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Spine Conditions

The spine is a wondrous network of bones, discs, facet joints, ligaments, spinal nerves and muscles, all combined and connected in an incredibly complex way to provide both stability and wide range of movement. The spine is actually a series of joints, joints that sometimes need help functioning as they are intended. Keeping this system mechanically aligned and held snuggly together allows for healthy function and pain-free movement. When optimal function is compromised, spasms, tightness, and pressure on nerves result.               

Many episodes of low back pain pass within a few weeks to a month (acute episode). However, individuals with continuous pain lasting 8 weeks or more after onset (chronic episode) will often have symptoms at 1 year. Pain doesn't always develop immediately following an injury because the body is good at adapting to strains and stress. However, the injured area will cause strain to build up over time and eventually symptoms will develop. This is why injuries from the past can still cause current pain. Symptoms can include muscle ache, shooting or stabbing pain, pain that radiates down leg or arm, limited flexibility. 



Osteopathic Manipulation

Osteopathic Manipulative Treatment (OMT) focuses on correcting mechanical dysfunction. Structural integrity allows these complex joints to function as they were designed, reducing irritation, inflammation and pain. Healthy function improves blood flow to nourish tissue and further reduce inflammation. Strain on surrounding body tissue caused by compensation is reduced preventing further complications. OMT addresses the root biomechanical causes of injuries and conditions to alleviate pain and restore optimal function of the body.

Osteopathic Manipulative Therapy (OMT) helps to:

  • Correct structural and tissue abnormalities in vertebrae, muscles, myofascial structures, etc.
  • Relieve joint restriction and misalignment
  • Restore muscle and tissue balance
  • Promote the movement of bodily fluids


Look well to the spine for the cause of diseases. -Hippocrates

  • Excellent experience! The staff and Dr. Minotti are all friendly, helpful, and knowledgeable. I received PRP Therapy in both knees and have noticed significant improvement in daily movement and functionality. Highly recommend. Charity C

  • I’m writing this review on behalf of my mom who is a patient here. She raves about Dr. Philip. She had gone in for frozen shoulder and back pain, and is currently undergoing OMT (osteopathic manipulative therapy). After a few treatments, she experienced significant improvements, and she attributes them to “Dr. Philips magic hands”. Not only is he kind and intelligent, but it is very evident that he genuinely cares about his patients. Bottom line: I would highly recommend Dr. R Philip. Maryam

  • Friendly staff,schedule flexibility is good. The doctors I have seen so far are nice, knowledgeable and helpful in helping you making decision. Their services and treatments are good. Frederick M P

  • Dr. Philip’s work in OMT has not only helped to relieve neck pain I had dealt with for years, it is obvious he truly cares for the well-being of his patients through his careful listening and willingness to offer recommendations and guidance. Jennifer F

  • No more pain, 10000% recommend Dr. Philips. David B

  • Dr. Philip has been awesome in helping me heal through several different joint issues. He is very kind and has a great bedside manner as well as being thorough and knowing his stuff! Highly recommend! Kim L

  • Dr Philip and then NTXMSK team are awesome. From the initial evaluation and follow up my foot pain was resolved. A therapeutic approach that works. Joseph DAmore

  • Significant difference in my strength after the treatment!! I wasn't sure how much difference the prp could make, but I thought worth a try. I would have been pleased with half the improvement I received. I'm amazed at the difference 8 weeks after treatment. Dr Minotti is more like a super smart brother, that answers questions in a friendly manner, the way only experts can! Michele I

  • I am so grateful for Dr. Minotti and his staff! After 10 years of dealing with a painful musculoskeletal injury, Dr. Minotti‘s prolotherapy has made an incredible difference in my life. His skill in how he administers treatment is wonderful — gentle, effective, and always making it as comfortable as possible. Thank you, NTXMSK! Anna F

  • I have had shoulder pain for 10+ years and was recently told that I’d need a complete shoulder replacement. A friend recommended that I see Dr Minotti before doing any surgery. Thankfully, I did. Dr Minotti did PRP on my right shoulder 8 weeks ago. The whole thing only took about an hour and was relatively painless(a few injections). My shoulder feels better than it has in 10 years. I still have a small amount of pain but NOTHING like before the PRP. He also said that it will continue to get better for another month or so. I couldn’t be happier with the results and I would HIGHLY recommend anyone see him if you’re having joint pain. Dr Minotti is a lifesaver for me! Rick T

  • As many people know, very significant osteoarthritis causes great knee pain...

    As many people know, very significant osteoarthritis causes great knee pain and - wanting to avoid surgery - in late August, 2020, I received a Platelet Rich Plasma (PRP) treatment given by Dr. Minotti. Dr. Minotti is an extremely gifted D.O. who uses ultra sound to precisely administer the PRP shots into pivotal places in each knee. I experienced only minor discomfort for 48 hours and on the third day, I was already experiencing relief when I walked. Now, five weeks later, I walk with ease and my expectation is that this knee comfort will continue to grow for another few weeks AND it will also slow down the progression of the osteoarthritis. I am so pleased with the results, I am planning to have another treatment within six months to build up my knees even more. This PRP procedure has exceeded my very best expectations and I highly recommend it and Dr. Minotti to anyone who has such a need.

  • Arthritis in hands and stress fracture foot

    Arthritis in my finger joints was getting worse and simple tasks caused a lot of pain. Also was experiencing loss of strengthin hands. Dr Minotti was able to walk me through various options and help me make an informed decision on what treatment plan was best for me. I chose to go with PRP and although the treatments were uncomfortable, they worked! I had my first treatment on the most damaged joints and all but a couple were now pain free. I opted to do a second treatment and now everything is pain free. My joints are flexible and not aching. I can sew and do all my projects without any pain. I also hada stress fracture in my foot that was not healing with conventional methods. Dr. Minotti walked me through the PRP process and was able to get me back on my feet with just one treatment. I highly recommend him and his team. They always make me feel welcome and make sure I understand the whole process. Follow up was great too. Thanks Dr. Minotti! Beverly S

  • Dr. Minotti is on the cutting edge.

    This PRP procedure has been excellent and definitely worth while. It has greatly helped my osteoarthritis and keeps my knees much more flexible. My quality of life has greatly improved seeing Dr. Minotti. Patricia O

  • I have been pleased with the outcome of my treatment.

    I have had degenerative pain in my thumbs & lower back. I was treating the back pain with chiropractic treatments but not experiencing a more permanent outcome With PRP treatments I am getting more relief each time I have received a treatment. I am satisfied with the progress being made and plan to continue treatments further. Nancy P.

  • Dr. Minotti and Natasha are an awesome team

    I had the prp procedure done on my cervical and lumbar areas well over 7 months ago and haven't experienced any pain from both areas.Dr.Minotti is so down to earth. He's so cool, and very educated and knowledgeable. I'm so comfortable whenever see him and Natasha, because they make you feel at ease. Wendy M

  • PRP improved my shoulder and low back/hip pain

    I had struggled with pain in my shoulder as well as low back, hip/sacral area for several years before meeting Dr. Minotti.I had spent quite a bit of time, enegy and financial resources on visits with other doctors and chiropractors before meeting the team at North Texas Musculoskeletal. I consider myself to be a pretty active inliidual and was very disappointed that I was having to refrain from many types of activities that I enjoyed because the pain was so limiting. It even got to a point where picking up my infant was nearly impossible at times. After treatment with PRP, I was able to slowly ease back into normal exercises and activities that I had missed. I have such high regards for Dr. Minotti and recommend PRP to many that are suffering from pain and would like a more natural approach where our own body can do as it was designed and help heal itself. Charity B.

  • I felt like I was well informed beforehand and post procedure was great.

    Dr. MInotti and his staff are very good communicators , explained things and didn't try to pressure me into decision. Very helpful and friendly. Charlotte B

  • Dr Minotti answered my questions in a way that easy to understand. The procedure went exactly as ...

    Dr Minotti answered my questions in a way that easy to understand. The procedure went exactly as described and the results are excellent. My knee is pain free for the first time in a long time. Lance G

  • PRP is working

    My injection is slowly making my life much better. Pain is considerably less Terry H

  • Outstanding!

    After multiple consultations with several different providers, I heard through a colleague about NTMSK and Dr. Minotti. After my initial visit, I'm sure glad I was referred to NTMSK! Before leaving the office, I knew I was in the right place! I've been under the care of Dr. Minotti for the last 8 months and always look forward to the follow up visits. My shoulder is much better than when I initially saw Dr. Minotti in the latter part of 2019. Thank you NTMSK and Dr. Minotti! Rob F

  • excellent

    My knee pain is almost gone and after 7 months I have noticed increased strength and range of motion when doing yoga. I am grateful for Doctor Minotti& staff. Deborah Y

  • PRP for Achilles Tendinitis

    I cannot say enough positive things about this provider. After nearly 16 years of chronic pain due to a stress fracture that rubbed on my Achilles tendon, I finally found relief! ONE treatment of Platelet Rich Plasma solved this issue. Regenerative Orthopedics should be the best practice standard!! Thank you, Dr. Minotti! Teresa C

  • Always providing great counsel

    Dr. Minotti's bedside manner is always exceptional. He listens well, offers great advice, and is very comprehensive. I trust him and will continue to seek out his medical opinions on my health. I can't recommend him enough. Joel S

  • Huge success treating torn rotator cuff with PRP

    Dr. Minotti is very caring and knowledgeable. We're blessed to have a leader in this field in the DFW metroplex! I'm so happy to be out of pain, back to full strength and to have avoided surgery that would have been costly and would have had long downtime. His staff is great too--no bruising after my blood draw which I greatly appreciated. I highly recommend Dr. Minotti. Rachel L

  • Life changing!!

    I was a chiropractor junkie. The more I went the more I needed it. I have spondylolisthesis meaning L5 has slipped forward causing me pain and discomfort in my low back and hips. After the first treatment I was 80 percent better and able to resume normal activities. I decided to have a second treatment because I wanted to get to start working out without aggravating my low back. This has truly been life changing and I recommend it to everyone. I have not been to a chiropractor in over 9 month!! Sandra L

  • I always walked out with a smile on my face after each appointment

    Dr. Minotti is very thorough, and takes time to listen and is always conservative with his treatment recommendations. I have had muscle manipulation treatments and PRP on my shoulder and big toe on my right foot. I have been in much better health since I started being treated by Dr.Minotti, no more chiropractor for me! I have been seeing Dr.Minotti over 4 years. He's the best!!!! BE

  • Myriad of problems in the shoulder. Torn rotator cuff. Arthritis. Cysts.

    Myriad of problems in the shoulder. Torn rotator cuff. Arthritis. Cysts. Being the dutiful American health care prisoner , I went to my primary care physician. Naturally, surgery was recommended. However, it ain't what you know, it's who you know, and I eventually ended up on Dr. Minotti's doorstep. After a lifetime of bad decisions, finally one I can safely say was one of the best. Just a good man. Knows his business. I can't say that PRP is a picnic (actually it's only mildly annoying. More weird than painful) but it took half an hour, no scalpels, no cuts. And so much more affordable than surgery. He said it would take about 8-12 weeks ...and it did. Spot on. I had a second round three months later. It's now three months after that, and I am 100% fully operational. It's like nothing ever happened. Bottom line: go see this guy for your aches and pains and tears and such. Office staff is exceptional. His assistants are amazing (thank you for letting me squeeze the rubber duck). Detailed explanations during the procedure. Wonderful man, wonderful doctor, wonderful results. Bob B

  • Professional staff. Dr Minotti spent a long time and I felt amazing when I left...

    Professional staff. Dr Minotti spent a long time and I felt amazing when I left; hip pain better! I like the natural approach. Highly recommend. Kim R

  • These guys are super! They are some of the few DOs who still practice manipulation. If you’ve not taken advantage of their services, you should try them out. Dr Jay Roop is my Dr and he’s fabulous! A nice gentle touch combined with great training to see quickly what’s out of alignment he needs to focus on. He’s a Dr who listens! He also is a Family Medical qualified Dr who focuses on the manipulation practice since he knows how effective it can be. Judy

  • So happy to have FINALLY found real osteopathic physicians that perform OMT. I receive ongoing treatment from Dr. Cox for numerous skeletal issues and injuries. He is precise, efficient and very, very good. Dr. Minotti has given me PRP procedures for shoulder injuries, including osteoarthritis and bursitis. I have relief for the first time since October of 2016. Would not hesitate to recommend! Teresa

  • They are wonderful! They have helped my daughter so much with numerous soccer injuries, both knee and back. Highly recommend! Leah Leah

  • I felt that I had tried everything, from massage and chiropractic, to acupuncture and even Cervical epidural steroid injection (which were VERY expensive, painful, and even traumatizing); and nothing seemed to work. Then, my Orthopedist told me about Dr. Minotti … WOW! The lessening of pain was amazing and fast – I soon cut back on my medications, and have since eliminated them altogether. The increase in range of motion and mobility, combined with the significant decrease in pain, are phenomenal. I now recommend Dr. Minotti to everyone I know who is suffering from any kind of joint or muscle pain. Jim Mayher

  • I was very IMPRESSED with the treatment I received from Dr. Roop. I limped into his office in pain from an injury the previous night. Upon examination, Dr. Roop knew exactly what I had done and how to treat me. I walked out of his office limp free and within 24 hours I was completely pain free. Debra

  • I drive 90 minutes to see Dr. Minotti. He’s that good.

  • Dr. Minotti is simply the best in the business. His needle technique is unparalleled, and is ALWAYS on the cutting edge with his continuing education. Unlike many "regenerative" or pain clinics around this area, this clinic is not a cash machine or conveyor belt and does NOT price gouge. Front office staff VERY educated, and pleasant as well. Definitely a 5 star rating. Wendy Herman

  • Dr Cox was recommended to me by a friend. I was suffering with very painful sciatica and had tried several different modalities with no relief. I was amazed at how Dr Cox could tell where the pain was with just palpation. The manipulation was very gentle. I was given exercises to do. It started getting better after the first treatment. Unlike chiropractic treatments which require several visits a week for as long as it takes, my visits to Dr Cox were a couple weeks apart. As I got better, the visits were even further apart. My sciatica pain is gone. My husband is now planning a visit to Dr Cox as well. I highly recommend Dr Cox. Sue Carle Estes

  • Dr. Minotti is the absolute BEST. He is compassionate, caring and very professional. He makes sure you are receiving the best care possible. Edna

  • Dr. Minotti was able to provide the care I needed rather than just giving me medicine to relieve pain. He has proven to work at the root issue of my pain with a specific plan at addressing overall wellness. I would recommend Dr. Minotti for any friend or family. James

  • Best experience I have had with any physician. Not only did he listen , but he took steps to positively address my issues.

  • One morning I woke up with a horrible pain in my right shoulder. The pain expanded to include all of my right arm and part of my neck. I noticed I was loosing strength in my right arm as well. I scheduled an appointment with Dr. Roop, and upon my first visit he was able to reduce the pain significantly. After my third visit the pain was totally gone.

  • I have had episodes similar to this one in the past, but I’ve never had the pain dissipate as quickly as with the treatment provided by Dr. Roop. I firmly believe in his knowledge and expertise and whole-heartedly recommend his services for others who are suffering from this type ailment. Monty

  • Dr. Minotti asks straight forward questions and then, intently listens so the patient can answer clearly. He does not dictate a plan of care but develops one with the patient’s input. His compassion is unsurpassed. John

  • The visits are always on time. He is very patient explaining the procedures and ideas on how to improve my health issues. I never feel rushed. I have recommended Dr. Minotti dozens of times. I could not be more pleased with his service.

  • ABSOLUTELY the very best in his field. A God send to me. Dr. Minotti has helped me more than any other physician I have consulted with regarding my pain level.

Regenerative Orthopedics


We often forget that our spine is a series of joints, each susceptible to joint damage. With strain, or even just life, ligaments holding the vertebrae together can become lax. Muscles weaken, creating less spinal stability. The spine is no longer able to hold in place the protective discs between vertebrae. Surrounding tissue becomes inflamed, causing further joint damage. Medical research has discovered ways to maximize the oldest form of healing: your own body. By understanding how the healing process actually occurs, physicians are able to enhance the natural physiologic process of cell replacement.

Healthy function of joints is controlled by mesenchymal stem cells that regulate replacement of damaged cells, modulate inflammation, and stimulate cell growth. Mesenchymal stem cells are able to differentiate into multiple forms of musculoskeletal tissue, such as bone, cartilage, tendons and ligaments. When the balance between the supply of new cells is adequate to maintain healthy function, the body is in homeostasis. However, imbalance in this function leads to degeneration of tissue, such as osteoarthritis. Read more.


Platelet Rich Plasma (PRP), Prolotherapy, and Stem Cell Therapy are regenerative procedures that help heal collagenous tissue, such as tendons, ligaments, and cartilage. Ligaments in the back, as elsewhere in our body, are designed to handle a normal amount of stress that will stretch them to their natural limit. Once the stress is removed, the ligaments will return to their normal length. When excess stress is applied, stretching the ligament beyond its natural range of extension, the ligament will not return to its normal length. Instead, it will remain permanently “over-stretched," diminishing its ability to hold the vertebrae in their proper place. Such a condition is called “ligament laxity.” Regenerative procedures can strengthen the connecting tissues to make the spinal column more stable, reducing friction and inflammation that cause back pain and often lead to osteoarthritis.


Natural forces within us are the true healers of disease. ―Hippocrates


Regenexx is a world-wide network of select, highly skilled physicians who are specially trained in interventional procedures for orthopedic conditions. Regenexx provides the world's most advanced, research-driven, regenerative orthopedic procedures in North America, Europe, the Middle East, Asia and Australia. Specializing in advanced non-surgical procedures for joint Injuries, osteoarthritis, and other orthopedic conditions, Dr. Minotti brings these procedures to you!

Back Pain video

If you have back pain, platelet rich plasma therapy may help. It uses parts of your own blood to help your body heal itself. PRP can help your back feel better and work better.


Common conditions causing back pain

Ligament strain. Injury occurs when ligament tissue is over-stretched or torn, resulting in damage to the ligament fibers (tough, fibrous tissues that connect the bones together). A strain that occurs in the lumbar region of the back is referred to as a lumbar strain. Ligament laxity of overstretched tissue results in mechanical dysfunction and inflammation of surrounding tissue. Muscles and tissue surrounding the strain will attempt to compensate for the instability. These conditions lead to back spasm that can cause both severe lower back pain and difficulty moving.

Bulging or ruptured discs. Discs act as cushions between the bones (vertebrae) in the spine. The soft material inside a disc can bulge or rupture and press on a nerve. However, a bulging or ruptured disc can occur without back pain. Disc disease is often found incidentally during spine X-rays given for another reason.Backpain

Spinal stenosis. Spinal stenosis is narrowing of spaces in the spine, causing pressure on the spinal cord and nerves that travel through the spine to the arms and legs. Most cases occur in the lumbar region of the back and are often caused by the wear and tear related to osteoarthritis.

Skeletal irregularities. Back pain can occur if the spine curves abnormally. Scoliosis, a condition in which your spine curves to the side (laterally), also may lead to back pain, but generally only if the scoliosis is severe.

Irritation of large nerve roots that travel to the legs

Irritation of smaller nerves in lower back

Sprain. Tendons attaching the muscles to bones and can become sprained with excess force resulting in a sprain. The large paired lower back muscles (erector spinae) can also become sprained, often resulting in small tissue tears.

Degenerative disc disease. Narrowing of the discs between vertebrae causes compression of the nerves extending through the vertebral canal often resulting in tissue degeneration.

Cervical Spine Pain Decrease After Regenexx Procedure

  • Cervical pain decrease:

    Prior to receiving treatment, patients report average pain of 4.7/10. One month after treatment, pain levels decrease to an average of 3.2/10, a decrease of 32%. The questionnaire used is the Numeric Pain Scale (NPS).

    Cervical pain decrease

  • Cervical function improvement:

    Prior to treatment, patients report being limited to an average of 54% of their optimal function. After receiving treatment, they report averages up to 75%. The functional questionnaire represented here is the Functional Rating Index (FRI).

    Cervical function improvement

Lumbar Spine Outcomes

  • Lumbar Spine Outcomes:

    Lumbar pain decrease: Prior to receiving treatment, patients report average pain of 4.7/10. One month after treatment, pain levels decrease to an average of 3.3/10, a decrease of 30%. The questionnaire used is the Numeric Pain Scale (NPS).

    Lumbar Spine Outcomes

  • Lumbar function improvement:

    Prior to treatment, patients report being limited to an average of 50% of their optimal function. After receiving treatment, they report averages up to 72%. The functional questionnaire represented here is the Functional Rating Index (FRI).

    Lumbar function improvement





We Can Help

To learn more about what we can do to help with your condition, call our office at 817-416-0970. We will thoroughly diagnose your condition and present you with treatment options. From there we will guide you along your road to recovery.