Lumbar radiculopathy is commonly known as “Sciatica”. It is a relatively common condition affecting an estimated 12-40% of patients who are suffering from low back pain.
Patients with radiculopathy typically complain of pain in the buttock and the leg. It may occur with or without back pain.
A definitive diagnosis is made with an MRI of the lumbar spine which shows the lumbar nerves being compressed in the spinal canal. However, MRI changes described above are always not seen. In such cases, an EMG test is ordered which shows if the spinal nerve is irritated or not.
To complicate matters, disorders of the disc, facet joint and the sacroiliac joint can also cause pain in the buttock and the leg. This is called ” Pseudo Radiculopathy” This makes the diagnosis of radiculopathy even more challenging.
Similarly, the treatment of radiculopathy is also difficult.
Medications like anti-inflammatories and opioids and physical therapy/chiropractic care are the first line of treatment. Nerve medications like gabapentin and pregabalin can be used. Those who fail these modalities can benefit from epidural steroid injections. Surgery is utilized as a last resort to treat unresolved radiculopathy.
However, in spite of the above treatments, many patients continue to suffer from radiculopathy.
Stem cell therapy is a novel therapy to consider in these patients. Radiculopathy by definition means inflammation of the nerve. Stem cells are known to secrete very potent anti-inflammatory proteins and thus relieve inflammation and pain. Thus it seems logical to use stem cells to treat the inflammation of the nerves.
Stem cells are the new frontier in pain management. They do have a tremendous potential to treat back pain. Their use in other pain conditions is expanding.
Can stem cells help radiculopathy?
We want to share our experience of using bone marrow stem cells to treat radiculopathy.
Craig had a disc rupture in the lower back which compressed his nerve in January of 2018. This resulted in severe buttock and leg pain requiring surgery. The disc pushing on the nerve was removed relieving his pain.
Unfortunately, 6 months later his leg pain started to bother him again and was getting progressively worse. His surgeon ordered an MRI which did not reveal any nerve compression and hence he was not a surgical candidate. Craig tried physical therapy, anti-inflammatories, opioids, nerve medication[gabapentin] and CBD oil without any success.
He then had an EMG test which showed that his S1 nerve in the spine was inflamed.
After enduring pain for a year and a half, he saw us for a consultation. An epidural steroid injection was done in an attempt to calm the nerve. Unfortunately, it helped for only one day.
Now, he had only 2 options.
The traditional Spinal Cord Stimulation or the novel Stem Cell Therapy. Risks and benefits of both were discussed and Craig chose stem cell therapy.
Stem cell therapy was performed by extracting his own bone marrow stem cells from the iliac crest [bone which is in the back of the hip]. They were concentrated and injected back into the epidural space around the inflamed S1 nerve. Since his new MRI showed tears in the discs and fluid [implying inflammation]in the facet joints, his discs and facets were also injected with stem cells.
Below is the x-ray picture of his procedure.
In less than 2 weeks, his pain was improved significantly and in one month he had complete resolution of this pain. He was finally free of the agonizing pain which was bothering him for almost a year and a half.
Not only he is pain-free but more importantly, he is now very functional and able to perform well at his job. This has also made him feel much better psychologically.
To hear how stem cell therapy made a difference for Craig, watch the video below.
Stem cells seem to have the potential to treat refractory radiculopathy. However, to get the best results, the following conditions have to be met.
The procedure must be performed by an appropriately trained physician
The epidural space which has the nerves should be injected.
Unfortunately, stem cell procedures are not covered by insurance and they can be expensive. Beware of the “fake” stem cell clinics. There are plenty of them in every city. Do your homework. After all, it’s your hard-earned money. Most importantly, it’s your health.
Dr. Sairam Atluri is a pioneer of stem cell therapy in the Cincinnati area. He is one of the very few in the country performing intra-discal and subchondral injections to treat back pain and joint pain. He gives national talks and teaches other physicians about stem cell therapy. He is also a co-editor of one of the largest textbooks about regenerative medicine. Dr. Atluri is part of the team which wrote the ASIPP guidelines for stem cells to treat back pain. He is one of the few in the area to be certified in Regenerative Medicine by American Society of Interventional Pain Physicians [ASIPP].