Lately, I am seeing more and more advertisements and publicity about the use of stem cells to treat lower back pain. Can these cells regenerate and repair old, degenerating spine discs?
Watch: Video: What Is a Degenerative Disc and the Degenerative Cascade?
While the concept seems appealing, I am concerned that patients may be drawn in by hope and hype without having the full picture of the science.
First let's discuss what stem cells are: They are cells that are located within the body that have not yet transformed to perform a certain function. It is hypothesized that these cells will transform when placed into a certain environment to accommodate a certain need.
With regard to lower back pain treatment, it is hypothesized that when injected into a degenerated disc, stem cells could turn into cartilage cells and regenerate the disc, thereby alleviating disc-related back pain. It certainly sounds great.
Stem cells can be harvested from adults, so we don't need to involve the debate about use of embryonic stem cells here.
Where is the science?
While the idea seems promising, we still have a long way to go to see if some of these techniques will actually work without causing unintended complications.
To be considered as a possible treatment for lower back pain, even some very basic questions are still unknown about stem cell injections. Namely:
- What modifications are needed given that we know the disc environment is very low in oxygen and has no blood supply?
- What is the optimal amount/dose for the injection?
- What are the right indications for use?
- What should the stem cells be mixed with (e.g. saline, hyaluronic acid)?
- Which stem cells are the best for each situation (adipose, mesenchymal, placenta, etc)?
Perhaps most importantly, the longer-term risks related to stem cell injections are unknown. Will these stem cells eventually cause harm to the body or lead to other unintended complications?
The science is still in the very early stages, so there is a real risk of unintended consequences that may not show up for years.
What this means for you
While the technology has great potential, please be careful. If you really want to consider this option, I would suggest trying to enroll in one of the FDA studies concerning stem cells and back pain. In the clinical trials, you will be closely monitored for the potential benefits as well as the side effects. In the clinical trials, your safety is the prime concern.
If you are willing to take your chances outside a clinical study, please go to an office that fully discloses the experimental nature of the concept.
Stem cells for back pain is a promising concept. Unfortunately, we still do not know what we do not know. Hoping stem cell injections will be the solution to back pain is not the same as knowing they will be the solution.
It’s like being a Chicago Cubs fan: We wish they would win the World Series again, we just do not know if that day will ever come.