Should You Get Your Disc Injected with Stem Cells?

By Chris Centeno, MD /

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It seems to be the latest craze; all the cool providers, most after taking a weekend course, are doing it. So should you get your disc injected with stem cells? The question certainly seems simple enough; however, the answer is a bit more complex. This isn’t a new fad for us. We were the first in the world to inject stem cells into discs, and over the past dozen years, we’ve learned a few things along the way. The short answer is, it’s not frequently as simple as just treating the disc. Let’s first review the anatomy of the spine, and then I’ll explain this answer in more detail.

The Anatomy of the Spine

To enhance your understanding of the anatomy of the spine (as well as the disease processes I’ll discuss throughout), be sure to watch the video above as it contains helpful visuals. First, your discs sit between your vertebrae, the spinal bones, and act as shock absorbers for those vertebrae. You also have facet joints that run along the back of the vertebrae, occurring where every two spine bones articulate. There are spinal nerves that come out at each facet joint level, one on each side. The multifidus muscle provides stability for all of the spinal structures, and there are ligaments that provide a different kind of stability.

When a Stem Cell Injection into the Disc Makes Sense 

So when should you get your disc injected with stem cells? There are a couple of scenarios in which a stem cell injection into the disc makes sense and can be very helpful. First, if there’s a painful tear in the disc and the disc itself is definitely causing the pain. Patients who have this issue typically can’t sit very well due to pain. Second, if a torn disc is leaking chemicals onto the nerve and this is irritating the nerve. You can take a look at our own Dr. Pitts in one of our procedure suites performing an actual stem cell injection for a torn disc at this link. In both of these instances, the disc still has good height and hasn’t yet collapsed.

Another disc problem that may warrant a stem cell injection is when a disc bulge compresses a spinal nerve and that can’t be managed with injecting platelet lysate around the nerve (epidural). However, in our experience, getting rid of this type of disc bulge requires specially cultured stem cells that aren’t available in the US. We only use these special cells at our licensed advanced cell culture site in Grand Cayman.

When a Stem Cell Injection into the Disc Doesn’t Make Sense

There are a few other scenarios that are very common in which a stem cell injection into the disc simply doesn’t make sense as patients with these conditions can often be treated without injecting directly into the disc. These include a herniated disc or a tweaked spinal nerve. In these cases, our experience has shown us that it’s best to treat with a precise X-ray–guided injection of healing growth factors right at the spot of the irritated nerve. This is called a platelet lysate (PL) epidural, and we’re on our fourth-generation PL. This type of treatment can often also be used to manage a disc bulge irritating a nerve.

However, any of these conditions may require treating more than the disc and/or the nerve. The stabilizing muscle called the multifidus can shrink. This can cause active instability, which then tweaks the nerve and causes more multifidus atrophy. So this may need to be treated separately to restore spinal stability. The facet joints can also get injured, and these may also need to be treated. Ligaments that provide passive stability can get loose, and they can cause the vertebrae to slip. Those ligaments may need to be tightened down through an injection. The key is to use the right treatment for the right type of problem.

Why Treat the Whole Spine?

When the disc loses its ability to hold onto water, it collapses, the facet joints get arthritis, the multifidus shrinks, and the ligaments get lax. These are signs of a whole spine disease. It’s not just a disc disease, so injecting stem cells into the disc here is not going to do much. In order for your treatment to be successful, your provider is going to have to deal with all of your spinal issues at once: the nerves, the discs, the multifidus, the loose ligaments, and the irritated facet joints.

We see cases where doctors have injected stem cells into the discs of patients who really have a whole spine disease with a collapsed disc, and, understandably, the patients aren’t getting much relief. So why treat the whole spine in these cases? Because if your provider really focuses on treating the entire spine and all of its different parts, he or she can provide much more successful treatments for patients.

Why Not Just Inject the Disc Anyway?

Of all of the types of complications that can happen with a low back injection, perhaps the worst is discitis. This means that the disc gets infected. If this happens, it’s a big deal requiring IV antibiotics and likely surgery. Hence, staying out of the disc if it doesn’t need to be injected, is always the best move.

The upshot? Should you get your disc injected with stem cells?  The answer is just because all the cool providers are doing it, it doesn’t mean it’s the best treatment for your condition. Based on our extensive experience, stem cell treatments in the disc do work well, but it’s imperative that these treatments be used in the right patients, such as those with pain due to torn discs or torn discs leaking chemicals onto the nerve or a disc bulge that can’t be managed in any other way. In many patients, treating several areas of the spine (nerve, facet joint, multifidus, etc.) with advanced orthobiologics (stem cells, advanced platelet treatments) outside the disc works better than treating just the disc.

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19 thoughts on “Should You Get Your Disc Injected with Stem Cells?

  1. DavePG

    Another interesting post. I wonder if stem cells could help Warriors basketball coach Steve Kerr who reportedly has been suffering from the effects of Cerebrospinal Fluid (CSF) Leak since back surgery in July 2015. Kerr said this recently: “And I can tell you if you’re listening out there, if you have a back problem, stay away from surgery. I can say that from the bottom of my heart.”

    1. Regenexx Team Post author

      Dave,
      Definitely agree with Coach Kerr! We treat CSF leaks regularly…

  2. Clive Andrews

    Can a stem cell treatment help heal a disc with early DDD?

    1. Regenexx Team Post author

      Clive,
      Injecting stem cells into a degenerated disc likely wouldn’t help. The most effective treatment for a degenerated disc is to treat the ligaments and facet joints surrounding it. Given that the spine is one interconnected “Machine”, treating early can prevent colateral damage. Please see: https://regenexx.com/the-regenexx-procedures/back-surgery-alternative/ and https://regenexx.com/blog/how-to-read-a-low-back-mri-report/

      1. Robin

        I always get a bit puzzled on this topic. If, as you state, “injecting stem cells into a degenerated disc wouldn’t help” then please help me understand the following articles Regenexx published several years ago:
        1. New Research on Stem Cells and Degenerated Discs (published on July 13, 2009).
        2. Stem Cells and Disc Repair (published on February 24, 2009).
        These articles clearly seem to suggest that in some people who receive cultured stem cells disc rehydration (or regeneration) is possible. Am I interpreting the outcomes these patients had incorrectly?

        1. Chris Centeno Post author

          Robin, the term “degenerated” covers many disc types. This is everything from a disc with good disc height and a bulge to a disc that has collapsed with huge bone spurs. So again, for those with the right degenerated disc types, stem cell procedures can be helpful. While we have seen rehydration in some of the cultured patients, this is not a reliable change. The biggest reliable change in those patients is reduction of disc bulge size.

  3. Robin

    Got it. Thanks!

  4. Chris Jeon

    When you say “The stabilizing muscle called the multifidus can shrink.”, is this caused by injecting stem cells into the disc or doing the platelet lysate treatment? Or was this sentence meant to say that “you may already have this problem instead of the disc bulge/herniation, we need to treat this instead”

    1. Regenexx Team Post author

      Chris,
      Neither, the multifidus can shrink either as a result of surgical damage or because the spinal nerve that innervates it is offline.

  5. Justin

    Have you learned when PRP works to get rid of of disc bulges versus when stem cells (same day or cultered) are needed? The latest pricing chart seems to only mention PRP for bulges? Has PRP treatment advanced since this post? (https://regenexx.com/resources/faqs/)

    1. Regenexx Team

      Hi Justin,
      Most disc bulge patients can be managed well with epidural platelet lysate injections without ever injecting the disc. If an intradiscal stem cell procedure is needed, (into the disc itself) specially cultured stem cells injected in a specific fashion are needed.

  6. Arturo

    I have two herniated disks

    And I would like to understand if stem cell is a option for me

    The internal liquid for the disk did not step out it was a minimal herniated that was my doctor said

    1. Regenexx Team

      Hi Arturo,
      For Herniated Discs it’s usually best best to stick with a technology that doesn’t inject the disc, but instead instills isolated growth factors around the irritated nerve. This is called platelet lysate and a precise, image guided, epidural injection around the nerves is less invasive than a disc injection. The focus is to ramp up your body’s own natural repair mechanisms, which can get rid of the herniated disc. This explains more about when stem cells would be apprrropriate: https://regenexx.com/blog/should-you-get-your-disc-injected-with-stem-cells/ Importantly though, treating the whole problem rather than just the symptom is needed. To see what may be needed in your specific case, we’d need more information. To do that, please use the “Are You a Regenexx Candidate” button here: https://regenexx.com/conditions-treated/spine/

  7. Shelley

    Diagnosis cervical Myelopathy. Previously diagnosed with idiopathic PN. Tingling and pain from knees through feet. Left thumb is numb. Some weakness. Neck pain. Lower back pain. Herniated discs are pressing on my nerves. Have been told surgery is the only way. The sooner the better or permanent nerve damage can occur. Or worse. Second opinion??

    1. Regenexx Team

      Hi Shelley,
      We’d need more information to do that. To begin that process, please uses the Candidate button here: https://regenexx.com/conditions-treated/spine/ We have a locations in Birmingham and London, UK.

  8. Sunny

    Sir/Madam

    I suffered L5-S1 disc herniation after an accident
    So wanted to know if i go for stem cell treatment then would it reduce the bulge & also is it a one time treatment or i need two get stem cell treatment at various intervals say every two to four yrs?

    1. Regenexx Team

      Hi Sunny,
      We treat herniated discs regularly, and they are generally treated with platelet procedures rather than stem cells. We’d need more information to see if you would be a Candidate and to see what type of procedure would be needed in your case. Our India Regenexx location can do the type of exam needed: https://regenexx.com/providers/regenorthosport/

  9. Ryan

    I recently injured my back in the weight room. Got an MRI and I have L4-L5 mild disc bulge, L5-S1 large disc protrusion pressing on nerve roots. Would the best course of action be stem cell or platelet lysate? I know it’s different for every patient but how many treatments would be needed to see results and how long will it take for the disc to return to pre-injury levels? Also how effective is this treatment versus a microdiscectomy?

    1. Regenexx Team

      Hi Ryan,
      Avoiding the surgery when possible is always preferable, as all surgery is damage to accomplish a goal. To weigh in on what the best option would be in your case, and what expectations would be, we’d need more information. To do that please use the Candidate form here: https://regenexx.com/conditions-treated/spine/

Chris Centeno, MD

Regenexx Founder

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.
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