Stem cell therapy has a huge application to back pain. It is very common that I see patients toting their MRI results that tell me that they have been told that they have disc problems that is the cause of their back pain. In my experience it is very common that patients have abnormal MRI results showing degenerative disc issues but their true primary pain generators are actually in the pelvis. There is only one way to tell and confirm if this is true and that is a detailed palpation exam with a good regenerative injection specialist. If I examine a patient and can reproduce the so-called “jump sign” when I palpate the gluteal attachments in the pelvis, it is highly likely that we have identified the primary pain generators and stem cells/PRP is definitely the therapy of choice.
It is actually very common that the large gluteal muscles that stabilize and work the hips are strained. In fact, I consider this pelvic strain/sprain to be by far the most common cause of back pain. On all patients with back pain it is essential to do a thorough palpation of all the structures in the low back region including the lumbar spine, sacroiliac, gluteal insertions and the hips, as well as the IT bands (down the lateral part of the femur). I very often find that the gluteal insertions light up with the "jump sign" and the patient reports that their pain is reproduced as I apply specific pressure to specific attachments in the pelvis. Unfortunately, these “stretched insertions” don't show upon MRI's and therefore, are commonly overlooked as the potential root-cause of pain.
Some of you may be aware that back surgery has a pretty poor track record of improving back pain. The reason for this in not that the surgeon is lacking etc. but that the diagnosis of the primary pain generator is wrong. Part of the issue is modern medicine is we are overly reliant on MRI to make the diagnosis. When I went to medical school many years ago we were taught that there is no substitute for a good history and physical exam. I think this dictum is still relevant today. A simple yet detailed palpation exam remains a very elegant way to identify the structures that are the root-cause of the pain. We call these palpation exams “advanced digital guidance systems”. When we identify the “jump sign” we have made the diagnosis of where the pain is originating with a high degree of certainty.
With stem cell therapy we generally only need one session to regenerate the affected pelvic attachments and solve the root-cause of the back pain. On occasion the patient may require a booster PRP session 6-8 weeks after the stem cell therapy session for complete resolution. At Fountain, we like to recommend an active rehab with swimming and cycling. I also find that using a foam roller on a carpeted floor helps patients roll out the kinks in their pelvis and speeds the healing process.
As usual, we ask patients to avoid anti-inflammatory pharmaceuticals for pain. They may use Tylenol or mild painkillers such as codeine or tramadol to make themselves more comfortable while they heal.
At our center we have an overall success rate exceeding 85% for back pain. Results tend to be long-lasting.
A word about Sciatica
Sciatica refers to radiating pain down the leg and is often taken by conventional docs to imply nerve impingement. In reality, a sciatica type syndrome is actually very rarely due to sciatic nerve impingement. The pain from Gluteal muscle strain (known as enthesopathy) radiates in a manner indistinguishable from nerve pain. So called "sciatica" type syndrome is far more likely to be due to damaged gluteal attachments (i.e. strain) with radiating pain down the leg.
Every now and then I see a patient who comes in and tells me they were told that their sacroiliac joints were dysfunctional. In connective tissue terms, we would say that the problem is loose SI joints. This is a perfect case for stem cell therapy. In fact, I consider that regenerative approaches with stem cells and PRP is the only sensible way to fix the problem (to "tighten" the joints). Steroids, as usually is the case, are contraindicated because they can further weaken the joint. In my view there is no reasonable surgical option.