Regenerative Therapy Pain Management Treatments for Arthritis
Regenerative Therapy for ArthritisAdmin2019-12-17T14:33:05-05:00
Regenerative therapy is becoming a significant treatment option for arthritis patients, in addition to people with similar autoimmune conditions. Arthritis is a painful inflammation of the joints, most often affecting the weight-bearing joints like the knees, hip, and spine as well as the shoulder, neck, and smaller joints (hands and feet).
Two of the most common types of arthritis are osteoarthritis (wear and tear, or injury to the cartilage cushioning the joints), and rheumatoid arthritis (an autoimmune disorder). Osteoarthritis is a chronic condition typically requiring long-term medications. Common arthritis symptoms include joint pain, swelling, and stiffness. The effectiveness of traditional pain management treatments varies greatly between patients.
Platelet-rich plasma therapy (PRP) takes advantage of the blood’s natural healing properties to repair damaged cartilage, tendons, ligaments, muscles, and bone. Doctors who use PRP therapy to treat osteoarthritis theorize that platelet-rich plasma:
Inhibits inflammation and slow down the progression of osteoarthritis.
Stimulates the formation of new cartilage.
Increases the production of natural lubricating fluid in the joint, thereby easing painful joint friction.
Delivers proteins to the treated area that alter a patient’s pain receptors and reduce pain sensation.
Stem Cells Therapy to Treat Arthritis
Stem cell injections are a cell-based therapy that can help manage inflammatory conditions such as tendonitis, joint pain associated with early arthritis, and cartilage damage. The injections have been shown to help treat conditions that were unresponsive to alternative therapies such as Durolane (injection treatment to help relieve the pain of knee osteoarthritis).
There is evidence that stem cell therapy benefits may include dramatic anti-inflammatory effects and the potential to aid tissue repair.
Stem cells can be delivered by injection directly into an arthritic joint or applied during a surgery, such as for the repair of a torn knee meniscus. When administering stem cell injections, many physicians use medical imaging (such as ultrasound) to help deliver the stem cells precisely to the site of cartilage damage.
Stem cells can also be administered through an IV. The benefits of this type of deployment for osteoarthritis include the ability to reach less involved joints (non-weight-bearing joints like the fingers) and tissues to help reduce inflammation.
Patients with osteoarthritis who are ideal candidates for stem cell therapy include patients who:
Have not responded to current medical treatments.
Are no longer responding to current medical treatment.
Cannot tolerate recommended treatment for their condition.
Want to avoid surgery.
Find other treatments have been ineffective.
Stem Cell Therapy Treatment Studies
Stem cell and PRP therapies are minimally invasive treatments, offering an alternative to painful surgery and lengthy recovery times. Both therapies help to quickly reduce joint inflammation, with many patients reporting improvements in just one or two days.
Patients who undergo stem cell and PRP therapy for arthritis report a reduction of painful symptoms, and an increase in range of motion and mobility. The anti-inflammatory results of the procedure last two to three months, and many patients see gradual improvement in their overall condition over time.
Currently, there are no established medical guidelines for who can and cannot receive stem cell therapy for arthritis. Patients must talk with their doctor to determine if they are a good candidate for stem cell therapy.
Researchers at the Mayo Clinic campus in Jacksonville, Florida conducted the world’s first prospective, blinded and placebo-controlled clinical study to test the benefit of using bone marrow stem cells. Study participants all had a history of arthritic pain and disability in both knees. The patients received an injection of their own stem cells in one knee and a saline (placebo) injection in the other knee. The participants did not know which knee received the stem cell injection.
Researchers were surprised to find participants not only reported a dramatic improvement in the knee that received stem cells, but in the other knee as well! Some researchers thought a placebo effect was responsible; however, in follow-up visits more than a year later the participants continued to report both knees were significantly better after the treatment ended than before entering the study. The researchers hypothesized that the stem cells can travel to where they are needed in the body.
A study published in the Journal of Bone and Joint Surgery found that patients receiving injections of stem cells following meniscus surgery healed faster and experienced less pain than those who did not receive similar injections. The meniscus is located between the thighbone, femur, and tibia (shinbone) and absorbs shock from the two bones pressing together.
Study participants who received a low-dose injection fared the best, with 24% experiencing “significantly increased meniscal volume” compared to only 6% of the patients in the high-dose group, and none in the control group. Patients receiving injections also reported less osteoarthritis pain.
Another stem cell study published in the journal Stem Cells found that high doses of stem cells injected into patients’ knees stalled the progression of osteoarthritis while increasing the volume of cartilage. Patients experienced less pain and no side effects.
Stem cell treatments are safe, particularly because they don’t pose the risk of rejection since the cells come from the patient’s body. Tissue rejection occurs when the immune system recognizes implanted material as foreign and begins attacking it. However, the body typically won’t fight against its own tissue.
PRP Therapy Treatment Studies
Similar to the stem cell studies, researchers studying the effects of PRP therapy (platelet-rich plasma therapy) often work with patients who have knee osteoarthritis. One clinical study on the use of PRP to treat knee arthritis published in 2013 involved 78 patients with osteoarthritis in both knees (156 knees). Each knee received one of three treatments:
One PRP injection.
Two PRP injections.
One placebo saline injection.
Researchers evaluated the subjects’ knees at six weeks, three months, and six months following the injection. Researchers found:
Knees treated with one or two PRP injections saw a reduction in pain and stiffness, as well as improvement in knee function at both six weeks and three months. However, at the six-month mark, positive results declined, but pain and function were still better than before the PRP treatment.
The group that received placebo injections saw a small increase in pain and stiffness and a decrease in knee function.
The platelet-rich plasma used in this study was filtered to remove white blood cells and had three times the platelet concentration of normal blood.
However, not all clinical studies provide evidence that PRP alleviates osteoarthritis symptoms. Several studies found PRP injections were no better than a placebo. Even in studies that provided evidence that PRP works, not all patients seemed to benefit.
Proponents of PRP assert that in studies where the therapy failed to treat symptoms successfully in some cases was due to formulation or administration variables. PRP preparation methods, the amount of PRP injected, and the frequency of injections can make the PRP treatment less effective. Proponents of PRP also assert that PRP therapy, like other osteoarthritis treatments, works for some and not others, or it works best in conjunction with other treatments, such as physical therapy.
Stem Cell Therapy Safety
Stem cell therapy with adult stem cells is considered safe because the stem cells are collected from the patient, minimizing the risk of an unwanted reaction. The most common side effects are temporary swelling and pain.
While most stem cell therapy for arthritis is considered safe, it carries the same risks as any other medical procedure, such as a small risk of infection. There may be an elevated risk of tumors if the treatment:
Uses pluripotent (embryonic) stem cells instead of adult stem cells.
Uses cultured stem cells (taken from the patient and grown in the lab over time).
Uses stem cells mixed with other chemicals.
As with most regenerative therapies, research is ongoing. FDA regulations are relatively new and subject to change.
Novus Spine & Pain Center
Novus Spine & Pain Center in Lakeland, Florida specializes in stem cell therapy and PRP therapy for pain management. By using a comprehensive approach and cutting-edge therapies, we work together with patients to restore function and regain an active lifestyle, while minimizing the need for opiates.