You have back pain. It has been present, in varying degrees of severity, for the past three months. Your primary care doctor initially treated you with a steroid, and you see a physical therapist that she recommended. You took the steroid as prescribed and somehow carved time out of your hectic schedule to participate in PT three times a week.

 Unfortunately, the physical therapy didn’t work, and the steroids helped while you were taking them but when you stopped, your gnawing back pain returned—this time even more severe than before. 

 After consulting with your doctor again, she referred you to a neurosurgeon for an evaluation. An MRI was performed, which the neurosurgeon explained, shows that you have degenerative disc disease (DDD), a term to describe changes to spinal discs that occur as people age, or as a chronic effect of an injury. You learned that DDD can lead to significant back pain, and can also be a precursor to osteoarthritis, herniated discs, and even spinal stenosis, a narrowing of the spinal canal that leads to “pinched”nerves. The neurosurgeon recommended a conservative approach, involving steroid injections, some anti-inflammatory medication, and more physical therapy. 

 Nothing worked. It has now been over six months of near constant low back pain. The pain is weaving its way into the fabric of your daily life, making it hard to work, even tougher to take care of your kids. It is wounding your relationship. It is even making it difficult to think clearly.

 At this point it’s serious. The neurosurgeon explains that you have the option of having a lumbar fusion surgery. He explains that for your condition, surgery has a good chance of significantly alleviating your pain, but it will come with a cost. Risks, some of which are unpredictable, and a lengthy recovery, including eight weeks out of work are just a few. He then tells you that there is one other non-surgical option: autologous stem cell therapy.

A less invasive, non-surgical option seems to make sense for an active person with a busy life. Surgery should be a last resort, and you and the neurosurgeon are in agreement to consider stem cell therapy.

 

Stem Cell Therapy It’s Not The Future – It’s Today

 The procedure involves taking bone marrow aspirate from the patient’s hip bone and subsequently injecting the stem cells into the patient’s damaged lumbar discs. It is performed in the office with local anesthetic. Patients leave the office 20-30 minutes after the procedure.

 

Why Stem Cells Work

Stem cells have the ability to turn into other types of cells. Injecting stem cells into an area of tissue damage, such as a lumbar disc, stem cells can take on the cell type of the damaged cells, thereby replenishing them and healing the damage. Bone marrow aspirate has been shown to contain mesenchymal stem cells (MSC’s), which promote cartilage growth. CD34+ stem cells, which are also present in bone marrow aspirate, can promote tissue vascularization. Both the MSC’s and CD34+ cells can assist in tissue repair. 

 The Outcomes

 Results have been encouraging. A 2015 study in the journal Stem Cells, entitled “Percutaneous Injection of Autologous Bone Marrow Concentrate Significantly Reduces Lumbar Discogenic Pain Through 12 Months,” reported that patients who received this treatment experienced significant pain relief 12 months after treatment (1).  Additionally, a 100 patient phase II clinical trial demonstrated that a single injection of stem cells could reduce back pain from degenerative discs. The study found that 50% reduced low back pain for up to 12 months (2).

 Autologous stem cell therapy has the advantage of being a non-surgical option for patients suffering from low back pain that has been unresponsive to more conservative management strategies. Patients need to know that AST is not an option for everyone with degenerative disc disease, and certainly there are no guarantees that an autologous stem cell injection will work. Additionally, unlike surgery, patients will usually not experience an immediate benefit from the stem cell injection. Results will sometimes take months to a year. Autologous stem cell therapy is a promising option for patients with DDD. It makes sense that a patient suffering from back pain should consider stem cell therapy before making the jump to surgery. 

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1. Pettine, et al. Percutaneous Injection of Autologous Bone Marrow Concentrate Cells Significantly Reduces Lumbar Discogenic Pain Through 12 Months. Stem Cells. 201533: 146-156.

2. Clinical trial shows stem cell injections reduce low back pain. Emory News Center. 2014. Available at Emory.edu