Oct 30, 2020
Whether as a result of injury or age related wear-and-tear, pain in the neck can be more than just a saying: it can be debilitating.
According to the Mayo Clinic, neck pain is the fourth leading cause of disability in the United States. Most episodes of acute neck pain will resolve without treatment, but almost half of the people with neck pain will suffer from recurrent episodes.[i] The good news for these patients is that science and technology are working together to help physicians identify the source of neck pain and offer new options for long-lasting relief.
Identifying the Source of Neck Pain
Advancements in imaging have allowed physicians to get a better look at the intricate details of the spine. This enables them to see the different structures in the cervical spine (neck) more clearly and can help them identify the source of chronic, unresolved neck pain.
Common sources of chronic neck pain include the following:
- Arthritis: Osteoarthritis of the spine can lead to degeneration that is associated with the normal wear and tear of joints, discs and bones in the spine as people age. The arthritis can lead to bone spurs that can make movement of the neck painful and create narrowing of the space around the spinal nerves and spinal cord; a condition called spinal stenosis.
- Cervical Facet Joint Dysfunction: The facet joints are the small joints that connect the individual bones in the neck called the vertebrae. These joints allow for movement of the neck and provide stability of the spine. When these joints become inflamed, injured, or get out of alignment, neck pain, stiffness and reduced mobility may result.
- Herniated Discs: The discs are gel filled structures that act as cushion or shock absorbers between the vertebral bones in your spine. They consist of a strong outer layer that protects the disc’s gel-like interior. If the outer layer weakens or tears, the disc may protrude into the spinal canal and affect nearby nerves, causing neck pain, arm pain or muscle spasm.
There are many other causes of neck pain including nerve and spinal cord problems, fracture and non-spine sources like tumor. It is important that your physician perform a comprehensive evaluation of your medical history and physical examination to give you an appropriate diagnosis for your neck pain.
Cellular Treatments that Help Resolve Neck Pain Naturally
Most cases of neck pain can be resolved with physical therapy, activity modification and over-the-counter anti-inflammatory medications. Lifestyle improvements such as maintaining proper posture and avoiding prolonged neck bending from the use of mobile devices (ie., “text neck”) are also helpful.
When neck pain persists, spine specialists can offer a number of options for long-lasting pain relief. Orthobiologics are cells and substances derived from cells that are naturally found in the body and have the ability to heal injured tissues. These cellular products are providing new options for treating stubborn neck pain.
· Platelet Rich Plasma puts the healing properties of the patient’s own blood to work in repairing damaged joints and helping with nerve pain. The platelets in the blood release growth factors and proteins that promote tissue repair, while the plasma carries the hormones, electrolytes and nutrients required to nourish cells during the healing process. PRP treatments should be customized to the particular individual and their injury in order to be effective.
· Cell based therapies use a patient’s own bone marrow or adipose (fat) tissue derived cells. These cells are comprised of adult stem cells and many other healing cells. They produce molecules that direct other cells in the area to form new blood vessels, decrease inflammation, awaken other stem cells and encourage formation of new healthy tissues. Stem cells are special cells that have the unique ability to develop into the specific kind of cell needed, whether that be a tendon, ligament, cartilage or bone cell. Skilled regenerative medicine practitioners use highly specialized processes to prepare these cells that are then delivered directly to the injured area to stimulate healing.
· Prolotherapy (Proliferative Therapy) uses dextrose and other natural substances that are injected into a chronically injured ligament, nerves or joint in order to help the body jump start its own natural healing response.
Applying Proven Treatments to Neck Pain
Regenerative medicine specialists have been using orthobiologics in the past decade with great success to treat other orthopedic conditions, including knee arthritis, back pain, tennis elbow, tendon tears and more.
A select few qualified physicians are now applying their experience to put these powerful sources of healing to work to address neck pain. To ensure maximum safety and efficacy, patients considering orthobiologic treatments for chronic neck pain should take note of the following important points:
- Cells are derived from your own body: Regenerative products that come from your own body (autologous) have been proven to be safe and effective in peer-reviewed research. The U.S. Food and Drug Administration (FDA) currently does not allow the use of donor stem cell products derived from amniotic fluid or other fetal tissues to treat orthopedic conditions since they have not been proven in safety and efficacy. These products also pose a risk of disease transmission or immune reaction. Moreover, these donor tissues do not to contain living stem cells, as opposed to what is claimed by the companies that market these products.
- Customized treatment: The best outcomes occur when your own cells and platelet rich plasma are prepared using the most advanced protocols to create a treatment that is customized to your specific injury.
- Targeted delivery: To maximize effectiveness, these regenerative treatments should be delivered under image guidance with fluoroscopy (x-ray) or ultrasound to ensure precise delivery to the injured area. Only physicians with fellowship training in advanced image guided procedures are certified to perform these procedures.
- Expert physicians: If you are considering regenerative medicine for the treatment of your spine condition, seek a board-certified physician who specializes in treating orthopedic injuries and has advanced training in regenerative medicine. These physicians are best suited to obtain the best results employing the latest research, technology and safety protocols.
Since orthobiologic treatments for neck pain are relatively new within the field of regenerative medicine, patients need to ask the right questions and research the appropriate physicians to deliver the best care.
Drs. Christopher J. Rogers and Mary A. Ambach of San Diego Orthobiologics Medical Group together have successfully treated thousands of patients with cell-based therapies for more than three decades. They are published authors and stem cell researchers who were chosen to participate in a first of its kind, FDA-approved clinical trial to treat knee osteoarthritis. The SDOMG facility in Carlsbad contains the most advanced Regenerative Medicine technology in San Diego and offers same day treatments with the highest level of safety, efficacy and patient satisfaction.
[i] https://www.mayoclinicproceedings.org/article/S0025-6196(14)00833-7/abstract
[ii] https://www.stemcures.com/stem-cell-therapy-for-neck-pain-cincinnati
Oct 27, 2020
ASK THE DOCS: Facebook Live Series
Every 1st Wednesday of the month at 12:30 PT
Live Question and Answer session with Regenerative Experts
Non-Surgical Treatment of Tendon and Ligament Injuries using PRP and Cell Based therapy
Join us on our Free Facebook Live Series called Ask the Docs. In this session, SDOMG physician experts will answer your questions related to Non-Surgical Treatment of Tendon and Ligament Injuries using PRP and Cell Based therapy.
CLICK HERE to register for this LIVE event.
Sep 11, 2020
What’s the Difference Between Platelet Rich Plasma and Cell Based Therapies?
Regenerative medicine therapies are increasingly being used for people with painful orthopedic conditions. Commonly used orthobiologics include platelet rich plasma (PRP) and other cell based therapies.
Platelet rich plasma therapy includes the concentration of platelet cells from a patient’s own blood. These cells deliver hundreds of growth factors which facilitate the body’s ability to control inflammation, decrease pain and promote tissue healing.
Adult Stem Cells are found in every tissue in the body. A patient’s own bone marrow and fat tissues contains precursor cells called mesenchymal stem cells that have the ability to develop into new cells and repair damaged tissues. These cells also reduce pain and inflammation.
So What’s the Difference?
Many patients ask, “If both platelet rich plasma and adult stem cell therapy help with healing and inflammation, why choose one over the other?”
The fact of the matter is each treatment offers unique benefits. An experienced regenerative medicine specialist knows that several key factors are important when determining which treatment will provide the best outcome for you.
These considerations include:
· The severity of the medical condition being treated (e.g. mild, moderate or severe)
· The location of the injury (e.g. spine or joint)
· The type of tissue requiring treatment (e.g. bone, tendon, cartilage, disc or muscle)
· The patient’s age and overall health, including any other medical conditions.
Knowing How PRP is Different Than Cell Based Therapies
Many clinics claim to offer stem cells or platelet rich plasma treatments, however, the effectiveness of these treatments and experience level of the physicians varies widely from one clinic to another.
· Treatments that use donated tissues such as umbilical cord blood, amniotic tissue and exosomes are not permitted under current FDA guidelines. These products are NOT to be used in orthopedic conditions, because they have not been tested for safety or efficacy.
Only autologous biologics such as your own blood, bone marrow and minimally manipulated fat are compliant with current FDA guidelines for safety and efficacy.
· Dose matters. The number of cells obtained is determined by the method used. The best results are achieved when your physician uses advanced tissue processing methods to produce highly concentrated platelet rich plasma or mesenchymal stem cells. It takes your physician years to master the skill of cell harvesting for maximal benefit.
· To ensure the safe, effective and comfortable delivery of cells into the damaged tissues, a fellowship trained physician should use advanced image guidance using diagnostic ultrasound or x-ray (fluoroscopy). Physician assistants, naturopathic doctors, chiropractors and nurses do not complete this level of training.
When considering treatment with regenerative medicine, it’s important to understand the pros and cons of the different options. Be aware that treatments vary among different clinics and outcomes are determined by physician experience and the methods used to deliver these treatments. Be sure to ask your physician about their training, experience and whether or not they document their patient outcomes.
When done properly, cell based therapies significantly help patients to heal quickly and completely allowing them to enjoy an active life without pain.
Drs. Christopher J. Rogers and Mary A. Ambach of San Diego Orthobiologics Medical Group have successfully treated thousands of patients with platelet rich plasma and other cell based therapies for more than a decade. Their facility in Carlsbad contains the most advanced Regenerative Medicine technology in San Diego and offers same day treatments with the highest documented levels of safety and efficacy.
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Aug 6, 2020
Many people are discovering the benefits of cell based therapies, commonly known as stem cell treatments, in treating orthopedic conditions such as osteoarthritis, tendon injuries and chronic low back pain. These treatments have offered patients hope for long term pain relief and healing. Patients have obtained significant medical benefits from physicians who offer safe and evidence based cell therapy.
Although there is increasingly abundant data on the benefits of these treatments, many stem cell therapies are in the investigational stages of development. The U.S. Food and Drug Administration (FDA) regulates the use of stem cells in clinical practice. Healthcare providers that offer cell based therapies are obligated to comply with state and federal regulations.
Unfortunately, in the U.S. there are more than 600 clinics that promote stem cell treatments that are neither safe nor effective. The level of healthcare provider training at these clinics is highly variable with many delivering treatments from unqualified individuals. So when patients ask, “Does stem cell treatment work?”, the answer is, “It depends on the clinic what they are offering as stem cell treatment.”. We believe it is important for physicians and their patients to understand the key differences between cell based treatments and the providers who offer them.
Several “stem cell” clinics use birth tissue derived from umbilical cord blood or amniotic tissue. Others will offer exosomes which are products derived from stem cells. These products are not FDA compliant for orthopedic use. They require FDA approval of a Biologics License Application before physicians are permitted to market them to patients. In an effort to evade FDA scrutiny, the manufacturers of these products claim that their birth tissue products do not contain live stem cells. Yet the clinics that sell these products make very different claims.
What sets San Diego Orthobiologics Medical Group apart from other clinics is our commitment to only use FDA compliant cell based therapies that are supported by the scientific evidence. In addition, we use cells that are obtained from the patient’s own body (autologous cells) to maximize safety.
Two Sources of Cell-Based Treatments
Stem cells are found throughout the body. Common sources used to obtain stem cells are bone marrow aspirate concentrate (BMAC) and adipose tissue (fat) that has been processed in an FDA compliant manner. These tissues are known to contain live stem cells, however it is difficult to accurately measure the number of cells at the time of treatment. In addition to stem cells, there are many other kinds of cells in bone marrow and fat that contain healing properties. Cell based treatments that are obtained from these tissue sources comply with current FDA guidelines and are supported by several scientific studies that report on the safety and efficacy of these therapies for orthopedic conditions.
- Adipose-derived cells are collected from a mini-liposuction procedure, typically from the abdomen or buttocks. San Diego Orthobiologics Medical Group offers LIPOGEMS® autologous fat tissue product for treating joint and soft tissue injuries. LIPOGEMS® preserves cells within the fat without jeopardizing their native structure. This enables reparative cells within the fat to continue to work as a functional unit allowing the body to repair damaged or degenerated tissues.
- Bone marrow derived cells contain a rich supply of cells that have been shown to stimulate the body’s ability to improve circulation, decrease inflammation and heal injured tissues. San Diego Orthobiologics Medical Group offers bone marrow aspirate concentrate, which provides a significant amount of regenerative cells to support the body’s natural healing response.
Patient Safety is Paramount
Because San Diego Orthobiologics Medical Group uses a patient’s own tissue, there is minimal risk of disease transmission, infection or immune reaction. This would not be the case for donor birth tissue derived products. Moreover, autologous cells used in our treatments are preserved in their natural state and possess the greatest healing potential. Donor or birth tissue products have not been proven to be safe or effective for orthopedic conditions. There have been cases of bacterial infection with the use of donor products and most do not contain any living stem cells at all.
In addition to using a patient’s own cells, San Diego Orthobiologics Medical Group also protects our patients using:
- State of the art cell processing techniques in our Orthobiologics lab using some of the most advanced regenerative medicine technology in San Diego.
- Innovative equipment to image the joint and spine such as musculoskeletal ultrasound and fluoroscopy (digital x-ray). These tools provide detailed visualization of the injured structures and significantly improve the comfort and effectiveness of cell based therapies.
- Fellowship trained physicians who have decades of experience treating patients with orthopedic conditions. We also track our safety and efficacy outcomes with the DataBiologics registry to help patients make informed medical decisions.
An Investment in Safety
San Diego Orthobiologics Medical Group invests significant time and expertise to ensure we offer FDA compliant and evidence based therapies in order to provide our patients with safe, comfortable and effective treatments. As dedicated healthcare professionals, we understand that every patient is unique and that the best outcomes are derived after a comprehensive evaluation, patient education of all treatment options and customized medical care.
Drs. Christopher J. Rogers and Mary A. Ambach of San Diego Orthobiologics Medical Group are experts in the field of regenerative medicine and have been providing safe, effective and FDA-compliant cell based treatments to their patients for decades. They serve as faculty members and lecturers at national and international medical conferences and are considered experts in the field of regenerative medicine.
Jun 19, 2020
The human body is programmed to heal. Whether it is recovering from a small scrape or from major surgery the body’s initial response to any kind of injury or trauma is to kick into healing mode.
But sometimes it can use a little help. And that is what cell-based therapies offer.
How Cell-Based Therapy Works
Cell-based therapy assists the body to heal injured tissues. This is especially useful for the treatment of injured tendons, ligaments and joints. Cell-based therapy delivers targeted healing factors that are taken from the patient’s own cells to boost the body’s ability to speed healing and recovery.
There are several treatments options available, and each one offers unique benefits that enable your physician to choose the best option for you.
- Platelet Rich Plasma therapy concentrates platelet cells from the blood and delivers them to the injured tissues. These cells are rich in growth factors that are needed to initiate the body’s healing and repair processes. Using a patient’s own blood, the platelets are separated and concentrated. They are then placed into the injured area to boost healing.
- Prolotherapy delivers a targeted solution of concentrated dextrose and local anesthetic to injured ligaments, tendons or joints. The body responds to the dextrose solution as an irritant which, triggers healing responses that had stalled prematurely.
- Stem Cells are found throughout the body and are activated when an injury occurs. Tissue harvested from the patient’s own bone marrow or adipose (fat) contain mesenchymal stem cells (MSCs). They activate healing by producing molecules that direct other cells in the area to form new blood vessels, awaken resident progenitors and stimulate new tissue growth. Cells can be obtained from several sources, however, only bone marrow and adipose (fat) tissue are FDA-compliant for orthopedic indications. Umbilical cord blood products are not approved by the FDA and not supported by clinical research for orthopedic use.
What to Expect While Recovering from Therapy
Unlike major surgery, cell-based therapies do not require hospitalization. They are performed in our office procedure suite with local anesthetic. Recovery usually takes less than 4 days from these minimally invasive procedures.
There may be some swelling and discomfort in the injected area, but these symptoms typically lessen within a few days. Patients begin physical therapy to regain strength and range of motion within the first few weeks. Depending on the extent of the original injury, as well as the specific treatment used, some patients are able to resume their normal activity levels just days after their procedures.
Staying well hydrated and following a nutrient-rich diet are key to overall wellness and are especially important before and after these treatments since the body’s requires high-quality fuel to power their healing efforts.
San Diego Orthobiologics Medical Group is a leader in regenerative medicine therapies and offers a great variety of treatment options depending upon each patient’s unique needs. With decades of experience in the field of minimally invasive interventional treatments, Drs. Christopher J. Rogers and Mary A. Ambach are experts in the field of regenerative medicine. They serve as faculty members and lecturers at national and international medical conferences and serve on the board of directors for several national regenerative medicine organizations.
