The spinal column consists of 33 individual vertebrae with dozens of joints between them. Strong enough to withstand the rigors of daily wear and tear, but doing so decade after decade may be asking a lot. Deterioration can happen for a number of reasons - accidents, sports, hard labor, osteoarthritis, immune disorders, etc. Regardless of cause, sudden or gradual, the common denominator is usually severe pain. 

back pain

There are 7 vertebrae in the cervical region which is your neck area, then 12 in the thoracic region which is your back, followed by 5 going down in the lumbar region or lower back, and another 5 in the sacral region and 4 in the coccygeal region which is technically your tail bone area. Any inflammation within these areas can potentially result in a domino-effect of radiating pain.

Any injury or disease involving the spine quickly affects mobility.  Individuals unfortunate enough to be affected live in a world of perpetual hurt. The simple acts of sitting, walking, gripping, voiding, etc. can become cumbersome and daily reminders of injury. 

The last ray of hope - surgery - has been shown to be ineffective in providing effective reprieve from symptoms in a significant proportion of patients.  Whats more is that such invasive measures can prove to be a bigger setback than the pathology itself.  

For the right patient, in the right context, minimally invasive stem cell therapies can change the course of many lives for the better.


What is Chronic Back and Neck pain?

Chronic back pain is a broad term that pertains to inflammation, nerve impingement, degenerative disc damage and tissue breakdown in the spine. Such pain typically lasts 12 weeks or longer.

Neck pain is one of the most pervasive problems in the world today. Repetitive strain associated with most modern jobs is truly not kind to our necks. We spend a great deal of time viewing our screens at uncomfortable angles.  Its no surprise that signs of osteoarthritis can be seen in 50% of the population of people over 50. 

Spinal injuries of all types have the potential to make life a struggle for those living in its clutches. Depression is not uncommon as the stark reality of a completely altered quality of life sets in. 

Relieving back and neck pain without surgery is now possible with new avenues in regenerative medicine - including Platelet-Rich Plasma (PRP), stem cell, and exosome therapies.

Advantages of these biological therapies over standard surgical options include their relative simplicity, the fact that they can be performed on an outpatient basis, are minimally invasive, can be done much faster, with fewer complications and a higher success rate in the right patient population. Biological therapies are ideal for patients between 20 and 70 years of age with mild to moderate disease burden.


Overview of Biological Therapies

Biological therapies (e.g. PRP, stem cell, exosome therapies) mark a new dawn in the field of healthcare.

The actual procedures involving such therapies are all pretty straightforward.  With respect to PRP and stem cells, the cells are extracted from the patient, processed, and then administered back into the same patient at the intended target site. PRP is derived from peripheral blood, whereas stem cells can be obtained from bone marrow or one's own fat tissue.  Stem cells may also be derived from a separate donor (e.g. umbilical cord).  Exosomes are microscopic packets of instructions from one cell to another.  In this instance, the exosomes are derived from donated stem cells and the message they're conveying is induction of tissue repair and regeneration at the target site.   


Words of Caution

Important caveats include the following.  When PRP science was in its infancy, providers would draw a patient's blood into a test tube similar to what you may be used to seeing at a commercial lab today.  They would then isolate the PRP from that sample.  It's important to note that regenerative medicine has progressed tremendously since those bygone days.  A significant majority of clinics unfortunately continue to cling to the dated method of PRP processing despite much superior methods being available.  

The main drivers for this inability to adapt has been that the newer methods are more skill intensive and costlier.  To fully harness the benefits of PRP therapy, take the time research your provider and their methods.  If blood collection tubes are used at any point in the procedure, it's a cheaper outdated method.  If you're being offered "rock bottom prices," the quality of the procedure probably matches that price.  

One of the biggest caveats regarding stem cells involves donated cells.  Make sure the cells originate within the United States.  Stateside labs are regulated by the Food and Drug Administration (FDA).  As such, they have to abide by fairly strict standards of cleanliness and protocol.  Clinics import cells from abroad easily and cheaply.  However, you're truly rolling the dice when it comes to your health when you subject yourself to procedures at such clinics.  

While on the topic of offshore stem cell therapy, prospective patients are often marketed a familiar line - "we can do special procedures at offshore sites that are disallowed by the FDA here in the states."  Indeed clinics have garnered a supernatural aura about their methods through these marketing campaigns.  As a consumer, you should understand that its generally a bad idea to trade world class health for third world health.  More specifically, no credible data has been published to vouch for the effectiveness of these "too good to be legal" methods.  

Such offshore arrangements protect the clinic in the event of gross negligence.  The FDA is certainly stringent, but they also allow for legitimate avenues for pursuing investigational therapies.  These clinics have opted to not pursue those processes as it's easier to find havens abroad where anything goes without repercussions.  That's not to say success is impossible to get reasonable care at such sites, but if you lament a crosstown doctor's appointment, you might want to reconsider flying to a different country on short notice in the event of an unexpected post-procedural complication.  

Finally, it needs to be stressed that Regenerative Medicine is a field of medicine.  If a clinic chooses to perform just PRP therapy or commit to one form of stem cell therapy, it is not a Regenerative Medicine practice despite glossy marketing that suggests otherwise.  One mode of therapy cannot possibly treat all ailments any more than one tool can fix all mechanical problems with one tool.  It would behoove you as a patient to interview your provider and get a sense of their depth and breadth of understanding of this field of Medicine.


Make Neck and Spinal Pain Relief Happen

That's right...take a proactive role.  Initial steps start before the injury even happens.  Maintain a healthy weight by being mindful of a healthy diet.  This may entail testing to ensure you're not mounting a low-grade inflammatory response to certain foods as well as checking to see if your calcium and vitamin levels are supportive of appropriate bone density.  Exercise your neck and back.  This will help with mobility, and musculoskeletal strength.  Adopt practices in your daily activities that avoids injury rather than react to it once it happens.  

If you do injure your neck or back, take an adequate amount of time off to recover fully.  Don't cut corners as you risk significantly prolonging recovery - the opposite of the desired effect.

Finally, despite the pain being acute or chronic, learn to act early.  "Toughing it out" can be detrimental as over months and years, at the microscopic level, the injury can not only progress but lead to further damage that becomes unresponsive to conservative measures including to biological therapies.  

Do your homework, research and meet with Regenerative Medicine specialists early.  Share your goals and expectations with them and get a sense for what's realistic.  Don't settle for cheap or lofty promises.  Once the disease has advanced beyond the point of no return and surgery is the only option, repeat this process with more than one spine surgeon.  Surgery is a major endeavor and being at your health optimum is paramount.  Regenerative Medicine specialists can still offer vital help here - for example with a supportive post surgical injection to help shorten recovery time. 

By Vasilly Eliopoulos and Khoshal Latifazai, Founders of Rocky Mountain Regenerative Medicine, is the only full-service integrative and regenerative medicine clinic of its kind in the nation specializing in Stem Cells for Spinal Disorders.