Regenerative medicine has become quite the buzz today in the medical world. With so much about baseball players getting a “PRP” shot in their elbow and the likes of Tony Robbins writing a book about it or even it being mentioned at every doctor and chiropractic office in your immediate area — how do you know which treatment is the best for you?
This blog will break down the different types of regenerative medicine into laymen terms, so that you will have a clear understanding of each one and the benefits of one type over another.
We will do our best to state facts and avoid being biased in any way, shape, form or fashion.
First, the number one thing to understand is that all stem cell therapy is regenerative medicine, but not all regenerative medicine is stem cell therapy. Regenerative medicine is the umbrella term for all the various therapies we will discuss in this blog. By definition, regenerative medicine is the process of replacing or "regenerating" human cells, tissues or organs to restore or establish normal function.
In the world of bones, joints, the spine, and soft tissues such as muscle and cartilage; regenerative medicine is also referred to as orthobiologics. Orthobiologics is the use of biological tissues found in the human body, such as blood, fat or bone marrow to regenerate or repair torn or damaged tissues. While this is a decent definition for those of us in healthcare, it really doesn’t tell you much as a consumer. Also, there are some orthobiologics that do NOT come from your own body. Let’s start breaking them down.
PRP or Platelet Rich Plasma
This is probably the most basic level of regenerative medicine out there. PRP comes directly from your blood and is used to ignite the body’s own natural healing process. Think about it like this — you get a cut on your arm and through your blood the body sends signals to begin the healing process. White blood cells and platelets help clean and clot the area as well as fight any foreign bodies that might cause infection. These platelets also signal to the body to begin laying down new tissue to repair what has been damaged.
The platelets are a key component of your blood that initiate the healing process. Why not use this power in other areas as well? Blood is drawn from your own body and put into a centrifuge that spins it so fast it separates kind of like water and oil. Red blood cells drop to the bottom of the cylinder while the yellowish plasma or PRP stays at the top. This plasma is a concentrated does of healing factors and signal proteins that can spark your healing process. So by injecting this concentrated dose of platelet rich plasma into your affected area we are giving the body a direct dose of healing potential.
"But don’t we have blood in our body already that can do this job?"
Yes, we do, but there is very little blood inside of the joint, hence the reason cartilage tears like the ones in the meniscus of your knee or the disks in your back do not heal. Limited blood supply equals limited nutrients, equals less ability to heal.
PRP also has immense anti-inflammatory properties which is why you hear about athletes using this method of treatment for their elbow, knees and toes versus the damaging affects of repeated steroid use. It works really well for tendinitis and other chronic inflammatory problems, but does usually require 2-3 treatments to get the most benefit.
There are NO stem cells in PRP. PRP relies solely on the platelets to signal the healing process.
Stem Cell Therapy
Stem cells are unique in that they can become any type of tissue in our bodies. They are cells with blank slates essentially and the body uses them to form new tissue — bone, muscles, cartilage, etc. When we are young our stem cells are very active because we are growing and constantly replacing old tissue. As we age, our stem cells become less active and usually come to the party only when there is an injury.
The majority of our stem cells as adults are found in our bone marrow and our fat tissue. If you have heard that fat tissue stem cells are better or vice versa, know that the research on this shows zero preference for either one being superior to the other. A stem cell is a stem cell as far as these 2 tissues are concerned and any attempt to push that agenda is nothing more than a marketing ploy.
What does come into question is the overall health of your stem cells. This is directly related to how healthy of a human being your are. The healthier we are as individuals, the healthier our stem cells will be both in our fat and our bone marrow.
Tissue is removed from either your pelvis (bone marrow) or the fat in your abdomen (fat tissue) and much like PRP, it’s spun down so we can grab a concentrated dose of the regenerative soup that comes from either the fat or the bone marrow. This soup that is rich in stem cells, proteins, and healing agents is injected directly into the area of damage or degeneration. It is important to note that this treatment offers the best results when it is injected directly into the damaged tissue versus just a blanket injection where the fluid is just injected into the joint space.
If you’ve been told you need a knee replacement or you are “bone on bone,” stem cell therapy would be a potential method of treatment for you. We see a lot or people with “degenerative joint disease” that are at their wits end and waiting until the pain is so bad they opt for surgery. Know that this does NOT have to be the case. We have seen many people improve their joint health and pain exponentially and avoid surgery altogether.
NOTE: There are a lot regulations regarding the use of fat tissue. Please take care to do your research on the provider who is offering this therapy to make sure it is right for you.
Other Types of “Stem Cell Therapy”
We often get calls about umbilical cord tissue or amniotic tissue or Wharton’s jelly as a source of stem cell therapy. These therapies do not come from our own bodies. They are donated sources of regenerative medicine and may or may not be a viable source of stem cells.
There is conflicting research out there about these products and their efficacy in orthopedics and whether or not they actually contain live stem cells. Usually these products come from donations of healthy mothers of a C-section delivery. The placental sac that the baby resides in during pregnancy is loaded with regenerative properties. The sac is processed and the tissues are frozen and preserved or emulsified into a powder and then reconstituted with saline before injecting. There is a lot of variability from tissue to tissue and it is near impossible to know which products or outcomes are superior to another.
There are many practices out there who do not have the ability or expertise to extract bone marrow or fat tissue, so this is a solution for them to offer stem cell therapy. The problem is that results are hit and miss with this tissue and calling it “stem cell therapy” may be an attempt to ride this as a buzz word.
Regenerative medicine could be the future of healing for orthopedic issues such as knee degeneration and back pain. More and more research comes out each year about the harmful effects of steroid injections, surgeries, and pain medications.
As we continue to explore the amazing healing properties our bodies have and dive more into regenerative medicine, we could in fact see the end of crippling injuries that prevent us from living the active life we all desire. There is research on regenerative medicine for stroke patients and patients with spinal cord injuries happening right now and the results are very interesting.
NOTE: Be sure to do your research on who is offering you regenerative medicine services and what they are calling “stem cell therapy.” Spine and joint injections require an in depth amount of training and expertise to perform. If you are NOT receiving these injections in a specialist’s office, you may be getting subpar results and being over charged regardless of which regenerative medicine avenue you choose.
In fact, in our next blog (releasing in 2 weeks), we will discuss the aforementioned problem of who should be doing these types of services and whom you should look for when researching.