Lower Back Pain & Spine Pain - The BIOS Orthopedic Institute

The BIOS Orthopedic Institute

Alberto J. Panero, D.O.

Regenerative Orthopedics Specialist & Sports Medicine Specialist located in Sacramento, CA

Regenerative Orthopedics Specialist & Sports Medicine Specialist located in Sacramento, CA
Lower back pain is incredibly common and ranges from mildly irritating to debilitating. If you’re dealing with chronic lower back pain, come see Dr. Alberto J. Panero at The BIOS Orthopedic Institute in Sacramento, California. He will evaluate the spine and accompanying areas to devise the right cutting-edge treatment for your relief.

What causes lower back pain?

More often than not, back pain is a result of multiple issues. You may have injury or inflammation of the soft tissue around the spine, or an issue with the vertebrae, facet joints, or discs. Tightness in muscles or misalignment of discs can compress nerves, creating residual pain in your legs, hips, pelvis, or shoulders.

What type of pain should concern me?

If you know you pulled a muscle and the pain resolves within a few weeks, you’re probably OK. However, it’s always a good idea to be examined when you’re experiencing low back pain or any other pain along your spine.

Particularly worrisome pain includes:

  • Dull and achy pain that’s contained to the lower back
  • Electrical, burning pain that radiates from your low back down your legs
  • Muscle spasms in the back area
  • Pain that increases with long sessions of sitting or standing
  • Difficulty changing positions: Especially going from standing to sitting

How can regenerative orthopedics help?

Regenerative orthopedics offers a non-invasive (nonsurgical) way to address your pain. Dr. Panero uses musculoskeletal ultrasound to diagnose and map your pain origins. This ultrasound can also help develop a strategy for healing. We can also use live x-ray, fluoroscopy, to guide treatments at various areas of the spine.

Treatments may include directed bone marrow concentrate injection which contain growth factors and mesenchymal stem cells or platelet rich plasma therapies, which induce your own healing mechanisms to go into overdrive. With the right therapy, the structure of discs and soft tissue may actually be changed for the better.

Regenerative orthopedics doesn’t just address the symptoms of pain but looks for the origin. For example, you may be feeling pain at your sacroiliac joint (SI), but the origin of this pain is actually due to a disc misplacement and the SI pain is compensatory.

Can regenerative orthopedics help if I have been told I need back surgery?

It’s quite possible your condition may be resolved with nonsurgical methods, but Dr. Panero can only tell after a thorough medical history and exam. It’s worth exploring because stem cell and platelet rich plasma therapies are far more tolerable and have a much shorter healing time. In many cases, this more conservative and less invasive therapy is superior to conventional surgeries and prescription medications.


Platelet Rich Plasma (PRP) Injections – blood is taken from your arm and centrifuged down to concentrate your platelets within a plasma medium. Once injected, the platelets degranulate and release activated growth factors and cytokines to reduce inflammation and promote healing. 1 injection may be all you need, however, there are times where multiple injections may be provide additional benefit. Not covered by insurance.

Platelet Lysate injections (PL) Injections – After the PRP is prepared, the platelets are activiated and forced to release their growth factors and cytokine within the plasma. This plasma is then filtered to remove cellular debris. The platelet lysate rich in growth factors and cytokines is then used for the epidural injections to decrease inflammation and promote healing.

• Sacroiliac Joint Injection: $875 single injection / $1,200 for bilateral injection

• Facet Joint Injections: $1650 for up to 3 bilateral level injections (6 injections total). 3 levels may include SI joint. Includes trigger point injections into the lumbar musculature. Discount for series of 3 injections, $1450 each session ($4350).

• Epidural Injections: $ 1,850 for up to 2 level bilateral injection

• Facet + Epidural Injection : $2,450 for up to 3 bilateral level injection. If elect to proceed with series of 3 injections, $2100 each session ($6,300).

Mesenchymal Stem Cell Injections – bone marrow is aspirated from the back of your pelvis and centrifuged in a special kit to concentrate growth factors, cytokines, and the stem cells, which are then re-injected into your spine. The goals are to change the micro-environment of the joints or discs, reduce inflammation and pain, and promote healing. Bone marrow concentrate may be injected into joints and into discs, but not into the epidural space. Not covered by insurance.

Cost: $4500 for one session which includes 3 layers of injections: Facet and Sacroiliac joint injections, epidural PRP injection, and trigger point injections into the lumbar musculature. Same cost for intra-discal injection.

Dr Panero is superb. Always and I have unqualified respect and admiration and trust in him. I am fortunate to be a patient and client of his. His staff are excellent and so professional and thoughtful too.

Leslie S.

I was very happy with Dr. Panero. He took his time to listen to me and evaluate me. Then he went over all my options and answered all my questions. I am very glad I was referred to him!

David M.

Very personable and knowledgeable presenting options for the problem and then going forward from the choice made. I would definitely recommend him to friends and family! Office staff is fabulous as well.

Jim M.

I just had my first visit with Dr. Panero and found him to be knowledgeable and personable. I appreciate the fact that he was straightforward with my options for treatment, which are limited due to the nature of my orthopedic problem. I will continue with his recommended injections.

Karen L.

Finally after 3 months of being brushed off, I found a Doctor who cared to take an extra minute to treat me as an individual and listen. I saw several doctors without a diagnosis and I now have that and a plan of care. Truly grateful for Dr . Panero!!! Very Thorough.

Davina R.