Key Takeaways
- Both use your own biological materials. BMAC uses stem cells from your bone marrow; PRP uses concentrated platelets from your blood. Neither involves third-party donor products at our clinic.
- They work through different mechanisms. BMAC delivers mesenchymal stem cells plus growth factors; PRP delivers concentrated platelets and their associated growth factors. Both are designed to support your body’s natural processes.
- Different conditions may call for different approaches. PRP is often considered for milder conditions and as a first-line regenerative option; BMAC may be considered for more significant tissue concerns that haven’t responded to conservative care.
- Cost differs significantly. PRP is generally less expensive per treatment; BMAC involves more complex harvesting and processing. Neither is typically covered by insurance.
- A stepped approach often makes sense. Many clinicians recommend conservative treatment first, then PRP for persistent symptoms, then BMAC if less invasive options haven’t provided adequate relief.
- Not everyone is a candidate. Certain medical conditions and the severity of your joint or spine condition affect whether either treatment may be appropriate for you.
Exploring Regenerative Options for Chronic Pain
Chronic pain and musculoskeletal conditions often leave patients searching for alternatives to surgery or long-term medication. Two regenerative approaches—bone marrow stem cell therapy (BMAC) and platelet-rich plasma (PRP)—use your body’s own biological materials to support natural healing processes.
While both may help reduce discomfort and support tissue health, they work through different mechanisms and may be appropriate for different situations. Understanding how each treatment works, what conditions they may address, and their respective considerations helps you have an informed conversation with your physician about which approach—if either—might be right for you.
What Are Bone Marrow Stem Cell Therapy and PRP?
Both treatments are forms of regenerative medicine that use your own biological materials. They differ in their source, how they’re prepared, and their potential mechanisms of action.
What Is Bone Marrow Stem Cell Therapy (BMAC)?
Bone marrow aspirate concentrate (BMAC) therapy uses mesenchymal stem cells (MSCs) harvested from your own bone marrow. These multipotent cells have the ability to self-renew and may differentiate into various tissue types.
At Integrated Spine, Pain, and Wellness, we harvest bone marrow from your iliac crest (hip bone), process it in our office to concentrate the stem cells and growth factors, and deliver it to the target area the same day.
BMAC may work through several potential mechanisms:
- Paracrine signaling: Stem cells secrete growth factors and cytokines that communicate with surrounding tissues
- Cellular differentiation: MSCs may differentiate into various cell types depending on their environment
- Immunomodulation: Components may help modulate inflammatory responses
What Is PRP (Platelet-Rich Plasma) Therapy?
PRP therapy concentrates platelets from your own blood to several times their normal levels, then delivers them to the target tissue. When activated, these platelets release growth factors—including PDGF, TGF-β, and VEGF—that may support your body’s existing repair mechanisms.
The preparation involves drawing your blood and processing it through centrifugation to separate and concentrate the platelets. The entire process uses your own blood, processed in-office, typically within an hour.
The Critical Distinction: Autologous vs. Third-Party Products
When researching regenerative medicine, you’ll encounter clinics advertising various “stem cell” or “regenerative” products. Understanding what you’re actually receiving is essential.
What We Offer: Your Own Cells and Platelets Only
At Integrated Spine, Pain, and Wellness, both our BMAC and PRP treatments use exclusively autologous materials—meaning they come from your own body:
- BMAC: Your own bone marrow, harvested, processed, and delivered the same day
- PRP: Your own blood, drawn, concentrated, and injected the same day
What We Don’t Use:
Many clinics offer products derived from:
- Umbilical cord tissue
- Amniotic fluid
- Adipose (fat) tissue from donors
- Other third-party sources
These products raise important questions about cell viability, quality control, and regulatory status. At our clinic, Dr. Goyle has chosen to use only autologous materials because you know exactly what you’re receiving—your own cells or platelets, fresh and viable.
This autologous approach also eliminates rejection risk and keeps treatments within FDA guidelines for minimally manipulated cells.
How Do These Treatments Differ in Their Approach?
The fundamental difference lies in what’s being delivered and how it may interact with your tissues.
BMAC: Delivering Stem Cells Plus Growth Factors
Bone marrow stem cell therapy delivers mesenchymal stem cells along with the growth factors and other regenerative components naturally present in your bone marrow concentrate. These stem cells may:
- Secrete bioactive molecules that interact with surrounding tissues
- Differentiate into various cell types depending on their environment
- Support the local tissue environment through cellular signaling
The stem cells don’t simply replace damaged tissue directly—current understanding suggests they may work primarily through paracrine effects, secreting factors that influence surrounding cells and tissues.
PRP: Delivering Concentrated Growth Factors
PRP delivers concentrated platelets that, when activated, release growth factors designed to support your body’s existing healing processes. PRP may:
- Provide concentrated growth factors to the target area
- Support cellular activity and tissue processes
- Work with your body’s natural repair mechanisms
PRP doesn’t introduce new cell types—it concentrates what’s already in your blood and delivers it where it may be beneficial.
A Helpful Way to Think About It
Both treatments deliver concentrated regenerative components from your own body to a target area. BMAC delivers stem cells plus growth factors. PRP delivers concentrated platelets and their associated growth factors. The choice between them often depends on your specific condition and its severity.
What Conditions May Each Treatment Address?
Both therapies focus on musculoskeletal conditions but may be appropriate for different situations based on condition type and severity.
Conditions That May Be Considered for BMAC:
- Moderate knee osteoarthritis or degenerative changes
- Hip joint concerns
- Shoulder conditions
- Disc-related back pain
- Chronic joint discomfort that hasn’t responded to conservative treatment
- Situations where a more concentrated regenerative approach is desired
BMAC is often considered after conservative treatments (physical therapy, medications, possibly PRP) haven’t provided adequate relief. It’s positioned as an option between failed conservative care and surgical intervention for appropriate candidates.
Conditions That May Be Considered for PRP:
- Tendon concerns (rotator cuff, Achilles, tennis elbow, patellar tendon)
- Ligament issues
- Mild to moderate joint discomfort
- Soft tissue injuries
- As a first-line regenerative option before considering BMAC
- Often used in combination with BMAC to potentially enhance effect
PRP’s accessibility and lower cost make it a common starting point for regenerative treatment when conservative care hasn’t been sufficient.
Conditions Where Neither May Be Appropriate:
- Severe, end-stage joint degeneration (“bone-on-bone” arthritis)
- Complete tendon or ligament tears requiring surgical repair
- Conditions requiring mechanical stabilization
- Advanced spinal stenosis with cord compression
- Active infections or certain systemic health conditions
For these situations, surgical intervention or other approaches may be more appropriate. During your consultation, Dr. Goyle will provide honest guidance about whether regenerative treatment makes sense for your specific condition.
How Do BMAC and PRP Compare for Different Concerns?
Understanding when each treatment might be considered helps you have a more informed conversation with your physician.
For Joint Conditions (Knee, Hip, Shoulder):
Both BMAC and PRP may be considered for joint conditions. PRP is often tried first due to its lower cost and simpler procedure. If PRP doesn’t provide adequate response, BMAC may be considered as a next step. For moderate conditions, some physicians recommend BMAC initially. The treatments can also be combined.
For Tendon and Soft Tissue Concerns:
PRP has been widely used for tendon conditions and is often considered a reasonable first-line regenerative option for these concerns. BMAC may be considered for more significant tendon issues or when PRP hasn’t provided adequate relief.
For Spine and Disc Conditions:
BMAC is more commonly considered for disc-related back pain, delivered directly to the affected disc using image guidance. PRP may be used in combination. Both require careful patient selection—not all back pain is appropriate for regenerative treatment.
What Are the Benefits of Each Approach?
Both treatments offer distinct potential advantages as part of a comprehensive pain management strategy.
Potential Benefits of BMAC:
- Delivers your own mesenchymal stem cells plus growth factors
- May provide a more concentrated regenerative approach for significant tissue concerns
- Single treatment session (though some patients may benefit from repeat treatment)
- Autologous—uses your own cells, eliminating rejection risk
- Minimally invasive compared to surgical alternatives
- Outpatient procedure with minimal downtime
Potential Benefits of PRP:
- Uses your own platelets—safe and autologous
- Simpler, quicker procedure than BMAC
- Lower cost per treatment
- Can be repeated if beneficial
- Well-established track record in sports medicine and orthopedics
- Can be combined with other treatments including BMAC
Shared Benefits:
- Both are minimally invasive, outpatient procedures
- Both use your own biological materials
- Both avoid the risks and recovery time of surgery
- Both can be performed with image guidance for precision
- Neither requires general anesthesia
What Are the Limitations and Considerations?
Both treatments have important limitations to understand before making a decision.
Considerations for BMAC:
- Higher cost than PRP
- Requires bone marrow aspiration (minimally invasive but more involved than a blood draw)
- Results vary—not all patients respond
- Response develops gradually over months
- Limited large-scale clinical trial data for many orthopedic applications
- Not appropriate for severe, end-stage conditions
- Cannot reverse extensive structural damage
Considerations for PRP:
- Results vary—not all patients respond
- Lack of standardized preparation protocols across clinics can lead to inconsistent products
- May require multiple treatments
- Response develops over weeks to months
- Not appropriate for severe conditions or complete tears
- May be less effective for more significant tissue damage
Honest Expectations for Both:
We believe in transparency about what these treatments can and cannot do:
- Results are not guaranteed. Some patients respond well; others don’t experience meaningful improvement.
- Results take time. The body’s response develops over weeks to months—these aren’t quick fixes.
- They’re not cures. These treatments are designed to support your body’s natural processes, not guarantee specific outcomes.
- Not everyone is a candidate. Your specific condition, its severity, and your overall health all affect appropriateness.
Who May Be a Good Candidate for Each Treatment?
Patient selection significantly influences outcomes for both BMAC and PRP.
Potential BMAC Candidates:
- Chronic joint or disc-related pain from mild to moderate degeneration
- Have tried conservative treatments without adequate relief
- Good overall health
- Non-smokers or willing to stop smoking
- Realistic expectations about gradual improvement
- Conditions that haven’t progressed to end-stage
Potential PRP Candidates:
- Tendon or soft tissue concerns
- Mild to moderate joint discomfort
- Looking for a first-line regenerative option
- Good overall health
- Realistic expectations
Who May Not Be a Good Candidate for Either:
- Active infections
- Certain blood disorders or clotting conditions
- Uncontrolled systemic illness
- Severe, end-stage joint degeneration requiring surgery
- Complete tears requiring surgical repair
- Conditions requiring mechanical stabilization
During your consultation, Dr. Goyle will evaluate your specific situation and provide honest guidance about candidacy.
What to Expect During Treatment
Both procedures are performed as outpatient treatments in our office.
The BMAC Procedure:
- Bone marrow aspiration: Using local anesthesia for comfort, Dr. Goyle extracts a small sample of bone marrow from your posterior iliac crest (back of your hip bone). Most patients tolerate this well.
- Processing: The bone marrow sample is processed in our office using specialized equipment to concentrate the mesenchymal stem cells and growth factors.
- Image-guided injection: Using fluoroscopy or ultrasound, Dr. Goyle delivers the concentrated BMAC precisely to the target area.
- Total time: Approximately 1-2 hours
The PRP Procedure:
- Blood draw: A sample of your blood is drawn, similar to routine lab work.
- Centrifugation: The blood is processed through centrifugation to separate and concentrate the platelets.
- Injection: The concentrated PRP is delivered to the target area, often with ultrasound guidance.
- Total time: Approximately 45 minutes to 1 hour
Recovery for Both:
- Most patients return home the same day
- Some soreness at injection and/or aspiration sites is normal
- Avoid anti-inflammatory medications (NSAIDs) as directed
- Gradual return to activity based on your specific treatment plan
- Follow-up appointments to monitor response
Timeline for Response
Both treatments produce gradual responses—not immediate relief.
BMAC Timeline:
- Weeks 1-2: Some discomfort at aspiration and injection sites is normal
- Weeks 4-8: Many patients begin noticing gradual changes
- Months 3-6: Continued response; this is when many patients report the most noticeable changes
- Months 6-12+: Ongoing gradual response for some patients
PRP Timeline:
- Days 1-7: Some soreness at injection site is normal
- Weeks 2-6: Many patients begin noticing gradual changes
- Months 1-3: Continued response development
- Months 3-6+: Some patients continue to notice changes
Individual timelines vary significantly. During your consultation, Dr. Goyle will discuss realistic expectations based on your specific condition.
Cost Considerations
Neither BMAC nor PRP is typically covered by insurance, so cost is an important factor.
General Cost Comparison:
- PRP: Generally less expensive per treatment
- BMAC: Higher cost due to the bone marrow harvesting and processing involved
Why the Difference?
BMAC requires bone marrow aspiration, specialized processing equipment, and more time—all of which contribute to higher costs. PRP requires only a blood draw and centrifugation.
A Stepped Approach:
Many patients start with PRP for appropriate conditions due to its lower cost and simpler procedure. If PRP doesn’t provide adequate response, BMAC may be considered as a next step. This graduated approach can be both medically appropriate and financially sensible.
Dr. Goyle can discuss specific costs and whether financing options are available during your consultation.
Our Complete Regenerative Medicine Approach
BMAC and PRP are two options within our comprehensive regenerative medicine offerings. Depending on your condition, Dr. Goyle may also discuss:
Autologous Conditioned Serum (Regenokine®):
Dr. Goyle is one of only nine physicians in the United States—and the only doctor in Arizona—offering the Regenokine® Program. This innovative treatment processes your own blood to create a serum concentrated with anti-inflammatory proteins that target inflammation at its source.
Regenokine® is the treatment professional athletes like the late Kobe Bryant used to return to competition with minimal downtime. It works through a different mechanism than both BMAC and PRP—focusing specifically on anti-inflammatory proteins rather than stem cells or platelets. It may be appropriate for different conditions or used in combination with other treatments.
MLS M7 Class IV Laser Therapy:
Our state-of-the-art therapeutic laser delivers light energy to support the body’s natural processes and address inflammation. This non-invasive treatment requires no downtime and can complement regenerative injections.
Interventional Procedures:
For certain conditions, epidural steroid injections, facet joint injections, trigger point injections, or other interventional approaches may be recommended—either instead of or alongside regenerative options.
The Right Treatment for You:
We don’t push one treatment over another. Dr. Goyle evaluates your specific condition and recommends what’s most appropriate—which might be BMAC, PRP, Regenokine®, a combination, interventional procedures, or referral for surgical consultation if that’s what your condition requires.
Why Choose Integrated Spine, Pain, and Wellness
Elite Training: Dr. Ashu Goyle is double board-certified in anesthesiology and interventional pain management, with fellowship training from the Cleveland Clinic—one of the nation’s premier medical institutions.
Autologous Only: We exclusively use your own biological materials for regenerative treatments. No third-party donor products, no cells of uncertain origin or viability.
Image-Guided Precision: All injections use fluoroscopy or ultrasound guidance for accurate placement.
Exclusive Access: As one of only nine Regenokine® providers nationwide—and the only provider in Arizona—Dr. Goyle offers treatment options unavailable elsewhere in the state.
Comprehensive Evaluation: We don’t treat everyone who asks. Dr. Goyle provides thorough evaluations and honest guidance about which treatment—if any—is appropriate for your specific condition.
Recognition: Dr. Goyle has been recognized as a Phoenix Magazine “Top Doc” from 2011-2020, reflecting his commitment to excellent patient care.
Making the Decision: Which Treatment Is Right for You?
Choosing between BMAC and PRP—or determining if either is appropriate—requires careful evaluation of your specific situation.
Factors to Consider:
- Condition type: What’s causing your pain? Joint, tendon, disc, or other?
- Condition severity: Mild, moderate, or advanced?
- Treatment history: What have you already tried?
- Goals: What are you hoping to achieve?
- Timeline: What are your expectations for improvement?
- Budget: What can you afford, given that neither is typically covered by insurance?
- Overall health: Are there factors that might affect your candidacy?
A Common Approach:
Many clinicians recommend a stepped approach:
- Start with conservative treatment (physical therapy, anti-inflammatory medications)
- If conservative care isn’t sufficient, consider PRP as a first-line regenerative option
- If PRP doesn’t provide adequate response, consider BMAC
- Reserve surgery for conditions that truly require it
This graduated approach ensures you’re not jumping to more intensive treatments before trying less invasive options.
The Consultation: What to Expect
During your consultation at Integrated Spine, Pain, and Wellness, Dr. Goyle will:
- Review your complete medical history
- Discuss your symptoms, concerns, and goals
- Examine the affected area
- Review any imaging studies (MRI, X-rays)
- Evaluate your candidacy for regenerative treatment
- Provide honest guidance about your options
- Discuss realistic expectations
- Answer all your questions
You’ll leave with a clear understanding of whether BMAC, PRP, or another approach may be appropriate for your situation—and honest guidance if regenerative treatment isn’t the right path for you.
Take the Next Step
Choosing between regenerative treatments requires professional evaluation of your specific condition, medical history, and treatment goals. The specialists at Integrated Spine, Pain, and Wellness provide comprehensive assessments to determine which regenerative treatment—if any—may be appropriate for your needs.
Whether you’re considering BMAC, PRP, Regenokine®, or simply want to understand your options, we’re here to provide honest guidance and personalized recommendations.
Contact Integrated Spine, Pain, and Wellness today to schedule your consultation.
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Frequently Asked Questions
Q1. What’s the main difference between BMAC and PRP?
BMAC uses mesenchymal stem cells harvested from your own bone marrow, along with growth factors naturally present in the concentrate. PRP uses concentrated platelets from your own blood that release growth factors when activated. Both are autologous (from your own body) and both are designed to support your body’s natural processes—they just deliver different components.
Q2. Which treatment is more effective?
It depends on your specific condition. Neither treatment works for everyone, and individual responses vary significantly. PRP may be appropriate for milder conditions and tendon concerns; BMAC may be considered for more significant joint or disc conditions. During your consultation, Dr. Goyle will recommend the approach most appropriate for your situation based on the available evidence and his clinical experience.
Q3. Can BMAC and PRP be used together?
Yes, they’re often combined. PRP may complement BMAC by providing additional growth factors to the treatment area. Dr. Goyle can discuss whether a combined approach might be appropriate for your condition.
Q4. Why don’t you use umbilical cord or amniotic stem cells?
We exclusively use autologous materials—your own bone marrow or blood. Third-party products from umbilical cord tissue, amniotic fluid, or other donor sources raise questions about cell viability after processing and storage, quality control, and regulatory status. Using your own cells eliminates these concerns and keeps treatments within FDA guidelines.
Q5. How do I know which treatment is right for me?
The best way to determine which treatment—if any—is appropriate is a consultation with Dr. Goyle. He’ll evaluate your condition, review your imaging, discuss your goals, and provide honest guidance based on your specific situation.
Q6. Are these treatments covered by insurance?
Neither BMAC nor PRP is typically covered by insurance for musculoskeletal conditions. Both require out-of-pocket payment. Dr. Goyle can discuss specific costs and any available financing options during your consultation.
Q7. How long do results last?
Duration of response varies by individual and condition. Some patients maintain benefit for extended periods; others may benefit from repeat treatment. Neither treatment provides guaranteed permanent results. Dr. Goyle can discuss realistic expectations based on your specific situation.
Q8. What is Regenokine® and how does it compare?
Regenokine® is an autologous conditioned serum therapy that concentrates anti-inflammatory proteins from your own blood. It works through a different mechanism than both BMAC and PRP—targeting inflammation rather than delivering stem cells or platelets. Dr. Goyle is one of only nine physicians in the U.S. offering this treatment—and the only provider in Arizona. It’s the approach professional athletes like the late Kobe Bryant used.
Q9. What if neither BMAC nor PRP is right for my condition?
If regenerative treatments aren’t appropriate for your situation, Dr. Goyle will recommend alternative approaches—whether that’s interventional procedures, continued conservative care, or referral for surgical consultation. We provide honest guidance, even when that means recommending something other than what you came in asking about.
Q10. What are Dr. Goyle’s qualifications?
Dr. Ashu Goyle is double board-certified in anesthesiology and interventional pain management. He completed his fellowship training at the Cleveland Clinic—one of the nation’s premier medical institutions. He has been recognized as a Phoenix Magazine “Top Doc” from 2011-2020 and is one of only nine Regenokine® providers in the country—the only one in Arizona.
