Among several modern developments in medical sciences, stem cell therapy is one. It involves the use of stem cells to activate or substitute cells in an injured part or organ. There are a few established sources of stem cells in the human body. These cells are used in the treatment of many disorders including autoimmune conditions such as osteoarthritis or acute joint pains, pain in nerves, back pain, spinal disc related pains, etc. A thorough understanding of how stem cell therapy helps treat back pain can help you take the needful steps.
Let us imagine you have the capability to do multiple tasks. As part of your day job, let us say – you are a biologist, and you teach the subject at a high school. During the nights, say – you are busy writing detective novels and over the weekends, you are busy playing the violin for a music band. Stem cells can also very similar; thee cells can perform any multiple functions that other cells perform. These cells can behave just like any other cell – by fully embracing the characteristics and functions of such other cells.
Each cell in your body has unique things to do. For example, the cells in the muscle form the basis for the tissues of your muscles. Similarly, those in your bones are wired to develop into your skeletons (which are made of bones). So, all our cells are programed for a specific set of actions. The only exception to this rule is the stem cell. These are cells that help other cells to bounce back from damages or cell repairs. In essence, stem cells can make new cells to minimize injuries, if any. The fact is stem cells are devoid of antigens, and hence these cells – once in a new, transplanted area – do not consider themselves as foreign bodies. Thus, stem cells are endowed with unique properties to boost your immune mechanisms and defense systems through cell repairs.
Therapies involving stem cells are administered to treat degenerative disc disorders, fat grafting (this is done to avoid problems in a few joints), healing of tissues and to boost overall healing of the body. In orthopedics, stem cell therapies are increasingly used for medical conditions where conventional treatment approaches have failed to yield desired outcomes. Specific medical conditions for which stem cell therapies are used include impairment of bones or ligaments and injuries in your tendons (tennis elbow, rupture of Achilles tendons, etc.).
Various types of cells
Your body is made of different types of cells. These are blood cells, bone cells, fat cells, muscular cells, nerve cells, skin cells and of course, the versatile stem cells. As the names indicate – blood cells help pass oxygen to all parts of your body; bone cells are the basis for the making of your bones; fat cells help make hormones amid other things like storing needful energies; muscular cells render support to bones as well as help in mobility; nerve cells help in forming your nerves and skin cells work as natural shield to your body. The versatile stem cells help repair cells damaged or injured, assuming the functions of such impaired cells – i.e., any of the types of cells listed above.
Stem cells are of five distinct types, namely – uni-potent stem cells (are of a single form or lineage; mainly seen in tissues of adults), oligo potent stem cells (can diversify and differentiate as many cells), multipotent stem cells (these are from cord blood or from tissues of adults), pluripotent stem cells (they are known for their frequent multiplication) and totipotent stem cells (these have the capability to develop into multiple number of cells).
Your body’s ability to make stem cells decreases once you reach 25 years of age. With a reduced production of stem cells, your ability to set right damages of cells also tends to get weaker. This is one simple explanation for why older people take a longer time to heal, while young people recover sooner.
So what causes back pain to occur?
As you may know, discs in the spine serve as buffering points. A jelly type substance keeps these discs well hydrated and each is kept intact inside a lining (or walls) called as annulus. Your spinal health is directly related to the amount of jelly present in between the bones. So, when there is a loss of this essential substance or drop in the number of cells (called as disc cells), you may end up in a back pain.
A disc with inadequate jelly or hydration is labelled as a flat disc or a blackened disc. It is often spotted while taking an MRI scan. Blackened or flat disc is identified as a root cause of many problems associated with the spine – especially back pain or neck aches.
This medical condition in turn triggers damages to your muscles, nerves as well as facet joints. Of these, the facet joint syndrome occurs when your joints – which enable your spine to move, start degenerating. This condition results in an acute level of back pain – especially in your lower back areas. You need to note each of the discs play an important role in keeping your spine healthy and to enable it to function well. Back pain may hence be triggered due to other such triggered causes as well. Salient among them are – ligaments getting loose around your joints, the apertures of the backbone that let pass nerves through them tend to contract and this adding further stress to the passing nerves, discs that serve as buffer or support for the backbone get impaired (a medical condition called degenerative disc disorder), bulged discs that can either compress or strain your nerves, impairment of facet joints, etc.
Through conventional methods of treatment of these conditions include physical therapy as well as administration of drugs that heal swelling or inflammation. If your pain is very severe, injecting steroids is another option. The term back pain in general refers a wide range of discomforts. Back pain may occur due to a mild inflammation or cancerous growth in the lower back area. Hence, it becomes extremely important to assess the root cause of the back pain. You may also need to remember that no two people have the same type of back pain.
Many therapies may offer cure but the positive effects may vanish over a period of time. Hence, modern treatments such as platelet-rich plasma, bone marrow concentrate, etc. are gaining traction.
How is stem cell therapy performed?
Stem cell therapy starts off with development of a treatment plan that best suits your present medical condition. Stem cells are taken (harvested) from your bone marrow; this may be done with anesthesia to ensure minimal pains. Your Iliac crest can yield upto 500 million cells. If it is taken from fats (read: adipose tissues), a liposuction procedure is done to extract needful stem cells. In case these sources are not available to the patient, stem cells are received from a donor.
Modern developments in stem cell extraction resort to a well-guided technique that uses fluoroscopy. The efficacy of such guided extraction of stem cells is reported to be almost 100% as against cells extracted without guidance through fluoroscopy. These technologies aim to guide the needle point to safest access points and also lead to richly-endowed zones to extract bone marrow.
Such extracted stem cells are then taken to the lab for activation. Soon after, the activated stem cells are injected into a body part where they are needed most. This activity is often performed with the support of an imaging device – such as ultrasound or MRI. Once these injected stem cells start multiplying, they begin working on your medical condition.
They are few essential aspects to stem cell therapy. Before stem cells are transplanted, they are spun inside a centrifuge to make them concentrated or to render greater assimilation. At times, a minimal amount of plasma (which is rich with platelets) is added to ensure the activated stem cells survive in the newly transplanted area or body part. As stem cell therapy does not involve surgical interventions, it is fairly easy for patients to walk soon after the procedure is done. Though no serious side effects may develop, a few patients have reported a mild pain or soreness. However, such effects have been reported very rarely.
Once injected, stem cells are naturally primed to adapt to the impaired status of discs or cells, and start their duplication process. This regeneration process depends on the place where the stem cells are injected, and also on the nature of cells already resident in the transplanted area or body part. However, if you have suffered a bone loss or erosion, injection of stem cells may not result in regrowth of the bone you have lost. But, you may be able to sense a positive difference in the inflammation or pain levels. All these only substantiate the need to go for treatments at the earliest possible stage; detection and interventions done at fairly advanced stages may not result in complete regeneration of impaired cells. Also, the pains you may need to endure can be much less when treatment is initiated at the earliest phase of the degenerative disease.
How stem cell therapy is used in the treatment of back pain?
Stem cells are injected in the target areas – i.e., areas where there is discomfort or pains. As the location needs to be accurate, this activity requires guidance through radiology or imaging equipment. Hence, this activity is not to be done by a physician who does not have the relevant experience. It is often performed by a spine specialist. This specialist also needs to be well-experienced in injecting stem cells with the aid of advanced x-ray techniques called as fluoroscopic procedures.
An accurate injection of the stem cells forms the main part of this therapy. As getting the stem cells injected in an inaccurate point yields nil results, locating the injection spot is the most critical part of the procedure. Stem cell therapy to treat back pain has been successfully used for treating discs that have turned painful. Apart from pain in discs, this therapy is also used for the treatment of degenerative disc disorders, impairment of facet joints as well as instability of sacroiliac joints. Besides these disorders and conditions, stem cell therapy has been used to repair tears observed in discs. Patients with such disc tears find it extremely difficult to remain seated for a longer time. This therapy is considered as an ideal treatment for such patients.
Factors influencing the treatment of back pain through stem cell therapy
You may need to remember that stem cells aim to boost your health in a holistic manner. Hence, it is not an overnight cure to your back pain. You need to give it needful time to start the healing process. It may take at least 3 to 4 weeks for the treatment’s effects to start showing up. It may also take more than 3 months for the swollen areas of your spine to return to a normal state.
Also, the number of dosages of stem cells may vary with people. Most people may see a decrease in back pain over a single sitting of this therapy. Yes, one dose of stem cells can start to regenerate your discs – either in the cervical or lumbar regions. However, for some people – it may take a few more injections to start the healing activity; the need for multiple sittings is often seen among people whose conditions are acute or extremely severe. You may also need to note that the outcomes of stem cell therapy may keep improving all through one’s life.
The acceptance of stem cell therapy as a treatment option for disc damages is growing steadily. Spine specialists are able to distinctly differentiate the various types of disc damages for which this therapy may be applied. For example, the finer differences between a herniated disc and a bulging disc are well documented. A disc hernia is a common outcome of a wound or injury in a disc. A hernia occurs when the disc’s material (resembling a jelly) gets pushed outside its walls or disc linings. As it emerges out, it can cause added stress to your spine and also on nerves passing through it. All these may turn physical movements and performing basic activities as extremely uncomfortable, done with greater degrees of pain.
On the other hand, bulged disc is also categorized under degenerative disc disorders. But here, the material that prevents shocks from the discs (a jelly) is seen pushing the outer walls. Despite this push, the shock absorbent (jelly) is housed well within the walls or disc linings.
A well experienced spine specialist is able to note down these finer differences. The herniated disc may be treated either by injecting plasma (replete with platelets) or stem cells from your bone marrow.
Scientific developments in stem cell therapy to treat back pain
Studies are being done to isolate genes that can act as ideal prospects for intervention, especially for degenerative disc related disorders. Also, research is underway to enhance the delivery mechanisms. These studies focus on the adverse effects of radiological dyes as well as anesthesia (administered locally), and assess alternative ways for better delivery of stem cells.
Modern studies also focus on reducing the risks associated with extraction of stem cells. As mentioned, stem cells are extracted either from the marrow (bones) or from fats (mostly you’re your abdomen). Experts state that extraction from fats may pose some risks. As incisions are needed to extract cells from fats, the odds of a likely infection cannot be fully ruled out. Orthopedic experts however claim that the process of extracting stem cells from bone marrow poses relatively lesser risks.
Treatment through stem cell therapy is being expanded to treat narrowed presentation of L1-L2, L3-L4 and L5-S1. These developments present themselves as great substitutes to surgeries done on the spinal discs. These are viewed as a welcome change; a significant percentage (nearly 30%) of people who underwent lumbar spine surgeries expressed “not being fully satisfied” with their post-surgical outcomes. But, surgical options are still considered when the impairment is acute, wherein patients may run the risk of losing control of their bladder or circulation of blood to their lower limbs.
Risks associated with stem cell therapy
The risks linked to administering anesthesia (often, locally) may lead to breathing difficulties or may also trigger a few allergies. There may also be risks related to likely damages inflicted onto your blood vessels or nerves. These may be encountered when extracting cells or transplanting cells into the organ that awaits treatment. Also, allergic reactions such as swelling or pain – in the area of injection may also occur.
You can reduce the likelihood of these risks by sharing your medical history with your treating doctor (orthopedic specialist or spinal surgeon). If you happen to experience allergies soon after the procedure, it is extremely important to share the signs and symptoms with members of the medical team. You may also need to stop smoking ahead of your therapy. Cessation of tobacco is found to expedite your healing activity.
In sum, versatile stem cells help repair cells that are damaged or injured. This repair is done by mirroring the functions of impaired cells. Accurate injection of cells plays a major role in stem cell therapy. This therapy has been successfully used for treating degenerated discs or related disorders. It is also used in the repair of facet joints as well as instability of joints (especially, sacroiliac joints). Patients with such disorders find it extremely difficult to remain seated for long owing to severe back pain. Stem cell therapy is considered as one of the modern approaches to treat chronic back pain with no elaborate surgical interventions.