Frequently asked, plainly answered

Common questions, in one place.

Short, accurate answers, organized by topic. For the full clinical depth on any therapy, follow the link at the top of each section to the dedicated service page.

01 · General

The clinic, your visit, and how we work.

What to expect at a consultation, who performs the procedures, and how we decide whether biologic therapy is the right path for you.

About the clinic
What should I expect during my first visit? +

A 45–60 minute consultation with Dr. Glowney. We review your history and imaging, perform a focused physical exam, and walk through which therapies (if any) are appropriate for your situation. You leave with a clear plan, not a sales pitch.

Who actually performs the procedure? +

Dr. Jason Glowney performs every aspiration, injection, and image-guided delivery personally. He does not delegate procedures to a PA or RN. Lab processing is performed in our on-site biologics lab by trained clinic staff under his oversight.

How is this different from standard orthopedic care? +

A standard orthopedic visit typically ends in one of three places: physical therapy, a cortisone injection, or a surgical referral. We add a fourth path, autologous biologic therapy, and we tell you honestly when one of the first three is the better answer for your case.

Am I a candidate for PRP or cellular therapy? +

Candidacy depends on your imaging, condition stage, and overall health. Mild-to-moderate joint and tendon conditions respond best. Advanced, diffuse arthritis typically does not: in those cases we'll tell you, and refer you to the right specialist instead.

How do I get started? +

(1) Request a consultation by phone, web form, or email: we follow up within one business day. (2) Send any recent imaging (MRI, X-ray) so Dr. Glowney can review it before your visit. (3) Come in for an unhurried conversation about whether biologics fit your goals.

What's the difference between PRP, BMAC, and "stem cell" therapy? +

PRP uses concentrated platelets and growth factors from your blood. BMAC uses mesenchymal stromal cell–containing material from your own bone marrow. Consistent with FDA guidance, we don't use the colloquial "stem cell therapy" framing: every therapy we offer is autologous (your own cells, minimally manipulated), not donor-derived or culture-expanded.

How long does it take to see results? +

Biological response varies by patient and condition. Many patients note progressive improvement over 4–12 weeks. We schedule functional follow-up at 6 and 12 weeks to track progress objectively, and reassess at 12–16 weeks if meaningful response hasn't emerged.

Are you part of any research studies? +

Yes. Dr. Glowney founded the Boulder Biologics Research Center (formerly Apeiron Research Center), our non-profit sister organization, which runs IRB-approved trials investigating cellular therapies for orthopedic and systemic conditions. Eligible patients are offered enrollment when a study fits their situation.

02 · Cellular therapy (BMAC)

Bone marrow aspirate concentrate & MSCs.

What MSCs actually are, how they differ from what's marketed elsewhere as "stem cells," and what the procedure day looks like.

Full cellular therapy page
What are mesenchymal stem cells (MSCs)? +

Mesenchymal stromal cells (MSCs) are a population of cells found in bone marrow and other connective tissues that meet specific defining criteria, plastic adherence in culture, expression of certain surface markers, and multilineage differentiation potential. In our clinic the MSC-containing fraction is delivered as part of a minimally-manipulated bone marrow aspirate concentrate (BMAC), characterized by flow cytometry.

Is this the same as a "stem cell injection" I've seen advertised? +

No. We do not perform commercially-marketed "stem cell injections" of unregulated, expanded, or donor-derived cell sources. Our cellular therapy is autologous (your own marrow), minimally manipulated, and used in a single in-clinic procedure consistent with FDA guidance.

How does this differ from PRP? +

PRP uses concentrated platelets and growth factors derived from blood. Autologous cellular therapy uses MSC-containing material from bone marrow: a richer biologic profile, including progenitor cells, growth factors, and signaling molecules. Indications also differ; BMAC is generally reserved for more advanced joint disease where PRP alone is unlikely to be enough.

Is the bone marrow aspiration painful? +

Aspiration is performed in-clinic under local anesthesia, drawing from the posterior superior iliac spine (PSIS). Most patients report moderate pressure during the procedure but little sharp pain. Soreness at the harvest site for 2–5 days afterward is expected.

How long does the whole appointment take? +

Total clinic time is typically three to four hours. Most of that is biologic preparation and processing in our on-site lab, not procedure time. The aspiration itself and the image-guided delivery each take 10–30 minutes.

Why deliver to both the joint space and the subchondral bone? +

In moderate-to-severe joint disease, the pathology lives in both compartments. Contemporary research increasingly views the osteochondral unit, cartilage plus the underlying subchondral bone, as a single mechanical and biologic system, so directed delivery to both is often more effective than intra-articular alone.

What conditions do you most often consider this for? +

Most commonly evaluated:

  • Moderate-to-severe knee, hip, and shoulder osteoarthritis
  • Post-meniscectomy and cartilage injury
  • Rotator cuff tears and labral pathology
  • Avascular necrosis (early-stage)
  • Recalcitrant tendinopathy where PRP has been inadequate
What can I expect after the procedure? +

Plan for 2–5 days of soreness at the harvest site and at the injection site. We provide tailored activity modification guidance and rehab milestones, with functional follow-up at 6 and 12 weeks.

Does insurance cover autologous cellular therapy? +

Most insurance plans currently do not cover autologous biologic cellular therapy, coverage policies vary by insurer and indication, but these therapies are commonly classified as investigational. All clinical services at Boulder Biologics are self-pay, with transparent pricing during your initial conversation and documentation for HSA/FSA reimbursement where applicable.

03 · Platelet-rich plasma

PRP: preparation, procedure, and recovery.

What's actually in the syringe, how the protocol differs from kit-based PRP, and what the response curve looks like week-by-week.

Full PRP page
How is PRP prepared in your lab? +

PRP is prepared from your own blood using a controlled, multi-step laboratory process: venous draw into anticoagulated tubes, a low-force "soft spin" to separate plasma from red cells, a higher-force "hard spin" to concentrate platelets into a pellet, and resuspension to an indication-specific platelet concentration. Baseline CBC and post-processing analysis are documented for every preparation. Our protocols follow published reporting frameworks (PAW, DEPA).

Is the PRP procedure painful? +

Most patients experience mild-to-moderate discomfort during the injection itself. Anatomic location and underlying condition affect this. Non-acidic, non-platelet-toxic local anesthetics are used for comfort, and ultrasound or fluoroscopic guidance reduces unnecessary needle passes.

How effective is PRP? +

PRP can be clinically helpful for selected musculoskeletal conditions, but effectiveness is variable. PRP is not a single standardized product, and outcomes are influenced by diagnosis, disease severity, formulation, delivery technique, rehabilitation, and individual patient biology.

Evidence is strongest for knee osteoarthritis, lateral epicondylitis (tennis elbow), and rotator cuff tendinopathy. Improvement is usually gradual, often emerging over 4–12 weeks.

How much blood is drawn? +

The amount varies by patient and indication, number of sites, severity, baseline platelet count, target concentration. Volumes are generally comparable to, and often less than, those drawn for routine laboratory testing. Collection uses sterile technique and you're monitored throughout.

Can multiple injury sites be treated during a single PRP visit? +

In selected cases, yes, but this is an individualized decision. Considerations include total PRP volume, recovery profile across sites, and whether the indications share a similar formulation. Dr. Glowney makes the call during your evaluation.

Can I drive myself home after PRP? +

Yes. PRP uses only local anesthesia, so you can drive yourself to and from the appointment. If the treated site is in a lower limb where soreness might affect pedal control, let us know in advance and we'll plan accordingly.

Should I take NSAIDs after PRP? +

We recommend avoiding NSAIDs in the early window after PRP. Inhibiting the inflammatory cascade right after the injection may blunt the very biologic response we're trying to support. Acetaminophen, ice, and elevation are acceptable for discomfort within the first few days.

When can I return to activity? +

Avoid strenuous activity for the first 24–48 hours. After that, return gradually to your rehabilitation program as outlined in your post-procedure plan. Progressive, condition-specific loading is part of how PRP outcomes are optimized, especially for tendinopathy.

What's different about Boulder Biologics PRP? +
  • Protocol-driven, not kit-based: platelet concentration is adjusted to indication and your individual baseline.
  • On-site, same-day processing: no shipping, no storage delays.
  • Two-spin density-gradient preparation with controlled centrifugation forces.
  • Leukocyte and RBC content tailored to indication rather than a one-size-fits-all formulation.
  • Image-guided delivery on every procedure.
  • Documentation of every preparation: baseline CBC and post-processing analysis.

04 · PRP variants

PRP+HA, PRP+protein-rich plasma, LD-PRP & hydrodissection.

Where each variant fits, why we'd reach for one over the others, and the safety considerations behind them.

PRP variant pages
Why might I be offered PRP + Hyaluronic Acid instead of PRP or HA alone? +

Because they target different drivers of OA symptoms. HA addresses the joint's mechanics (lubrication, viscoelasticity). PRP modulates the biologic environment (inflammation, signaling). Combined delivery may produce more durable improvement than either alone in knee OA, though responses vary and end-stage disease may not respond robustly to any injection.

How is the hyaluronic acid product chosen? +

HA products vary by molecular weight, crosslinking, and whether they are single- or multi-injection protocols. We match the HA preparation to the clinical picture, crosslinked, higher molecular-weight products are typically preferred for chronic OA; lower-MW formulations may be considered when faster diffusion through synovium is preferred.

What is PRP + Protein-Rich Plasma and how does it differ from standard PRP? +

Standard PRP focuses on platelet concentration. This protocol focuses on soluble plasma proteins, particularly alpha-2-macroglobulin (A2M) and fibrinogen, concentrated from platelet-poor plasma while retaining a controlled platelet dose. The rationale: A2M is a broad-spectrum protease inhibitor that may slow MMP/ADAMTS-driven cartilage breakdown in OA.

Why is fibrinogen sometimes useful and sometimes harmful? +

Fibrinogen can form a provisional matrix that binds and localizes growth factors, useful in controlled OA contexts. But in inflammatory joint disease, fibrinogen and fibrin degradation products may amplify inflammation. This is why we select patients carefully and avoid protein-rich preparations in inflammatory arthropathies.

Who should NOT consider the protein-rich protocol? +

Generally avoided in:

  • Active inflammatory or autoimmune arthropathies (RA, psoriatic, gouty flares)
  • Active infection at or near the planned injection site
  • Coagulopathies or anticoagulant regimens that can't be safely managed
  • Pregnancy (procedural and biologic safety not established)
How is LD-PRP (low-density PRP) different from standard PRP? +

Standard PRP is processed to a higher platelet concentration than baseline, driving a more pronounced inflammatory and proliferative response. LD-PRP is processed to a lower concentration: better suited to peri-neural and soft-tissue applications where you want some biologic signaling without the inflammatory burden.

What conditions do you use LD-PRP and hydrodissection for? +

Common contexts include:

  • Peripheral nerve entrapment (carpal tunnel, ulnar at elbow, peroneal at fibular head)
  • Post-surgical neuralgia and adhesion-related nerve irritation
  • Sensitive soft-tissue regions where standard PRP would be too inflammatory
How long does the LD-PRP / hydrodissection procedure take? +

Total clinic visit is approximately two hours, preparation takes about one hour in our on-site lab; the procedural portion (image-guided delivery) takes 10–30 minutes depending on number of targets.

05 · Prolotherapy

Hypertonic-dextrose injection for ligament and tendon support.

A non-biologic injection that stimulates a local repair response, different from PRP, with its own indications and cadence.

Full prolotherapy page
What is in a prolotherapy injection? +

A solution of hypertonic dextrose (a medical-grade sugar solution at concentrations above physiologic levels) mixed with saline. A local anesthetic may be added for comfort. It is not a biologic: there are no cells or growth factors in the syringe.

How is prolotherapy different from PRP? +

PRP is autologous and biologic, concentrated platelets and growth factors from your blood. Prolotherapy is non-biologic, the dextrose acts as a local irritant that stimulates an inflammatory response, theoretically promoting collagen synthesis at the injection site. Different mechanisms, often different indications.

How many injections will I need? +

Improvement, when it occurs, is typically gradual and often requires a series of injections spaced over weeks to months. The exact cadence depends on the structure being treated and your response. Most protocols involve 3–6 sessions, with reassessment between.

Is prolotherapy painful? +

Most patients tolerate prolotherapy well, especially with local anesthesia. Mild-to-moderate soreness for several days after the injection is common, and is part of the intended inflammatory response.

When can I return to activity? +

Most patients can resume light activity the same day. We recommend avoiding strenuous activity for 24–72 hours, then a gradual return as guided by your post-procedure plan and any concurrent rehabilitation.

Does insurance cover prolotherapy? +

Prolotherapy is generally not covered by commercial insurance plans or Medicare for musculoskeletal indications. We discuss expected costs in advance and supply HSA/FSA reimbursement documentation where applicable.

06 · EPAT (Pulse Activation)

Extracorporeal pulse activation, non-invasive, multi-session.

Acoustic-wave therapy for chronic tendinopathy and fasciopathy, delivered weekly over a short series.

Full EPAT page
Is EPAT the same as shockwave therapy? +

Yes, EPAT (Extracorporeal Pulse Activation Technology) is commonly known as shockwave or extracorporeal shockwave therapy (ESWT). The technology delivers low-frequency acoustic waves to soft tissue to stimulate a local biological response.

Is EPAT painful? +

The applicator pulses directly against the treatment site, which can cause mild discomfort during the session, but it's generally well tolerated and does not require anesthesia. The intensity is dialed to your tolerance.

How many sessions will I need? +

EPAT is most effective when repeated weekly over four to six weeks. Improvement is typically gradual across the series, the biologic and mechanical effects accumulate. Some patients benefit from a brief maintenance series later in the year.

Are there any side effects? +

EPAT is generally well tolerated. Reported side effects are usually mild and self-limited:

  • Transient soreness or aching at the treatment site (1–3 days)
  • Mild skin redness or bruising
  • Brief numbness or tingling, usually resolving within hours
Can I exercise after a session? +

Yes. EPAT has no downtime: most patients resume normal activity immediately after a session. We usually recommend avoiding maximal-intensity loading of the treated tissue for 24 hours, then a gradual return.

Does insurance cover EPAT? +

EPAT is generally not covered by commercial insurance plans or Medicare for musculoskeletal indications, despite being FDA-cleared. We discuss expected costs in advance and provide HSA/FSA documentation.

Can EPAT be combined with other treatments? +

Yes. EPAT is often most effective alongside structured physical therapy and progressive loading, particularly for tendinopathy. It can also be considered as a precursor to or follow-up after biologic therapy, depending on the indication.

07 · Longevity medicine

Healthspan, biological aging, and HRT.

How longevity care differs from an annual physical, what hormone replacement decisions look like, and how long a program runs.

Full longevity page
How is this different from a regular annual physical? +

Annual physicals are designed to screen for current disease. A longevity assessment quantifies your biological age, your trajectory across multiple systems (epigenetic, cardiometabolic, neurocognitive, mitochondrial), and the modifiable drivers, then builds a personalized plan to change that trajectory before disease emerges.

Do you prescribe hormone replacement therapy (HRT)? +

Yes, when clinically appropriate. HRT decisions follow individual assessment of hormone metabolism, cardiovascular risk, family history, and patient goals, with ongoing monitoring and documentation. We do not prescribe hormones without a complete workup and follow-up cadence.

Do you offer peptide therapy? +

We discuss peptide options where the evidence base and regulatory status support their use. We do not promote unregulated or research-only compounds for general "optimization."

How long is a longevity program? +

Most clients begin with a comprehensive assessment, followed by 3–6 months of active optimization with quarterly follow-up. Long-term care is structured around an annual cadence with interval testing.

Is longevity care covered by insurance? +

Standard labs may be covered by insurance. Specialty testing (epigenetic clocks, advanced metabolics) and longevity consultations are typically not covered. We provide transparent pricing during your initial conversation and supply HSA/FSA documentation where applicable.

Can I do both orthopedic and longevity care here? +

Yes, and many of our patients do. There's real synergy: musculoskeletal function is a longevity variable, and biologic strategies often appear in both pathways.

08 · Insurance & billing

Pricing, payment, and reimbursement.

The honest summary: most biologic and longevity services are self-pay, and we provide documentation for HSA/FSA reimbursement.

Pricing conversation
Does insurance cover orthobiologic therapy? +

Most plans (commercial and Medicare) currently do not cover autologous biologic procedures. They are commonly classified as investigational despite a substantial evidence base for some indications. All clinical services at Boulder Biologics are self-pay: one clear price, discussed up front.

Can I use HSA or FSA funds? +

In most cases, yes. We provide itemized documentation suitable for HSA/FSA submission. Your account administrator is the final authority on eligibility, but biologic procedures and longevity consults typically qualify.

What does a PRP or BMAC procedure cost? +

Pricing depends on the joint, the number of sites, and the specific formulation (e.g., standard PRP, PRP + HA, BMAC). We provide transparent, written pricing during your consultation so there are no surprises at the time of the procedure.

Do you offer payment plans? +

Yes. We work with several medical financing partners that offer 0% APR options for qualified patients. We'll walk through what's available during your visit.

Still wondering

If your question isn't here, ask Dr. Glowney.

A 45–60 minute consultation is the surest way to find out whether biologic or longevity care fits your situation. We answer honestly, including when the answer is "not right now."