Conditions We Treat

Regenerative Medicine Candidates

Physician-led regenerative care — with an honest answer about whether it’s right for you.

The Diagnostic Difference

Regenerative Medicine Candidates is a symptom. The source is the answer.

Regenerative medicine holds real promise. Orthobiologics, platelet-rich plasma, and cellular therapies aim to support the body’s own capacity to repair injured tissue rather than merely suppressing inflammation. For the right patient, the results can be meaningful.

It has also become one of the most abused corners of medicine. The field has filled with franchises, med-spas, and non-physician operators marketing miracle cures the science does not yet support — often to people in pain who are vulnerable, desperate, and paying cash.

We take the opposite approach. National Pain Centers was an early, physician-led adopter of regenerative medicine, not a bandwagon follower. Every procedure is performed and overseen by a physician. And we will tell you, plainly, when regenerative therapy is not the right choice for you — even though saying yes would be more profitable.

It is worth being specific about how the exploitation works, because patients rarely see it. A clinic advertises stem cell therapy for arthritis. A seminar is held, often at a hotel or a restaurant. The person who evaluates you may not be a physician. The imaging, if any, is cursory. The price is quoted in the thousands, cash, and there is a discount if you commit today. Nobody mentions that your arthritis is bone-on-bone and that no injection will regrow cartilage.

Every element of that sequence is designed to convert hope into revenue before scrutiny arrives. And the people most susceptible are exactly those in the most pain, who have been told nothing more can be done, and who would try anything.

We don’t sell hope by the vial. For some patients, regenerative options are a genuinely valuable tool. For others, they aren’t the right choice — and we’ll say so.

The Ethics of Regenerative Medicine

Why we say no more often than the clinic down the street

We tell you what the evidence actually shows

We are candid about what is well-supported today, what is emerging, and what remains investigational. Some regenerative therapies have solid evidence for specific conditions. Others do not — yet. You will hear that distinction from us clearly, before you spend a dollar.

A physician performs your procedure

Not a technician, not a sales representative, not a nurse working under a franchise protocol. Dr. Joshi performs and oversees regenerative procedures personally, with image guidance and quality-controlled biologics.

We decline patients who aren't candidates

If your condition is unlikely to respond, or if a proven conventional treatment would serve you better, we will tell you and recommend that instead. Turning away a paying patient is the clearest test of whether a practice’s incentives are aligned with the patient’s.

We don't promise outcomes

No reputable physician can guarantee what regenerative therapy will do for you. Any clinic that does is telling you something about itself, not about the medicine.

Pain Generators

What can cause regenerative medicine candidates

Below are the conditions we most commonly identify and treat. Many patients have more than one contributing source at the same time — which is precisely why careful diagnosis matters.

Conditions Where Regenerative Options May Help

Tendon

Tendinopathy & Partial Tendon Tears

Rotator cuff, patellar, Achilles, and elbow tendinopathies — where degenerated tendon may respond to biologic approaches that support repair rather than simply blunting inflammation.

Joint

Mild to Moderate Osteoarthritis

Knee, hip, and shoulder arthritis in earlier stages, where the goal is to improve function and delay or avoid joint replacement in appropriate candidates.

Ligament

Ligament Injury & Joint Instability

Partial ligament injuries and mild instability, where targeted biologic treatment combined with rehabilitation may improve outcomes.

Spine

Selected Spinal & Sacroiliac Conditions

Certain facet, sacroiliac, and disc-related conditions in carefully selected patients.

Approaches We Offer

PRP

Platelet-Rich Plasma (PRP)

Concentrated platelets from your own blood, delivered precisely under image guidance to the injured structure. Among the best-studied regenerative approaches.

Orthobiologic

Orthobiologic Therapies

A range of biologic approaches selected to match the tissue and the pathology, always performed with image guidance and quality-controlled preparations.

Cellular

Autologous Lipoaspirate Stem Cells

Cellular therapy derived from your own tissue, offered to patients who want it, performed by a physician, with candid discussion of the current state of evidence.

Cellular

Exosome Approaches

An emerging area. We offer it, we do not market it, and we are explicit that it is emerging rather than established. Patients deserve that honesty.

When Regenerative Medicine Is Not the Answer

Honesty

Advanced, Bone-on-Bone Arthritis

When cartilage loss is severe, regenerative therapy is unlikely to deliver what a patient hopes for. We say so rather than take the payment.

Honesty

The Wrong Pain Generator

If the structure being injected isn’t actually the source of your pain, no biologic will help. Diagnosis comes first — always.

Honesty

When a Proven Treatment Exists

If a conventional, well-evidenced treatment would serve you better, that is what we recommend, even when it is less lucrative for us.

Honesty

When Expectations Cannot Be Met

If what you’re hoping for isn’t achievable, the ethical answer is to tell you before treatment, not after.

How to Evaluate Any Regenerative Provider

Question

Is a physician actually performing the procedure?

Not a technician, a nurse working under a franchise protocol, or a sales representative. Ask directly who will hold the needle, and what their training is.

Question

Is the injection image-guided?

A biologic placed near a structure rather than into it accomplishes nothing. Ask whether ultrasound or fluoroscopic guidance is used — and if the answer is no, ask why.

Question

Will they tell you when you're not a candidate?

Ask directly: “Under what circumstances would you tell me this isn’t right for me?” A provider who cannot answer that question has told you everything.

Question

Are outcomes promised or guaranteed?

No ethical physician guarantees regenerative outcomes. Guarantees, urgency, seminar sales, and discounts for same-day commitment are the recognizable signature of an operation optimized for revenue.

Important safety information

Regenerative therapies vary considerably in their level of clinical evidence. Some are considered emerging or investigational and are not FDA-approved for all uses. Be cautious of any provider promising a cure, guaranteeing results, pressuring you to decide quickly, or offering treatment without a physician’s evaluation. If you experience fever, spreading redness, severe swelling, or worsening pain after any injection, seek immediate medical care.

How We Find the Source

Diagnosis is a procedure, not a guess

Imaging alone rarely provides the answer. Findings of degeneration are extraordinarily common in people with no pain whatsoever — so an abnormal image doesn’t prove we’ve found the culprit. Conversely, some of the most treatable causes may not appear on imaging at all.

So we build the diagnosis from several converging sources:

01 — A genuinely thorough history and physical examination

Before any regenerative discussion, we determine what is actually generating your pain. A biologic injected into the wrong structure will never work — and the failure will be blamed on the therapy rather than the aim.

02 — Correlated imaging

Imaging interpreted against your symptoms and exam to characterize the tissue, the severity, and whether biologic treatment is plausible for your specific pathology.

03 — Virtual MSK Movement Assessment

Objective, wearable-free measurement of how you move — establishing a functional baseline before treatment and tracking whether you genuinely improve afterward, rather than relying on impressions.

04 — An honest candidacy conversation

We tell you what the evidence supports for your condition, what results are realistic, what it costs, and whether we think it’s the right choice. Sometimes that conversation ends with us recommending something else entirely.

This is the difference between treating a picture and treating a patient. We confirm the source before committing you to a therapeutic procedure.

Treatment Options

Precise, non-opioid, physician-performed care

Once we know the source, treatment can be targeted. Every procedure is performed personally by Dr. Joshi, using low-dose imaging, non-opioid sedation when appropriate, and hand-selected medications and products. We do not delegate procedures, and we do not use opioids as a treatment strategy.

Image-Guided Platelet-Rich Plasma (PRP)

Your own concentrated platelets, delivered precisely into the target tissue under image guidance — because a biologic placed near the pathology rather than into it accomplishes nothing.

Precision Matters

Every injection is image-guided and physician-performed, using low-dose, pulsed technique to minimize radiation exposure.

Orthobiologic Therapies

Selected to match the specific tissue and pathology, prepared with quality-controlled methods, and performed by a physician who has been doing this since before it was fashionable.

Autologous Lipoaspirate Stem Cells & Exosome Approaches

Offered to patients who want them, performed by a physician, with an explicit and honest discussion of what is established versus what remains emerging. We do not market these therapies. We make them available responsibly.

Why We Offer Them At All

Because if a patient is going to pursue these therapies, they are far safer doing so with an experienced physician who will tell them the truth than with a franchise selling a package. Our expertise is the safety argument.

Combined Interventional & Regenerative Strategy

Often the best plan pairs a precise interventional procedure addressing the pain generator with a regenerative approach supporting tissue repair — and always with rehabilitation.

Rehabilitation as an Essential Component

A biologic injected into a structure with unchanged mechanics is a temporary measure. Our multi-disciplinary team, including chiropractic and musculoskeletal expertise, builds rehabilitation into every regenerative plan.

Diagnostic Work Before Any Regenerative Discussion

We determine what is actually generating your pain first — with examination, correlated imaging, and diagnostic blocks where appropriate. A biologic aimed at the wrong structure fails, and the failure gets blamed on the therapy rather than the aim.

Conventional Treatment When It Serves You Better

If a well-evidenced conventional treatment would help you more, that is what we recommend — even though it is less lucrative for us. This is not a difficult ethical question. It is simply the job.

We don't rush to implant

A spinal cord stimulator is a legitimate tool for the right patient at the right time. But it’s an implant, and we treat it as a genuine last resort — not an early default reached for after a couple of quick attempts. First we find the root cause, address it, and rehabilitate it. Only when the better options are truly exhausted do we consider going there.

The National Pain Centers Difference

The same procedure is not the same procedure

Two practices can list the same procedure on a website and deliver profoundly different experiences, risks, and outcomes. Here is what changes when the details are done right.

Performed personally by Dr. Joshi

Never delegated to a technician, resident, or rotating staff. You’re treated by the physician who developed and teaches the technique — and in image-guided procedures, the difference between physicians is measured in millimeters.

Dramatically less radiation

Pulsed, low-dose imaging and a few precisely targeted spot images instead of continuous live X-ray. Based on our own procedural dose data, this reduces radiation exposure by at least 50% — and often far more — versus conventional continuous fluoroscopy, with no compromise in accuracy. For conditions treated repeatedly over years, that difference compounds.

Non-opioid sedation

When sedation is used, we use ketamine-based sedation, not fentanyl. Opioid sedation exposes you to unnecessary opioids, can complicate workplace drug testing, and can actually increase pain sensitivity. Ketamine can do the opposite.

Smaller needles, tissue-sparing lesions

Precision means we don’t need to be destructive to be effective — smaller-gauge needles and lower-temperature, longer-duration ablation that spares the healthy tissue around the target.

We actually numb you first

Thorough local anesthesia of skin and underlying tissue before the procedure begins. It takes an extra minute. We take it.

Independent, and obsessive about quality

Nearly four out of five U.S. physicians now answer to a corporate owner. We’re physician-owned, so our only incentive is your outcome. What a practice refuses to do tells you as much as what it offers.

Common Questions

Regenerative Medicine Candidates, answered

Through an actual physician evaluation — history, examination, correlated imaging, and an honest conversation. Candidacy depends on what tissue is involved, how severe the damage is, and whether the structure being treated is truly generating your pain. Any clinic that offers you regenerative therapy before determining that is selling, not treating.

Yes, and we do it regularly. If your arthritis is too advanced, if the target isn’t the actual pain generator, or if a proven conventional treatment would serve you better, we will tell you — even though saying yes would be more profitable for us.

Regenerative therapies vary considerably in their evidence and regulatory status; some are considered emerging or investigational and are not FDA-approved for all uses. We say that plainly rather than obscuring it, and we do not market these therapies. Be very cautious of any provider who implies otherwise.

Because it is cash-pay, largely unregulated in practice, and marketed to people in pain who are willing to try anything. The three questions worth asking anyone: Is a physician actually performing it? How many years have they done it? Will they tell you when it’s not right for you?

No, and no ethical physician can. Individual results vary. Any clinic guaranteeing outcomes from regenerative therapy is telling you something important about themselves.

We were physician-led early adopters rather than bandwagon followers. Every procedure is performed and overseen by a physician with image guidance and quality-controlled biologics. We are candid about evidence, we decline inappropriate candidates, and we build rehabilitation into every plan.

Because it’s true, and because a practice whose incentives are aligned with its patients will say so. Turning away a paying cash patient is the clearest available test of that alignment. We do it regularly.

Four: Is a physician performing the procedure, and what is their training? Is the injection image-guided? Under what circumstances would you tell me I’m not a candidate? What does the evidence actually show for my specific condition? The answers, and the willingness to give them, tell you what you need to know.

Generally not — most regenerative therapies are elective and paid out of pocket. That cash-pay dynamic is precisely why the field has attracted operators whose interests are not aligned with patients’, and precisely why the physician performing your care matters so much.

Find out what's actually causing your pain.

A precise diagnosis is the beginning of a real solution. Let’s find your pain generator — and treat it.

This page is provided for general educational purposes and does not constitute medical advice, diagnosis, or treatment, nor does it create a physician-patient relationship. Individual results vary, and no specific outcome is promised or guaranteed. Radiation-reduction figures reflect National Pain Centers’ own procedural dose data compared with conventional continuous-fluoroscopy technique. Certain regenerative therapies are considered emerging or investigational and are not FDA-approved for all uses. Always consult a qualified physician regarding your medical condition. If you are experiencing a medical emergency, call 911.

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