Condition · Spine
Back & neck pain: non-surgical and regenerative spine care in Orlando
An MRI report is not a diagnosis. Dr. Chantasi — board-certified in Physical Medicine & Rehabilitation and Pain Medicine — works out which structure is producing your pain, then explains which options, from rehabilitation to PRP to surgery, are worth your time.
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Is stem cell therapy an option for back pain?
Short answer
For selected patients with a clearly identified source — such as a facet joint, the sacroiliac joint or spinal ligaments — PRP or, less often, a cell-based product may be discussed. The evidence is early and mixed, no stem cell product is FDA-approved for back or neck pain, and no injection has been shown to reliably rebuild a degenerated disc. Exercise-based care remains the foundation.
Most back and neck pain improves with time and active care. When it does not, the reason is often that the pain source was never pinned down. Facet-joint irritation, muscle guarding and a nerve-root problem can all occur together, and each calls for something different.
Seek prompt medical care — not a scheduled consultation — for:
Progressive leg or arm weakness, loss of bowel or bladder control, numbness in the groin or “saddle” area, fever, unexplained weight loss, severe pain after trauma, or rapidly worsening neurological symptoms. In an emergency, call 911.
Common presentations
Five common sources of spinal pain
Each behaves a little differently. The pattern of your symptoms is often more informative than the scan.
- 01
Facet joints
The small paired joints at the back of each vertebra. Typically a local ache in the neck or low back, stiffness in the morning, and pain with leaning back or twisting. Arthritis here is common with age.
- 02
Sacroiliac joint
Where the pelvis meets the base of the spine. Pain sits low, often to one side, and can spread into the buttock, groin or upper thigh. Several conditions mimic it, so careful examination matters.
- 03
Discs
Discs lose water and height with age, injury and genetics. Degeneration does not always hurt; when a disc is the source, pain tends to worsen with sitting and bending. Regenerative procedures have not been established as a way to restore a damaged disc.
- 04
Nerve roots
Radiculopathy — sciatica in the leg, or arm pain from the neck — often burning or electric, sometimes with numbness or weakness. The neurological exam guides how urgent it is. Nerve pain outside the spine is evaluated differently.
- 05
Muscles & ligaments
Strain, myofascial pain and spinal ligament problems, often layered on top of one of the above. Usually the most responsive to rehabilitation and posture and movement training.
Physician evaluation & diagnosis
Why the imaging report is only part of the answer
In pain-free adults, disc degeneration shows up on imaging in more than a third of 20-year-olds and in the large majority of 80-year-olds.1 A finding is a clue, not a verdict.
History & neurological exam
Where the pain travels, what provokes and eases it, strength, reflexes, sensation and gait — plus what has already been tried. This is the PrimeCell Candidacy Assessment, performed by the physician.
Imaging, read against the exam
X-ray and MRI findings are matched to your symptoms. New imaging or nerve studies are ordered only when the result would change the plan.
Diagnostic injections, when needed
If the source is still uncertain, a targeted, image-guided test injection can help confirm whether a specific joint is responsible before anything more involved is considered.
Care categories
From rehabilitation to biologics — in that order
A plan is built around the pain source. Depending on the finding, some steps are performed at PrimeCell and others are coordinated with a therapist, your primary care physician or a spine surgeon.
- 01
Active rehabilitation
Standard care
Exercise, core or cervical stabilization, posture and movement training, and other non-drug therapies. The American College of Physicians recommends starting chronic low back pain care here.2
- 02
Medication
FDA-approved
Anti-inflammatories when rehabilitation alone is not enough, and other medicines selected for your health history. Opioids are not a long-term answer.
- 03
Injections performed at PrimeCell
FDA-approved drugs
Trigger-point injections, peripheral nerve blocks, small and intermediate joint injections and other ultrasound-guided soft-tissue injections, matched to a confirmed source.
- 04
PRP, PRF & prolotherapy
Off-label
Considered for facet joints, sacroiliac joints, ligaments and paraspinal soft tissue when the source is clear. Image guidance is used because nerves and blood vessels sit close by.
- 05
Cellular & exosome products
Not FDA-approved
Umbilical-cord-tissue-derived stem cell injections, perinatal (birth-tissue) allograft injections and exosome products are investigational for every spinal use, including discs. Discussed only for selected patients, after written informed consent that names the product’s source and status, and for stem cell products under Florida law.
- 06
Coordinated or referred spine procedures
Referral
Epidural steroid injections, facet joint and medial branch blocks, radiofrequency ablation, and EMG/nerve-conduction studies are not performed at PrimeCell. When one of them is the right next step, Dr. Chantasi coordinates it with, or refers you to, an interventional spine or neurodiagnostic specialist.
- 07
Surgical or specialist referral
Referral
For progressive neurological deficit, instability or structural compression that will not respond to conservative care — made directly, not after months of injections.
Candidacy
Who may be a candidate for a regenerative spine procedure
May be worth evaluating
- Back or neck pain for three months or more despite genuine rehabilitation
- A suspected facet, sacroiliac, ligament or soft-tissue source
- Stable neurological findings
- Understanding that these procedures remain investigational for many spinal uses
Usually not a candidate
- Any of the red-flag symptoms above, or progressive weakness
- Spinal instability or severe compression that needs a surgical opinion
- Infection, active cancer, pregnancy or uncontrolled diabetes
- Expecting a restored disc or a single-visit cure
Evidence & limitations
What the research on PRP for back pain shows
Short answer
Early and encouraging in places, but not settled. Most published trials of PRP for chronic low back pain are small and use different techniques, and there is very little research on the neck.
A 2023 systematic review in Biomedicines found favorable results in most randomized trials of PRP for degenerative low back pain, but graded the evidence as Level II and could not pool the results because injection sites, preparations and patients varied so much.3 A 2024 network meta-analysis in the Journal of Pain Research suggested PRP’s benefit grew over time compared with steroid, radiofrequency and anesthetic injections — and its authors were explicit that larger trials are needed.4
Neither review addresses neck pain, where PRP research is limited to small individual studies. For cell-based products, the FDA’s position is that none is approved for these uses.5 Completed assessments join PrimeCell’s Outcomes Follow-Up program, which has no published results yet.
What to expect
The first visit, and after
- Bring prior imaging reports and discs, and a list of therapies, medications and injections you have tried.
- Expect a hands-on examination; wear clothing that lets you bend and move.
- You leave with a diagnosis or a plan to reach one — and a written estimate if a procedure is proposed.
- After a spinal procedure, soreness for several days is common; rehabilitation resumes on a set schedule, and any change tends to build over weeks to months.
Cost & process
Self-pay, quoted in writing
PrimeCell is a self-pay practice and does not bill insurance; regenerative spine procedures are generally not covered by insurance. Your estimate reflects the diagnosis, the number of levels or sites, image guidance and the preparation used. Qualifying patients can use Cherry payment plans. No referral is needed.
Who evaluates your spine
Kenny Chantasi, DO
Spine pain sits at the center of PM&R and Pain Medicine — the two specialties in which Dr. Chantasi is board-certified. He performs PrimeCell’s evaluations and procedures himself.
- Board certification
- Physical Medicine & Rehabilitation, and Pain Medicine (AOBPMR)
- Academic
- Former Assistant Professor of Rehabilitation and Regenerative Medicine, Columbia University Irving Medical Center / NewYork-Presbyterian
- Leadership
- Former Department Chair and Medical Director, Sanford Rehabilitation Hospital
- Practice
- PrimeCell, 2295 S Hiawassee Rd, Ste 103, Orlando (MetroWest) · Directions
Questions
Back & neck pain FAQ
Can regenerative medicine restore a degenerated disc?
Current evidence does not justify that promise. Neither PRP nor any cell-based product has been shown to reliably restore normal disc structure. Care goals focus on specific symptoms and function.
How do you know whether a facet or sacroiliac joint is the cause?
By combining the symptom pattern, examination, imaging and response to earlier care. When uncertainty remains, an image-guided diagnostic injection can help. No single finding is always definitive.
Is PRP a replacement for radiofrequency ablation or surgery?
Not automatically. The right option depends on the pain source, neurological findings, spinal stability and how you responded to earlier treatment.
Does PrimeCell perform epidural steroid injections or radiofrequency ablation?
No. Epidural steroid injections, facet and medial branch blocks, radiofrequency ablation and EMG/nerve-conduction studies are coordinated with or referred to a specialist. PrimeCell performs trigger-point injections, peripheral nerve blocks, joint injections and ultrasound-guided procedures, including PRP, in the office.
Can I avoid back surgery?
Many people with back pain never need surgery, and PrimeCell starts with a non-surgical plan for eligible patients. That is not a guarantee: progressive nerve damage or instability is better served by a surgical referral from the start, and Dr. Chantasi will say so directly.
How soon could I feel better after a procedure?
Some patients notice gradual change over several weeks to months; others have limited or no improvement. Timing depends on the source, the procedure and rehabilitation.
Does insurance cover regenerative spine procedures?
Generally not. PrimeCell is self-pay and provides a written estimate before anything is scheduled.
Look beyond the imaging report.
A spine evaluation that puts your symptoms, neurological findings, movement and imaging together — and a written plan built around the actual source.
$97Initial physician consultation · offer valid through October 31, 2026
THE PATIENT AND ANY OTHER PERSON RESPONSIBLE FOR PAYMENT HAS A RIGHT TO REFUSE TO PAY, CANCEL PAYMENT, OR BE REIMBURSED FOR PAYMENT FOR ANY OTHER SERVICE, EXAMINATION, OR TREATMENT THAT IS PERFORMED AS A RESULT OF AND WITHIN 72 HOURS OF RESPONDING TO THE ADVERTISEMENT FOR THE FREE, DISCOUNTED FEE, OR REDUCED FEE SERVICE, EXAMINATION, OR TREATMENT.
References
- Brinjikji W, Luetmer PH, Comstock B, et al. Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. AJNR Am J Neuroradiol. 2015;36(4):811-816. doi:10.3174/ajnr.A4173
- Qaseem A, Wilt TJ, McLean RM, Forciea MA. Noninvasive treatments for acute, subacute, and chronic low back pain: a clinical practice guideline from the American College of Physicians. Ann Intern Med. 2017;166(7):514-530. doi:10.7326/M16-2367
- Machado ES, Soares FP, Vianna de Abreu E, et al. Systematic review of platelet-rich plasma for low back pain. Biomedicines. 2023;11(9):2404. doi:10.3390/biomedicines11092404
- Zhang X, Zhang A, Guan H, Zhou L, Zhang J, Yin W. The clinical efficacy of platelet-rich plasma injection therapy versus different control groups for chronic low back pain: a network meta-analysis of randomized controlled trials. J Pain Res. 2024;17:1077-1089. doi:10.2147/JPR.S444189
- U.S. Food and Drug Administration. Consumer alert on regenerative medicine products including stem cells and exosomes. fda.gov
Medically reviewed by Kenny Chantasi, DO, on September 23, 2026. General education only; not medical advice. Candidacy is determined at an individual evaluation. Individual results vary and are not guaranteed.