Regenerative therapies (Stem Cell and/or Platelet Rich Plasma) can be performed for many painful conditions of the spine. A RIC physician will carefully evaluate your condition, which consists of discussing with you your history, performing a physical exam, and review of relevant imaging studies (such as MRI and x-rays). Based on your evaluation a determination for the most appropriate regenerative therapy will be made for your problem. Note that not all conditions should be treated with regenerative therapies, as some conditions may be too far advanced. In that case RIC may have alternative treatments available, or further guidance.
Lumbar Disc Degeneration Pain
Disc degeneration is a common cause of low back pain. As people age or suffer injuries, the discs can degenerate, including disc bulging, loss of disc height, and loss of the ability for the disc to distribute the normal forces from the body. These degenerative discs can become painful. Regenerative therapies can be injected under image guidance into the disc and may restore your normal function (i.e. return you to activities that you have not been able to perform) and reduce back pain. Currently at RIC, we perform these procedures in the low back only (i.e. lumbar spine) as there is little evidence for benefit in the thoracic and cervical area, and intradiscal injections in these areas may have unacceptable risk.
Dr. Levi Miller is currently conducting research for low back pain as related to degenerative discs. If you are interested in participating in a study, please contact the clinic.
Disc Herniations and Radiculopathy Pain (sciatica, slipped disc)
Disc herniations are a common cause of pain, resulting in nerve root compression that can cause arm or leg pain pain from the pinched nerve. Commonly these problems are treated with steroid injections, which may not be the right choice for many people as steroids can cause weight gain and other negative effects. While current regenerative technologies do not yet exist for curing disc herniations, the resulting radicular pain can be treated with PRP lysate (i.e. growth factors from platelets) to diminish pain and improve your activities. PRP lysate is a naturally occurring component of your blood that can help to restore and heal pain from a pinched nerve.
Facet joint pain (also called zygapophyseal joint)
The little joints in the back, called facet joints, are common causes of back and neck pain. These joints are in the neck, mid back, and lower back (i.e. cervical, thoracic, and lumbar spine). The joints can become painful after a car accident that has caused whiplash, or from arthritis resulting from aging.
The historical treatment for pain of the facet joints is a destructive process, called rhizotomy, also called radiofrequency ablation. While this procedure can provide relief from neck pain, many people would rather undergo a Regenrative Therapy to heal injured or arthritic joints instead of a destructive process. Regenerative Therapies are an excellent alternative to rhizotomy to reduce your pain and increase your function.
Painful facet joints can be diagnosed by a procedure call ‘medial branch blocks’ to ensure that these joint are the actual source of back pain. Once it has been confirmed that the facet joints are the source of pain, success with a Regenerative Therapy is much more likely.
Sacroiliac Joint Pain (SI joint)
The sacroiliac joints commonly cause low back and buttock pain. This can arise from injuries that may become arthritic over time. The sacroliliac joint is also a common cause of back and buttock pain after a patient has lumbar fusion surgery. Sacroiliac pain can be diagnosed with a precise diagnostic joint injection with image guidance to confirm that it is the source of pain. Once the diagnosis has been made, a Regenerative Therapy may be injected intra-articularly (i.e. into the joint) to decrease pain and increase your activity.