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Treatment of Chronic Lower Back Pain Using Stem Cells

back pain treatment

Treatment of Chronic Lower Back Pain Using Stem Cells

Treating Lumbar Spinal Degeneration with Stem Cells

In this article, we will be reviewing a case study performed by Dr. Alturi and his peers on the effectiveness of bone marrow stem cells in the treatment of chronic lower back pain due to severe lumbar spinal degeneration.

The case study saw 67% of patients showing significant improvements in their pain management 12-months after the initial stem cell injection.

Before we dive into the details of the case study, let’s first understand how much lower back pain affects Americans.

Impact of Lower Back Pain

Low back pain is the most expensive medical condition in the United States.

With an annual expenditure of $134.5 billion in 2016, surpassing diabetes, heart disease, and hypertension. Furthermore,  low back pain causes more global disability than any other condition.  With 50% to 80% of adults experiencing lower back pain at some point in their life, with adults of working age being the most vulnerable group of low back pain.

Health care costs in America have been a major burden on our economy leading to the implementation of various reform measures, regulations, and guidelines which often come down to public policy priorities for reducing health care spending. Despite increasing disability and health care costs, there has been escalating growth of various methods for the treatment of chronic low back pain, including over-the-counter (OTC) medications, structured exercise programs, physical therapy, drug therapy, interventional techniques, and surgical interventions.

lower back pain

Among these methods, regenerative medicine therapy as an interventional method has been added in recent years. Regenerative medicine is based on the process of replacing, engineering, or regenerating human cells, tissues, or organs to restore or establish normal function. Consequently, regenerative medicine incorporates biomedical, and technologies to improve cellular migration, replication, and modeling.

The American Society of Interventional Pain Physicians has developed guidelines on performing regenerative medicine procedures and also a position statement on bone marrow concentrate (BMC) injections for musculoskeletal and spinal use. Systematic reviews have shown the value of cellular spinal injections incorporating lumbar disc injections, epidural injections, facet joint injections, and sacroiliac joint injections. However, the evidence has been variable with the highest evidence being presented for lumbar disc injections.  Few studies have evaluated the role of bone marrow mesenchymal stem cells (BM MSCs) in managing spinal pain with disc injections.

Case Trial Overview Background:

Regenerative medicine interventions are applied to assist in the repair and to potentially replace or restore damaged tissue through the use of autologous/allogenic biologics and it continues to expand. The anti-inflammatory, immunomodulatory, and regenerative properties of bone marrow mesenchymal stem cells (BM-MSCs), an investigation into their therapeutic efficacy and safety in patients with severe chronic low back pain, have not been demonstrated in controlled studies. Multiple pain generators have been hypothesized to be responsible for severe spinal degeneration and it is difficult to identify a single pain generator; consequently, resulting in inadequate therapeutic results.


The study was undertaken to evaluate the effectiveness of autologous bone marrow  MSCs in the treatment of chronic low back pain due to severe lumbar spinal degeneration with the involvement of multiple structures.

Study Design:

A prospective, open-label, nonrandomized, parallel-controlled, 2-arm exploratory study.


A private, specialized, interventional pain management and regenerative medicine clinic.

Methods Used:

The treatment group patients received a one-time bone marrow concentrate injection into spinal structures (i.e., discs, facets, spinal nerves, and sacroiliac joints), along with conventional treatment, whereas, the control group received conventional treatment with nonsteroid anti-inflammatory drugs, over-the-counter drugs, structured exercise programs, physical therapy, spinal injections, and opioids, etc., as indicated.


Outcomes were assessed utilizing multiple instruments, including the Oswestry Disability Index (ODI), Numeric Rating Scale (NRS-11), EuroQOL 5-Dimensional  Questionnaire (EQ-5D-3L), Global Mental Health (GMH), and Global Physical Health (GPH). Multiple outcomes were assessed with primary outcomes being minimal clinically important differences  (MCID) in ODI scores between the groups and/or a 2-point reduction in pain scores.  

In the study group, total nucleated cells, colony-forming units-fibroblast, CD34-positive cell numbers, and platelets were also recorded, along with post-procedure magnetic resonance imaging changes.

Outcomes were assessed at 1, 3, 6, and 12 months.


Significant improvement was achieved in functional status measured by ODI, pain relief measured by NRS-11, and other parameters measured by EQ-5D-3L, GMH, and GPH, in the study group relative to the control group at all time periods.

The results showed significant improvements at 12-month follow-up with 67% of the patients in the study group achieving MCID utilizing ODI when compared to 8% in the control group. Greater than 2-point pain reduction was seen in 74% of the patients at 3 months,  66% of the patients at 6 months, and 56% of the patients at 12 months.

Both MCID and pain relief of 2 points were significantly different compared to the control group. Opioid use decreased in the investigational group, whereas, there was a slight increase in the control group. Age, gender, opioid use, and body mass index did not affect the outcomes in the stem cell group.


The first available controlled study utilizing BM-MSCs in severe degenerative spinal disease with interventions into multiple structures simultaneously, including disc, facet joints, nerve roots, and sacroiliac joint based on symptomatology, showed promising results.

Laser Spine & Back Surgery Alternative: Regenerative Stem Cell Therapy

Laser Spine and Back Surgery Alternative - Regenerative Stem Cell Therapy

Laser Spine & Back Surgery Alternative: Regenerative Stem Cell Therapy

regenerative therapy subheading

According to the CDC, eight out of ten Americans will experience back problems at some point in their lifetimes. In fact, Americans spend 50 billion dollars on back pain treatments every year, and the indirect costs (including lost wages, legal, and insurance) are upwards of 100 billion dollars annually.

While 90 percent of lower back pain cases are resolved within six weeks, 7 percent of those affected will develop chronic back pain requiring advanced treatment. Proper diagnosis is the key to developing a treatment plan. Most cases of back pain are related to misalignment of the spine and muscular issues, and will not require or benefit from surgery as the first line of treatment.

For cases of chronic low back pain that require advanced treatment, laser spine surgery is often offered as a minimally-invasive procedure to attempt to alleviate the patient’s pain. In other cases, more traditional back surgery may be suggested by a doctor.

Is laser spine surgery or back surgery the only option for patients to treat their lower back chronic pain?


There is a viable alternative to laser spine surgery and traditional back surgery options. It is regenerative stem cell therapy.

First, let’s take a look at laser spine surgery – what it is, how it’s used, what it is effective at treating, and the potential risks involved with the procedure.

Second, we will discuss regenerative stem cell therapy.

What is Laser Spine Surgery?

Operating room lights for back surgeryWhile many patients believe that laser spine surgery is an experimental treatment, the fact is that the holmium laser was approved for use in orthopedics and spine surgery in the 1980s. Laser spine surgery is often advertised as a safer, minimally-invasive procedure compared to the traditional “open” spine surgery. It can be performed through an incision as small as 1/4” providing more comfort to the patient, less soft tissue disruption and faster recovery time.

The process consists of the surgeon making a small incision to allow the insertion of a small tube through which a fiber optic holmium laser is inserted. The main benefit of using the laser in a small tube is that it doesn’t take up much room and it can deliver a very powerful beam of energy. Soft tissue and soft tissue bleeders respond well to the heat of the laser because of their water content. The laser cuts, cauterizes, or vaporizes the soft tissues. The beam is very small and can be accurately aimed at a specific target without injuring nearby tissue.

While the laser is an effective tool for certain types of spinal surgery, it may not be the first choice for treatment. It is often used for the treatment of stenosis, facet syndrome, or sacroiliac joint syndrome. For bone related diagnoses such as bony spinal stenosis, laser surgery is not an effective treatment as the laser will not cut bone.

The Potential Risks

While laser spine surgery is a minimally-invasive procedure, like any form of surgery, there are potential risks. The procedure does require an incision and the laser itself can result in serious complications. These range from pain at the graft site, infection, excess bleeding, and blood clots, to more serious problems like nerve damage, complications from anesthesia, or leaking of spinal fluid.

One of the more common complaints after the procedure is that it does not provide enough relief of back pain.

While recovery is relatively quick, portions of soft tissue are often removed to reduce nerve compression which leads to pain.

Your body sends pain signals as warning signs of operational issues. Getting rid of that which causes pain is like putting a piece of tape over the check engine light in your car. It doesn’t fix the problem. Inflammation causes many issues, but it’s your body’s way of telling you there is an underlying issue that needs to be addressed.

Destroying that which signals the brain doesn’t eliminate what caused the issue. With that in mind, for removing tumors or shrinking disk material around a nerve, laser spine surgery can be good; but it does act as a physically reductive agent in virtually all applications.

When Surgery Is Not an Option for Patients

Due to risks, some people are unable to get surgeries due to co-morbidities (additional diseases or disorders). So, even if they want to have surgery, it isn’t an option.

An Alternative to Laser Spine Surgery: Regenerative Stem Cell Therapy

Along with laser surgery, the traditional medical treatments for low back pain and herniated discs include physical therapy, exercise, pain medications, anti-inflammatories, and therapeutic injections. All of these treatments are aimed at restoring function and a normal life for the patients.

In more severe cases such as bony spinal stenosis, invasive surgeries like spinal fusion may be required. This can mean general anesthesia and long term physical therapy. In a large number of cases, even with surgery, ongoing pain and dysfunction can remain.

Today, patients have a second minimally-invasive and a completely non-surgical option to laser spine or traditional back surgery.

Regenerative stem cell therapy is a viable alternative for addressing issues that cause chronic lower back pain.

play with grandkids pain free after regenerative stem cell therapyTreatment involves allowing your body to heal itself, using naturally occurring cells, and growth factors.

While treatment may be applied differently by other medical practices, we will explain how it is provided at our practice.

Renew Medical Centers provide advanced regenerative cell therapy (stem cell injections) combined with platelet-rich plasma (PRP) injections and other regenerative treatments to treat orthopedic injuries, arthritis, and other degenerative conditions.

These regenerative treatments have a unique ability to assist your body in regenerating tissue, reducing pain, and reducing inflammation in damaged muscles, tendons, ligaments, cartilage, spinal discs, and bone.

Lower back conditions treated with regenerative and stem cell therapy include:

  • Degenerative disc disease
  • Herniated or bulging disc
  • Facet joint pain and injuries
  • Pinched nerve
  • Sciatica
  • Spinal stenosis
  • Osteoarthritis
  • Rheumatoid arthritis
  • Spondylolysis
  • Sacroiliac joint injuries
  • Bone fractures
  • Continued pain after surgery
  • And more

With our procedures, we use ultrasound guidance for optimal results. Some other regenerative cell therapy providers do not use ultrasound guidance. Without ultrasound guidance, it is less likely the treatment will be placed in the problem area and address the issue.

Treatment is a minimally invasive, outpatient procedure.

Regenerative and stem cell therapy is a low risk, viable alternative to surgery. As discussed, it is a completely different approach to treating chronic lower back pain.

As opposed to removing, shrinking, or fusing problematic areas with surgery, regenerative treatment gives the patient an opportunity for their body to heal degenerated and injured tissue.

With any medical treatment, there are no guarantees that it will or will not work for a patient. Each patient’s condition is unique. There are some cases where a patient will not be a candidate for regenerative treatment.

However, there are many cases where a patient is not a candidate for surgery but they are for regenerative treatment.

Before determining if a patient is a candidate for regenerative treatment at Renew Medical Centers, one of our doctors must first do a full diagnostic of the area of pain during a patient consultation.

When patients consider the possibility that regenerative and stem cell therapy may work for them, they often tell us, “Why risk having unneeded, unwanted surgery?”

Many patients who have had complications from surgery decide to get regenerative treatment in order to address the problems surgery created or did not address.

Other than the back and spine, areas treated also include knees, hips, shoulders, hands and wrists, feet and ankles, and more.

In this video, one of our patients discusses her experience with treatment for her lower back:

RenewYour Body WithRegenerative Therapy

To learn more about regenerative medicine and treatment options, register to attend one of our free local classes, and get your questions answered.

If you would like to schedule a your patient consultation with one of our doctors at Renew Medical Centers and determine if you are a candidate.