Table of Contents
- 1 Regenerative Medicine
- 2 History Of Regenerative Medicine For Pain
- 3 Stem Cell Technology In The Advancement Of Regenerative Medicine
- 4 Regenerative Medicine For Pain Principles
- 5 Ethical Considerations
- 6 Regenerative Medicine Procedures
- 7 Pain Conditions Treated With Regenerative Medicine
- 8 Regenerative Medicine Procedures For Pain
- 9 Benefits Of Regenerative Medicine For Pain
- 10 Conclusion
- 11 References
Chronic pain associated with physical injury or deformity is responsible for numerous damaging effects on a person’s ability to function through daily activities and job responsibilities. The primary cause of physical disability in the United States is a result of musculoskeletal pain following injury, disease, or illness. Chronicity of pain increases the rate of physician appointments, disability claims, and loss of productivity. Using estimates from both acute and chronic pain conditions, back pain alone accounts for a significant measurement of pain in approximately 100 million adults.
While not approved for all instances of pain management, regenerative medicine can be considered as an appropriate measure of treatment in specific individual circumstances. Regenerative treatment processes are a result of the alliance of research in chemistry, medicine, robotics, biology, computer science, genetics, and engineering to construct a biologically compatible structure for many different tissues found in the body. The idea behind tissue engineering for regenerative medicine in pain treatment is that research is used from science and technology to develop a biologically sound substitute for the body that will restore or improve function of any lost or damaged tissue.
Although relatively new in the field of acute and chronic pain management, regenerative medical procedures do date back as early as 1962 when scientists developed the first synthetic skin substitute. There are a number of misconceptions about regenerative medicine or cell therapy, including the origination of the cells, how clinically viable treatments may be, and that cell therapy or regenerative medical procedures always use stem cells. Fortunately, technological advancements have permitted the development of new processes for the treatment of orthopedic conditions without requiring an operative procedure.
In point of fact, many of these new processes are a minimally invasive means of using regenerative medicine for the treatment of pain. The more common conditions that have been successfully treated using regenerative medical procedures include arthritic bodily changes resulting in pain, and injuries to cartilage, tendons, muscle, bone, spinal discs, and other tissue types. Successful treatment goals include the reduction of pain, the return to activities of daily living, and greater productivity in the work place.
History Of Regenerative Medicine For PainRegenerative medicine emerged from a number of different advances in complementary scientific and technological fields. These processes are also known as tissue engineering, which utilizes living tissue and other biocompatible substances. Growth factor found in the body and other physical elements can be used to generate substances that will repair tissue that was damaged as a result of injury, or even to replace an organ that is failing as a result of the aging process.
The vast majority of early regenerative procedures were tissue-based, being developed for skin grafting. The first successful tissue that was engineered for grafting procedures was finalized in the 1970s, a mere eight years after the first synthetic tissue was developed. Howard Green and colleagues from Harvard Medical School began by harvesting a skin biopsy, later perfecting the practice of growing skin epidermis. This particular technological advancement has been applied in clinical practice to help individuals with a number of other conditions. Following these advancements, regenerative medical improvements have developed from technology in stem cell research, enabling successful bone marrow transplantation for individuals suffering from leukemia.
Stem Cell Technology In The Advancement Of Regenerative MedicineStem cells are an undifferentiated cell from a multicellular organism. These cells are capable of developing into other specialized types of cells found within the body through differentiation, triggered by cellular programming. There are two different types of stem cells found in a developing organism and one that is genetically reprogrammed within the laboratory.
Embryonic stem cells are the most immature and are found within the early stages of a growing embryo, usually after it has been left to develop five to six days. After the egg and sperm have united, the fertilized egg divides and creates stem cells that differentiate into the specialized cells the body requires to function.
The second type of stem cell, found naturally in organisms, is adult stem cells. These are present in developed tissue, such as muscle, skin, bone, brain, and blood. Also called tissue stem cells, they can self-renew and generate one specialized cell type. Under normal circumstances these tissue stem cells, or adult stem cells, will generate the type of cells that make up the organ in which they reside. These cells are used by the body to divide and repair injured areas or regenerate into specialized cells to replace the ones that are dead or damaged.
The third type of stem cells, which are genetically reprogrammed in the laboratory, are induced pluripotent stem cells. After years of stem cell research and development, it was discovered that artificially triggering certain genetic components would prompt different cells to become pluripotent stem cells, which were similar in nature to embryonic stem cells, thus avoiding ethical concerns associated with using human embryonic tissue for research and regenerative medicine.
Science has a strong interest in stem cells because of their renewing properties and the ability of the tissue to develop into any type of tissue in the body of the organism. Researchers believe that they have the potential for immeasurable clinical uses in health. Research is advancing many treatment options and improving success rates for individuals who suffer from diseases such as Type I diabetes, Duchene’s muscular dystrophy, stroke, Parkinson’s disease, heart disease, Alzheimer’s disease, osteoarthritis, vision and hearing loss, and rheumatoid arthritis. Other uses for these treatment modalities include spinal cord injuries and severe burns. There are many researchers and scientists who believe that stem cell research will lead to the potential for repair and replacement of damaged or diseased body tissue.
Following the bioengineering of skin for grafting, scientists were able to successfully engineer cartilage. Today, both of these products are commercially available to health care providers through the work done in tissue engineering and stem cell research. The release of these products were quickly incorporated into treatment plans and generated enthusiasm for the potential of producing different types of tissue that make up the human body. However, a number of different obstacles have prevented the progress toward this goal. For instance, both skin and cartilage tissue does not have a pronounced requirement for vascularization. Most other tissues in the body require greater number of vessels and oxygen supply to stay healthy. While skin and cartilage can be completed using more simplified techniques because of their reduced vascular requirement, further development will be required before other tissue can be completed for use in medical treatments.
Regenerative Medicine For Pain PrinciplesHaving discovered the ability of the body to organize and regenerate tissue after cell death, researchers aimed their future studies at the goal of regenerative medicine and tissue engineering to replace tissue that had been damaged, lost through injury, or deteriorating with advanced age. Many diseases and injuries that result from failing tissue could potentially be successfully treated using regenerative medicine therapies. However, the research and application has both ethical and legal considerations.
Ethical ConsiderationsMany regenerative medicine studies and treatments involve the use of living cells and therefore both legal and ethical issues are inherent in the use of platelet-rich plasma and, more specifically, embryonic stem cells. Although stem cell research holds great promise for the development of successful treatment modalities for conditions that thus far have no permanent treatment, research also raises both ethical and political controversies. Reprogramming adult stem cells to produce pluripotent stem cells avoids these ethical issues that are specific to embryonic stem cell research.
The U.S. Food and Drug Administration (FDA) does not currently require approval for use of adult stem cells, however stem cell therapy does not currently have FDA approval. Physicians may prescribe treatment modalities “off label” when they believe a treatment can benefit their patient, even though that treatment has not undergone clinical trials for the specific individual diagnosis.
Regenerative Medicine ProceduresOf primary concern in the use of tissue engineering for individual treatment is maintaining the environment from which the stem cells originated. This allows the engineered cells to function as if they remain in the native bodily tissue and produce the best results. Three types of regenerative medical treatment are used for musculoskeletal chronic pain.
Stem Cell Therapy
This procedure is used for patients who experience neck pain or low back pain from degeneration of the discs in the vertebrae or joint pain as a result of osteoarthritis in the knees, hips, or shoulders. Currently stem cell therapies are used as interventional procedures for a number of chronic pain conditions. The patient’s own adult stem cells are extracted, purified, concentrated, and then injected into the damaged tissue. This process is usually non-surgical and the individual has very little recovery time. Most patients report only some soreness around the site of the injection. Sometimes there is also slight bruising. There have been no reports of serious side effects from treatments using stem cell therapy.
The future of this research includes the generation of cells that could be used to replace damaged tissue or the generation of transplantable organs. Researchers are working toward the development of engineered tissue that requires greater vascularization and could potentially treat diseases, such as macular degeneration, stroke, osteoarthritis, spinal cord injury, and diabetes. Bone marrow transplantation using stem cell therapy has been an effective treatment modality since the late 1960s for people suffering from leukemia.
Amniotic membrane therapy is another type of regenerative medicine used in the treatment of chronic pain. This type of cell holds several unique properties that make it a sound choice for use in regenerative medicine. There are two types of cells in the amniotic membrane: epithelial cells and stromal cells. Both types have features that are very similar to stem cells because they are able to differentiate in vivo. In the literature using animal subjects in a minimally invasive surgical procedure (laminectomy) found that the subjects had less epidural fibrosis and adhesions using amniotic membrane therapy. Using human subjects, research investigating the use of amniotic membrane found the treatment effective when individuals had general tissue damage, such as treatment for tendinitis.
Amniotic membrane meets several criteria for use as it is widely accessible, non-tumorigenic, and capable of differentiating. A major focus in the use of these cells has been in tissue engineering, they may also have the capacity to protect and stimulate injured tissue by acting as vectors for the delivery of exogenous factors to treat injury and disease. Inconsistencies in isolation and culturing methods must be addressed before progress and future therapeutic applications can be achieved. Amniotic membrane cells are used as interventional therapy in the treatment of chronic pain conditions with very little recovery time and avoidance of side effects and disability that can accompany open surgical procedures. As with stem cell therapy the compound is injected and some patients report soreness or bruising at the site.
Although first used in the 1970s, platelet-rich plasma therapy was limited to operating room procedures because the equipment was large and expensive and the procedure required large quantities of the patient’s blood. Starting in the 1990s, multiple reports and studies were released demonstrating dramatic improvement in healing using platelet-rich plasma therapy. Today it is used to target a number of different conditions in which the patient develops chronic pain. The procedure requires an injection of autologous growth factors, secretory proteins, and concentrated platelets. These compounds work in unison to repair damaged tissue and speed the healing of surgical procedures.
In addition to the use of platelet-rich plasma therapy in pain management, the procedure is also widely used in healing bone grafts and fractures, in plastic surgery, and wound care. The success experienced in healing fractures spurred the integration of platelet-rich plasma therapy in other orthopedic conditions and sports medicine for connective tissue repair. Reduction in pain at two years post-treatment for chronic tendinitis was reported at 93%. The treatment received media attention after Pittsburgh Steelers’ wide receiver Hines Ward received the treatment for medial collateral ligament sprain and went on to win the Super Bowl that year.
The injection of platelet-rich plasma to an injured area delivers growth factors concentrated from five to ten times greater than is normally found in plasma. The compound is prepared through withdrawal of blood from the patient, centrifugation to increase the concentration, and then injected into the area that was damaged or injured. When the blood is centrifuged, it separates into three different components. The top layer is clear serum, platelets and white blood cells are found in the middle, and the red blood cells are at the bottom. Estimates are that the concentration of platelets in centrifuged blood hovers around 1 million platelets per uL. Typical concentrations of platelets from whole blood are between 150,000 and 350,000 platelets/uL.
Platelets contain a high concentration of growth factor, which is central to the function of platelet-rich plasma therapy in regenerative medicine for pain management. Once injected into the damaged area, the platelets release other proteins that are believed to affect the regenerative influence patients experience after treatment. This process enhances the differentiation of cells, which is believed to be the underlying process required for the generation of new tissue. As with stem cell therapy, most patients report only some soreness at the injection site that may or may not be accompanied by bruising.
Platelet-rich plasma therapy has received more attention from researchers since 2000 when the process became more cost effective. This attention has led to the discovery of beneficial effects on the proliferation of cells and an increase in total collagen production. Results from studies that scrutinize the success of treatment have supported the use of platelet-rich plasma therapy in the treatment of lateral epicondylitis, patellar tendinopathy, Achilles tendinopathy, osteoarthritis, medial collateral ligament tears, rotator cuff tendinopathy, rotator cuff tears, and anterior cruciate ligament tears. Platelet-rich plasma therapy has also been successfully used to treat other chronic pain conditions resulting from tendonosis, muscle fibrosis, arthritis, articular cartilage defects, meniscal injury, chronic synovitis, joint inflammation, muscle strains, and arthrofibrosis. The treatment is non-surgical, minimally invasive, and has a low side effect profile.
Pain Conditions Treated With Regenerative MedicineIndividuals interested in using regenerative medicine treatment options to provide pain relief for their specific conditions should undergo a consultation with an expert physician in regenerative medicine. These consultations are necessary to determine if a regenerative medicine therapy is an appropriate treatment protocol for the patient’s pain condition. The consultation often includes an in-depth evaluation of the underlying condition, previously attempted treatments, and an evaluation of the potential for using regenerative medicine techniques for pain treatment. The physician will offer guidance about the procedures involved and what patients may expect from any protocols used. Because of many misconceptions about the use and application of stem cell therapy, this appointment can serve to afford the patient with information about both the process and answer questions.
During this initial consultation the physician will perform a brief but detailed personal history to ensure an accurate diagnosis of pain. Because there are numerous different musculoskeletal conditions that result in pain and could benefit from regenerative medicine therapies, an accurate diagnosis to determine the most appropriate regenerative therapeutic procedure. There is no one regenerative medicine therapy that fits all musculoskeletal chronic pain conditions. In cases where a precise cause of pain cannot be identified, a prerequisite of treatment is to ensure that certain other diagnoses are ruled out. Although the side effect profile of most regenerative medicine therapies is low, your physician will generally assess for your specific degree of risk for persistent difficulties.
Chronic pain can be the result of a number of different causes. Pain that lasts for more than three months, which may be progressive or recur intermittently, and usually outlasts the typical healing time, is defined as chronic pain. Damaged muscles, ligaments, or joints that make up the spinal region can also be a source of both acute and chronic pain conditions. Approximately 100 million people in the United States suffer from chronic pain conditions that can range from mild to excruciating and can be simply inconvenient or completely incapacitating. Chronic pain not only results in physical disability, but long-term can result in significant psychological and emotional suffering that can limit an individual’s ability to function fully.
Generally, chronic back and neck pain is characterized by pain that will arise from the back but may radiate out toward the limbs. Specific symptoms are varied and can include experiences of shooting, burning, spasms, radiating pain, tingling, or aching. Other symptoms can be more generalized feelings of soreness, tightness, stiffness, weakness, or discomfort. However, there are specific clusters of symptoms that generally depend upon the underlying cause of the chronic pain. It is expected that the pain will fluctuate, sometimes dependent upon the environment in which the patient finds themselves. The emotional tax of chronic pain can increase the perception of pain. Negative feelings, such as anxiety, stress, depression, or fatigue, may increase the perception of pain. There is also sizeable evidence that chronic pain in combination with negative emotions can compromise the immune system.
Pain is thought to be an indicator of tissue damage or an underlying injury. A number of existing treatments are designed to help the patient cope with the chronic pain without addressing the underlying damage or injury to the musculoskeletal system. However, new regenerative medicine therapies have provided physicians with advancements that target the underlying problem and promote the ability of the body to heal itself through the use of undifferentiated stem cells. Patients who experience the following list of conditions are potentially viable candidates for regenerative medicine treatment protocols.
Osteoarthritis is a chronic joint condition that causes degenerative cartilaginous changes. It is believed that the damage can be the result of wear and tear on the joint through a number of years or as a direct result of a specific injury. With enough damage to the cartilage that protects the joint, there is a high risk opposing bones will rub directly against each other. This direct contact causes damage to the ends of the bones and a significant inflammatory response and pain. Treatment options that do not include regenerative medicine will only help to manage the pain and not cure the condition. Stem cell therapy is believed to be more fitting since the goal is to repair the condition and reduce the bone-on-bone contact.
This is a degenerative condition of the individual bones of the spine, called vertebrae. Most commonly, spondylolisthesis occurs when the vertebrae slips over one another or becomes dislocated. Patients may experience nonspecific low back pain because a large number of individuals with this anatomical distortion do not present to their physician with related symptoms, including pain. With spondylolisthesis the nerves around the weakened vertebrae can become compressed, resulting in pain and potentially muscle weakness. These symptoms can include pain in the back or buttocks, pain that travels down one or both legs, which may or may not be associated with numbness or weakness, difficulty walking, or in rare cases, loss of bladder or bowel control. Estimates are that 12% of the population has had difficulties with spondylolisthesis.
This common condition is characterized by a narrowing of the spinal canal. With spinal stenosis there is a restriction from this narrowing that results in neurogenic claudication. The spine is a row of 26 bones that allows movement and bending. Through the center is an opening, or canal, that protects the spinal cord. The narrowing with spinal stenosis can occur in the center, in the canals, or the spaces between the vertebrae. This narrowing puts pressure on the nerves in the spinal cord and can result in pain or numbness in the legs or shoulders, depending upon where the restriction is located.
Spinal stenosis is more common in individuals over the age of 50 years, but may occur in younger people who suffer an injury to the spine or are born with a narrowing of the spinal canal. General recommendations are that patients attempt more conservative forms of treatment before starting regenerative medicine protocols.
Spinal deformities are genetically linked issues that are related to the natural curvature of the spine. They generally involve the entire length of the spinal column and are relatively uncommon. Conditions can affect the cervical, thoracic, or lumbar spinal regions and symptoms will vary widely depending upon the location. Some of these conditions are visible at birth, while others are only diagnosed when signs and symptoms develop.
A compression fracture is typically caused by osteoporosis and has a higher prevalence rate among post-menopausal women and in those individuals with a long history of corticosteroid use. These fractures result in a decrease in height of the vertebrae of at least 15 to 20%. In one study, which examined 7,000 women over the age of 65, researchers found that 5% had suffered a compression fracture over a four-year period. Previous studies have suggested that nearly 4% of adults evaluated in a primary care setting could attribute back pain symptoms to a compression fracture.
Degenerative Disc Disease
Degenerative disc disease is a condition that results in symptoms from changes to the vertebral discs in adults as they age. It is believed that the aging process increases the risk of tears to the disc, which is a likely cause of the pain associated with this condition. Spinal discs are soft and compressible that helps cushion the spinal column, which allows the spine to flex, twist, and bend. Although it can occur anywhere along the spine, it most often occurs in the lower back and neck. The pain can occur throughout the spine but in some instances has been reported to be localized to the affected intervertebral disc.
Treatment modalities have been limited to physical therapy, pain medications, spinal fusion surgery, and steroid injections. Each of these treatments is done with the goal of pain management. New advances in regenerative medicine and stem cell therapy have led to treatment options for patients suffering from degenerative disc disease. Following extraction of the patient’s stem cells, usually from the bone marrow in the hip, the cells are engineered, concentrated, and injected into the site of the injury.
A herniated disc is characterized by damage to the intervertebral discs, which cause them to bulge from the intervertebral space or to rupture completely. The daily stress of movement, poor posture, injuries, and age can cause them to bulge, rupture, or herniate. The expansion of the disc material puts pressure on the surrounding nerves and spinal column, which is believed to be the source of pain. Herniated discs are more commonly found in aging people. Treatments include physical therapy, which has shown promise in relieving pain and improving the ability to function daily, however, it requires a significant time commitment in the therapist’s office and in daily home exercises.
Surgical treatment options may be suggested to cut out or remove the bulging or herniated material from the spinal column. The removal of the herniated disc carries a number of different risks related to the area of the spinal column where the disc is located and the weakened area of the column following surgery. Surgery is not always successful and there is a slight risk of damage to the spine or nerves, and risk of infection. New techniques being used in the area of regenerative medicine using a patient’s own stem cells has shown good results with regeneration and rebuilding of the network of cells that make up the injured disc.
This is a common form of chronic foot pain found between the ball of the foot and the heel. There is a thick connective tissue on the bottom of the foot, called the plantar fascia, which connects the ball of the foot to the heel. This plantar fascia supports the arch of the foot and can become strained from a number of different sources, including overuse, tight calf muscles, and poor foot placement. The damage forms tiny tears along the ligament, which is the likely source of pain. Treatments usually target the symptoms of pain once the underlying cause of the condition has been corrected.
Regenerative medical treatments are an ideal choice for patients who have chronic pain in the plantar fascia and have corrected the underlying biomechanical issue that caused the initial condition. These therapies will promote healing of the damaged tissue. In fact, several studies provide realistic support for the use of platelet rich plasma therapy as an effective method of treatment to reduce or eliminate the pain associated with plantar fasciitis.
Sacroiliac Joint Pain
The sacroiliac joint is a large joint area that is located at the base of the spine. The joint connects the spine to the hip, or pelvis. In many cases, the individual can identify an injury that transpired previous to the onset of pain. Degenerative arthritis, pregnancy, abnormal walking patterns, and leg length discrepancy are other causes of sacroiliac joint dysfunction that results in pain. There is limited evidence that current treatments, such as steroid injections, radiofrequency neurotomy, and pulsed radiofrequency, are successful. Once the underlying causative issue is relieved, there is limited evidence that regenerative procedures can affect some degree of pain relief. This pain relief appears to last longer than that of steroid injections.
Also known as sciatica, lumbar radiculopathy occurs when a herniated disc, often between L5 and S1, pushes against the nerve. Patients experience pain that travels down the leg. The primary goal is to reduce the size of the disc and reduce the compression on the nerve root, thus reducing the pain. There are a number of different treatment options for patients who suffer from lumbar radiculopathy. However, if they are unsuccessful, or if patients do not receive relief from their pain, they can be a candidate for stem cell repair.
In cervical radiculopathy, patients experience chronic pain originating from the cervical spine, or the neck area. When a disc in the neck pushes against a nerve root exiting the cervical spine, it causes pain to travel down the arms. Radiculopathy in younger individuals can be from a herniated disc or neck injury. Older adults may suffer but physicians expect to also find osteophyte formation causing narrowing of the foramen, a reduced disc height and degenerative changes in the intervertebral joints.
Failed Back Surgery
There are a small number of patients who experience such severe, unremitting back pain that they choose to undergo surgery to gain relief. Some patients may continue to suffer pain following surgical repair, which is recognized as a failed back surgery. In these cases the pain can be caused by scar tissue that develops around the surgical site as the patient heals, disc herniation, post-operative pressure on the spinal nerve, or altered joint mobility in the spine. Individuals with a history of other emotional disturbances, such as difficulty falling or staying asleep, depression, or anxiety are at an increased risk of developing chronic pain conditions following a back surgery.
Pain symptoms of a failed back surgery are usually dull, aching pain that is diffuse across the back and legs. Some patients do suffer from stabbing, pricking, or sharp pain in the limbs. When other treatments have failed to relieve pain following a failed back surgery, regenerative medicine treatment options might be considered.
Regenerative Medicine Procedures For PainRegenerative medicine for pain procedures take approximately 30 minutes. The patient is usually seen in an outpatient clinic and able to undergo the procedure without general anesthesia. Regenerative medicine treatment protocols are done on an outpatient basis and require little to no recovery period. Oftentimes individuals are able to return to work directly following the procedure.
The majority of the time, regenerative medicine involves using the patient’s own stem cells and other supporting cells. The harvested material is concentrated, purified, and injected into the damaged area where the expected results include regeneration and repair of damaged tissue. The concentration of the stem cell therapy should not be altered in any way. Most patients report very little discomfort during or after the procedure, although some report minor soreness or bruising at the site of the injection.
Benefits Of Regenerative Medicine For PainUsing stem cell therapy or tissue engineering, physicians expect that patients will achieve a number of different benefits, including:
- Faster recovery time following the procedure
- Improvements in joint, ligaments, and tendon function
- No significant incisions or trauma to the area
- Very little pain or discomfort during the procedure
- No general anesthesia
- Renewal and repair within the joint
- Very low side effect profile and little risk of allergy or adverse reaction
ConclusionPain is a serious public health concern and it has been suggested that up to 90% of the population will experience a painful condition at one time in their life that affects their daily function. There are some estimates that back pain is associated with an annual cost exceeding $100 billion, which includes medical expenses and loss of productivity. Chronic pain is also associated with a number of negative consequences in an individual’s life, including emotional and mental distress. This emotional and mental trauma also contributes to an increase in perception of pain. Chronic pain is associated with missed work, increases in sedentary choices, and a loss of productivity.
Following an accurate diagnosis, physicians specializing in pain conditions may recommend that patients who were referred for regenerative medicine therapy, first undergo an initial consultation with an expert pain specialist. This is to ensure that a number of different treatments already available to provide patients with relief from chronic pain will be utilized prior to using regenerative medicine and stem cell therapy in their individual cases. Although there is evidence that regenerative medicine will benefit a wide variety of chronic pain conditions, as with other therapies, there are individuals whose pain will not respond to treatment.
Individuals who suffer from intractable pain will require more aggressive and long-term forms of treatment to combat their symptoms. Regenerative medicine in stem cell therapy is not approved for all types of pain conditions and your doctor will help determine which particular treatment protocol is right for your individual condition.
A regenerative medicine procedure involves taking the patient’s own stem cells and other supporting cells from one of the known sites in the body. The material will then be purified, concentrated, and injected into the damaged tissue area where it is expected that the stem cell therapy will help to repair and regenerate tissue. Most people report very little discomfort, although there might be some minor soreness or bruising at the site of injection.
Regenerative medicine treatment protocols are relatively new and historically have very few studies documenting their effectiveness on different types of pain conditions. There is new evidence regarding the effectiveness of stem cell therapy for a range of different conditions that have failed to respond to all other interventions. Improvements continue to be experienced as the system and procedure continue to undergo technological advancements. In the future, regenerative medicine may emerge as the premier method of treating chronic pain.
NOTE: Regenerative medicine often uses a patient’s own stem cells. This means that adult stem cells are drawn from the patient and returned to the same patient in the form of treatment. Currently, the United States Food and Drug Administration (FDA) does not have any approval requirements for the use of adult stem cells that are injected back into the same patient. The FDA has not approved the use of adult stem cells to treat aging or to prevent, treat, or cure any disease or medical condition mentioned.
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