| One-Minute Clinician

Regenerative Medicine--Miracle or Mirage?

A new and emerging field in medicine is here and some people call it regenerative medicine; some people call it stem cell treatment.  I think it’s important that we define those terms. Regenerative medicine includes this field of medicine where we can hopefully see some regeneration of tissue, regeneration of cells, and reorganization of those cells into functional tissues. Stem cell treatment really should refer to just stem cells. I think that’s where we’re seeing a little bit of a disconnect. People are using the word “stem cell treatment” very loosely and even fraudulently where their treatments contain no stem cells or at least no living stem cells. This field is absolutely going to be the future of pain management and medicine in general. If we can reverse conditions and diseases and regenerate tissues that have been damaged, a lot of current treatments are no longer going to be needed. It’s amazing stuff. We do that with a combination of both stem cells which can include autologous, or stem cells from the patient’s own body, and non-autologous which means cells that are not from that same patient. And we can use other growth factors and cell mediators and signaling agents. Different technologies are being used for a variety of conditions, including musculoskeletal issues, spinal conditions, disc problems, and neurodegenerative conditions such as multiple sclerosis, Parkinson’s, central stroke.

We’ve seen patients who have not had a response and we have seen patients who have exceeded our expectations, and I think at present we can't make any claims that it helps this much, or it helps in these specific patients. My advice to physicians and patients is to know that (1) it can be helpful, but at the same time it could be a complete waste of time, (2) to research who they’re going to for treatment and avoid unscrupulous providers. So far, insurance companies have reimbursed for stem cell treatment in conjunction with various leukemias, but they haven’t really reimbursed for musculoskeletal or intrathecal or neurodegenerative applications. We have been able to avoid joint replacement surgery with stem cell treatment, which saves payors a lot of money. So, from a business standpoint, it makes no sense not to cover it. But a major concern that the insurance companies have at present is what are the right treatments? What are the right combinations of treatments? Who are the right people to do these treatments? I think it will be covered eventually when we can sort through the present uncertainties.

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