Where can I get best stem cell treatment for lower back pain ?
This is a very important question for many reasons. You deserve the best stem cell treatment for lower back pain primarily because you are paying from your pocket as this procedure is not covered by Insurance. You are suffering from pain for a long time and failed multiple treatments. You want results. You want to avoid any complications. Choosing the right clinic is critical.
Media is flooded with stories about stem cell scams by shoddy doctors and shady clinics. These clinics are accused of
Using Stem Cells to treat untreatable conditions like cancer, Parkinson’s disease, spinal cord injuries, Multiple Myeloma, end stage lung disease etc.
Charging vulnerable patients exorbitant prices.
Causing serious complications from these procedures.
Stem Cell Procedures not working.
Unfortunately, ALL THESE CLAIMS ARE TRUE.
So, are stem cells for back pain a scam too? Not if it is performed the appropriate way. If you want the best stem cell treatment for lower back pain you should ask your doctor these few pertinent questions.
1.What kind of stem cells should be injected in the Spine?
There are 2 types of stem cells. Autologous or Homologous. If the stem cells are derived from the patient they are called autologous. Most commonly, they are extracted from the bone marrow or the adipose [fat] tissue. The other kind are called Homologous stem cells. These are those obtained from other humans. Examples of homologous stem cells are those that are derived from embryonic tissue, amniotic tissue and cord blood.
Among all these options autologous bone marrow stem cells appear to be the best option currently as they have the most supporting clinical data. In the confusing world of FDA regulations for stem cells, these bone marrow derived stem cells seem to be the most FDA compliant. In addition to stem cells, bone marrow also contains numerous platelets, growth factors and potent anti-inflammatory proteins which aid in regeneration and providing pain relief.
Proponents of the adipose stem cells tout that these are more effective than bone marrow because more number of stem cells exist in fat than in bone marrow. However, currently they don’t seem to be meeting the requirements of the FDA guidelines. Strong enzymes like collagenase are needed to extract stem cells from the adipose tissue. This is not approved by FDA. Moreover, the enzymes used to extract stem cells from the adipose tissue seem to be causing complications. Clinical studies supporting the use of adipose stem cells for back pain is sparse especially in comparison to the bone marrow data. Local anesthetic like lidocaine which is used to extract fat is known to damage the stem cells. Until FDA clarifies its position on adipose stem cells, using them is risky. In fact, FDA has sent warning letters to clinics using adipose stem cells. FDA has also send warning letters to amniotic tissue stem cell manufactures.
There are many homologous commercial products derived from amniotic tissue and cord blood that claim to have stem cells. These claims have never been proved to be true independently. More interestingly, if they truly have stem cells, they would be in noncompliance with the FDA. These products have growth factors but not stem cells. There are no clinical studies proving the efficacy of amniotic or cord blood products to treat back pain. Homologous products also have rare instances of rejection as they are from other humans and occasional risk of transmitting the genetic diseases of the donor.
If you are getting spinal injections, confirm that your doctor is using your own bone marrow stem cells. If you doctor is offering to inject “non FDA compliant” amniotic or umbilical cord stem cells, thank him for his time and leave immediately.
2.Where should the stem cells be injected in the spine?
Stem cells work only if injected into the structure that is causing the pain, so It is important to identify the structure. Numerous structures in the spine are known to cause back pain. These include the discs, nerves, facet joints, sacroiliac joints, ligaments and muscles. Studies have shown that in pain patients suffering from back pain only without any leg pain, the most common source of pain is the discs. Other structures commonly implicated in back pain seems to the Facet joints and Sacroiliac joints. Although physical examination by the doctor is not very helpful, MRI scan and diagnostic injections can possibly identify which discs or facets are causing the pain. In these patients, stem cell therapy can possibly provide pain relief. Although the numbers are not very large, clinical studies have shown that results of stem cells injected into discs are promising.
In patients with predominantly leg pain, the source of pain is most like the nerves. In this condition, stem cell injections around the inflamed nerve may not be useful. There is no clinical data to support the use of stem cells in this setting.
Currently, there is no clinical evidence supporting the use of stem cell injection into the other structures that cause back pain like ligaments, muscles or sacroiliac joints.
If you are having predominantly low back pain without pain down the leg, make sure your doctor is injecting the discs. If other structures like muscles and ligaments are injected but the disc is not, the likelihood of success is low. If you are having sciatica or predominantly leg pain, stem cell injections may not help.
3. Is the physician qualified to perform this procedure?
These spinal procedures should be performed only by well trained and qualified physicians. If not the patients may not get the pain relief they are seeking and the rate of complications may be higher. The physician should be board certified in a speciality which treats the spine and also should be very proficient in placing needles in the discs. Additionally, make sure your doctor is well trained and certified in regenerative medicine. This certification should be done by reputed organizations like American Society of Interventional Pain Physicians [ASIPP] or Interventional Orthopedic Foundation[IOF]. It is mandatory that disc injections are performed under fluoroscopic [x-ray] guidance. If your doctor is not using fluoroscopic guidance to inject stem cells in the spine, you are in the wrong clinic.
There are stem cell clinics mushrooming which are charging exorbitant fees for these injections. They also spend a lot of advertising. Most of these centers have poorly trained physicians or physician extenders like physician assistants/nurse practitioners performing these injections. I cannot emphasise the importance of verifying the qualification of the person performing the injection. Since these procedures are expensive and mostly paid from your pocket, you have the right to choose the proper physician.
Meticulous attention should be paid to sterility during the performance of the procedure to avoid discitis which a very painful condition requiring hospitalisation and intravenous antibiotics for many weeks. When bone marrow is being used, confirm that the doctor extracting the stem cells from multiple sites in the iliac crest and not just one site. Also, the physician should be using a centrifuge to concentrate and maximise stem cells. Some doctors are taking stem cells from only one area of the iliac crest and not centrifuging. This results in low numbers of stem cells. Studies are showing that more the number of stem cells injected, better is the pain relief.
Make sure your physician is board certified in a speciality which treats spine and is proficient in doing disc injection. Additionally confirm that he is trained/certified by reputable organizations like ASIPP or IOF. If a nurse practitioner or a physician assistant is performing the procedure, you are in the wrong place.
So coming back to the original question. Where can i get best stem cell treatment for lower back pain ? Here is the answer.
1.Your bone marrow stem cells should be used.
2. The procedure should be performed by a qualified physician under fluoroscopic guidance.
3. Injection of stem cells into the discs should be part of the protocol.
If any of the above 3 criteria are not met, you are in the wrong clinic. Armed with this information, you can now avoid being scammed at least regarding stem cells for back pain. You will get the results you want.