The difference starts with evaluation and patient selection, and Regenexx emphasizes highly targeted image-guided treatment.

It really depends on the treatment and on your specific condition, since the number of sessions varies quite a bit from one therapy to the next. There is no single answer that fits everyone. The best way to get an accurate sense of your timeline is a consultation, where Dr. Etelzon can review your situation and walk you through what to expect for the approach that is right for you.

The biggest surprise is usually not the pain relief. It's getting their life back. Patients come in hoping their pain will improve, but what they often don't expect is being able to return to activities they had quietly given up on. I've had patients get back to golfing, hiking, playing tennis, traveling comfortably, exercising, getting down on the floor with their grandchildren, or simply walking without constantly thinking about their pain.

One of the most rewarding moments is when a patient tells me they stopped doing something years ago because they thought they'd never be able to again. That's the goal. Not just reducing pain scores, but restoring function, confidence, and quality of life.

One case that has stayed with me was a 70-year-old gentleman who came in with years of severe lower back pain and a visibly curved posture. He simply couldn't stand upright comfortably anymore. After a detailed exam and careful review of his imaging, I felt he was an appropriate candidate for a regenerative approach and proceeded with a targeted bone marrow derived stem cell and PRP treatment for his lower back.

What surprised even me was how quickly he responded. Within 24 hours he was standing upright, and his wife said he looked taller. Over the following days and weeks his pain continued to improve, he no longer relied on pain medication, and eventually he was able to return to playing soccer, the sport he had loved since childhood but had given up because of his pain. What made the difference was selecting the right patient, identifying the true pain generators, and treating the problem precisely rather than simply masking symptoms.

Great care only works if the patient truly understands the plan. For patients with language barriers or limited health literacy, we simplify medical language, use visual explanations like imaging or anatomy models, and provide translation support when needed.

One technique I rely on consistently is the teach-back method, asking the patient to explain the plan back to me in their own words. If they can clearly tell me what the diagnosis is, what we're doing, and what happens next, I know we're aligned.