Regenerative Medicine: Pharmacological Considerations and Clinical Role in Pain Management

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

Abstract

Purpose of Review

Low back pain affects at least 80% of individuals at some point in their lifetime and is the fifth most common reason for physician visits in the USA. Treatment of an acute episode of LBP generally includes rest, activity modification, physical therapy, NSAIDs, and patient education.

Recent Findings

A small percentage of patients will develop chronic pain lasting > 6 months duration. Platelet-rich plasma (PRP) is one of the main pillars of regenerative medicine, as its release of bioactive proteins supports the aim of RM of restoring the anatomical function in degenerative conditions. Mesenchymal stem cells (MSCs) are multipotent stem cells, multipotent progenitor cells, or marrow stromal cells found in various body tissues, including bone marrow, lung, and adipose tissue. Evidence from well-designed case–control or cohort studies for the use of PRP and MSCs in lumbar facet joint, lumbar epidural, and sacroiliac joint injections is currently described as level IV evidence. PRP and MSCs are used autogenously to help facilitate the healing process, and their injection has been studied in the long-term management of discogenic low back pain. PRP has been compared to steroid injections in the sacroiliac joint for chronic low back pain, with favorable results. MSCs have also been shown to be useful in intervertebral disc regeneration and treatment of chronic low back pain associated with degenerative disc disease.

Summary

Currently, the price for these treatments is extremely high, and thus the standard of care continues to be steroid injections and other treatments. This could change, however, with more robust data and research on the safety and long-term efficacy of biologics compared to other interventional management.

Related collections

Most cited references 64

Record: found
Abstract: found
Article: not found

What low back pain is and why we need to pay attention

Paulo Ferreira, Manuela Ferreira, Peter Croft … (2018)

Low back pain is a very common symptom. It occurs in high-income, middle-income, and low-income countries and all age groups from children to the elderly population. Globally, years lived with disability caused by low back pain increased by 54% between 1990 and 2015, mainly because of population increase and ageing, with the biggest increase seen in low-income and middle-income countries. Low back pain is now the leading cause of disability worldwide. For nearly all people with low back pain, it is not possible to identify a specific nociceptive cause. Only a small proportion of people have a well understood pathological cause-eg, a vertebral fracture, malignancy, or infection. People with physically demanding jobs, physical and mental comorbidities, smokers, and obese individuals are at greatest risk of reporting low back pain. Disabling low back pain is over-represented among people with low socioeconomic status. Most people with new episodes of low back pain recover quickly; however, recurrence is common and in a small proportion of people, low back pain becomes persistent and disabling. Initial high pain intensity, psychological distress, and accompanying pain at multiple body sites increases the risk of persistent disabling low back pain. Increasing evidence shows that central pain-modulating mechanisms and pain cognitions have important roles in the development of persistent disabling low back pain. Cost, health-care use, and disability from low back pain vary substantially between countries and are influenced by local culture and social systems, as well as by beliefs about cause and effect. Disability and costs attributed to low back pain are projected to increase in coming decades, in particular in low-income and middle-income countries, where health and other systems are often fragile and not equipped to cope with this growing burden. Intensified research efforts and global initiatives are clearly needed to address the burden of low back pain as a public health problem.

0 comments Cited 1026 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Non-specific low back pain.

Rachelle Buchbinder, Martin Underwood, Chris Maher (2017)

Non-specific low back pain affects people of all ages and is a leading contributor to disease burden worldwide. Management guidelines endorse triage to identify the rare cases of low back pain that are caused by medically serious pathology, and so require diagnostic work-up or specialist referral, or both. Because non-specific low back pain does not have a known pathoanatomical cause, treatment focuses on reducing pain and its consequences. Management consists of education and reassurance, analgesic medicines, non-pharmacological therapies, and timely review. The clinical course of low back pain is often favourable, thus many patients require little if any formal medical care. Two treatment strategies are currently used, a stepped approach beginning with more simple care that is progressed if the patient does not respond, and the use of simple risk prediction methods to individualise the amount and type of care provided. The overuse of imaging, opioids, and surgery remains a widespread problem.

0 comments Cited 730 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

A systematic review of the global prevalence of low back pain.

Damian Hoy, Christopher Bain, Gail Williams … (2012)

To perform a systematic review of the global prevalence of low back pain, and to examine the influence that case definition, prevalence period, and other variables have on prevalence. We conducted a new systematic review of the global prevalence of low back pain that included general population studies published between 1980 and 2009. A total of 165 studies from 54 countries were identified. Of these, 64% had been published since the last comparable review. Low back pain was shown to be a major problem throughout the world, with the highest prevalence among female individuals and those aged 40-80 years. After adjusting for methodologic variation, the mean ± SEM point prevalence was estimated to be 11.9 ± 2.0%, and the 1-month prevalence was estimated to be 23.2 ± 2.9%. As the population ages, the global number of individuals with low back pain is likely to increase substantially over the coming decades. Investigators are encouraged to adopt recent recommendations for a standard definition of low back pain and to consult a recently developed tool for assessing the risk of bias of prevalence studies. Copyright © 2012 by the American College of Rheumatology.

0 comments Cited 477 times – based on 0 reviews      Review now

Bookmark

All references

Author and article information

Contributors

Elyse M. Cornett:

ORCID: http://orcid.org/0000-0001-7961-3931

elyse.bradley@lsuhs.edu

Journal

Journal ID (nlm-ta): Curr Pain Headache Rep

Journal ID (iso-abbrev): Curr Pain Headache Rep

Title: Current Pain and Headache Reports

Publisher: Springer US (New York )

ISSN (Print): 1531-3433

ISSN (Electronic): 1534-3081

Publication date (Electronic): 8 September 2022

Pages: 1-15

Affiliations

[1 ]GRID grid.64337.35, ISNI 0000 0001 0662 7451, Department of Anesthesiology, , Louisiana State University Health Shreveport, ; 1501 Kings Highway, Shreveport, LA 71103 USA

[2 ]GRID grid.38142.3c, ISNI 000000041936754X, Department of Psychiatry, Massachusetts General Hospital, , Harvard School of Medicine, ; Boston, LA 02114 USA

[3 ]GRID grid.64337.35, ISNI 0000 0001 0662 7451, School of Medicine, , Louisiana State University Health Shreveport, ; Shreveport, LA USA

[4 ]GRID grid.259828.c, ISNI 0000 0001 2189 3475, Department of Anesthesiology and Perioperative Medicine, , Medical University of South Carolina, ; Charleston, SC 29425 USA

[5 ]GRID grid.412004.3, ISNI 0000 0004 0478 9977, Department of Anesthesiology, , University Hospital Zürich (USZ), ; Zurich, Switzerland

[6 ]GRID grid.189967.8, ISNI 0000 0001 0941 6502, Department of Anesthesiology, , Emory University School of Medicine, ; Atlanta, GA USA

[7 ]GRID grid.5361.1, ISNI 0000 0000 8853 2677, Department of Anesthesia and Intensive Care, , Medical University Innsbruck, ; Innsbruck, Austria

[8 ]GRID grid.511862.9, ISNI 0000 0004 0640 4305, Department of Anesthesiology and Intensive Care Medicine, , See-Spital, ; Horgen, Switzerland

[9 ]Medical Director, Comprehensive Spine and Sports Center, Campbell, CA and Advisor, Le Reve Regenerative Wellness, Campbell, CA USA

[10 ]Comprehensive Spine and Sports Center, 3425 S Bascom Ave #200, Campbell, CA 95008 USA

Author information

Elyse M. Cornett http://orcid.org/0000-0001-7961-3931

Article

Publisher ID: 1078

DOI: 10.1007/s11916-022-01078-y

PMC ID: 9453705

PubMed ID: 36074255

SO-VID: ef108ba6-64ed-4dc0-a73e-bdbda8535f58

License:

This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.

Regenerative Medicine: Pharmacological Considerations and Clinical Role in Pain Management

Read this article at

Abstract

Purpose of Review

Recent Findings

Summary

Related collections

Irish Journal of Paramedicine

Most cited references 64

What low back pain is and why we need to pay attention

Non-specific low back pain.

A systematic review of the global prevalence of low back pain.

Author and article information

Contributors

Journal

Affiliations

Author information

Article

History

Categories

Comments

Comment on this article

Similar content 127

Cited by 4

Most referenced authors 2,357