What is the update on stem cells for back pain?
The last time I talked about this was in 2018.
So what's the latest news about this controversial topic?
If you watch any advertisement for this procedure online or on tv,
you would think it was approved, tried and true procedure for improving back pain.
As of now. that is simply not the case.
Determining if stem cells can relieve back pain is more complicated than you think.
First of all, doctors still have trouble determining the cause of back pain.
Is it from a bad disc? Bone spurs on your nerves?
Overstretched muscles or ligaments?
Or is it due to the wear and tear caused by arthritis in your spine?
Unfortunately, most of the time, doctors do not know the answer to these questions.
Fortunately, most episodes of back pain do improve or resolve themselves.
However, if the pain does not improve,
it can be a very long and frustrating process trying to identify the cause.
Sometimes doctors inject different parts of the spine with numbing medicine.
If the pain goes away after the injection, it's possible they found a source.
Of course, this is provided the medication was injected into the right area,
and the injection showed a greater effect than a placebo.
My prior video explained placebo.
Please watch if you're unfamiliar with that term.
The premise behind using stem cells for back pain is that they will enable
the injured areas to regenerate to their normal, healthy state.
Some doctors inject stem cells into discs hoping the disc will regenerate back to normal.
Others inject stem cells into joints of the spine hoping to re-establish normal cartilage in the joint.
The assumption is that the abnormal joints or the abnormal discs are the source of pain.
As I mentioned earlier, it's not always clear if these assumptions are correct.
In addition, the required concentrations of stem cells, the harvesting of stem cells,
and their ability to live in the injected areas are still being studied.
While multiple studies have been performed, none have addressed all these concerns.
Furthermore, the nature of human studies makes the research complicated.
It's hard enough to take one group of real live people,
give them a treatment,
and find another similar but distinct group,
and give them a non-effective treatment,
and then follow both groups for an extended period of time without bringing in various biases to the study.
The logistics alone are enough to give anyone a headache.
Then, you have to take into account all the real and personal ethical concerns
involving human subjects in experiments.
Could you imagine if you were in a study, not knowing if you received the real stem cells?
And even if you receive the real stem cells, what if you were given the minimum concentration,
which might have the same result as the control group?
Could you imagine if they put a large needle in your hip,
drew out your stem cells,
but didn't use them because you were in the control group?
What if you were enrolled in a study solely for being over 70 years old? --
because we want to know how effective stem cells are from older people
compared to stem cells from younger people.
What if you are in a group that received donated stem cells from other people or other animals?
As you can see, there are many variables both the researcher and the subject need to consider.
Another important issue with these stem cell studies is in regards to the placebo effect.
There was evidence that the placebo injection of salt water into the disc
resulted in a significant improvement in back pain.
One company terminated their research because they were unable to prove that
stem cells had a greater effect in relieving back pain than the placebo.
I applaud this company for their ethics.
I imagine it was a very difficult decision for the researchers and their investors.
At this time, there is very little evidence suggesting the regenerative capacities of stem cells
in improving back pain.
So this is my update.
I still dream of the day that I can get an injection and all the pain goes away.
Right now that's all it is, a dream.
For my own patients, I counsel them not to use stem cells for their back pain.
I wouldn't recommend it to my friends and family,
so I'm giving you the same advice.
Be cautious,
because the research so far is not conclusive.
The long-term effects are still unknown.
Although we can be optimistic for what the future holds,
we need to stay vigilant about what the present has to offer.
Thanks for watching.