Clinical research regarding stem cell therapy benefits has grown dramatically in recent decades. The most promising thing about stem cell therapy — and similar prolotherapy treatments including PRP — is that they offer relief for patients with chronic pain and difficult-to-heal injuries, all without medications or risky reconstructive surgeries. Today researchers are also uncovering ways to apply stem cell treatments for common chronic conditions such as heart disease, neurodegenerative diseases and diabetes.
The most common use of stem cell treatments in prolotherapy is managing pain. Most consider stem cell therapy to be a form of “interventional pain-management,” meaning it’s a minimally invasive technique. Treatment involves injecting stem cells (along with an anesthetic and sometimes other substances) around painful and damaged nerves, tendons, joints or muscle tissue.
What specific types of conditions can stem cell therapy help treat? Some of the most common include osteoarthritis knee pain, tennis elbow, shoulder pains or rotator cuff injuries, tendonitis, Achilles tendon injuries, ACL injuries and now cardiovascular diseases like atherosclerosis.
There are now more options available to patients than ever before for various types of prolotherapy treatments, but the type of prolotherapy I recommend the most is the unique approach to stem cell therapy offered by the Regenexx clinic. I have personally visited the Regenexx clinic in the Cayman Islands to receive treatments performed by Dr. Chris Centeno, Dr. John Schultz and Dr. John Pitt for back and tendon injuries. The form of stem cell therapy offered by these doctors is considered to be one of the most thoroughly researched and effective in the world.
What Is Stem Cell Therapy?
Stem cell therapy is a type of treatment option that uses a patient’s own stem cells to help repair damaged tissue and repair injuries. It’s usually performed relatively quickly through injections, and is a simple outpatient or in office procedure.
This type of treatment has also been found to help:
- Speed up the length of time it takes for injuries or wounds to heal
- Reduce pain, even chronic joint pain, with less need for medications
- Increase functionality, range of motion, flexibility and sleep quality
- Reduce muscle compensations and risk for future injuries
- Decrease nerve damage
- Increase collagen
- Help generate new heart and blood vessel tissue
- Help heal skin wounds, prevent formation of scar tissue and reduce hair loss
- Return patients to their normal activities as quickly as possible
According to the National Institute of Health,
Stem cells are important for living organisms for many reasons. In the 3- to 5-day-old embryo, called a blastocyst, the inner cells give rise to the entire body of the organism, including all of the many specialized cell types and organs such as the heart, lungs, skin, sperm, eggs and other tissues. In some adult tissues, such as bone marrow, muscle, and brain, discrete populations of adult stem cells generate replacements for other cells that are lost through normal wear and tear, injury, or disease.
The California Stem Cell Agency reports that there is “no limit to the types of diseases that could be treated with stem cell research.” Because of their amazing abilities to help with regrowth, stem cell therapy treatments are now being used (or continuously researched) in regards to treating:
- Orthopedic injuries and muscukoskeletal problems
- Wounds and incisions following surgeries
- Spinal cord injuries, brain trauma and spinal stenosis
- Cardiovascular diseases, including hypertension, coronary heart disease, stroke and congestive heart failure (ranked as the number one cause of death in the United States every year since 1900!)
- Hair loss
- Vision impairment
- Diabetes and other pancreatic dysfunctions
- Neurodegenerative diseases such as Parkinson’s, multiple sclerosis and Alzheimer’s
How It Works
Stem cells are usually taken from one of two areas in the patient’s body: bone marrow or adipose (fat) tissue in their upper thigh/abdomen. Because it’s common to remove stem cells from areas of stored body fat, some refer to stem cell therapy as “Adipose Stem Cell Therapy” in some cases. (1)
Once stem cells from removed from one of these locations, they are placed in a “centrifuge machine” that spins them very, very quickly and concentrates the substances that are most valuable (including up to seven different types of natural growth factors). The sample of concentrated stem cells is then injected directly into the patient’s affected, painful area− allowing the cells’ growth factors to go to work immediately, building new skin cells, connective tissue and so on.
What exactly makes stem cells so beneficial and gives stem cell injections the power to do this healing? Stem cells have the following unique characteristics, uses and healing abilities:
- They are “unspecialized,” meaning stem cells can be removed from one part of the body and replaced into another part that is damaged, and then transform into the exact type of cell needed in order to help carry out repair work.
- Unlike other cells, stem cells divide and can become another type of cell with a specialized function (muscle cell, a red blood cell, heart cell, brain cell, etc.) (2)
- Because they contain natural growth factors, stem cells accelerate the body’s natural healing response and lower pain without the need for pain-killing medications.
- They reproduce quickly and can continue dividing in areas even after long periods of inactivity — so benefits are experienced within a short period of time. Most patients need to receive treatments for anywhere between one week to three months, but many start experiencing reductions in pain, improved mobility and better overall functionality within 1–2 treatments.
1. Treats Orthopedic Injuries
The type of stem cells being used in the most cutting-edge orthopedic practices — including those offered at the Regenexx clinic mentioned above — are called Mesenchymal stem cells (MSCs). A growing body of research shows that MSCs have the capability of differentiating and forming new orthopedic tissues that make up muscle, bones, cartilage and tendons, ligaments and adipose tissue. (3)
Research suggests that in treating orthopedic problems, fat-derived MSCs tend to under-perform bone marrow derived stem cells, therefore bone derived is the preferred method. (4) This is especially true when bone marrow cells are dramatically concentrated using advanced centrifuge equipment. Certain studies have found that these advanced samples can contain up to 25 different growth factors and other beneficial rebuilding substances.
In studies regarding orthopedic care — such as those used for cartilage replacement, bone repair and soft-tissue repair — bone marrow stem cells injections have been found to: reduce chronic pain, heal stubborn injuries, improve functionality and return patients to their normal routine sometimes within just one week.
Wondering if MSCs for orthopedic injuries are safe? There is no evidence of overgrowth of MSCs in damaged tissue or reason to believe there’s risk for tumor growth. Advanced clinics such as Regenexx actually count cells before injecting them and carefully monitor progress. According to research used by Regenexx, MSCs safely stop proliferating once they physically contact each other, because this signals to them that the affected area has reached its full potential in growth. (5)
2. Can Be Used to Treat Cardiovascular Diseases
Cardiovascular diseases can deprive heart tissue of oxygen and cause scar tissue to form which changes blood flow/blood pressure. Research suggests that stem cells taken from adult bone marrow have the ability to differentiate into those needed to repair the heart and blood vessels, thanks to the secretion of multiple growth factors. Several ways in which stem cell therapy is now being used and further researched in regards to improving recovery of heart disease are:
- Helping to stimulate repair and growth of blood vessel tissue
- Generating specialized muscle cells of the heart to grow new tissue
- Decreasing formation of scar tissue, helping to restore blood flow and blood pressure capacity
- Decreasing overstretching of cardiac cells, thereby restoring normal cardiac output (this helps prevent heart failure)
- Improving formation of new capillaries
Although more research is needed to assess the safety and efficacy of this approach, stem cell types used in heart disease treatment include: embryonic stem (ES) cells, cardiac stem cells, myoblasts (muscle stem cells), adult bone marrow-derived cells, umbilical cord blood cells, mesenchymal cells (bone marrow-derived cells) and endothelial progenitor cells (these form the interior lining of blood vessels).
3. Helps Heal Wounds and Incisions
Studies have found that stem cell treatments can help improve the growth of healthy new skin tissue, improve collagen production, stimulate hair growth after loss or incisions, and help replace scar tissue with newly formed healthy tissue.
One of the ways stem cells help facilitate wound healing is by increasing collagen concentrations in the skin, which shrinks as it matures and thereby strengthens and tightens the damaged area. This same mechanism also applies to treating connective tissue injuries related to collagen/cartilage loss, such as those caused by osteoarthritis or overuses that affect ligaments or tendons.
4. Treats Neurodegenerative Diseases
Recent progress in the treatment of diseases like Parkinson’s, Huntington’s, Alzheimer’s and stroke recovery show that transplanted adult stem cells can be used to form new brain cells, neurons and synapses following cognitive degeneration or brain injuries. (6) Research conducted by the Research Center for Stem Cell Biology and Cell Therapy in Sweden is still underway, but current findings show that stem cells can improve synaptic circuits, optimize functional recovery, offer relief from degeneration symptoms, slow down disease progression and potentially even more.
Some of the ways that stem cell injections/grafts work in neurodegeneration treatment are: normalizing striatal dopamine release, impairing akensia (loss of voluntary movement), replacing neurons destroyed by the ischemic lesions following strokes and halting destruction of nigrostriatal dopaminergic neurons.
5. Might Help Overcome “Immune Rejection” Disorders (Including Diabetes and Autoimmune Diseases)
Immune rejection is the term used to describe damage to healthy tissue and cells in patients with autoimmune disorders and other inflammatory conditions. In people who suffer from type 1 diabetes, for example, the cells of the pancreas that normally produce insulin are destroyed by the patient’s own immune system; in people with thyroid disorders, the thyroid gland is attacked and damaged.
Research continues to show us that certain adult stem cells are capable of differentiating and producing needed cells, such as insulin-producing cells that eventually could be used in with people diabetes. This strategy is still being researched extensively and is not yet widely available, as scientists continue to experiment with reliable strategies for generating new cells/tissues that will not be rejected or harm the patient once implanted.
Stem Cell Therapy Potential for Multiple Sclerosis Treatment
Meanwhile, a promising clinical trial led by Dr. Richard Burt of Northwestern University that explores the potential benefits of stem cell therapy for multiple sclerosis is underway as of March 2018. The 110 patients participating either received a drug treatment or hematopoietic stem cell transplantation (HSCT). The clinical trial looks promising given that after one year of treatment only one relapse occurred among patients in the stem cell group compared with 39 relapses in the drug treatment. And, after about three years, the stem cell transplants had a 6 percent failure rate compared with a failure rate of 60 percent in the control (drug treatment) group.
The researchers note that stem cell therapy doesn’t work for all cases of MS and it’s not an easy process. First patients must undergo chemotherapy to destroy their “faulty” immune system. Then stem cells that help make blood through a process called hematopoiesis are removed from the patient’s bone marrow and reinfused into the patient’s bloodstream. These fresh stem cells, which are not affected by MS, rebuild the patient’s immune system. Despite this challenging process, preliminary results demonstrate that this could be an effective treatment in the future. (7, 8)
Stem Cell Therapy vs. Other Types of Prolotherapy
- With any prolotherapy treatment, the injection, irritation and needle microtrauma to the affected area are what help to start the repair process. Because stem cell prolotherapy supplies natural growth factors (which dextrose prolotherapy using glucose does not), the process is often faster and more powerful.
- Most prolotherapy/PRP treatments rely on using your body’s own growth factors along with a portion of stem cells, but more advanced stem cell treatments such as those offered at Regenexx use advanced injections that have a much higher concentration of stem cells.
- The type of stem cells used by organizations like Regenexx are carefully isolated and grown inside a culture lab by a biologist over about a two-week period, at which point they mature enough to be used in injections.
- The use of mesenchymal stem cells (or MSC’s) seems to be especially beneficial and appropriate for treating degenerative diseases — where there is lost tissue, torn fibers and sometimes a bulging disc involved. In conditions where the body has stopped recognizing that an area is damaged, such as with osteoarthritis or chronic pain, these stem cell treatments may be most useful because they start the halted healing process once again.
History and Future Uses
For decades researchers and doctors primarily used two kinds of stem cells taken from animals and humans, especially when they were still embryos (not yet born). These are called embryonic stem cells and non-embryonic (“somatic” or “adult”) stem cells. In the late 1990s, it was discovered that stem cells could be taken from human embryos and grown inside of laboratories for reproductive purposes, including for in vitro fertilization.
Then in 2006 a “breakthrough discovery” was made that some specialized adult stem cells could be “reprogrammed” and used in many other ways to help repair damaged tissue. These are referred to as “induced pluripotent stem cells (iPSCs)” and are the type used in many of the treatments described above. There remains a lot to learn about the potential uses of stem cell therapies, and how scientists can continue to explore transforming unspecialized adult stem cells into the types of specialized cells needed.
The NIH reports that in future years some of the primary goals of stem cell therapy research are to: identify how undifferentiated stem cells become the differentiated cells that form the tissues and organs, determine how stem cells can turn human genes on and off, learn to predictably control cell proliferation and differentiation, and investigate more uses for stem cells in serious medical conditions such as cancer and birth defects.
The hope going forward is that stem cells can also be used as a “renewable source of replacement cells and tissues” to treat common and serious diseases without the need for organ transplants or surgeries, including: macular degeneration, spinal cord injury, stroke, burns, heart disease, diabetes, osteoarthritis, rheumatoid arthritis and cancer.
Cancer treatment is a particular important area under investigation, as early studies are showing that stem cells are safe and well-tolerated in patients with acute and chronic leukemia, lymphoma, multiple myeloma and other cancers. (9)
Where to Go
Stem cell treatments are offered by various doctors who practice pain-management and other techniques, including orthopedics and anesthesiologists. Depending on the type of treatment needed, it’s also possible to visit a neurologist, cardiologist, etc. Commonly these treatments are offered at clinics with a team of doctors who work together to specialize in diagnosing, preventing and/or correcting a range of musculoskeletal, neurological or connective tissue disorders/injuries.
If you’re planning on visiting a doctor for pain management, look for a physician who has board certification through an organization like the American Board of Anesthesiology or American Board of Pain Medicine. I recommend viewing this Physician Finder tool to locate a practitioner who performs the advanced type of stem cell applications described above.
Personally, I most suggest checking out Regenexx, one of the only organizations to run large-scale analysis of patient stem cell procedure outcome data. It has published numerous findings from tracking their own patients on their website. Much more detailed information on improvements that can be expected following PRP procedures — including those for knee meniscus, arthritis, hip dysfunction, knee pain, wrist/hand injuries, ankle/foot pain and shoulder/rotator injuries — can be accessed through Regenexx directly.
Once you find a qualified physician, here’s a brief overview of what you can expect from stem cell therapy treatments:
- You’ll likely visit a clinic or doctor’s office, as opposed to a hospital, and first receive an initial consultation. You will then be led to lay down comfortably so that the doctor can clean, anesthetize and remove a blood/stem cell sample from the the target area.
- Some clinics can prepare the injections relatively quickly while you wait, but others will have you return several days later while you wait for the sample to be placed in a centrifuge machine and spun to concentrate the stem cells. Depending on the treatment this might be one day or two weeks. Then the concentrated stem cells will be injected into the damaged tissue.
- After most treatments, patients are able to go home the same day and experience little or short-lasting discomfort.
- It’s normal to experience some swelling or minor pain near the injection site, but many are able to go about their normal activities and overcome the pain within 1–2 days.
- Most stem cell therapy treatments are still not covered by medical insurance, so it’s worth discussing your pricing options with the doctor you choose beforehand. Keep in mind that as with all therapies, results are expected to vary from person to person, so you might wind up needing more injections than initially thought in order to experience significant improvements.
Although stem cell treatment is considered to be very safe, there are also side effects that are possible. Make sure to find a qualified practitioner and let them know if your experience following a treatment does not sound like the typical one described above. Like other types of non-invasive treatments and prolotherapy techniques, some mild side effects after injections are normal. Side effects of stem cell treatments can sometimes include:
- Swelling or redness at the injection site — this should go away within one to two days
- Increased pain and stiffness in the affected area for a short period of time
- Rarely signs of an allergic reaction
- Although very rarely, cases of spinal fluid leaks and permanent nerve damage have also been reported
- Stem cells treatments are now used to help heal orthopedic injuries, connective tissue damage, neurological problems, heart disease, immune rejection disorders and much more.
- Benefits of stem cell treatments include speeding up healing time, lowering chronic pain, reducing need for medications, increasing functionality, decreasing nerve damage and improving collagen concentrations.
- Stem cells are taken from one of two areas in the patient’s body: bone marrow or adipose (fat) tissue in their upper thigh/abdomen, however advanced stem cell procedures using MSCs derive the stem cells from bone marrow most often.
- I recommend finding a qualified physician to perform orthopedic stem cell treatments here.