Regenerative Injection Stem Cell Therapy Program for Chronic Low Back Pain
By Steven Meier
Regenerative injection therapy (RIT) with mesenchymal stem cells (MSCs) provides an excellent resource in the treatment of chronic back pain. Using RIT, back pain is treated comprehensively, naturally and safely, providing a superior alternative to conventional methods of pain management, which rely on anti-inflammatory and narcotic medication, corticosteroids, and interventions, such as nerve ablation and spine surgery. At Meier Orthopedic Sports and Regenerative Medicine (MOSM), back pain is treated with RIT in a uniquely comprehensive manner to address all aspects of the condition for the optimal response.
Degenerative discs are treated by injecting mesenchymal stem cells (MSCs) directly under fluoroscopic guidance. Segmental instability between the vertebrae and within the sacroiliac joint is treated with prolotherapy to strengthen and tighten supportive ligaments that have become lax with age and wear-and-tear. A post-procedure physical therapy program is instituted for core-strengthening to recruit the spine-stabilizing musculature. As a result, the strength and stability of the spine is optimized naturally to combat chronic pain and improve function in a lasting manner with minimal downside risk of complication.
The RIT protocol utilized at MOSM has been developed through an evidence-based approach relying on basic science and clinical research. There are numerous clinical studies demonstrating the positive effects of prolotherapy and the advanced biologics of platelet rich plasma and stem cell therapy. Investigators have found that patients treated with RIT experience tissue regeneration in supportive anatomic structures associated with less back pain, greater mobility and better function with less reliance on pain medications and other conventional treatment.
If you are interested in learning more about what RIT and other forms of regenerative medicine can do for you, get in touch with Dr. Steven Meier and the orthopedic team at MOSM by calling 310.736.2793 today.
The comprehensive RIT protocol for back pain at MOSM starts with a one to two hour long procedure in an ambulatory surgery center that includes the harvesting and processing of mesenchymal stem cells (MSCs) from the patient’s own bone marrow or adipose (fat) tissue, concentration of PRP from a blood specimen, the injection of the MSC/PRP preparation directly into the intervertebral discs under fluoroscopic guidance and prolotherapy injections to treat the posterior structural ligament complex of the spine and sacroiliac joints. After one and two months respectively, a second and third round of prolotherapy is administered during a one-hour-long office visit. A physical therapy program is instituted three to six weeks after the initial procedure and usually involves performing physical therapy two to three times per week for approximately six weeks.
Read more about regenerative injection treatments from AAOmed.org.
Review of the Literature
Animal studies on prolotherapy show that the procedure induces the production of new collagen.1,2 In one double-blinded animal study, over a six week period, ligament mass increased by 44%, ligament thickness increased by 27%, and the ligament-bone junction strength increased by 28%.3 Other studies have similarly demonstrated improvements in ligament and tendon diameter and strength with prolotherapy.4,5 In a study on chronic low back pain in humans, Klein et al analyzed tissue biopsies three months after completion of a prolotherapy program showing statistically significant increases in collagen fiber and ligament diameter.6
In a retrospective review Hauser et al., 145 patients with chronic back pain treated with prolotherapy reported clinically significant lower levels of pain, stiffness, and medication usage, as well as improved mobility and range of motion up to 12 months after treatment.7 In a randomized controlled trial Yelland et al. found that for chronic low-back pain, significant and sustained reductions in pain and disability occurred with ligament injections using the prolotherapy technique.8 In another randomized controlled study, Klein et al. showed that objective testing of range of motion, isometric strength, and velocity of movement significantly improved after an injection therapy regimen.9 In yet another randomized controlled trial, Ongley et al. demonstrated that prolotherapy injections combined with other co-interventions including spinal manipulation and exercise are more effective than control injections combined with control co-interventions.10 In a meta-analysis by Dagenais et al., a number of clinical studies were reviewed and analyzed resulting in the authors concluding that repeated ligament injections can give prolonged relief of pain and disability as part of a multimodal treatment program without the risk of serious adverse events.11 In a double-blind study by Lutz et al. using intradiscal platelet rich plasma, the North American Spine Society Survey was used to demonstrate that at eight weeks follow up, the majority of patients treated with intradiscal PRP were satisfied with their treatment versus only 13% of those in the placebo group.12
For more information on how Dr. Steven Meier can provide you with the healing you need through RIT and many more procedures, fill out our online contact form or dial 310.736.2793. A healthier and happier life is possible through our regenerative orthopedic medicine in Beverly Hills.
Next, read about Amniotic Stem Cells.
- Schwarz R. Prolotherapy: a literature review and retrospective study. J Neurol Orthop Med Surg. 1991; 12:220-229.
- Schmidt H. Effect of growth factors on proliferation of fibroblasts from the medial collateral and anterior cruciate ligaments. J Orthop Res. 1995:13:184-190.
- Liu Y. An in situ study of the influence of a sclerosing solution in rabbit medial collateral ligaments and its junction strength. Connect Tissue Res. 1983; 2:95-102.
- Maynard J. Morphological and biomechanical effects of sodium morrhuate on tendons. J Orthop Res. 1985; 3:236-248.
- Hackett G, Ligament and Tendon Relaxation Treated by Prolotherapy. Charles C. Thomas; Springfield, IL; 1958.
- Klein R. Proliferant injections for low back pain: histologic changes of injected ligaments and objective measures of lumbar spine mobility before and after treatment. J Neurol Orthop Med Surg. 1989; 10:141-144.
- Hauser RA, Hauser MA. Dextrose Prolotherapy for Unresolved Low Back Pain: A Retrospective Case Series Study. Journal of Prolotherapy. 2009;1(3):145-155.
- Yelland MJ, Glasziou PP, Bogduk N, Schluter PJ, McKernon M. Prolotherapy injections, saline injections, and exercises for chronic low-back pain: a randomized trial. Spine (Phila Pa 1976). 2004 Jan 1;29(1):9-16
- Klein RG1, Eek BC, DeLong WB, Mooney V. A randomized double-blind trial of dextrose-glycerine-phenol injections for chronic, low back pain. J Spinal Disord. 1993 Feb;6(1):23-33.
- Ongley MJ, Klein RG, Dorman TA, Eek BC, Hubert LJ. A new approach to the management of low back pain. Lancet 1987;2(8551):143–6.
- Dagenais S, Yelland MJ, Del Mar C, Schoene ML. Prolotherapy injections for chronic low-back pain. Cochrane Database of Systematic Reviews 2007, Issue 2. Art. No.: CD004059. DOI: 10.1002/14651858.CD004059.pub3.
- Lutz G. Intradiscal PRP study and MRI predictors of outcome. Presented at: International Spine Intervention Society Annual Meeting; July 30-Aug. 3, 2014; Orlando, Fla.