You've Tried Everything Else. There's One More Option Worth Knowing About.
If you've been managing spine or joint pain with cortisone shots, physical therapy, or medications — and you're still not better — you may be a candidate for a more targeted approach. Our physicians specialize in advanced, image-guided non-surgical procedures designed to address the underlying source of your pain.
Or call (760) 721-4000 | No obligation. No pressure. Honest answers.
Serving Carlsbad · Laguna Hills · North County San Diego · South Orange County.
115,700+
Procedures in Our Clinic Network
15+ Years
Interventional Sports Medicine Experience
#1
Part of the Nation's Largest Orthobiologic Clinical Network
Still in Pain After Trying Everything? You're Not Alone — and You're Not Out of Options.
Most patients who find us have already been through the standard playbook: pain medications, injections, months of physical therapy. Some have been told surgery is their only remaining option. They come to us frustrated, skeptical, and often in significant daily pain.
What we offer isn't a miracle. It's a different clinical approach — one that uses advanced imaging to pinpoint the exact source of your pain and treats it with precision, using your body's own biology to support repair. It's not right for everyone, and we'll tell you honestly if it's not right for you.
Who this is most often appropriate for:
Active adults in their 40s–70s with spine or joint pain who want to exhaust non-surgical options before committing to surgery — and who are ready to invest in a thorough evaluation to understand what's actually happening in their body.
Led by Two of Southern California's Most Experienced Non-Surgical Orthopedic Physicians
Dr. Steve Derrington, DO — Founder & Medical Director
Dr. Derrington is one of the most experienced non-surgical orthopedic physicians in Southern California, with over 15 years of experience in the field. He is credentialed in advanced orthobiologic protocols — completing rigorous training and certification for image-guided orthobiologic procedures — and leads one of the largest orthobiologic clinic in the region.
He serves as a Faculty Instructor for the Interventional Orthobiologic Foundation (IOF) and OrthoSono, teaching other physicians the diagnostic skills and precision injection techniques he uses with patients every day.
Credentials:
- Board Certified: Physical Medicine and Rehabilitation
- Fellowship Trained: Interventional Spine, Sports & Regenerative Medicine
- 15+ years of experience in interventional orthopedic medicine and orthobiologics
- Credentialed provider — ultrasound & fluoroscopic guided procedures
- Owner of one of the largest orthobiologic clinic in Southern California
- Faculty Instructor, IOF & OrthoSono
- Speaker at many national orthopedic conferences
What this means for you:
You're not a training case. You're being evaluated by a physician who teaches these techniques to other doctors across the country.
Dr. Melanie Worley, DO
Dr. Worley is a dual board-certified physician in emergency medicine and sports medicine, and one of a small number of physicians in the country to have completed fellowship training in orthobiologics at the Centeno-Schultz Clinic — one of the leading orthobiologic training institutions in the country. She also completed a sports medicine fellowship at West Virginia University.
Her research in orthobiologics earned a Top Research Award from the Interventional Orthobiologic Foundation (IOF), and she has presented at The Orthobiologic Institute (TOBI) and the Regenexx Annual Conferences — placing her among the most academically credentialed orthobiologic physicians practicing in Southern California today.
Outside of medicine, Dr. Worley competes at an elite level. She has run the Boston Marathon three times with a sub-3-hour personal record, earned a World Championship title at the Ironman 70.3, and competes in HYROX — one of the most demanding fitness competitions in the world.
Credentials:
- Dual board-certified: Emergency Medicine & Sports Medicine
- Fellowship-trained: Centeno-Schultz Clinic
- Credentialed provider — ultrasound & fluoroscopic guided procedures
- Top Research Award — Interventional Orthobiologic Foundation
- Presenter: TOBI & National Orthobiologic Conferences
- Sports Medicine Fellowship, West Virginia University
What this means for you:
When Dr. Worley evaluates your spine or joint condition, she brings the clinical rigor of a fellowship-trained orthobiologics specialist and the personal understanding of someone who has pushed a body to its physical limits — and knows what it costs to lose that capacity. Her patients don't need to explain why staying active matters. She already knows.
🏃♀️ Boston Marathon × 3 (sub-3hr PR) ⛵ Ironman 70.3 World Champion 💪 HYROX Competitor
What to Expect on Your Discovery Call
Your Discovery Call is a short phone conversation with our team to help you decide if an in-office evaluation is appropriate.
Free Candidacy ReviewYour Discovery Call includes:
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01
Questions about your condition, pain level, activity level, and prior treatments
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02
Plain-language explanation of non-surgical treatments we offer
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03
Pricing ranges and what to expect financially
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04
Next steps and scheduling a consultation if appropriate
This call is not a medical diagnosis or treatment. It's an opportunity to learn about our approach, ask questions, and determine if our clinic may be a good fit.
What Happens When You Reach Out — Three Steps to a Diagnosis You Can Act On
Step 1 — Free Candidacy Review (10–15 minutes, by phone)
We learn about your symptoms, what you're missing out on, what imaging you've had, and what treatments you've already tried. We explain our non-surgical approach in plain language and give you realistic pricing context. If an in-office evaluation makes sense, we schedule it. If it doesn't — we'll tell you that too.
Step 2 — In-Office Evaluation with Dr. Derrington or Dr. Worley
This is a genuine diagnostic consultation, not a sales call. Your physician takes a full history, performs a comprehensive physical exam, reviews your imaging, and gives you a real diagnosis — in plain language. Most patients tell us this is the most thorough evaluation they've received.
Consultation fee:
The consultation visit may be billed to Medicare or your PPO plan when applicable. Treatment procedures are typically paid out of pocket. If you don't have coverage, the fee is $350 — which includes a complete examination, imaging review, formal diagnosis, and a frank discussion of what options are appropriate for your specific condition. For context, a surgical consultation at a hospital system typically runs $400–$600+, without the same level of diagnostic depth.
Step 3 — A Targeted, Personalized Treatment Plan
If you're a good candidate, your physician builds a plan around your specific diagnosis. This often includes advanced, image-guided injection procedures combined with non-invasive light-based therapies to support recovery. We monitor your progress and adjust as needed — this is ongoing care, not a one-time visit.
Explore Your Non-Surgical Options Before You Commit
Your exact plan is determined after a thorough evaluation. These are the tools your physician may draw from:
Advanced Injection Therapies
Minimally invasive, image-guided procedures that use your body's own biological components to support repair in damaged nerves, discs, joints, ligaments, and muscles. Every injection is guided by ultrasound and/or fluoroscopy — real-time imaging that ensures accuracy down to the millimeter. This isn't a generic injection. It's a precision-targeted procedure delivered by physicians with over 15 years of interventional experience.
MLS Laser Therapy (Carlsbad Office)
A clinically validated, non-invasive laser therapy that reduces pain and inflammation and supports the body's natural healing response. Sessions are brief, comfortable, and can significantly enhance the results of injection procedures when used in sequence. Available exclusively at our Carlsbad location.
Redvive Red Light Therapy (At-Home)
Treatment effectiveness varies based on your specific condition, severity, and overall health. Not all patients are candidates. That's exactly why we evaluate carefully before recommending anything.
A note on outcomes:
Treatment effectiveness varies based on your specific condition, severity, and overall health. Not all patients are candidates. That's exactly why we evaluate carefully before recommending anything.
Conditions We Commonly Address — and What the Evaluation Process Looks Like
Our approach is designed for active adults who have been living with spine or joint pain and want a precise diagnosis and a clear set of options — before agreeing to surgery. Conditions we commonly evaluate include:
- Degenerative disc disease (DDD) and spinal osteoarthritis
- Disc bulges, herniations, and annular tears
- Pinched nerves and radicular pain (including sciatica down the leg)
- Facet arthropathy and SI joint dysfunction
- Spinal stenosis
- Spinal ligament laxity and instability
- Tendon and ligament injuries from sports, overuse, or age-related degeneration
Not sure if your condition qualifies?
Most patients aren't sure. The Free Candidacy Review exists exactly for this reason — to give you an honest answer before you commit to anything. If our approach isn't appropriate for your condition, we'll tell you directly and point you toward what is.
What Patients Say After Their Evaluation and Treatment
Patient experiences below reflect individual outcomes. Results vary significantly based on condition, severity, and overall health. Not all patients are candidates for non-surgical treatment. These accounts are not a guarantee of specific outcomes for your condition.
"He Was 97 With Severe Spinal Stenosis. He Never Complained About Back Pain Again."
"My father was 97 years old and in constant back pain. He'd already had two cortisone injections with little to no relief, and an MRI confirmed severe spinal stenosis. At his age, surgery was never on the table — but neither was simply accepting that this was how the rest of his life would feel.
I brought him to see Dr. Derrington. He was evaluated and treated the same day.
My father lived another three years after that visit. In all that time, he never complained about back pain again — not once.
If you're wondering whether this approach is worth exploring for a parent, a spouse, or yourself — I can only tell you what I watched happen. At 97, with a condition his previous doctors had essentially given up on treating, he got his comfort back. That's not nothing. That's everything."
"20 Years of Back Pain. Pain Free for Over a Year."
"I had two bulging discs for two decades and had tried everything — pain shots, chiropractors, acupuncturists, consistent stretching. I was desperate for a fix but terrified of surgery or disc replacement. Dr. Derrington treated me using my body's own biology. I have been completely pain free for over a year now. I work out three to four times a week with zero restrictions. If you're suffering like I was — don't wait."
"Disc Herniation. No Surgery. Back to Training in 9 Months."
"I herniated a disc working out — which was devastating because fitness is a core part of my daily life. Surgery wasn't realistic for me, and I didn't want it to be. Dr. Derrington walked me through non-surgical options and gave me confidence that there was another path. Nine months later it was the best decision I've ever made. I went from being unable to pick anything up off the ground and sleeping uncomfortably, to training with zero pain and feeling stronger than I have in years. I send everyone I know to him."
"Six Months of Physical Therapy Didn't Fix It. This Did."
"I had several bulging discs and did rest and physical therapy for six months before coming to Dr. Derrington. I still had significant back pain. The image-guided injections prompted the kind of healing that six months of PT simply couldn't — and my discs have been healing up nicely since. I wish I hadn't waited as long as I did."
"I'd Already Had Spinal Surgery. I Came to Protect What Was Left."
"After previous spinal surgery, I wanted to strengthen and maintain the vertebrae around the surgical site before problems developed there too. Dr. Derrington clearly explained the treatment approach, answered every question I had, and his team gave me detailed recovery instructions and a phased exercise plan. A couple of months later I'm feeling significantly better. It was a great experience from start to finish."
"I Couldn't Walk for 6 Months Because of Sciatica. The Pain Started Fading Within 3 Days."
"I had been unable to walk for six months because of severe sciatic nerve pain. Nothing had worked. Three days after my treatment with Dr. Derrington, the pain began to disappear. It's a little expensive — but completely worth it. I'm walking again. Dr. Derrington and his entire staff are incredibly helpful and caring. I am so grateful."
"After Two Years of Daily Back Pain, I Started Having Days Where I Forgot It Was There."
"I had been dealing with lower back problems for over two years. Dr. Derrington took the time to properly diagnose the source of the pain and built a targeted treatment plan around my specific condition. About four weeks after the procedure I could really feel changes happening. And then something I hadn't experienced in years — days where I completely forgot about the constant stiffness and pain in my lumbar region. I'm now able to sit and stand for longer periods, and I'm back to doing everything I did before. If you have back pain and want to avoid surgery, this is worth exploring."
*Individual results vary. Testimonials reflect patient experiences and are not a guarantee of specific outcomes. Consult with a physician to determine if treatment is appropriate for your condition.
Common Questions About Our Approach
Does insurance cover spine treatments like this?
Most of our injection therapies are not covered by insurance and are paid out of pocket — this is standard across regenerative orthopedic procedures nationwide. However, your initial in-office consultation can often be billed through Medicare or a PPO plan.
During your Free Candidacy Review, we walk you through typical pricing ranges for spine care so there are no surprises — and we discuss payment options proactively.
How does the cost compare to spine surgery?
A typical spine surgery — fusion, laminectomy, or disc replacement — carries a total cost of $20,000–$50,000+ when you factor in the procedure, anesthesia, hospital stay, and rehabilitation. Recovery often takes 3–6 months, with significant time away from work and daily activity. And for many patients, the surgery doesn’t fully resolve the pain.
Our evaluation and spine treatment protocols are a fraction of that cost. If a non-surgical approach is appropriate for your condition, the timeline for returning to activity is typically weeks, not months. We’re not anti-surgery. But we believe you should have the full picture before you commit to it.
How much does a consultation cost?
The consultation visit may be covered by Medicare or your PPO plan when applicable. Treatment procedures are typically paid out of pocket. If you don’t have coverage, our comprehensive in-office spine evaluation is $350.
This includes a full physical examination by Dr. Derrington or Dr. Worley, a thorough review of your MRI and imaging, a formal diagnosis of your specific spinal condition, and a direct conversation about which non-surgical options are — and aren’t — appropriate for you. The Free Candidacy Review that precedes the consultation is always at no cost.
How is this different from a cortisone shot in my spine?
Cortisone and epidural steroid injections reduce inflammation in the spine temporarily — they’re designed for pain management, not tissue repair. They don’t address why your disc, facet joint, or spinal ligament is damaged in the first place. Most patients find the relief lasts weeks to a few months before the pain returns.
Our approach uses image-guided procedures specifically designed to support the body’s own repair process at the exact damaged spinal structure — not the surrounding area, but the structure itself — under real-time ultrasound and fluoroscopic guidance. For spine patients who’ve had repeated cortisone shots with diminishing returns, this distinction is often what changes everything.
My spine surgeon said surgery is my only option. Is that true?
That’s the most common thing we hear from spine patients. Spine surgeons are trained to operate — non-surgical interventional orthobiologic spine care is a completely different specialty with different tools, different training, and a different perspective on what’s possible.
Dr. Derrington and Dr. Worley aren’t anti-surgery. If surgery is genuinely the right call for your spine condition, they’ll tell you that. But they can evaluate whether there’s a non-surgical path first — and for many patients with disc herniations, stenosis, or degenerative disc disease, there is one. That evaluation is worth having before you go under the knife.
Can this help with sciatica or nerve pain down my leg?
Yes — radicular pain (nerve pain that travels from the spine into the glute and down the leg, often called sciatica) is one of the conditions we most commonly evaluate and treat. It typically originates from a disc herniation, disc bulge, or spinal stenosis compressing or irritating a nerve root.
When the source of the nerve irritation is accurately identified through history, examination, and imaging then treatment is targeted with precision using your own healing system (not masking symptoms with steroids or cortisone)— many patients experience significant reduction in both back pain and the radiating leg pain. The evaluation is specifically designed to determine whether your sciatica has a cause that image-guided treatment can address.
What should I expect from the Free Candidacy Review?
It’s a 10–15 minute phone call about your spine condition specifically. Our team will ask about your symptoms, what you’re missing out on, how long you’ve been dealing with it, what imaging you’ve had, and what treatments you’ve already tried. We explain how our non-surgical spine approach works in plain language and give you an honest read on whether an in-office evaluation makes sense for your specific situation.
No pressure. No pitch. If we’re not the right fit for your spine condition, we’ll tell you — and try to point you in the right direction.
If You're Considering Surgery, Make One Phone Call First.
The Free Candidacy Review takes 10–15 minutes. There's no cost, no pressure, and no obligation. Our team will ask about your condition, explain what non-surgical options may exist for your situation, and tell you honestly whether an evaluation with Dr. Derrington or Dr. Worley makes sense.
If we're not the right fit, we'll tell you — and try to point you in the right direction.
Evaluation appointments are limited each week to ensure every patient receives adequate time with the physician. If you're ready to move forward, scheduling sooner avoids a wait.
The Candidacy Review call is always free. If an in-office evaluation is appropriate, the fee is $350.
No pressure, no obligation. We'll explain your options, typical costs, and next steps so you can make an informed decision. Results vary by individual. Our treatments are not suitable for all conditions. A thorough evaluation is required to determine if you are a candidate for non-surgical treatment. Some conditions may require surgical intervention. All treatment plans are personalized based on your specific diagnosis and medical history. Individual results vary. Testimonials reflect patient experiences and are not a guarantee of specific outcomes. Consult with a physician to determine if treatment is appropriate for your condition.
Our Locations
Carlsbad Office
5806 Van Allen Way Suite 101
Carlsbad, CA 92008
Areas We Serve: Carlsbad, Encinitas, Oceanside, Vista, San Marcos, Solana Beach, Del Mar, La Jolla, Rancho Santa Fe, and nearby communities.
Laguna Hills Office
25411 Cabot Rd Ste 116
Laguna Hills, CA 92653
Areas We Serve: Laguna Hills, Mission Viejo, Lake Forest, Irvine, and South Orange County.