Bone Marrow Aspirate Concentrate (BMAC) And Its Role In Joint Pain

Joint pain may interfere with many aspects of daily life, including mobility, work, rest, and emotional well-being. For some individuals, this discomfort becomes a long-term issue that standard treatment options may not fully address.

As interest grows in research‑based options that may reduce pain and improve joint function without surgery or prolonged medication use, physicians are increasingly utilizing bone marrow aspirate concentrate (BMAC) in suitable cases. Regenexx lab processes prepare BMAC from a patient’s own bone marrow, concentrating cells and growth factors that may support tissue healing and joint health.

What Is Bone Marrow Aspirate Concentrate?

BMAC is a procedure that collects and concentrates components—such as cells and growth factors—from a person’s own bone marrow. This approach may support the body’s natural healing process and promote improved joint function in orthopedic care.

To perform the procedure, a physician in the licensed Regenexx network uses a specialized needle to withdraw (aspirate) bone marrow, typically from the pelvic bone. Physicians usually numb the area with a local anesthetic, and many individuals tolerate the process well. The physician may also offer sedation based on clinical needs.

Bone marrow contains a variety of cells, including progenitor cells and other biologically active components that may aid in the repair of musculoskeletal tissue, such as bone, cartilage, and muscle. Since these components come from the individual’s own body, this process avoids risks associated with donor materials or laboratory-expanded cells.

Procedures using bone marrow aspirate concentrate are supported by a growing body of published research in orthopedic applications. These procedures align with current FDA guidance for the use of a person’s own (autologous) cells  and have demonstrated a low complication rate when performed by a physician in the licensed Regenexx network. 

Research And Evidence Supporting BMAC

Clinical interest in BMAC continues to expand, particularly regarding its potential role in managing joint-related symptoms associated with conditions such as osteoarthritis. Research in this area is ongoing, with a growing number of studies evaluating both the safety and reported outcomes of procedures using BMAC.

A 2021 systematic review examined 22 studies—18 clinical and four preclinical—focused on the use of BMAC injections for joint pain.^[1] The review included 4,626 participants and consistently reported reductions in joint pain and improved function following BMAC procedures.

The review also indicated that BMAC has been associated with a favorable safety profile. Across the studies included, minimal adverse events were documented. However, researchers also noted variability in study design, smaller sample sizes, and limited long-term follow-up in several trials.

While early findings appear encouraging, authors of the review emphasized the importance of additional high-quality, large-scale studies to better define how BMAC procedures may support orthopedic care and which individuals may benefit most.

As the evidence base grows, physicians in the licensed Regenexx network can continue refining the use of procedures using Regenexx lab processes to help reduce pain and promote improved joint function in select individuals who are candidates for the treatment.

The Benefits Of Bone Marrow Aspirate Concentrate In Interventional Orthobiologics

BMAC plays an important role in interventional orthobiologics—an area of care in which physicians utilize biologic materials derived from an individual’s own body to help manage orthopedic conditions. These procedures focus on addressing joint, tendon, ligament, and muscle concerns without immediate reliance on long-term medication or surgical intervention.

The concentrated components in BMAC—including cells and growth factors—are introduced directly to areas of tissue injury or degeneration. This targeted delivery may help support the body’s natural healing processes and assist in restoring mobility and function over time.

Procedures using Regenexx lab processes may be considered for individuals with more significant soft tissue injuries, such as partial tendon, ligament, or muscle tears, or those with joint issues related to arthritis or wear-and-tear degeneration. These procedures may support reduced inflammation, decreased joint pain, and improved movement.

For individuals with more advanced joint degeneration, orthobiologic procedures may help delay the need for joint replacement. Since the injectate is derived from the person’s own bone marrow, the process avoids concerns related to donor tissue and is considered less invasive than surgical alternatives.

Within the field of interventional orthobiologics, bone marrow aspirate concentrate continues to offer a research-based option for managing musculoskeletal conditions—one that aims to improve function and support joint health over the long term.

Conditions That May Benefit From Orthobiologic Treatment

Physicians use orthobiologic procedures to help support recovery in a variety of musculoskeletal conditions. These procedures help promote improved joint and soft tissue function. They may also reduce pain in cases where traditional treatments, such as surgery or long-term medication use, present limitations or additional risks.

Physicians in the licensed Regenexx network may consider orthobiologic procedures using Regenexx lab processes for the following orthopedic conditions:

• Knee Osteoarthritis: Knee osteoarthritis occurs when the cartilage in the knee joint wears down over time, leading to pain, stiffness, swelling, and reduced mobility. Symptoms may worsen with activity, potentially affecting daily movements such as walking or climbing stairs. Read more about knee osteoarthritis.

• ACL Tear: An ACL tear is a partial or complete rupture of the anterior cruciate ligament in the knee, often caused by sudden twists or high-impact movements. It may lead to pain, swelling, instability, difficulty bearing weight, or changing direction. Read more about ACL tears.

• Ankle Ligament Tears: Ankle ligament tears occur when the ligaments supporting the ankle are overstretched or torn due to trauma or excessive strain. This may cause pain, swelling, bruising, and instability, potentially affecting balance and mobility. Read more about ankle ligament tears.

• Plantar Fasciitis: Plantar fasciitis is a common cause of heel pain, resulting from inflammation of the plantar fascia, the ligament that supports the foot arch. It often causes sharp pain, especially in the morning or after long rest periods. Proper treatment can help improve mobility. Read More About Plantar Fasciitis.

• Hip Tendon Tears: Hip tendon tears occur when the tendons around the hip joint partially or fully rupture due to injury or degeneration. This may cause pain, weakness, and reduced mobility, often worsening with movement or prolonged activity. Read More About Hip Tendon Tears.
• Hip Osteonecrosis: Hip osteonecrosis occurs when reduced blood flow to the femoral head leads to bone tissue death, potentially causing pain, stiffness, and joint instability. Symptoms may worsen over time, affecting mobility and increasing the risk of hip joint collapse. Read More About Hip Osteonecrosis

• Shoulder Osteoarthritis: Shoulder osteoarthritis occurs when the cartilage in the shoulder joint wears down over time, leading to pain, stiffness, swelling, and reduced range of motion. Symptoms may worsen with movement, potentially affecting daily activities and arm function. Read more about shoulder osteoarthritis.
• Shoulder Instability: Shoulder instability occurs when the shoulder joint becomes loose or prone to dislocation due to weakened or damaged ligaments. It may cause pain, weakness, and a feeling of the shoulder slipping out of place, often worsening with overhead or repetitive arm movements. Read more about shoulder instability.
• Triangular Fibrocartilage Complex (TFCC): A TFCC (triangular fibrocartilage complex) tear is an injury to the cartilage and ligaments on the outer wrist, often caused by trauma or repetitive stress. It may lead to wrist pain, weakness, clicking sensations, and reduced grip strength, especially during rotation or weight-bearing activities. Read More About TFCC Tears.
• Thumb Arthritis: Thumb arthritis, or basal joint arthritis, occurs when the cartilage in the thumb’s base joint wears down, leading to pain, stiffness, and reduced grip strength. Symptoms may worsen with pinching or grasping movements, affecting daily activities. Read more about thumb arthritis.
• Lateral Epicondylitis: Lateral epicondylitis, commonly known as tennis elbow, is a condition caused by overuse of the forearm muscles, leading to tendon irritation on the outer elbow. It may result in pain, weakness, and reduced grip strength, often worsening with repetitive arm movements. Read More About Lateral Epicondylitis.
• Carpal Tunnel Syndrome: Carpal tunnel syndrome is caused by compression of the median nerve in the wrist, leading to numbness, tingling, weakness, or pain in the hand and fingers. Symptoms may worsen over time, affecting grip strength and fine motor skills. Read more about carpal tunnel syndrome.
• Non-Union Fractures: Non-union fractures occur when a broken bone fails to heal properly, often due to poor blood supply, instability, or infection. This may lead to persistent pain, swelling, and limited function, sometimes requiring additional treatment to promote healing. Read more about non-union fractures.
• Osteonecrosis (Avascular Necrosis): Osteonecrosis, also known as avascular necrosis, occurs when blood flow to a bone is reduced, leading to tissue death. This may cause pain, joint stiffness, and potential bone collapse, often affecting weight-bearing joints such as the hip, knee, or shoulder. Read more about osteonecrosis.
• Acetabular Cysts: An acetabular cyst is a fluid-filled sac that develops within the hip socket (acetabulum), often due to joint degeneration or cartilage damage. It may contribute to hip pain, stiffness, and reduced mobility, potentially affecting daily activities and movement. Read more about acetabular cysts.
• Herniated Disc: A slipped disc, or herniated disc, occurs when the soft inner portion of a spinal disc pushes through its outer layer. This may irritate nearby nerves, causing pain, numbness, or weakness in the back, neck, or limbs, depending on the location of the herniation. Read More About Slipped Discs.
• Bulging Discs: A bulging disc occurs when a spinal disc extends beyond its normal space without rupturing. Depending on the affected area, it may cause localized pain or nerve compression, leading to numbness, tingling, or weakness in the back, neck, or limbs. Read more about bulging discs.
• Spinal Stenosis: Spinal stenosis is when the spinal canal narrows, putting pressure on the spinal cord or nerves. It may cause pain, numbness, tingling, or weakness in the back, legs, or arms, often worsening with prolonged standing or walking. Read more about spinal stenosis.
• Spondylolysis: Spondylolysis is a stress fracture or defect in the vertebra, most commonly in the lower back. It may cause localized pain, stiffness, and, in some cases, nerve irritation, often worsening with activity or prolonged standing. Read more about spondylolysis.
• Sacroiliac (SI) Joint Dysfunction: The SI joint connects the spine to the pelvis and helps transfer weight between the upper body and legs. Dysfunction or inflammation in this joint may cause lower back pain, hip discomfort, and stiffness, often worsening with movement or prolonged sitting. Read more about sacroiliac joint dysfunction.

What Happens During A BMAC Injectate Procedure?

Physicians in the licensed Regenexx network follow a series of coordinated steps when preparing and administering BMAC using Regenexx lab processes. Each stage is guided by image-based precision and specialized protocols.

• Preparing The Bone Marrow Aspiration Injectate: The physician draws bone marrow from the pelvis using a needle and image guidance after numbing the area with local anesthetic.
• Processing The Sample: The physician places the marrow in a centrifuge, a machine that spins the sample to concentrate specific cells and growth factors into a smaller volume for injection.
• Injection into the Target Area: The physician uses image-guidance (ultrasound or fluoroscopy), real-time imaging that helps guide the injectate precisely into the area of tissue damage or degeneration.
• Post-Procedure Care: The physician advises a return to light activity within a few days and may recommend follow-up visits and temporary activity modifications.

Determining If Bone Marrow Aspirate Concentrate Procedures Are Right For You

Persistent joint pain or limited mobility—despite rest, physical therapy, or medications—may warrant further evaluation. When symptoms interfere with daily activities or do not improve over time, a physician may recommend additional diagnostic testing to better understand the cause and severity of the condition.

A thorough evaluation may include:

• Physical examination to assess movement, joint stability, and function
• Review of medical history, including prior diagnoses, treatments, and outcomes
• Imaging tests to help identify tissue damage, inflammation, or joint changes. These include:
• X-rays to evaluate joint structure, spacing, and signs of degeneration
• MRI scans to assess cartilage, soft tissue, and inflammation
• Ultrasound to visualize tendons, ligaments, and joint surfaces in real time

Physicians may recommend procedures using bone marrow aspirate concentrate for individuals who:

• Are not candidates for surgery
• Prefer less invasive alternatives
• Wish to delay or avoid joint replacement

For physicians outside the licensed Regenexx network, outcomes can vary widely and are closely tied to the clinician’s training and procedural technique. Physicians in the licensed Regenexx network use precise techniques, image guidance, and Regenexx lab processes to prepare and deliver injectates accurately.

While costs for orthobiologic procedures may vary, research-backed protocols performed by experienced physicians may help reduce symptoms and promote improved joint function. Individuals considering this option should consult a physician trained in interventional orthobiologics who follows standardized protocols and tracks patient outcomes over time.

Manage Chronic Pain With Regenerative Treatment Options

Chronic joint or soft tissue pain can interfere with daily life, limiting movement and impacting overall well-being. When traditional treatments offer limited relief—or carry risks that outweigh potential benefits—interventional orthobiologics may provide an alternative approach.

Procedures using Regenexx lab processes allow physicians to use components from the individual’s own bone marrow to support the body’s natural healing process. These procedures aim to reduce symptoms and promote improved function without the need for surgery or long-term medication use.

Consult with a physician in the licensed Regenexx network to determine whether these procedures align with your specific condition, goals, and treatment needs.