The Truth About ‘Bone on Bone’ Pain—and How to Avoid Surgery

When your primary care physician says you’re “bone on bone,” it can sound like a life sentence of pain, limited mobility, and inevitable joint replacement surgery. But that’s not the full story.

In this episode, Dr. Trip Goolsby and LeNae Goolsby, JD, founders of Infinite Health Integrative Medicine Center, break down what “bone on bone” really means, why it happens, and how regenerative medicine therapies can help your body naturally repair and restore joint function—without surgery, steroids, or downtime.

You’ll learn:

• What “bone on bone” actually looks like inside your joints
• Why pain often comes from inflammation and degeneration, not missing cartilage
• The science behind regenerative medicine and how it activates your body’s repair mechanisms
• Real-world results Dr. Goolsby has seen from patients who’ve avoided surgery

If chronic joint pain has been holding you back from living, moving, or leading at your best, this episode will show you what’s truly possible through evidence-based regenerative care.

👉 Learn more or schedule your consultation at YourInfiniteHealth.com

Transcript

no, I think I lost my list of jokes. No. Hold on.

So, ⁓ hey trip, hey, Lenae. What is the best thing that happened to you today. You dear. ⁓ my God. That was too easy for you. Hmm. ⁓ I'm trying to find.

A joke.

Here's kind of a weird one. Well, not a weird one. A lame one. Isn't that a dad joke by definition? It is a dad joke by definition. What did one slice of bread say to the other before they race? Before they race? Yeah, two pieces of toast were about to race. What did one say to the other? Kind of smack talk, just toast, give each other.

Toast runs in a race. You don't know no idea your toast Okay, yeah 300 297 to go Okay, so

In my DMs, I get a lot of people wanting information about regenerative medicine and then they say things like, when I'm like, well, what kind of pain are you dealing with? They're like, I'm bone on bone. Bone And that sounds terrible. You can almost hear the grinding. Yeah, it's a terrible... So people talk and I visualize in my mind's eye what the words other people say and sometimes it just...

I'm like, how do I unsee that? So bone on bone, what does it mean? Are those people candidates? Like, let's talk about that. And do they even really know what that means? Do other doctors know what that means? Tell me all about bone on bone.

So I guess I would be better placed if I were a radiologist to talk about bone on bone because bone on bone is a term related to the appearance on an X-ray examination, a plane X-ray examination of what degenerative arthritis amounts to or what the long-term...

long-term arthritis kind of evolves into on an x-ray examination. there are different stages on an x-ray that show progressive deterioration of the joint. And so what you see is bone-on-bone is kind of the end product of that erosion and destruction of the joint. That shows... Are erosion of like cartilage? Well, Like they have no cartilage? So on x-rays...

when you have the picture is taken, there's the bone, then there's generally a layer of cartilage depending on what kind of joint it actually is. And then there's a little space and then again, the other side generally has some cartilage which is translucent on the x-ray also. And then there's, and you can see a little bit, and then there's again bone. ⁓

So

you've got those kind of four or five levels in the x-ray that as the joint erodes and succumbs to gravity, the effects of gravity, let's say, ⁓ first you have a narrowing of the space in between the two more dense layers on the x-ray, and then it gets thinner and thinner and thinner, and then the two bone levels are

and then when there's no space in between, then it's the appearance. And there are other changes on the x-ray that occur at the same time. There's condensation of the bone. The bone becomes denser on each side as the bone reacts to the pressure and the erosion. then basically you have two dense bony surfaces of what looks like two dense bony surfaces.

⁓ there but it's in in reality what's happening in there is that it's not it's not well bone-on-bone gives the illusion as you were talking about you start thinking about it's grinding and there's nothing there to sounds gross yeah to lubricate or to but in fact there are still there are still all of the elements for the body to produce

⁓ and to repair themselves and reproduce cartilage. So there's still islands of cartilage there that on the entire surface of that bone on bone, there's still islands of cartilage that can be stimulated to repair if there's ⁓ given the right environment and the right stimuli.

And the reduction of the, generally speaking, there's generally a very high level of inflammation that's there that impedes the repair process and the stem cells that ⁓ actually do the repair, they're actually inhibited by the level of inflammation that's in there. So the joint doesn't actually repair itself. The cartilage doesn't repair itself because that environment is adversarial to... ⁓

to the stem cells going back to work. So in an ideal scenario you would first look to reduce inflammation. Correct. And how do you go about doing that? well that well

in the scenario that I see very often here is I'll see patients that have bone on bone or very narrow joints and they're generally inflamed and painful. And the key to getting an optimum outcome as I'm thinking ⁓ doing the regenerative medicine and using those bio-

nanoparticles to, to, Mezenchymal signaling cells. Well, Mezenchymal signaling cells, but exosomes, Mezenchymal signaling cells, Morton's jelly, PRP, all of these things actually go in and reduce the inflammation, help reduce that inflammation. But in fact, it's the whole body picture at that point is generally in patients that have those, that level of damage.

generally have very high levels of systemic inflammation too. And optimizing that environment that exists in their body wide actually results in significant amounts of pain resolution. And that's a more complex process. And what we do is I evaluate that. ⁓

thorough evaluations laboratory.

and that and we we optimize that environment in there first before proceeding with the regional or local administration of products to to activate the repair process and the stem cells the patient's stem cells to repair itself. Do you think that that is something that sets you apart from any other person trying to do stem cells? combined program that we

use is probably superior than to just getting it is superior. There's no probably it's superior. But go ahead. Yeah, it is. mean, because I will routinely have anywhere from 40 to 60 % reduction of pain simply by doing the optimization process itself. Well,

That's pretty impressive. I've had people say, I'm going to put off my ⁓ stem cell process because I feel so good because of the optimization process. Yeah. Which doesn't serve really. I mean, it serves, but it may slow the process, the degenerative process some, but it doesn't resolve it. the results of a local approach are far, far superior.

than just doing the optimization process. Do you find that people are ⁓ open? Because in my head, a lot of people just want a quick fix. And they think ⁓ a quick injection of stem cells into their joints is going to be the quick fix. And then they continue on their merry way, engaging in the behavior that. ⁓

you know, might have contributed to the pain point to begin with. Yeah, so in that setting, it's like the difference between ⁓ doing a full optimization process and getting, for example, ⁓ a testosterone shot. You you'll get the effect, but you won't have an optimum effect because there are many other elements that are involved.

in testosterone having its best effect. Okay. But I guess my question was, are people open to take, because the optimization process requires the, a lot of times significant behavioral modification.

in lifestyle choices. So do you find that people are open to starting that slow and steady shift, you know, to get optimized before they do the regenerative medicine approach or do you get resistance in that? ⁓

Only rarely actually do I get resistance in that because people tend to after having an explanation, people understand that if they're going to get a better result, especially since it's the vast majority of the regenerative care is not covered by insurance, ⁓ most people...

understanding they're paying out of pocket 100 % for that regenerative ⁓ procedure are going to say, yeah, I want to get the best outcome I can get. And realistically, optimization ⁓ very, ⁓ very often...

creates an environment that makes the patients feel so much better that they and it happens fairly rapidly that taking an extra few weeks to get that done ⁓ is not cumbersome for them and they do it. However, there are people, I just want to get the shot and do that. And that brings up the topic of why conventional medicine, reactive medicine with its steroid injections that actually compromise the joint.

⁓ ultimately and cause rapid deterioration and accelerate ⁓ the ⁓ appearance of degenerative joints. It's a quick fix. get, ooh, you know.

You get quick pain relief and that's, it's not a mindful process because it's going to accelerate the degeneration of a joint and it's not going to resolve or help repair the joint at all. Yeah. I think more people need to know about that. That's another episode. I have to put that on my list. Steroid, steroid stuff. Cool.

Well, ⁓ y'all, I hope you found that educational, informational, somewhat entertaining, and until next time.