Column: Is Regenerative Medicine the Answer to Your Chronic Pain?
By Christopher Sahler
Does your own blood hold the key to healing your medical condition? The evolving field of regenerative medicine uses biomedical materials, often from your own body, to regenerate cells and rebuild diseased and damaged tissues.
In the past, most cases of damaged tissue within the body were considered irreversible. The only options were medication and injections to effectively treat the symptoms, or surgery to repair or remove the injury. Developments in regenerative medicine hold the potential to change that.
Even now, newer biomedical therapies using amniotic membrane, blood, growth factors, platelets and stem cells are used to stimulate a person’s body to heal injuries and cure complex, often chronic conditions. For professional athletes like Super Bowl MVP Hines Ward and teammate Troy Polamalu, these therapies allowed them to quickly return to the playing field for the Pittsburgh Steelers’ playoff run, which would not have been possible had they received more traditional treatment. In other sports, Tiger Woods, Alex Rodriquez, Ray Lewis, Kobe Bryant and Mark Texeira are just of few pros who were able to overcome injuries in relatively short periods with the help of regenerative medicine.
A number of biomedical treatments have made it to the mainstream, too, to help ordinary people suffering from orthopedic conditions and chronic pain. The two most commonly used today are platelet rich plasma (PRP) and stem cell treatments.
PRP is typically administered in a specialist’s office as an injection, similar procedurally to other injections such as a cortisone shot. A sample of blood, drawn from the patient’s vein, is put in a centrifuge where the main components of red blood cells—platelets and nutrient poor plasma—are separated. The platelet rich plasma is then drawn into a syringe and injected directly into the diseased tissue, with the visual ad of ultrasound to ensure accurate delivery and safety. Once at the site of damaged tissue, PRP restarts the inflammation and healing process. Growth factors associated with the platelets are concentrated in much higher levels than the body can naturally produce, which increases and improves the healing potential of the tissue.
Stem cell therapy is another technique that has had promising results with healing damaged tissue and new, healthy tissue growth. A stem cell is what is known as a precursor cell that retains the ability to differentiate into various tissues, depending on what the body needs. In other words, stem cells can rebuild bone, tendon, ligament or cartilage when injected or surgically placed at the location of the injury.
These developments are particularly good news for the more than 25 million adults in the United States suffering with osteoarthritis. Studies indicate, for instance, that when compared to placebo or hyaluronic acid injections such as gel or viscosupplementation, PRP seems to be more effective in reducing pain and increasing function in knee osteoarthritis.
Results of other studies have been encouraging as well for treating a variety of other conditions such as Achilles tendinitis, back pain, plantar fasciitis, rotator cuff tears and tennis elbow. When trying to generalize the results to tendon problems throughout the body, one study found 82 percent of the patients had moderate to complete improvement of their symptoms.
In other areas of specialty, regenerative medicine has been promising in treating cardiovascular disease, brain and spinal injury, cerebral palsy and Type 1 diabetes and in organ regrowth. Indeed, the applications are countless, however, in relative terms, the science is still in its infancy. More studies need to be undertaken to determine the true potential and to standardize the delivery methods. For these reasons, insurance companies currently do not cover biomedical therapies. What is clear for now, though, is that these newer treatments are safe, effective and are increasingly available to help orthopedic and chronic pain patients.
Christopher Sahler, MD, is an interventional physiatrist and pain management specialist at ONS in Greenwich and Stamford who focuses on non-operative treatment of pain and musculoskeletal injuries to restore proper function and active lifestyles.