Stem Cell Therapy

What are Stem Cells?

Stem cells are cells in the body that can change into a variety of different cells. Some have the capability to change into broad types of cells (pluripotent), whereas others have more specialized capabilities (multipotent).

In chronic pain management and sports medicine, we use the latter type of stem cell for treatment. Multipotent cells have the unique ability to grow new bone, cartilage, tendons, ligaments, or nerve cells when they are injected into damaged tissue.

Mesenchymal stem cells are the main type of multipotent stem cells that we harvest and use for injection. These cells can be harvested from bone marrow (center of the bone) or adipose tissue (fat).

Mesenchymal Stem Cells from Bone Marrow

When harvested from bone, the cells are aspirated through a very small hole drilled deep enough to reach the marrow of the bone. When stem cells are harvested from adipose tissue (fat), they are extracted using liposuction.

In our office, bone marrow aspirate concentrate (BMAC) is the main source of mesenchymal stem cells we use for procedures. Mesenchymal stem cells from marrow have been shown to work better in repairing damaged tissue versus stem cells harvested from fat.

Bone marrow stem cells are optimal for repairing tissue injuries and damaged joints. They produce cells that build new cartilage, bone, and connective tissue structures. Once these stem cells are injected into damaged tissue, they begin to differentiate (change) into the particular type of cells needed to repair that injury.

Stem cells also have the unique capability of differentiating into blood vessel (epithelial) cells. This helps build a new blood supply in the area, promoting healing and bringing nutrients to the wounded tissue.

In 2008, a study was published describing the ability of bone marrow stem cells to grow new vascular tissue in damaged blood vessels. This new growth helped with tissue repair and regeneration, which is why stem cell therapy is often referred to as regenerative medicine. Regenerative medicine is the branch of medicine that focuses on using the body's own cells and regenerative abilities for healing.

Currently, regenerative medicine is being used for the treatment of some cardiovascular diseases, sports injuries, joint damage from osteoarthritis, nerve damage, and a number of other painful conditions.

Stem Cell Therapy for Osteoarthritis

The majority of our chronic pain patients come in for osteoarthritis treatment. This disease causes severe pain as a result of joint cartilage breaking down. In its advanced stages, osteoarthritis can lead to the distal end of the femur and the proximal end of the tibia making direct contact. When bones rub together, it results in severe pain and impaired mobility.

This femur/tibia junction is the place where the knee joint is located. The knee receives the greatest impact when you walk, run, or jump. The entire joint structure is designed to cushion this impact, protecting your bones from injury.

One of the first signs of osteoarthritis is swelling, soreness, and stiffness in a joint. This can feel worse after exercising, being on your feet too long, or after long periods of inactivity.

Once this degenerative condition develops, it does not go away. The only medical intervention available is to preserve the joint for as long as possible. This can be accomplished using:

• Certain medications
• Physical therapy
• Staying active
• Injecting platelet-rich plasma
• Injecting stem cells from bone marrow

Osteoarthritis is so painful because it affects more than just the cartilage. It can eventually damage the entire joint including the joint capsule, supporting structures (ligaments and tendons), muscle tissue, and adjacent bones.

When osteoarthritis destroys the joint capsule, the body is no longer able to make enough synovial fluid to cushion the joint. Sadly, once the cartilage and capsule structure are severely compromised, occasional pain turns into a chronic occurrence. Older adults are more likely to develop osteoarthritis, because this condition is often the result of years of wear and tear.

Some individuals have a genetic predisposition to developing it. In other words, if you have a close family member with osteoarthritis, you are more likely to develop it yourself. Similarly, if you have it, you are more likely to pass it on to your children.

Stem cell therapy can help people with osteoarthritis by growing new cells in the damaged areas. Because stem cells can adapt and grow into the same types of cells where they are relocated, they can create new:

• Cartilage
• Tendon or ligament
• Muscle
• Bone

For example, if your knee cartilage has been damaged from osteoarthritis, stem cells can be injected into this area to grow new cartilage. New tissue growth provides a joint cushion, which greatly reduces pain. If you have osteoarthritis, stem cell therapy can also be used prior to reaching the advanced stages of your disease.

By intervening as early as possible, we can help preserve your knee joint for a longer period of time. Once severe damage has occurred, however, we are less able to restore your knee to its former glory.

Stem Cells Therapy for Sports Injuries

Sports injuries are another main reason why patients come in to see us. If you are an athlete who has suffered an injury, you know just how disabling and painful it is. Knee injuries are one of the most common types of sports-related traumas. Within the knee structure, the anterior cruciate is the ligament most often affected.

This ligament is usually referred to as the “ACL,” and is one of two major ligaments in the knee that provide strength and joint stability. The ACL ligament is located in the front of the knee whereas the posterior cruciate ligament is located in the back.

Either of these ligaments can tear or rupture, but the ACL is more prone to this type of injury. This can occur after changing direction too quickly, landing the wrong way, or rotating the knee too far in one direction or the other.

• When someone tears their ACL, they often hear a popping sound, feel immediate pain, and are unable to just "walk it off."
• Within several minutes of being injured, major swelling occurs. This is your body's natural response to an injury.
• Unfortunately, after an ACL tear it is very common for the knee joint to feel unstable or wobbly.

If you experience a minor tear, there is a greater chance that conservative therapies will help your ACL to heal. Physical therapy, rest, ice, and elevation are generally the first line treatment for an ACL tear. However, if after a period of time you do not improve significantly, your doctor may prescribe other treatments including stem cell injections.

In certain cases, stem cells can rebuild connective tissue in the ACL to the extent that surgery can be avoided. However, in cases where a more severe injury or full ACL rupture has occurred, surgery may be the only option. Stem cells can be used after surgery to help speed up your healing process.

Our team of experienced doctors can help you with the initial healing stage as well as monitor your progress. Along the way, we will provide you with effective treatment solutions to manage your pain and get you back in the game. 

People who suffer a knee injury are more prone to developing knee osteoarthritis later in life. Although osteoarthritis cannot be prevented, you can lessen its impact and delay its onset by getting treatment early on.

Your doctor will assess how serious your knee injury is and evaluate the surrounding structures in the knee including cartilage, joint capsule, muscle, tendons, and bone. An X-ray or other type of image can help your doctor identify areas of concern that may require surgical intervention.

By catching these issues early and treating them properly, your body may be able to fully heal so that you have the best chances at putting off osteoarthritis for as long as possible. If we are unable to help you with more conservative treatments, we can refer you to an orthopedic surgeon in the area.

As a part of ongoing therapy to recover mobility, flexibility, and strength, we will also recommend a series of physical therapy treatments. Physical therapy can help you regain function in the knee so you can continue to enjoy an active lifestyle.

Testing & Imaging Prior to Stem Cell Therapy

Prior to receiving stem cell therapy, we will conduct a comprehensive medical exam, which includes your medical history, current medical conditions, prior surgeries and injuries, current medications you are taking, and any allergies you may have to medications.

If you have not seen another doctor prior to visiting us, we may ask you to get images of your injury to give us a better view of what's going on. With knee osteoarthritis, for example, an X-ray can show general internal structures, but an MRI may be ordered to help us see greater detail.

We may also request blood work to help us identify any health concerns that may affect treatment. This ensures that you are healthy enough for the bone aspiration procedure to harvest your stem cells.

BMAC Aspiration Procedure for Stem Cell Therapy

Bone marrow is located in the center of your bones and is responsible for a number of functions including:

• Red and white blood cell production
• Immune system response
• New cell growth and other important functions

To extract your bone marrow, a very small puncture is made on the outside of the bone to reach the center portion where the marrow is located. The hipbone has the greatest concentration of stem cells than in any other bone.

Your marrow will be extracted from the iliac crest. This is the bony protrusion located on the upper back side of your hip bone.

General anesthesia is not needed for this procedure; only light sedation and local anesthetic are used. This eliminates the risks associated with general anesthesia, which is the type of anesthesia used to put you to sleep during surgery.

For this procedure, you will lie down on your stomach so that the posterior hip area can be accessed. We will sanitize your skin with an iodine solution or other antibacterial agent to lower your risk of post-procedure infection.

Once you are comfortably sedated, the procedure will begin. Your doctor will first inject a local anesthetic to make the procedure as comfortable as possible. A special BMAC aspiration kit is used, which contains everything your doctor needs to extract and store your marrow.

The kit contains a thick bone marrow needle for aspiration, special fluids to facilitate aspiration, and a syringe to store your marrow once it has been removed.

Once your bone marrow has been extracted, it will be transferred into glass vials and spun in a centrifuge machine. This type of machine is used to separate the bone marrow into several layers of cells.

After this process is completed, a layer of platelet rich plasma and stem cells is formed. This layer will be aspirated from the glass vial using a needle. You are now ready for stem cell therapy!

Get Stem Cell Therapy in Torrance at Pacific Pain & Wellness Group 

Our doctors specialize in stem cell therapy and other regenerative medicine techniques to use your body’s own cells to naturally heal and repair itself.

Stem cell therapy may be able to help if you have:

• A new or old injury that needs healing
• Joint degeneration from osteoarthritis
• Chronic pain in a joint, ligament, tendon, muscle, or nerve

At Pacific Pain & Wellness Group, we care about you as much as you do. Our goal is to help you feel better so you can live better. We offer a number of innovative medical treatments to address chronic pain and acute trauma so that you can get back to doing what you love.

Contact us today at (310) 437-7399 to schedule your consultation and personalized treatment plan.