by Mark Walter M.D. 

“Stem cell injections represent the most powerful non-surgical tool we have to heal back pain.” 

– Mark Walter M.D., RegenOrtho.com 

According to a 2016 review in the Journal of Pain Management, 75 percent of back surgeries fail to relieve the pain. This is known as failed back surgery syndrome. As an M.D., who has specialized in Non-Surgical Regenerative Orthopedics for over a dozen years, one of the most common presenting complaints I encounter is back pain.  

In my experience, the true underlying cause of back pain is often misunderstood and misdiagnosed by the medical profession. As a result, the treatments, which are often invasive, commonly fail to relieve a patient’s pain.  

Unfortunately, MRI’s are often misleading. There are two reasons for this. They fail to identify the subtle micro-tears in tendons and ligaments, which are often the root cause of back pain. They also can detect abnormalities, which are incorrectly assumed to be the cause of the pain, resulting in inappropriate and invasive treatments that could, in fact, cause their own complications. This will often compound the problem instead of resolving it. 

Conversely, the non-surgical Regenerative Orthopedic approach can be highly effective. In my experience, it’s the treatment of choice for many types of back pain. The approach of using injections to treat back pain and rebuild commonly damaged structures has been used for many years, and is known as Prolotherapy (“prolo” stands for proliferation of joint tissue, as well as supportive ligaments and tendons). However, the capacity to “harvest” and inject a person’s own stem cells in the office setting is a new and exciting development in this treatment protocol, which enhances the stimulus to healing. 

The most common cause of low back pain is a sprain or strain of the pelvic tendons. This commonly gives a “sciatica-like” presentation and mimics nerve pain quite closely. Since this problem will not be visible on an MRI or x-ray, the most effective (and perhaps the only) method to correctly diagnose it is with a detailed physical exam by an experienced Regenerative specialist. This is a “hands-on” specialty.  

The doctor needs to palpate specific structures to elicit the so-called “jump sign.” If the doctor can, in fact, reproduce the symptoms by palpating certain structures with the thumb, this is virtually diagnostic of the problem’s root cause. Once a diagnosis is made, the next course of action is to determine which strength of solution should be injected to stimulate the body to heal the damaged structures. This will depend on the complexity and severity of the case, as well as the healing capacity and desires of the patient.  

Level one is the tried-and-true dextrose Prolotherapy (which has been used successfully for several years), where a concentrated sugar solution stimulates new blood flow to a region. Level two is high-density PRP (platelet rich plasma) prepared from a simple blood draw from the patient. This will bring a few stem cells and multiple growth factors to bear on the damaged region. Level three uses stem cells, known as adult mesenchymal stem cells, which are harvested from a person’s own body fat (usually around the abdomen) in a simple office procedure. The stem cells are then joined with PRP and injected in and around the damaged joint or region, often with the help of ultrasound guidance.  

For most cases, depending on the strength of solution, it takes three to eight sessions of regenerative injections to heal the damaged structures (usually spaced from two to eight weeks apart) and achieve the desired results. For patients, who have back pain and are candidates for Regenerative Orthopedics, we have more than an 85 percent success rate. The advantages of this approach include minimal risk and little down time. There will often be some soreness with the injections, but the vast majority of patients tolerate the injections once they understand that this treatment will likely be the most effective solution to fix their problem.   

Regenerative Orthopedics with stem cells represents an elegant and powerful non-surgical approach to heal back pain. Due to the minimal risk and downtime, I believe this approach could eventually become the treatment of choice for many orthopedic problems. This truly is the medicine of the future.    

Mark Walter, MD, CM, CCFP, has pioneered the field of Regenerative Orthopedics for the last 20 years, and is considered one of the top Stem Cell Orthopedic specialists in Florida. Dr. Walter received his M.D. degree from McGill, then completed his residency in Family Practice and Sports Medicine in 1982. He went on to do five years of post-doc fellowship work in Regenerative Orthopedics with the world-renowned Hackett-Hemwall foundation, in association with the University of Wisconsin. During that period, Dr. Walter was mentored by and worked with some of the top regenerative orthopedic teachers in the world. Dr. Walter is a leading expert in myofascial pain generators and ligament and tendon regeneration.    

For more information, to schedule a personal consultation with Dr. Walter (by phone or in-person), or to register for a free seminar, please call Stem Cell Orthopedics in Sarasota at 941-955-4325, email [email protected] or visit StemCellOrthopedics.com.