By Shane Mangrum, MD, board-certified physiatrist at Polaris Spine & Neurosurgery Center
These days, it seems like “regenerative technologies” are everywhere, but where did this science spring from? What is it, and can it help you?
In the 1920s, research on the adrenal cortex at the Mayo Clinic led to the discovery a substance known as “Compound E,” which eventually came to be called cortisone. In 1950, Dr. Phillip S. Hench won a Nobel Prize in Medicine for the application of cortisone to the treatment of Rheumatoid Arthritis, and the work he did changed the face of medicine.
Cortisone-type injections have been used extensively in the treatment of musculoskeletal injury in the years since Dr. Hench won his Nobel Prize. While helpful in many ways, these injections still employ a 1920s technology. Experts have suggested that “regenerative medicine will play an increasingly important role in the delivery of clinical care. …This is one of the biggest evolutions in medical history [emphasis added]. …There is only so much you can do to treat injuries and diseases. As we learn how to regenerate cells and strengthen the body’s repair processes, we can make tremendous advances in improving clinical care and maintaining long-term good health.”*
Today, professional athletes have used regenerative-type injections to actually “kick-start” tissue repair. These technologies are now becoming available to the masses with the application of platelet rich plasma and stem cell procedures to conditions like tendon injury, arthritis, and back and joint pain. These treatments can help repair injured tissues to provide lasting pain relief and to accelerate recovery times after an injury. They may also be used to treat back pain and spine pain, more generally, as well as pain caused by other musculoskeletal degenerative conditions. Even so, there has been a lot of misinformation spread about these therapies. If your doctor has recommended a form of regenerative injection therapy for treatment, we’ve created this guide to help you decide if it’s right for you.
Currently, regenerative injection therapy falls into two categories: Platelet-Rich Plasma (PRP) Therapy and Stem Cell Therapy. Let’s discuss both in more detail.
These injections start with drawing blood from a patient, and then spinning the blood in a centrifuge device to separate platelets from the other blood cells. This process creates a solution of concentrated platelets and growth factors that can then be injected into an area of injury to promote healing and tissue repair, spurring the body on to begin regenerating the deteriorated tissues.
Stem cell therapies
Instead of blood cells, these injections use cells from fat or bone marrow to promote the reparative response of diseased, dysfunctional, or injured tissue. Research has shown the potential for stem cell therapy to improve conditions such as heart failure, for example, by promoting cardiomyocyte regeneration and neovascularization, and recruiting resident stem cells.**
Both of these techniques involve very little patient discomfort and are performed as outpatient procedures in our surgery center.
Regenerative therapies can be highly effective, but they aren’t a “miracle cure,” and they don’t work the same way for everyone. Many people report some minor pain and swelling for the first few days after regenerative injection therapy, but this usually subsides quickly, after which the patient generally starts to see improvements. Talk to your doctor about how to care for your injury during the healing process and when you can return to sports after the treatment.
Choosing the right doctor
While regenerative injection therapies are safe, they should also only be administered by an experienced professional. Finding the right provider should involve doing some research, looking at reviews, and asking about prior experience. You also want to consider a physician who offers a diversity of treatment options besides regenerative therapies. That way, you’ll have confidence that if the treatment isn’t right for you, you’ll have other choices.
*Pascal J. Goldschmidt, M.D., Senior Vice President for Medical Affairs, Dean of the Miller School of Medicine and CEO of UHealth
**Sci. Rep. 6, 28250; doi: 10.1038/srep28250 (2016).
Read more about PRP injections here.