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“Stem cell injections represent the most powerful non-surgical tool we have to heal back pain.”
-Mark Walter M.D.,

According to a 2016 review in the Journal of Pain Management 75% of back surgery fails to relieve the pain. This scenario is all too common and it’s called failed back surgery syndrome. If you or someone close to you has serious back pain, please take note.

“To a man with a hammer, everything looks like a nail!”

– Mark Twain

Why on earth are the results so poor? The reason is simple. Orthopedic surgeons often miss the real diagnosis and the true root-cause of the pain. This is a huge problem. Good medicine starts with the right diagnosis. God knows that we as doctors can’t fix everything, but if you have the right diagnosis, your chances of success are of course, much better.

The problem starts with an over-reliance on MRI’s. MRI is a wonderful and useful tool, however the results can be misleading. The problem is that at least 40 or 50% of the general public have abnormal discs on MRI, and many of them have no backpain at all. Just because you have a disc abnormality detected on MRI does not mean this is the real root-cause of the pain.

So, what might be the real cause of the pain? As a regenerative orthopedic specialist for the last 22 years I have seen and treated thousands of patients with serious back pain. In my experience, by far the most common cause of low back pain is micro-tears in the attachments of the large ligaments and tendons of the low back and pelvis. These attachments are highly innervated and can become huge pain generators. Unfortunately, MRI’s, ultrasound and X-ray all miss these abnormalities, and hence, the true diagnosis may be  missed.

So, if all these standard imaging tests miss the diagnosis, what testing do we need to make the correct diagnosis? Since the micro-tears are too small to be seen on MRI or ultrasound, the only reliable way to pick them up is with a specialized physical exam technique called palpation interrogation. With this tried and true technique I carefully palpate all the major structures in the low back and pelvis. If I find the “jump sign” and reproduce a patients pain, I have actually demonstrated the pain generators and diagnosed the true root-cause of the pain with a high degree of certainty.

Once we have made this diagnosis, how do we fix it? In essence we are treating chronic strains and sprains in the low back and pelvis. These connective tissue problems may sound minor, but believe me, they can cause huge pain and can easily mimmic true sciatica and cause debilitating back pain.

Once we have diagnosed the precise regions where the microtears are located, the best and fastest way to heal them is by precisely injecting stem cells from a patients own fat, mixed with  growth factors from a patients own blood (PRP). By using DNA- matched, fresh stem cells with the PRP growth factors, you optimize the regenerative healing power.

The whole procedure is minimally invasive and extremely safe. It takes about 3-4 hours and is done in the office setting. Patient comes in, we take about 60-100 ccs of abdominal fat with a gentle liposculpting technique with just local numbing. Then we take some blood like a routine blood draw. After this, the patient rests for 60-90 minutes while we prepare the stem cell/PRP combo. Then we inject the stem cells precisely where they are needed. Best of all there is minimal downtime and patients can return to activities of daily living within 24 hours. 

The success rate of this procedure is of course totally dependent on the skills and experience of the doctor to correctly diagnose and inject the precise cause of the problem with properly prepare the stem cells and PRP.  When it comes to healing, there can be no guarantees. All you can do, is use the best techniques possible and give patients the greatest chance of success. If I examine a patient and confirm they are a candidate for this protocol, My own success rate is 80-85%. Once we have successfully healed the root cause of a patient’s pain, the results are long-lasting and may easily last 5 or 10 years or more. If, God forbid the pain recurs several years or more down the road. we can always repeat the stem cell procedure.

What’s the downside? Since the procedure is so safe and uses the patients own tissues, the main risk is you may pay your money and not get the results you hope for. Unfortunately, the costs of stem cell procedures are not yet covered by medicare or any other insurance company. The average cost of a stem cell procedure is $7,000-$10,000. depending on how many areas are involved. Although, these costs are substantial, for many the returns in terms of quality of life, are totally worth it! 

After the procedure I like to follow patients carefully and make sure they rehab correctly. Usually, patients will show improvement in the first few weeks (sometimes much faster!). The stem cells remain alive and active for at least 4 to 5 months so If for some reason the results are sluggish, I may recommend a PRP booster about week 6-10 to reignite the stem cells and improve results.

In short, the stem cell/ PRP combo is an elegant and powerful non-surgical approach to heal back pain (and many other conditions as knee or hip arthritis, rotator cuff etc.) Due to the minimal risk and downtime, I believe that this approach may eventually become the treatment of choice for many orthopedic problems. As you understand (and experience!) the power and application of regenerative orthopedics, you may agree that this approach really should be primary care orthopedics. This truly is the medicine of the future!

About Dr. Walter: Mark Walter MD, CM, CCFP has pioneered the field of Regenerative Orthopedics for the last 22 years and is considered one of the top Stem Cell Orthopedic specialists in Florida.

Dr. Walter is author of Stem Cell Orthopedics (now avail on amazon) and is a leading expert in myofascial pain generators and ligament and tendon regeneration. He received his M.D. degree from McGill (1980) and went on to do five years of post-doc fellowship work in Regenerative Orthopedics with the world-renowned Hackett-Hemwall foundation, in association with the University of Wisconsin. During that period Dr. Walter was mentored by and worked with some of the top regenerative orthopedic teachers in the world. 

For more information please visit us at To schedule a personal consultation with Dr. Walter (by phone or in-person) or to sign up for a free seminar, please call Stem Cell Orthopedics in Sarasota, FL at (941) 955-4325 or email us at  

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