Back pain has become a major public health concern, causing significant disability financial loss for many. Although most of us have had episodes of back pain, symptoms usually get better within a few weeks with conservative treatments such as avoiding painful activities, stretching, physiotherapy, chiropractic, massage, gentle exercise, and anti inflammatory medications.

When these fail, it can be worthwhile to try to identify the source of back pain, in order to make treatment more specific and effective.

There are multiple structures in the spine which can cause pain when they are injured or become degenerated. These most commonly include the discs, facet joints, ligaments, and muscles of the spine. Injection treatments can temporarily ease the pain, and offer pain control while waiting for healing to occur. However, if the underlying injury or condition does not heal, the pain problem will not go away, and the pain relief from injections will only be temporary.

Current treatments such as facet joint nerve ablations (RFA) only mask arthritis and do not address the underlying causes. Even surgery to remove a portion of the disc, fuse the disc, or replace the disc with an artificial one, will not restore the spine to its original condition. If the degenerative process continues to progress, eventually neural structures may become compressed, causing spinal stenosis, and often surgical removal of compressive bone or disc is the only option. Ideally, treating the degenerative process earlier can potentially prevent more severe problems from developing years later.

The idea of using stem cells to heal disc injuries is not new. As of 2013, there have been at least 34 animal studies, with at least 4 different animal models (dog, pig, rabbit, rat, and sheep) which showed that intradiscal stem cells caused injured discs to increase type II collagen expression, increased the disc height, and show less degeneration on follow up imaging. These effects occurred both with adipose and bone marrow derived stem cells. More recently, similar results have been seen in human trials. In 2015 Dr. Lutz showed that intradiscal injection of PRP alone diminished pain and improved function in patients with painful degenerative discs.

Even more impressive, were the recent two year follow up of a 2014 study by Dr. Pettine, which showed 80% success in using intradiscal stem cells to treat degenerative disc pain, with reductions in pain, disability, and radiographic improvement of disc morphology on follow up MRI. Adipose derived stem cells have been shown to have a protective effect on nucleus pulposus during disc compression, making the disc cells less less susceptible to injury.

Facet joint arthritis represents another significant source of chronic back and neck pain. Unfortunately, there is currently little medical literature regarding using either PRP or stem cells to treat this condition. A few papers describing this treatment showed that using PRP for facet joint arthritis provided good pain relief, but the results did not last more that six months. Our practice experience is similar. Just as with the knee, our early experience shows that for sustained benefit, facet arthritis should be treated with PRP AND stem cell therapy. This method yields much better and longer lasting results. Although radio frequency ablation of the nerve supply to facet joint (RFA) does provide temporary pain relief for 6 to twelve months, it can also weaken the intrinsic muscles of the spine, possibly causing impairments in spinal stabilization and coordination. As with other conditions, at Sierra Stem Cell Institute, we strive to provide a treatment which will provide healing, not just mask the symptoms.

At Sierra Stem Cell Institute, we are having good results with treating back conditions with Stem Cell injections and Platelet Rich Plasma injections. Contact us for an evaluation to see if this treatment is right for you.

If you have any specific questions regarding our use of regenerative injections to help with spinal conditions, please email us and we will be happy to discuss the literature and our success rates.