Back Pain

Stem Cell Therapy for sciatica like symptoms

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Marc Darrow MD,JD

There is a difference between a “true” sciatica and the phenomena of “pseudo sciatica,” or “fake sciatica.” If you have been diagnosed with sciatica you may have been one of the people where it took some time and a lot of tests and examinations to confirm that in fact you had sciatica or you did not have sciatica but you had sciatica like symptoms. Even then there may be still be some doubt about your diagnosis.

This article will discuss possible treatments for sciatica-like symptoms. If you do not have back pain, but you do have numbness, burning pain, weakness or other neurologic type symptoms that radiates into your legs and feet, treatments such as Platelet Rich Plasma Therapy and Stem Cell Therapy will likely not be effective for you. What this article will focus on is if you have a true sciatica or a pseudo sciatica. In the case of pseudo sciatica, Platelet Rich Plasma Therapy and Stem Cell Therapy may be able to help this condition.
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Stem Cell Therapy and PRP for sacroiliac joint dysfunction

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Marc Darrow MD,JD

Patients will often come into our office with an MRI, low back pain and a diagnosis of sacroiliac joint dysfunction. They are in our office because they may have been told that they should consider a surgical recommendation to spinal fusion. For many of these people, the MRI was the confirmation that their surgeon needed to go ahead with the surgical recommendation. For many patients, this may have been the same doctor who had taken them through a course of conservative treatments. These treatments may have included long bouts with anti-inflammatory medications, back braces, physical therapy, and cortisone injections.

All of these treatments did not help them. Why? A recent study in the Clinical Spine Journal (1) offers the suggestion that sacroiliac joint dysfunction patients do not get treatment relief because they do not have sacroiliac joint dysfunction. This may be somewhat difficult for you to believe because all along you have been told you have SI joint pain.

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Side-effects of corticosteroid injections including joint destruction

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Marc Darrow MD,JD

Systemic and local side-effects of corticosteroid injections including joint destruction

A patient will often come into our office with conflicting ideas about cortisone injections. The patient will tell us that his/her other doctors told them that cortisone injections are safe, effective, and will help their pain, if used sparingly. But, intuitively, the patient had doubts and concerns.

But as this patient continued to wait for a surgery, decisions had to be made as to how much pain management would be needed to “hold them over,” until the surgical date.

Corticosteroids are powerful anti-inflammatory substances. They are not used to relieve pain, but rather, to reduce inflammation, which in turn can lessen a patient’s level of discomfort. Numerous studies over the years have shown that prolonged use of cortisone will eventually cause degenerative joint disease in the joints they are injected into.

UNDERSTANDING THE POSSIBLE COMPLICATIONS OF CORTISONE INJECTIONS.

A December 2020 paper in the medical journal Radiology (1) says this:

  • Current management of osteoarthritis is primarily focused on symptom control.
  • Intra-articular corticosteroid injections are often used for pain management of hip and knee osteoarthritis in patients who have not responded to oral or topical analgesics.
  • “Recent case series suggested that negative structural outcomes including accelerated osteoarthritis progression, subchondral insufficiency fracture (stress fractures in the bone beneath cartilage), complications of pre-existing osteonecrosis, and rapid joint destruction (including bone loss) may be observed in patients who received Intra-articular corticosteroid injections .
  • The true cause and natural history of these complications are unclear and require further study. To determine the cause and natural history, large prospective studies evaluating the risk of osteoarthritis or joint destruction after Intra-articular corticosteroid injections are needed.

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Waiting for hip replacement and spinal surgery. Is stem cell therapy a realistic option to help you avoid surgery?

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Marc Darrow MD,JD

Many people email us about their hip and back pain. Some have been recommended to a hip replacement, some have been recommended to a spinal surgery. Some have been recommended to both surgeries and they are in the process of choosing between one or the other and exploring options to help them avoid one or the other surgery, even both. Some at this point are not even deciding which to get first, they may simply take the first one that is available.

The question that comes in to us is about stem cell therapy as an option and “which would you treat first? My hip or my back?” The benefit of stem cell therapy is that in the same visit, if you are a good candidate for treatment, we can treat both of your pain challenges at the same time. In this scenario, both areas can begin a simultaneous healing process. You do not have to wait for you hip to heal to start spinal treatments, you do not have to wait for your back to heal to start hip treatments. Below I will discuss the science behind these treatments.

Research: The question of which to have surgery on first, the hip or the spine, is much more complex and risky than thought

The option to have lumbar spinal surgery and hip replacement at the same time is clearly one that is not recommended for obvious reasons. So a decision has to be made. Spinal surgery or hip replacement surgery? One has to come first and one has to wait.

At Washington University School of Medicine, Departments of Orthopaedic Surgery and Neurology and Physical Therapy, surgeons and therapists wanted to examine patients who had hip osteoarthritis and back pain. The hip-spine complex can be a tricky and complex area to diagnose. Finding the true source or sources generating a patient’s pain can be equally complex. This makes the first surgery decision even more difficult.
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Is stem cell therapy a realistic treatment for pain after multiple spinal surgeries

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Marc Darrow MD,JD

We receive many emails from patients who have undergone numerous spinal procedures. These people are in continued pain and are looking for help. Because of the complexities of spinal surgery, especially in patients with numerous procedures, this question must be answered following a physical examination and consultation where realistic healing options can be discussed.

When a person contacts our office looking for options to a second or even third spinal procedure we do want to help them because research has made it clear the more surgeries, the worse off the patient is.Let’s explore the research in support of that statement.

The more surgeries the worse off the patient

Some people will get benefit eventually from surgery. Some will not. Doctors, including those from the University of Bern in Switzerland published their research findings (1) on patients who had to undergo multiple spinal surgeries. When they examined patients 12 months after their last surgery they found that the more surgeries a patient had, the less likely they would have clinical success.

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Alternative to spinal fusion surgery – Stem Cell Therapy and PRP

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Marc Darrow MD,JD

In our practice we often see patients who are in severe back pain. These people have an MRI, X-ray and/or scan that may show an inaccurate picture of what is causing their pain. What do I mean by inaccurate picture?

  • The MRI cannot show muscle spasms from a simple back strain which can cause excruciating pain.
  • Conversely, the MRI can show a large herniated disc which may be completely asymptomatic.

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Research: Epidural steroid injection does not prevent surgery

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Marc Darrow MD,JD

Epidural steroid injections do not heal a bad back. Some researchers consider epidural steroid injections to be, at best, a very short-term painkiller that sometimes prevents a patient from getting the proper treatment for his/her back pain.

The one thing that surgeons and regenerative medicine specialists agree on is the question being raised in the medical literature asking whether patients have been informed of the poor likelihood of long-term epidural injection treatments success for disability. The same question is also being raised about spinal surgery.

In the research below from some of the leading medical universities in the world, we see that the goal of epidurals and surgery is to provide pain relief. Unfortunately improving disability and function may not be an attainable goal with these treatments.
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Back pain after spinal fusion could be post-surgical muscle damage

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Marc Darrow MD,JD

Many people have successful spinal surgery. Some do not. There are many reasons why someone will have a failed spinal surgery. One reason among the many causes can be the muscle damage caused by the fusion surgery itself.

In a situation like this we would examine the spine and look for tenderness and weakness in the muscle attachments / tendons and the spinal ligaments. If these structures are damaged, we would treat with regenerative injections including platelet rich plasma therapy and/or stem cell therapy. Read More

Opioids, Spinal Cord Stimulators, and Failed Back Surgery: Why are people at high risk for failed back surgery still waiting for surgery?

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Marc Darrow MD,JD

It may be more challenging to get a spinal surgery these days. For some people it may be even more challenging to recover from it once they do have it. In this article i hope to share with you three main thoughts from recent research.

  1. Who is at risk for failed back surgery
  2. What happens to put people at risk for failed back surgery syndrome before the surgery?
  3. What can be done in situations for failed back surgery syndrome after the surgery?

I have made it a point throughout this website to display my great admiration for surgeons. I went to medical school to become a surgeon. As I saw more and more failed surgeries I decided to change my practice over to providing non-surgical methods. There are very many people who have had very successful spinal surgeries, My article here will help provide information on alternatives.

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Research: Some spinal surgeries and MRIs are unjustified and wasteful

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Marc Darrow MD,JD

As with other joint problems, I will often get emails that are simply an MRI report. The MRI tells me that the person has a disc herniation at L1 or L2 or L4 or L5. Then the report will describe varying degrees of degenerative disc disease. The email will end with “can you help?” That answer would be easier if there was some more information included in that email.

At no point in the email did the person say how bad their pain was, what type of limitations they had, or how their back problem was affecting their ability to work or be active. Information as simple as knowing how someone’s back feels today is good information to have when trying to determine if our treatments can help.

It is not the emailers fault for excluding this information. For some people, they have been trained that the MRI has captured the image of what is causing their pain and this image can be used as a roadmap or baseline to help doctors plot out a surgical path now or in the near future. I get the MRI report because these people are exploring ways to avoid that surgery.

RESEARCH: SOME SURGERIES AND MRIS ARE “UNJUSTIFIED AND WASTEFUL HEALTHCARE EXPENDITURES.”

The problem of over reliance on MRI is that they can send you to a surgery you may not need. A study that appeared in the medical journal Radiologia (Radiology) (1) examined the traditional recommendations of sending a patient to get an MRI and then offering a surgery based on what the MRI indicated. The researchers had concerns about the enthusiasm some surgeons had for surgery that was likely inappropriate.
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