BACK PAIN

Back pain affects eight out of 10 people at some point in their lifetimes, occurring in about 31 million men and women in the U.S. at any given time. Low back pain is the top cause of disability around the world, and among the most common reasons for work absences. It’s also the second most common cause of doctor visits, led only by respiratory infections. [1]
Back pain can develop following injury, as a result of overuse or as a consequence of a disease. Pain is often described as acute, which typically lasts a few days to a few weeks, or chronic, which lasts for several months or longer, and it can range from a dull ache to sharp, shooting pain. Many issues or conditions can cause back or spine pain, including:

  • Ruptured or herniated disc
  • Muscle spasms
  • Nerve impingement
  • Arthritis
  • Degenerative disc disease
  • Scoliosis
  • Spondylolisthesis
  • Spinal stenosis
  • Tumors
  • Infections
  • Fractures

The risk of developing back pain increases with age and is also greater for people who are obese and those who live sedentary lifestyles. Smoking, genetics and occupational risk factors can also increase the likelihood of back pain.
WHAT ARE THE SYMPTOMS?
The symptoms of back pain can vary depending on the underlying cause and what structures for instance, nerves or muscles – are involved. Some of the most common symptoms of back pain include [2]:

  • Pain along the spine, anywhere from the neck to the lower back
  • Sharp pain when using the back to lift, bend or perform other activities
  • Dull aching in the lower back, especially following long periods of standing or sitting
  • Shooting pain or burning sensations that radiate from the low back through the leg
  • Muscle spasms
  • Inability to turn the head without pain
  • Chronic headache

Back and neck pain can evolve as an injury or disease progresses.

TRADITIONAL MANAGEMENT

Like back pain symptoms, treatment can vary based on the underlying cause of back pain. In some cases when back pain is the result of minor overuse or strain, rest combined with over-the-counter pain medications may be enough to relieve symptoms. Applying either heat or cold – or alternating the two – may help reduce inflammation and increase circulation to aid in healing for minor back issues and discomfort.

When over-the-counter medications are not sufficient to relieve pain, prescription medications to reduce pain or treat muscle spasms may be used as well as cortisone injections to reduce inflammation, especially when nerve impingement is involved.

Lifestyle changes like weight loss and learning new ways to perform some activities like lifting or moving heavy objects may help reduce symptoms. Physical and occupational therapy can also play an important role in back pain management.

For very serious back issues including degenerative disc disease, spondylolisthesis, spinal stenosis and other chronic injuries, surgery may be required to remove discs, fuse the vertebrae, widen the spinal canal or address other issues. [3]

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STEM CELL THERAPY FOR BACK PAIN

Although early stem cell research used stem cells harvested from umbilical cords, today’s research in the U.S. uses cells derived from other sources, including bone marrow, blood and adipose (fat) tissue. Most research focuses on using a patient’s own stem cells (autologous stem cells). Stem cells used in back pain studies may also be referred to as mesenchymal stem cells, or MSCs.
Stem cells are valued in medical research because they have the ability to differentiate, or turn into, many other types of cells. Unlike a bone cell (chondrocyte), which can only be a bone cell, a stem cell can be prompted to turn into many types of cells. When injected into an area where damage has occurred due to disease or injury, stem cells can take on the characteristics of the damaged cells, replacing and replenishing them to heal the area. Stem cells can also prompt changes in local cells through cell-to-cell communication called paracrine signaling.
In addition, stem cells can promote the development of new blood vessels to increase circulation in damaged tissues, significantly reduce inflammation which can impede healing, and reboot faulty immune systems, which is especially important in the management of immune-mediated diseases.
In back pain, stem cells have been used to help support grafts, to reduce the effects of osteoarthritis and rheumatoid arthritis, and to manage degenerative changes that can affect the discs and the spinal canal.
Stem cells are of special interest in the management of low back pain, the most common type of back pain and a major cause of debility in the U.S. and worldwide. In one study of low back pain, 24 patients were injected with concentrations of their own stem cells derived from bone marrow to evaluate the effects on their symptoms, which had persisted for as long as 12 years in some patients. All of the patients showed some evidence of age-related disc degeneration. During the procedure, the stem cell concentrate was reinjected into the space surrounding the damaged disc. Of the original 24 patients, 12 were followed for 30 months to determine the efficacy of the approach over time. After two years, five patients reported their pain was better and three reported no improvement in their symptoms. The remaining four had not reached the endpoint of the follow-up period. [4]
Another group of researchers from the Emory Orthopedics and Spine Center recently demonstrated that a single injection of stem cells can lower back pain caused by degenerative discs. The study included 100 patients as part of a Phase II international clinical trial. Mesenchymal precursor cells (MPCs) derived from the bone marrow were used for this study, and were found to lower back pain by 50% for up to 12 months. W. Jeremy Beckworth, MD, assistant professor of Orthopaedics and Rehab Medicine, was part of the trial. “These are very exciting findings,” explains Beckworth. “The results provide significant hope for a condition that has been very tough to manage. Discogenic low back pain, a painful degenerative disc, is the most common cause of chronic low back pain.” [5]

Suggested Reading:

  1. Back Pain. US National Library of Medicine. Available at: National Library of Medicine.
  2. Understanding the Symptoms of Back Pain. WebMD. Available at: WebMD.com.
  3. Facts About Back Pain. National Institute of Arthritis and Musculoskeletal and Skin Diseases. Available at: The National Institute of Arthritis and Musculoskeletal And Skin Diseases
  4. HealthDay, WMDNfrom. Stem Cells to Relieve Low Back Pain. WebMD. Available at: WebMD.com
  5. Clinical trial shows stem cell injections reduce low back pain. Emory News Center. 2014. Available at: Emory.edu

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Stem Cells Dev. 2014 Nov 1;23(21):2553-67. doi: 10.1089/scd.2014.0203. Review.

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Curr Pain Headache Rep. 2013 Dec;17(12):377. doi: 10.1007/s11916-013-0377-0. Review.