Stem Cell Treatment
For Back & Lumbar Pain
It comes to no surprise to any back pain sufferer that this
condition is incredibly hard to treat. This is because of the
complexity of the spinal anatomy and function, the complexity of the
psychological overlay in pain transmission and perception and also
because of lifestyle factors such as exercise, nutrition, and sleep.
The Functional Medicine approach to back pain looks at the lifestyle
factors and the relationships between different body systems and
pain. It optimizes many of the factors that normally fuel the pain
“fire” - inflammation, hormones, digestion, stress,
metabolism, energy systems, etc. This is why Functional Medicine is
the ideal complimentary approach to Regenerative Medicine, which
aims at preparing the body to heal itself.
Why is low back pain so hard to treat? From a purely anatomical
perspective, let’s look at a diagram of a typical lumbar
segment. The aim of this exercise is not to learn lumbar anatomy,
but to perhaps appreciate what your Regenerative Medicine spine
physician considers as possible pain sources when you come in the
office complaining of lumbar pain.
Click to view full image
Every anatomical structure that has nerve endings in it (or is
innervated) has the potential to cause pain. From a superficial to a
deep level, here are some of the innervated lumbar segmental
Your lumbar pain can originate in any or all of these
- lumbar fascia
- spinal muscles
- bones (vertebrae)
- lumbar nerves
- facet joints
- thecal sac coverings
Or it can originate outside of the lumbar area altogether. It could
be the result of hip, knee, or ankle dysfunction, or maybe thoracic
or cervical spine problems. It is obvious then why most people
suffer from back pain for years without good explanations as to
where pain is coming from or what to do about it.
At this point, your spine specialist will have several
1. He could put you through “a series of three
epidurals”, followed maybe by “a series of three facet
joint injections”, and maybe by radiofrequency ablation, or,
if you are really “lucky”, you might end up with a
spinal cord stimulator implant. We will not dignify this approach
by even commenting on it. Although long dismissed by research, you
would be surprised this is still widely practiced, probably
because healthcare insurance still covers it.
2. Alternatively, your spine doctor may opt for a very rigorous
diagnostic work-up that will map out most of your pain sources and
then he might try to treat each one of these pain sources with
traditional conventional methods. We are intimately familiar with
this approach, as we have practiced it for years with some good
results. There are indisputable advantages to knowing precisely
where the pain comes from. Precision Medicine is the future.
However, the completion of a rigorous diagnostic work-up requires
a motivated doctor and patient, many procedures and office
follow-up appointments, and a longer time frame to completion,
during which time pain relief may not be achieved.
3. Regenerative Medicine treatment is the newest option for low
back pain treatment. Although commonly referred to as stem cell
treatments, regenerative treatments also use other regenerative
products, such as prolotherapy solution (dextrose solution),
platelet-rich plasma (PrP), amniotic fluid/umbilical cord
blood/Wharton’s jelly products and exosomes. This option of
treatment for low back pain uses some of the diagnostic
information obtained from the previous method, but it is a more
holistic approach. Think of it as “more is more”.
Since the risks of treating more structures than absolutely
necessary are minimal to none, we allow ourselves some margin of
error in our diagnostic approach when we use stem cells or other
regenerative solutions for low back pain. Decreased diagnostic
work-up complexity allows for a reduced time until treatment
We hope your Regenerative Medicine spine specialist will chose
the third option above every time it is appropriate. But to make
it successful, there are several fundamental strategies that need
to be implemented throughout this process:
1. Patient selection. Not every patient is a candidate for stem
cell treatments. Alignment deformities (scoliosis, kyphosis,
spondylolisthesis), spinal instability, severe spinal stenosis
with neurological deficits, severe disc degeneration, severe facet
joint arthritis, multiple affected spinal segments are all
absolute or relative contraindications for regenerative spinal
2. Precision Medicine diagnosis. This was discussed above. There
is also the trade off between how precise should the diagnosis be
versus how much time should be spent in delaying treatment at the
expense of a rigorous diagnostic work-up.
3. Precise delivery of regenerative solutions into the appropriate
structures. We believe strongly that these procedure should not be
done without fluoroscopic or ultrasound guidance (or both). The
timing go these deliveries is also very important.
4. Optimization of general health. This should be done through an
integrative medicine or functional medicine approach. 5.
Optimization of physical function. Again, we have several options
for fitness and exercise in our office. Without this, prevention
of further injury is very hard, if not impossible.
Stem cells are derived from bone marrow or adipose tissue. We have
proprietary algorithms for extraction and purification. Once
injected in the appropriate anatomical structure, these cells break
up and release signaling molecules that direct the existing tissue
(cartilage, tendon, ligament, bone) to repair and proliferate.
In conclusion, stem cells (and regenerative solutions in general)
could be a good treatment for back pain. Strict rules of patient
selection, regenerative cell selection, precise diagnosis and
delivery and for a holistic health optimization approach should be
applied in order for this treatment to be successful. Defining the
success of this treatment is not just in terms of the short term
relief of pain but also in terms of prevention of re-occurence.