Does stem cell therapy for neck pain work? This is one of those areas where there are some things that likely work to help neck pain, but most of what’s being offered is not what it seems. Let’s dig in.
What Causes Neck Pain
Before we get too much into stem cell therapy for neck pain, we need to review what can cause neck pain, as this will become targets for the stem cells:
- Facet joints – two little joints at the back of the spine at each level
- Discs – the shock absorbers between the neck bones
- Spinal nerves -t he nerves that come out, two at each level
- Ligaments – the “DUCT tape” of the body that holds the neck together
- Muscles – the things that move and stabilize the neck
What patients often fail to realize is that injecting stem cells or anything else into or around facet joints, discs, spinal nerves, and ligaments requires specialized imaging guidance and a subspecialist physician, and not the nurse or physician’s assistant often offered at the local chiropractic office offering free seminars. Meaning that most of the damaged neck structures causing pain that might need to be injected can’t be reached by blind muscle injections performed in these alternative medicine offices. Hence stem cell therapy for neck pain happens in a procedure room decked out with c-arm fluoroscopy and ultrasound.
Can Stem Cell Therapy Help with Neck Pain?
This question on stem cell therapy for neck pain is likely better answered by broadening this discussion to include all orthobiologics. These are substances like stem cells and platelet-rich plasma, which can kick off a healing response. Even making that change, there is only one published research study on the use of stem cells or PRP for neck pain. That’s our case study showing that culture-expanded mesenchymal stem cells injected into the C2-C3 facet joint were able to “cure” facet osteoarthritis that was leading to spinal nerve impingement in one patient. Please see below for a video on that patient:
This patient had been injured in a car crash where her C2-C3 facet joint was damaged along with her ligaments. This then caused that facet joint to become severely arthritic and to become so big that it began to press on the exiting nerve. The injection of cultured stem cells (not FDA approved and only permitted at our licensed Grand Cayman site) caused the joint to become smaller and relived the nerve pressure and pain.
We have also used bone marrow concentrate (a same-day stem cell therapy allowed here in the US) as well as platelet-rich plasma (also allowed in the US). For example, we routinely treat patients with chronic neck pain with platelet-rich plasma and lysate injected into damaged facets joints, nerves, discs, ligaments, etc… In our decade and a half worth of experience, these therapies help patients improve their function and reduce pain. In our practice, the vast majority of patients are successfully treated with much less expensive PRP and only a few require stem cells.
Does Stem Cell Therapy Work for Degenerative Disc Disease?
Most of this research comes from the low back and none yet has been published on the neck. What we know is that that you can see improvement in a degenerated animal disc if you inject bone marrow stem cells grown in culture (1). However, translating that type of result to humans has proven difficult.
Our research has also shown that you can see improvements in disc bulge size if you use a similar cultured stem cell population (2,3). Both of these require x-ray guided injections into the degenerated disc. However, no human research to date has been able to replicate the ability to regrow a severely degenerated disc so often seen in animal studies. Meaning, if you have a disc that’s completely collapsed and degenerated, stem cells are unlikely to help grow you a new disc.
What Are The Negative Effects of Stem Cell Therapy? How Safe is Stem Cell Therapy?
Our group has published the world’s largest safety study which only applies to bone marrow stem cells (4). These procedures were safe when more than 2,300 patients who had more than 3,000 procedures were tracked in a registry for up to 9 years. The negative effects seen in these patients were the same as those that would generally be seen in patients who had injections with other substances. Others have also published smaller, but still sizable safety papers with bone marrow cells (5). Hence, when it comes to the type of bone marrow stem cells we use, the published research supports robust safety.
The upshot? Stem cell therapy for neck pain is here and is being used. However, like any other medical procedure, exactly what to inject and precisely where is key to the success rates.
(1) Sakai D, Mochida J, Yamamoto Y, Nomura T, Okuma M, Nishimura K, Nakai T, Ando K, Hotta T. Transplantation of mesenchymal stem cells embedded in Atelocollagen gel to the intervertebral disc: a potential therapeutic model for disc degeneration. Biomaterials. 2003 Sep;24(20):3531-41. https://www.ncbi.nlm.nih.gov/pubmed/12809782
(2) Centeno C, Markle J, Dodson E, et al. Treatment of lumbar degenerative disc disease-associated radicular pain with culture-expanded autologous mesenchymal stem cells: a pilot study on safety and efficacy. J Transl Med. 2017;15(1):197. Published 2017 Sep 22. doi: 10.1186/s12967-017-1300-y
(3) Elabd C, Centeno CJ, Schultz JR, Lutz G, Ichim T, Silva FJ. Intra-discal injection of autologous, hypoxic cultured bone marrow-derived mesenchymal stem cells in five patients with chronic lower back pain: a long-term safety and feasibility study. J Transl Med. 2016;14(1):253. Published 2016 Sep 1. doi: 10.1186/s12967-016-1015-5
(4) Centeno CJ, Al-Sayegh H, Freeman MD3, Smith J, Murrell WD, Bubnov R. A multi-center analysis of adverse events among two thousand, three hundred and seventy two adult patients undergoing adult autologous stem cell therapy for orthopaedic conditions. Int Orthop. 2016 Aug;40(8):1755-1765. doi: 10.1007/s00264-016-3162-y.
(5) Hernigou P, Homma Y, Flouzat-Lachaniette CH, Poignard A, Chevallier N, Rouard H. Cancer risk is not increased in patients treated for orthopaedic diseases with autologous bone marrow cell concentrate. J Bone Joint Surg Am. 2013 Dec 18;95(24):2215-21. doi: 10.2106/JBJS.M.00261.