Back Pain When Hiking: Helping Agnes Scale Her Personal Mountain

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I love the creative ways patients find to let us know that they’re doing better. This last week, I received this great shot from Dr. Pitts who had treated Agnes, a patient who had significant back pain with hiking. Here she is, having just climbed Colorado’s Mt. Elbert at 14,433 feet!  So how did we help her avoid back surgery?

What Was Wrong with Agnes?

Agnes had an annular tear on her MRI. What is this? The low-back discs have two main parts. The inner gel is called the nucleus, and the outer covering is known as the annulus. The latter has many strong fibrous layers that are constructed like an onion. It’s possible to tear the fibers of the annulus, and this can cause pain. It’s also something that can happen with wear and tear and likely doesn’t cause pain. It’s thought that these tears in the annulus lead to degeneration of the disc over time.

Given that we were the first clinic on earth to treat damaged low-back discs by injecting stem cells, we’ve learned a thing or two through the last 12 years. While it’s easy enough to inject the disc, this isn’t always the answer. First, it’s more invasive that just injecting other structures, like the area around the irritated nerves (epidural), the facet joints, or the ligaments. Second, if the patient can be made better without injecting the disc, why take the additional risks of injecting that structure? These risks include the possibility of damaging the disc and the rare possibility of a disc infection known as discitis.

Learn about Regenexx procedures for spine conditions.

What Did Dr. Pitts Do for Agnes?

Agnes was injured in a car crash. While her MRI showed an annular tear, her exam looked like she may have injured her facet joints and ligaments. The facets are small joints that help guide the movement of each individual low-back disc along with the ligaments. Dr. Pitts also suspected that these ligaments had been injured, and this additional motion allowed by now-loose ligaments may be irritating the low-back spinal nerves. All of this was certainly enough to give her back pain when hiking.

Even though injecting the disc with platelets or stem cells can be very helpful, Dr. Pitts knew that there was a significant chance we could help Agnes without injecting inside the disc. So after a careful exam and review of her imaging, he chose to inject HD-PRP and HD-platelet lysate (HD=high dose) into her injured facet joints, around her irritated nerves, and into the damaged ligaments. How did she do? This is the note she sent Dr. Pitts:

“Hello Dr Pitts.
Yesterday has been one year since I had my second PRP injection. Iam still rebuilding my core through PT and as a result I have been stronger than ever. I have very little back pain and feel very fortunate to have found Centeno, you, and a great PT. I am back to yoga, just landed my first headstand;) my back pain is not cured, but I got the tools from you to live and thrive while working with my body.  I climbed 11 hours this summer to summit my first 14 er on mt Elbert!
Can not thank you enough.  Please feel free to use me as a reference for similar cases like mine, also happy to talk to anyone who has questions and doubts.
Agnes”

The upshot? We can’t help every patient, but the wide array of proprietary technologies that we have available to us allows our Regenexx providers to treat many different spinal problems. We’re glad that we helped Agnes climb and conquer her personal summit! Hopefully, now she can put back pain with hiking behind her!

Chris Centeno, MD is a specialist in regenerative medicine and the new field of Interventional Orthopedics. Centeno pioneered orthopedic stem cell procedures in 2005 and is responsible for a large amount of the published research on stem cell use for orthopedic applications. View Profile

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NOTE: This blog post provides general information to help the reader better understand regenerative medicine, musculoskeletal health, and related subjects. All content provided in this blog, website, or any linked materials, including text, graphics, images, patient profiles, outcomes, and information, are not intended and should not be considered or used as a substitute for medical advice, diagnosis, or treatment. Please always consult with a professional and certified healthcare provider to discuss if a treatment is right for you.

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