Condition · Nerves
Neuropathy & nerve pain: a cause-first evaluation in Orlando
Burning feet, tingling hands, numbness, electric pain or poor balance. Before any treatment is chosen, Dr. Chantasi’s job is to find out why — because the cause, not the symptom, decides what is likely to help.
Scheduling opens securely in Prospyr · in-office or telemedicine evaluation
The question most patients ask
Can stem cells or other regenerative therapies repair damaged nerves?
Short answer
Not in any way that has been shown in patients. No stem cell, exosome or platelet-rich plasma product is FDA-approved for neuropathy, and claims of nerve regeneration rest mainly on laboratory and animal research. What reliably changes the course of neuropathy is finding and treating the cause, protecting the feet, and using guideline-supported treatment for pain.
Neuropathy is a description, not a diagnosis. Diabetes is the most common cause, but vitamin deficiencies, thyroid and kidney disease, medications, alcohol, autoimmune conditions and compressed nerves all produce similar symptoms — and some of those causes are very treatable. A plan that starts with a device, a supplement package or an injection skips the step that matters most.
Seek emergency care — not a scheduled visit — for:
Weakness that comes on over hours or days, numbness spreading quickly up the legs or arms, loss of bladder or bowel control, trouble breathing or swallowing, or new symptoms after significant trauma. Call 911.
Common presentations
Four patterns of nerve pain
Where the symptoms sit, and how they spread, narrows the list of causes before a single test is ordered.
- 01
Feet first, then hands
Length-dependent polyneuropathy: burning, tingling or numbness that starts in both feet and creeps upward, sometimes reaching the fingertips. Balance often suffers, especially in the dark. The typical pattern of diabetic neuropathy.
- 02
One nerve, one territory
Entrapment neuropathy: a nerve pinched at a narrow point — the median nerve at the wrist (carpal tunnel), the ulnar nerve at the elbow, or nerves around the ankle. Symptoms follow that nerve’s map and are often worse at night.
- 03
From the spine
Radiculopathy: pain, tingling or weakness traveling down one arm or leg from an irritated nerve root in the neck or back. Back and neck pain is evaluated with this in mind.
- 04
Burning with “normal” tests
Small-fiber neuropathy: burning or prickling pain, often in the feet, while standard nerve conduction studies come back normal. Diagnosis relies on the examination and, sometimes, specialized testing.
Diagnostic approach
Finding the cause comes first
Tests are chosen from your history and examination, not run as a fixed panel. Results already in your records are used rather than repeated.
- Blood sugar
- Fasting glucose or hemoglobin A1c, and sometimes a glucose tolerance test — prediabetes can cause neuropathy, too.
- Vitamin B12
- A B12 level, with follow-up testing when borderline; long-term metformin use is a known risk factor.
- Metabolic
- Thyroid, kidney and liver function.
- Blood proteins
- Serum protein electrophoresis with immunofixation to screen for an abnormal protein.
- Exposures
- A review of medications (including past chemotherapy), alcohol use and toxins.
- Nerve studies
- Ultrasound of a suspected entrapment at the visit. Nerve conduction studies and EMG are arranged through a referral when the answer would change the plan, and a neurology referral is made when the picture is atypical.
Physician evaluation
What the PrimeCell Candidacy Assessment covers
Performed by Dr. Chantasi himself. Physical Medicine & Rehabilitation and Pain Medicine are specialties built around nerves, muscles and function.
History
When and where symptoms began, how they have spread, other conditions, medications, alcohol, family history and what has been tried.
Examination
Sensation (touch, vibration, temperature, position), reflexes, strength, gait and balance, and a careful look at the feet.
Workup
Targeted blood tests and nerve studies or imaging where indicated, and a review of records you bring.
Plan
A diagnosis or a clear route to one, cause-directed treatment, and pain management that fits your health history.
Care categories
Guideline-based care first
Some of these are provided at PrimeCell; others are coordinated with your primary care physician, endocrinologist, podiatrist or a neurologist.
- 01
Treat the cause
Standard care
Blood sugar control, B12 replacement when deficient, medication changes, reducing alcohol, relieving a compressed nerve. Where blood sugar and weight are part of the picture, physician-led medical weight management may be part of the plan.
- 02
Protect feet, balance and strength
Standard care
Daily foot checks and footwear advice, physical therapy for balance and strength, and fall prevention.
- 03
Medication for nerve pain
FDA-approved Off-label
The American Academy of Neurology recommends offering gabapentinoids, SNRIs, tricyclic antidepressants or sodium-channel blockers for painful diabetic neuropathy, and advises against opioids.1 Some, such as duloxetine and pregabalin, are FDA-approved for this use; others are used off-label.
- 04
Topical treatment
FDA-approved Off-label
A high-concentration capsaicin patch is FDA-approved for painful diabetic neuropathy of the feet; lidocaine preparations are sometimes used off-label.
- 05
Nerve-targeted injections
FDA-approved drugs Off-label
Peripheral nerve blocks with local anesthetic, and, for an entrapped nerve, an ultrasound-guided steroid or PRP injection, performed at PrimeCell when appropriate. For carpal tunnel syndrome, surgical release still outperforms PRP on function.2
- 06
Spinal cord stimulation
FDA-approved devices
Certain systems are approved for painful diabetic neuropathy that has not responded to medication; this is a specialist referral.
- 07
Cell-based & exosome products
Not FDA-approved
Investigational. No clinical evidence shows that stem cell, perinatal allograft or exosome products regenerate nerves in patients. Discussed, if at all, only after the workup, for selected patients, with written informed consent naming the product’s source and status.
Performed at PrimeCell
The evaluation and neurological examination, diagnostic ultrasound of nerves and entrapment sites, peripheral nerve blocks, trigger-point injections and ultrasound-guided injections, prescribing and monitoring of nerve-pain medication, and coordination of metabolic care.
Coordinated or referred
EMG and nerve-conduction studies, epidural steroid injections and radiofrequency ablation when nerve pain comes from the spine, spinal cord stimulation, neurology or endocrinology care, podiatry, and surgical release of an entrapped nerve.
Candidacy
When PrimeCell is a sensible first stop — and when it is not
A good fit for an evaluation
- Months of burning, tingling or numbness without a clear explanation
- Known diabetic neuropathy with pain that is poorly controlled
- Symptoms in one hand or foot that suggest a compressed nerve
- Wanting a straight answer about regenerative claims you have seen advertised
Go elsewhere first
- Rapidly progressive weakness or numbness — emergency care
- A foot wound, ulcer or signs of infection — same-day care with your physician or podiatrist
- Expecting an injection to regrow nerves or reverse long-standing diabetic neuropathy
- Active cancer, infection or pregnancy, for any cell-based product
Evidence & limitations
What the research does — and does not — show
Short answer
Medication guidelines for painful diabetic neuropathy rest on many randomized trials. The evidence for PRP around nerves is limited to entrapment conditions such as carpal tunnel, and the evidence for stem cells or exosomes in nerve repair is preclinical.
The 2022 American Academy of Neurology guideline, based on a systematic review of randomized trials, found several oral and topical medication classes effective for painful diabetic neuropathy — with the caveat that the expected benefit is a reduction in pain, not a cure.1
A 2026 systematic review in the Journal of Orthopaedic Reports found PRP improved pain and symptom scores at six months in several entrapment conditions, most notably carpal tunnel syndrome, while surgical release still produced better function.2 A 2024 review of stem-cell-derived exosomes for nerve regeneration found promising results only in laboratory and animal models — not clinical studies of an injectable product in patients.3 Neither addresses diabetic neuropathy itself, where the regenerative evidence is thinner still. The FDA has warned consumers about unapproved stem cell and exosome products.4
Completed assessments join PrimeCell’s Outcomes Follow-Up program, which tracks symptoms and function with standardized measures; it has no published results yet.
- Before
- Gather recent blood work, any nerve study or imaging reports, and a list of medications and supplements. A telemedicine first visit is available.
- First visit
- History, a full neurological examination and a plan for any testing still needed.
- Follow-up
- Results reviewed together, cause-directed treatment started, and pain treatment adjusted over several visits. Progress is usually gradual.
- Cost
- PrimeCell is self-pay and does not bill insurance. Any procedure comes with a written estimate first; qualifying patients can use Cherry payment plans. No referral is needed.
Who evaluates your symptoms
Kenny Chantasi, DO
Board-certified in Physical Medicine & Rehabilitation and in Pain Medicine, and a former Assistant Professor of Rehabilitation and Regenerative Medicine at Columbia University Irving Medical Center. Dr. Chantasi sees every PrimeCell patient himself — one physician who knows your whole picture.
Questions
Neuropathy & nerve pain FAQ
What causes peripheral neuropathy?
Diabetes and prediabetes are the most common causes. Others include vitamin B12 deficiency, thyroid and kidney disease, certain medications including chemotherapy, heavy alcohol use, autoimmune conditions, abnormal blood proteins, compressed nerves — and in some people no cause is found.
Can nerve damage be reversed?
It depends on the cause, how long it has been present and how severe it is. Some causes, such as B12 deficiency or a compressed nerve, can improve meaningfully with treatment. Long-standing diabetic neuropathy is managed to ease symptoms and slow progression rather than reversed.
Are stem cells FDA-approved for neuropathy?
No. No stem cell, exosome or PRP product is FDA-approved to treat neuropathy. Florida law allows physicians to offer certain non-approved stem cell therapies for pain management under strict conditions, which does not make them FDA-approved or proven.
Do I need a nerve conduction study?
Not always. Many cases are diagnosed from the history, examination and blood tests. Nerve studies help when the pattern is unusual, when entrapment is suspected, or when the result would change treatment. EMG and nerve-conduction studies are not performed at PrimeCell; when one is needed, Dr. Chantasi arranges it through a referral.
Will vitamins or supplements fix neuropathy?
Only if you are deficient. B12 replacement is the standard approach when neuropathy is caused by B12 deficiency; for most other causes, supplements have limited evidence. Your levels are checked before anything is recommended.
Does insurance cover a neuropathy evaluation at PrimeCell?
PrimeCell is a self-pay practice and does not bill insurance. Fees are explained before your visit, and any procedure comes with a written estimate.
Identify the cause. Then build the plan.
A physician workup for burning, tingling and numbness — with evidence-based care and a straight answer about what regenerative medicine can and cannot do for nerves.
$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
- Price R, Smith D, Franklin G, et al. Oral and topical treatment of painful diabetic polyneuropathy: practice guideline update summary. Report of the AAN Guideline Subcommittee. Neurology. 2022;98(1):31-43. doi:10.1212/WNL.0000000000013038
- Kennedy PJ, Nag S, Baria M, Rice E, Moore AM. A systematic review of the clinical application of platelet-rich plasma for peripheral neuropathic pain. J Orthop Rep. 2026;5(2):100725. doi:10.1016/j.jorep.2025.100725
- Dogny C, André-Lévigne D, Kalbermatten DF, Madduri S. Therapeutic potential and challenges of mesenchymal stem cell-derived exosomes for peripheral nerve regeneration: a systematic review. Int J Mol Sci. 2024;25(12):6489. doi:10.3390/ijms25126489
- 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.