Back, hip and pelvis pain are often one connected problem. The SI joint, the hip joint, the tendons around the hip and the muscles of the core and pelvic floor all share the load. We match the tool to the source: focused shockwave for tendons and soft tissue around the hip and low back, high-dose PRP or stem cells injected under live ultrasound into the hip or SI joint, and EMSELLA paired with focused shockwave when pelvic floor weakness is part of the picture. What we do not do: we do not inject spinal discs or facet joints.
If back and hip pain have taken your runs, your rounds of golf or just your sleep, you have probably been told a different story by every provider. The first step is finding which structure is actually driving it.
Which tool fits which source
SI joint pain: PRP under ultrasound
The sacroiliac joint connects the spine to the pelvis and is a common, often missed source of low back and buttock pain. We inject it with high-dose PRP under live ultrasound. The trials are small and split: in 40 patients, ultrasound-guided PRP beat steroid at three months, while a 26-patient double-blind trial found steroid better. We will tell you where the evidence stands for your case. More on SI joint dysfunction.
Hip arthritis: PRP or stem cells
For hip osteoarthritis, high-dose PRP or stem cell therapy is injected into the joint under live ultrasound. In a randomized trial of ultrasound-guided injections for hip arthritis, PRP improved pain, and the benefit held up to 12 months better than hyaluronic acid. Which treatment fits depends on how advanced the joint is. More in our hip pain guide.
Hip tendons and low back soft tissue: focused shockwave
Pain on the outside of the hip, often called bursitis, usually comes from the gluteal tendons. In a 229-patient controlled study, a steroid shot worked fastest in the first month, radial shockwave led at four months, and at fifteen months shockwave and a home exercise program both did better than the steroid. Focused shockwave, with EMTT, is also used for chronic muscle and soft-tissue pain around the low back. See focused shockwave.
The pelvic floor: EMSELLA with focused shockwave
The pelvic floor is the base of the core that stabilizes the pelvis. In one study of 85 women with low back and pelvic pain, 95% had some form of pelvic floor dysfunction, and in a small randomized trial, adding pelvic floor exercise to standard low back care lowered pain and disability. When leakage or pelvic floor weakness is part of your story, Dynamic Core+ pairs EMSELLA with focused shockwave. EMSELLA is never given alone here, and it is not a back pain treatment. See EMSELLA.
What we do not do
Knowing the limits is part of choosing the right clinic. If one of these is what you need, we will tell you and point you to the right specialist.
- We do not inject spinal discs
- We do not inject facet joints
- We do not treat nerve compression that needs a surgical opinion; progressive weakness, numbness or bladder changes need urgent evaluation
- We do not give EMSELLA alone; at Dynamic Athlete it is always paired with focused shockwave
- We do not guess: the source is found by exam, and by imaging when it adds something
Before you book, ask
- Which structure do you think is causing my pain, and how did you decide?
- Will the injection be placed under live ultrasound, and by whom?
- Is the pelvic floor part of my evaluation?
When not to wait
New leg weakness, numbness in the groin or saddle area, or new bladder or bowel changes with back pain are an emergency. Go to an emergency department. Everything else starts with an exam.
Frequently asked questions
Does shockwave therapy work for lower back pain?
Shockwave has been studied for chronic low back pain that comes from muscle and soft tissue. A 2021 meta-analysis of 10 randomized trials with 455 patients found less pain at one month and less disability at one and three months, so the evidence is for short-term benefit. It is not a treatment for disc herniation or nerve compression. At Dynamic Athlete focused shockwave, with EMTT, is used for soft tissue around the low back and hip, after an exam identifies the source.
Does PRP work for hip pain?
For hip osteoarthritis, yes, in trials. In a randomized trial of ultrasound-guided injections, PRP improved hip arthritis pain and the benefit held up to 12 months better than hyaluronic acid. It works best before the joint is severely worn. At Dynamic Athlete high-dose PRP is placed under live ultrasound by Aneesh Garg, DO, CAQ.
Can PRP be injected into the SI joint?
Yes. The sacroiliac joint can be injected with PRP under ultrasound guidance. The trials are small and split: in 40 patients, PRP beat steroid at three months, while a 26-patient double-blind trial found steroid better. We inject the SI joint; we do not inject spinal discs or facet joints.
Can pelvic floor problems cause back pain?
Pelvic floor problems and low back or pelvic pain often occur together. In one study of 85 women with lumbopelvic pain, 95% had some form of pelvic floor dysfunction, although that kind of study cannot show which causes which. The pelvic floor is part of the core that stabilizes the pelvis, which is why it is part of our evaluation when back, hip and pelvic symptoms overlap.
Does EMSELLA help back pain?
EMSELLA is an FDA-cleared pelvic floor treatment, not a back pain treatment. When pelvic floor weakness or leakage is part of the picture in someone with back or hip pain, we pair EMSELLA with focused shockwave as Dynamic Core+. EMSELLA is never given alone at Dynamic Athlete.
Are stem cells used for hip arthritis?
Stem cell therapy using your own tissue, microfragmented fat or bone marrow aspirate, is used for hip arthritis, typically when the joint is further along than PRP alone would address. At Dynamic Athlete it is always paired with high-dose PRP and placed under live ultrasound.
Is treatment for back and hip pain covered by insurance?
Regenerative treatments like PRP, stem cell therapy, shockwave and EMSELLA are usually not covered. HSA and FSA funds commonly apply, and Cherry financing is available. We give you the full cost before you start, so you can weigh it against the months pain is costing you.
Find the real source first
Same-week evaluations with Aneesh Garg, DO, CAQ. We examine the back, hip, SI joint and pelvic floor together, tell you which structure is driving the pain, and give you the full cost of the plan up front. HSA and FSA funds commonly apply, and Cherry financing is available.
Book an Evaluation
1790 30th Street Suite 270 · Boulder, CO 80301 · 303-997-1733