By A. Rahman Ford, Columnist
As many of us can attest to, lower back pain (LBP) is a debilitating and painful medical condition that severely impacts quality of life. An analysis of the Global Burden of Disease in 2010 showed that LBP ranked as the greatest contributor to disability out of nearly 300 conditions studied.
Lower back pain tends to peak in older age groups; thus, regions with higher life expectancies are disproportionately impacted. The number of people with LBP is projected to increase in the coming decades, especially in low- and middle-income countries. About 149 million work days are lost every year in the U.S. because of LBP, at an estimated cost of $100-200 billion.
Of course, the costs to the patient – both financial and emotional – can never be adequately quantified.
Tough Questions, Few Answers
Although the causes of LBP generally are multifarious, the National Institutes of Health maintains that the majority of cases are mechanical in nature. The gradual degeneration of the spine as a result of normal wear and tear – referred to as spondylosis – can result in a myriad of painful conditions that range from simple sprains, to herniated or ruptured discs, to injuries caused by trauma.
While the causes of lower back pain are rarely addressed, analgesic medications are routinely prescribed to treat its symptoms. Commonly prescribed medications include opioids, NSAIDS, anticonvulsants, antidepressants, counter-irritants and epidural steroid injections.
However, these analgesic treatments have shortcomings: potentially dangerous side-effects, adverse drug interactions, addiction, organ damage or only temporary relief. Other treatment options include physical therapy, transcutaneous electrical nerve stimulation (TENS), acupuncture and in extreme cases, surgery.
Sadly, neither the conservative management nor the more invasive surgical options consistently yield satisfactory results, because they fail to address the underlying disease processes. In fact, some treatments may actually lead to a worsening of the condition in the long term. Undoubtedly, new approaches are needed to solve the problem.
Research Supports Stem Cells for LBP
Many cases of lower back pain involve structural damage to the intervertebral discs, either by way of a herniated disc or degenerative disc disease (DDD). This condition is quite prevalent among older adults, with one study finding that 95% of older Americans exhibiting some degree of disc degeneration.
In the search for treatments beyond analgesics and surgery, several researchers have demonstrated the effectiveness of stem cell therapy in treating disc injuries in both humans and animals.
Leung et al. (2006) and Drazin et al. (2012) noted the potential for mesenchymal stem cells (MSC) to treat intravertebral disc degeneration in laboratory animals. Orozco et al. (2011) used autologous bone marrow-derived MSCs to treat 10 patients with lumbar disc degeneration, who exhibited rapid improvement in pain and disability.
Similarly, Pettine et al. (2015) reported significantly reduced pain scores in 26 patients who received autologous bone marrow-derived stem cells.
Coming to a Clinic Near You?
Just this year, Centeno et al. successfully used an injection of autologous bone marrow derived MSCs to treat DDD in 33 patients with lower back pain. The authors found “no safety issues, substantially reduced pain, increased function and reduced disc bulge size in most patients.”
That treatment utilized stem cell technology created by BioRestorative Therapies, which uses autologous bone marrow-derived MSCs to treat chronic lumbar disc disease. According to the company’s website, “not only could this program potentially eliminate surgery in many cases, but it could also provide substantially more effective treatment than current non-invasive therapies with a design to be curative.” The company has been cleared by the FDA for Phase 2 clinical trials to treat lower back pain due to DDD.
DiscGenics, a biotech company based in Utah, has also received FDA approval for a study of stem cell therapy to treat patients with intervertebral disc disease. DiscGenics’ approach is different, because it uses patented technology to derive its proprietary “discogenic cells” directly from adult human disc tissue.
“We believe it has the potential to offer pain relief and restored function to millions of patients suffering from the debilitating effects of lower back pain,” DiscGenics CEO Flagg Flanagan told The Salt Lake Tribune. “Receiving the go-ahead from the agency to begin in-human trials is a critical step forward for our clinical program.”
DiscGenics plans to begin enrolling 60 patients in the study before the end of the year.
Although both BioRestorative and DiscGenics have therapies that look promising, it will be some time – likely years – before either treatment is publicly available. But these studies could be a major step forward in finding an actual cure for back pain, not just another treatment that masks the pain.
A. Rahman Ford, PhD, is a lawyer and research professional. He is a graduate of Rutgers University and the Howard University School of Law, where he served as Editor in Chief of the Howard Law Journal. He earned his PhD at the University of Pennsylvania.
Rahman lives with chronic inflammation in his digestive tract and is unable to eat solid food. He has received stem cell treatment in China.
The information in this column should not be considered as professional medical advice, diagnosis or treatment. It is for informational purposes only and represent the author’s opinions alone. It does not inherently express or reflect the views, opinions and/or positions of Pain News Network.