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Stem Cell Treatment for Neuropathy? Can You Tell a Scam from Real?

Published on Dec 13, 2019

We get sent questions all of the time by patients. One recent question was about the difference between what a clinic chain says it offers as stem cell treatment for neuropathy and what we do. Since this is also a great way to explain the way to look for clinics that have high expertise in this area of nerve treatment versus very little, I thought it would make a great blog topic.

What is Neuropathy?

Before we can get into stem cell treatment for neuropathy, we need to understand neuropathy. Traditionally, neuropathy is a diffuse problem with nerves which is why it’s also called peripheral neuropathy (1). As we get older or due to natural or outside chemical exposures, our nerves can get damaged. In addition, they can be irritated or compressed in our spine, which can also cause a similar problem (radiculopathy) that mimicks neuropathy (2).

Neuropathy is usually worse where the nerves are longest, so it tends to have a “stocking-glove” distribution meaning it’s worse in the feet and hands. If you keep that same image, what neuropathy doesn’t have is numbness in specific areas, like the bottom versus the top of the foot or in some fingers more than others. In fact, when that’s happening, that’s a problem with a specific nerve, but regrettably, that diagnosis is often thrown into the same box as neuropathy.

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What is Stem Cell Treatment for Neuropathy?

Usually, this is an IV injection of donor umbilical cord blood or tissue. This is often combined with LASER or other heating treatments like infrared to try to get more blood flow to the extremities. Do we have any research that shows that an IV like this will help your neuropathy? Let’s dig in.

Right now, we don’t have a single study listed in the US Library of Medicine showing that an IV infusion of an umbilical cord product will help your neuropathy. Not even a lousy case report. Interestingly, there are cases of neuropathy that were CAUSED by intravenous umbilical cord blood (3-5). It was believed that these were due to an immune reaction to a mismatched donor. Meaning that all umbilical cord blood transfusions should be HLA matched to the person receiving the blood. This means that sophisticated tests should be done on the recipient and the blood sample being infused. However, this is almost never done in clinics offering these treatments.

So why are clinics offering umbilical cord stem cell treatment for neuropathy? The clinics that are doing this are often chiropractic or alternative health clinics or those also involved in anti-aging therapies. They have generally been sold a bill of goods by the vendors that sell the umbilical cord “stem cell” vials to them. That bill of goods is built on speculation and deception. Let’s dig in there as well.

Stem Cells and Neuropathy

The first deception that clinics offering stem cell treatment for neuropathy fall for is that they are being sold stem cells in the first place. This starts with the medical distributor that has registered an umbilical cord product with the FDA. This is not any form of FDA approval, but instead a free online registration.

The sales reps selling this stuff to doctors are taught to say that it’s:

FDA approved
Has millions of live stem cells per vial
These stem cell cells are highly effective and vital because they come from live births
That the cells in the older patients that could be used to treat neuropathy just aren’t any good anymore

Is any of this true? Nope. First, the umbilical cord product isn’t FDA approved, but misregistered. Meaning the FDA has come out many times warning these companies selling umbilical cord products as containing stem cells that their use of the FDA’s tissue registration system is incorrect and that the product is NOT “FDA approved”.

Second, many university and independent labs have tested these umbilical cord products and found no evidence of any living stem cells (12-14). The most recent was the CSU Translational Medicine Institute that also found no viable and functional stem cells. So the idea that these products have stem cells is a fraud. That also covers number three above.

What Does an Actual Regenerative Medicine Treatment for Neuropathy Look Like?

First, we have quite a bit of data published showing that the platelets from your blood can help heal damaged nerves (6-12). We also have randomized controlled trials where precise ultrasound-guided PRP injections can treat nerve issues like carpal tunnel syndrome. So your blood platelets are a better therapy than fake umbilical cord stem cells.

PRP is made from your blood. The doctor takes a sample of blood and isolates the platelets with a centrifuge. Platelets have growth factors, cytokines, and exosomes that can help in nerve repair and also help to stimulate other types of repair as well. We also use platelet lysate, which is where all of this stuff is removed from the platelets and concentrated.

The nerve is a single cell that goes from your spine to your hands or feet. Hence, it must be treated along its whole course. In the spine, that’s a fluoroscopy-guided epidural injection. In your arm or leg, that’s careful ultrasound-guided nerve hydrodissection. See below for my video of what that looks like:

Hence, treating nerves requires a VERY HIGH level of skill. Meaning, much less than 1% of all US physicians would have the ability to perform both of these precise, image-guided injections. How can you tell if a clinic knows how to do these complex procedures? Let’s dig in.

How To Identify Real Stem Cell Treatment for Neuropathy

I can break this down into the three simple steps:

Reverse address look-up
Who is the doctor
Do they offer umbilical cord “stem cells”

A reverse address lookup means that you take the address listed on the web page advertising neuropathy and copy/paste it into Google. Usually, you’ll see a chiropractic clinic pop up. What would a chiropractic clinic with a nurse or physician’s assistant performing the injections know about these complex procedures? Not much.

The training of the doctor is also critical. At Regenexx the physician must be trained in a medical specialty with significant interventional spine and ultrasound-guided injection training. Then that provider has to take and pass additional coursework before performing these complex nerve procedures. However, if you look up the doctor listed at a clinic and he shows up as a family doctor working at local urgent care clinics as well, it’s very unlikely that he or she has the training needed to perform fluoro-guided epidurals and ultrasound-guided nerve hydrodissection.

If the clinic advertises umbilical cord “stem cells”, now you know that there is no such thing. None of the products that these clinics use have any live and functional stem cells. Hence, if the clinic isn’t sophisticated enough to know this, then you need to run. Meaning, the clinic doesn’t know what it doesn’t know.

The upshot? Stem cell treatment for neuropathy is mostly a scam. We have no data that it works, the stuff that’s being injected doesn’t have any live and functional stem cells, and an IV is not the way that neuropathy can be effectively treated. Hence, using your own platelets and having a super-specialist inject them in the right places is usually the way to go.

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References:

(1) Hughes RA. Peripheral neuropathy. BMJ. 2002;324(7335):466–469. doi: 10.1136/bmj.324.7335.466

(2) Robblee J, Katzberg H. Distinguishing Radiculopathies from Mononeuropathies. Front Neurol. 2016;7:111. Published 2016 Jul 13. doi: 10.3389/fneur.2016.00111

(3) Mangaonkar A, Khateeb HA, Duma N, et al. Immune-Mediated Autonomic Neuropathies following Allogeneic Stem Cell Transplantation in Acute Myeloid Leukemia. Case Rep Hematol. 2017;2017:6803804. doi: 10.1155/2017/6803804

(4) Sumi M, Ichikawa N, Sato S, et al. Rinsho Ketsueki. 2008;49(12):1604–1608.

(5) Matsumoto H, Seki N, Yamamoto T, et al. Rinsho Shinkeigaku. 2005;45(10):748–753.

(6) Sowa Y, Kishida T, Tomita K, Adachi T, Numajiri T, Mazda O. Involvement of PDGF-BB and IGF-1 in activation of human Schwann cells by platelet-rich plasma. Plast Reconstr Surg. 2019 Aug 27. doi: 10.1097/PRS.0000000000006266.

(7) Shen YP, Li TY, Chou YC, Ho TY, Ke MJ, Chen LC, Wu YT1. Comparison of perineural platelet-rich plasma and dextrose injections for moderate carpal tunnel syndrome: A prospective randomized, single-blind, head-to-head comparative trial. J Tissue Eng Regen Med. 2019 Jul 31. doi: 10.1002/term.2950.

(8) Güven SC, Özçakar L, Kaymak B, Kara M, Akıncı A. Short-term effectiveness of platelet-rich plasma in carpal tunnel syndrome: A controlled study. J Tissue Eng Regen Med. 2019 May;13(5):709-714. doi: 10.1002/term.2815.

(9) Uzun H, Bitik O, Uzun Ö, Ersoy US, Aktaş E. Platelet-rich plasma versus corticosteroid injections for carpal tunnel syndrome. J Plast Surg Hand Surg. 2017 Oct;51(5):301-305. doi: 10.1080/2000656X.2016.1260025.

(10) Sánchez M, Anitua E2, Delgado D, Sanchez P, Prado R, Orive G, Padilla S. Platelet-rich plasma, a source of autologous growth factors and biomimetic scaffold for peripheral nerve regeneration. Expert Opin Biol Ther. 2017 Feb;17(2):197-212. doi: 10.1080/14712598.2017.1259409.

(11) Senna MK, Shaat RM, Ali AAA. Platelet-rich plasma in treatment of patients with idiopathic carpal tunnel syndrome. Clin Rheumatol. 2019 Aug 16. doi: 10.1007/s10067-019-04719-7.

(12) Berger D, Lyons N, Steinmetz, N. In Vitro Evaluation of Injectable, Placental Tissue-Derived Products for Interventional Orthopedics. Interventional Orthopedics Foundation Annual Meeting. Denver, 2015. https://interventionalorthopedics.org/wp-content/uploads/2017/08/AmnioProducts-Poster.pdf

(13) Becktell L, Matuska A, Hon S, Delco M, Cole B, Fortier L. Proteomic analysis and cell viability of nine amnion-derived biologics. Orthopedic Research Society Annual Meeting, New Orleans, 2018. https://app.box.com/s/vcx7uw17gupg9ki06i57lno1tbjmzwaf

(14) Panero, A, Hirahara, A., Andersen, W, Rothenberg J, Fierro, F. Are Amniotic Fluid Products Stem Cell Therapies? A Study of Amniotic Fluid Preparations for Mesenchymal Stem Cells With Bone Marrow Comparison. The American Journal of Sports Medicine, 2019 47(5), 1230–1235. https://doi.org/10.1177/0363546519829034