What do I need to ask at a clinic?

Who will examine me?

Ask who examines you and who chooses the treatment. Then ask who performs the treatment and checks on you afterward. Confirm that each person works at the office you called. You can also ask how to check each person's Arizona license.

Tell the doctor about your medicines and major health problems. Bring old X-rays and medical notes when you have them. Your doctor needs those details before recommending any treatment.

What exactly are you offering?

Ask for the exact name of the treatment in writing. Find out what it contains and what the clinic will do. The clinic needs to answer both questions, not give you a general term.

Ask how that treatment is meant to ease soreness or improve movement. Then ask how often people don't improve. A fair reply will say that the treatment may make no difference.

What could go wrong afterward?

Ask which problems happen often and which are serious. Find out whom to call during the day and after hours. Ask which warning signs mean you need emergency help.

Have the office explain each later check before you agree. Ask whether you'll need a driver or help at home. Take more time when the office can't explain those needs clearly.

What will this cost from start to finish?

Get the total price in writing before you decide. Include the first visit, treatment, later checks, and any repeated treatment. A small monthly payment can hide a much larger total.

Check coverage with your own insurance company. The office knows its bill, while the company decides what it pays. Don't sign until you understand the bill and your coverage.

Finally, ask about other treatments. Exercise, a brace, medicine, or surgery may belong in the discussion. You deserve a clear reason why the clinic recommends one treatment over another.

Evidence sources

1. A retrospective comparison of 523 bone marrow aspiration procedures against 435 open iliac crest bone graft harvests found aspiration significantly reduced complications - relevant because marrow aspiration for a joint injection is a real procedure with a real, if low, complication rate.

   Hernigou P, et al. — Morbidity of graft harvesting versus bone marrow aspiration in cell regenerative therapy. Int Orthop, 2014.

2. A phase I single-arm study of 10 patients with chronic discogenic low back pain found a single intradiscal injection of adipose-derived MSCs with hyaluronic acid produced no procedure-related or cell-related adverse events over 12 months - a safety signal in 10 people, not an efficacy result.

   Kumar H, et al. — Safety and tolerability of intradiscal implantation of combined autologous adipose-derived mesenchymal stem cells and hyaluronic acid in patients with chronic discogenic low back pain: 1-year follow-up of a phase I study. Stem Cell Res Ther, 2017.