Regenerative Medicine : Pharmacological Considerations and Clinical Role in Pain Management

© 2022. This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply..

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. 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.

Medienart:

E-Artikel

Erscheinungsjahr:

2022

Erschienen:

2022

Enthalten in:

Zur Gesamtaufnahme - volume:26

Enthalten in:

Current pain and headache reports - 26(2022), 10 vom: 08. Okt., Seite 751-765

Sprache:

Englisch

Beteiligte Personen:

Kaye, Alan D [VerfasserIn]
Edinoff, Amber N [VerfasserIn]
Rosen, Yale E [VerfasserIn]
Boudreaux, Megan A [VerfasserIn]
Kaye, Aaron J [VerfasserIn]
Sheth, Meeta [VerfasserIn]
Cornett, Elyse M [VerfasserIn]
Moll, Vanessa [VerfasserIn]
Friedrich, Claudia [VerfasserIn]
Verhagen, Johan Sibrecht [VerfasserIn]
Moser, Berthold [VerfasserIn]
Navani, Annu [VerfasserIn]

Links:

Volltext

Themen:

Anti-Inflammatory Agents, Non-Steroidal
Back pain
Biological Products
Biologics
Journal Article
Mesenchymal stem cells
Platelet-rich plasma
Regenerative medicine
Review
Steroids

Anmerkungen:

Date Completed 25.10.2022

Date Revised 25.10.2022

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1007/s11916-022-01078-y

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM345913442