Arthritis affects 1 in 4 Americans, and that number will likely increase to 1 in 2 Americans by 2040 (1). Spine arthritis is very common, and up to a shocking 85% of people with chronic lower back pain may actually have arthritis (1). These numbers are quite concerning given that conventional medicine does not have many viable treatments that are effective long-term (2). This has created a need for spinal arthritis relief and many people are finding it through regenerative therapies.
How does arthritis develop in the spine? What causes it?
Spine arthritis is inflammation and/or degeneration of the joints anywhere along the spine, and it can affect where the ligaments and tendons meet the bone (3). It occurs most commonly in the upper or lower spine (neck or low back) but can develop anywhere along the spinal vertebrae (3).
Research is still being done to determine all of the reasons that arthritis may develop. The most common type of arthritis that affects the spine is osteoarthritis, which is thought to be caused by injuries or wear and tear over time (3). Some people have autoimmune diseases, such as rheumatoid arthritis, which cause the body to attack specific tissues in joints (3). Other people experience different types of spondylitis, which can develop in tandem with conditions such as psoriasis or inflammatory bowel disease (3). Another category is called undifferentiated spondyloarthritis, in which symptoms don’t match any specific type of arthritis, but the pain and damage are very clearly arthritis-related (3). For patients whose arthritis isn’t obviously tied to an injury or autoimmune disease, we will look at past infections, other existing disorders, genetics, and age.
What are the most common symptoms of spinal arthritis?
Interestingly, a number of people with arthritis may not have any symptoms, especially if they have arthritis in their neck. For those that do experience symptoms, pain and stiffness are most often reported. Other common symptoms include (3):
Loss of flexibility or mobility
A feeling of “grinding” between bones when moving the spine
Pain, tenderness, swelling, or stiffness in other joints
What is regenerative medicine, and how can it help?
Regenerative medicine seeks to treat the root causes of any malady, whether it be an injury, disease, disorder, or simply due to time or age. Regenerative therapies bring non-surgical pain relief that lasts because they heal by creating living, functional tissue to replace or repair damaged tissue. Incredibly, if regenerative therapies are employed soon enough, they can bring real healing and pain relief that prevents the need for surgery.
This is amazing news, given that any form of invasive procedure or surgery on the spine is associated with high risks of adverse effects (4). Not only do regenerative therapies remove the risk of complications from the surgery, but they also remove the risk that comes with conventional pain management options that are used as a part of post-operative care. Painkillers such as NSAIDs and opioids can cause unwanted side effects, long-term toxicity, and addiction (4). Many patients and physicians are beginning to be quite wary of using opioids and NSAIDs, either to help with surgery pain or, for those who don’t require surgery, as a part of their long-term pain management plan.
Other conventional treatments for spine arthritis include steroid injections, physical therapy to improve muscle composition and flexibility, and lifestyle changes (such as improving posture, losing weight, or quitting smoking) (3). However, all of these treatments can vary in their effectiveness. Steroid injections, even if they do work, bring only temporary pain relief, because they aren’t able to fix the root cause (5). After about six months, patients find that their pain levels, stiffness, and reduced functionality are at about the same levels as they were before the steroid injections were first given. Additionally, steroids have a degenerative effect on soft tissues and cartilage that can actually cause progression of the underlying arthritic condition.
With that in mind, regenerative therapies are all the more appealing. They can be a very necessary help when it comes to treating arthritis of the back and neck, as well as healing the effects of chronic pain and accompanying symptoms.
Pulsed Electromagnetic Field Therapy (PEMF)
PEMF therapy is a revolutionary way to help heal chronic pain. Our bodies contain electrical currents, and a certain level of current means that we are healthy and our bodies are performing well. However, if those currents are disrupted or if our cell’s charge just isn’t optimal, we will be more prone to sickness, injury, and disease. Pulsed electromagnetic field therapy resonates a magnetic field over the site of pain or injury. The pulse interacts with cellular charge and metabolism, boosting our cells’ energy and helping them to function better (4). PEMF therapy can affect many different types of cells at once, which is good news when treating something as complex as an arthritic joint with muscles, tendons, ligaments, lining, and bone that may all need repair or energy changes.
PEMF has no negative side effects, and, according to many studies, is able to reduce pain intensity as well as improve mobility for those experiencing low back pain (6). It works specifically well for osteoarthritis, as many patients find that it improves pain and stiffness, and even allows for greater functionality (7). At Temecula Center for Integrative Medicine, we use PEMF in conjunction with all of our regenerative therapies in order to optimize and maximize healing.
Stem Cell Therapy
Stem cell therapy is the process of introducing ethically donated stem cells into the body. These stem cells disperse to areas in need of healing and recruit and optimize the body’s existing stem cells. These recruited, existing stem cells then work more efficiently to heal damaged tissues. Stem cell therapy has the potential to aid the healing of spinal arthritis by regenerating damaged or lost cartilage tissue and combatting further tissue degeneration (9). Additionally, stem cells create a strong anti-inflammatory response in the body, which is thought to be part of the cause of the great pain relief that this therapy can bring to those suffering from spine arthritis and back pain, according to multiple studies (2, 8, 9). They also release many different types of cytokines, which are growth factors that combat pain relief from many avenues (9).
Not only can stem cell therapies act to relieve pain, but they can also address the root cause of arthritis of the spine, which is tissue degeneration or malfunction. While some treatment plans work only to manage symptoms, stem cells offer the chance to halt degeneration and work to repair what is damaged. The trajectory is actual improvement, rather than hoping to minimize symptoms or simply keep arthritis from interfering more with day-to-day life as time goes on. And, although stem cell therapy is still considered experimental by the FDA, many studies have been done to determine the safety and efficacy of stem cell therapy, including its effect on arthritis, spinal arthritis, and back pain.
Platelet Rich Plasma
Another therapy that we offer is platelet-rich plasma (PRP) therapy, which harnesses the great potential of platelets, a component of our blood. These platelets contain many growth factors (similar to the ones that stem cells can release) which stimulate regeneration by kickstarting the body’s natural repair and healing process. We draw your blood, use a centrifuge to separate out the plasma and platelets, and then inject this mixture into the area affected by arthritis. It is an incredible option to relieve chronic pain and reduce inflammation and has been considered for many years an effective treatment option for osteoarthritis (10).
We have seen many patients with spinal arthritis find true healing and pain relief through these regenerative therapies. If you are suffering from arthritis in your spine, other types of arthritis, back or neck pain, or other bone- or joint-related symptoms, please reach out! We would love to discuss your current health, partner together to create a treatment plan, and help you find true healing - not just pain management! We look forward to hearing from you.
Jonathan Vellinga, MD is an Internal Medicine practitioner with a broad interest in medicine. He graduated Summa cum laude from Weber State University in Clinical Laboratory Sciences and completed his medical degree from the Medical College of Wisconsin.
Upon graduation from medical school, he completed his Internal Medicine residency at the University of Michigan. Dr. Vellinga is board-certified with the American Board of Internal Medicine and a member of the Institute for Functional Medicine.
Arthritis Foundation. (n.d.). Arthritis by the Numbers: Book of Trusted Facts & Figures. arthritis.org. 2019.
Diekman, B. O., & Guilak, F. (2013). Stem cell-based therapies for osteoarthritis: challenges and opportunities. Current opinion in rheumatology, 25(1), 119–126. https://doi.org/10.1097/BOR.0b013e32835aa28d
Spinal Arthritis (Arthritis in the Back or Neck). Johns Hopkins Medicine. (n.d.). https://www.hopkinsmedicine.org/health/conditions-and-diseases/spinal-arthritis
Elshiwi, A. M., Hamada, H. A., Mosaad, D., Ragab, I., Koura, G. M., & Alrawaili, S. M. (2019). Effect of pulsed electromagnetic field on nonspecific low back pain patients: a randomized controlled trial. Brazilian journal of physical therapy, 23(3), 244–249. https://doi.org/10.1016/j.bjpt.2018.08.004
Publishing, H. H. (n.d.). Back pain: What you can expect from steroid injections. Harvard Health. https://www.health.harvard.edu/pain/back-pain-what-you-can-expect-from-steroid-injections.
Andrade, R., Duarte, H., Pereira, R., Lopes, I., Pereira, H., Rocha, R., & Espregueira-Mendes, J. (2016, October 28). Pulsed electromagnetic field therapy effectiveness in low back pain: A systematic review of randomized controlled trials. Porto Biomedical Journal. https://www.sciencedirect.com/science/article/pii/S2444866416300514.
Iannitti, T., Fistetto, G., Esposito, A., Rottigni, V., & Palmieri, B. (2013). Pulsed electromagnetic field therapy for management of osteoarthritis-related pain, stiffness and physical function: clinical experience in the elderly. Clinical interventions in aging, 8, 1289–1293. https://doi.org/10.2147/CIA.S35926
MediLexicon International. (n.d.). Using stem cells to combat osteoarthritis. Medical News Today. https://www.medicalnewstoday.com/articles/324979#Stem-cells-and-osteoarthritis.
Burke, J., Hunter, M., Kolhe, R., Isales, C., Hamrick, M., & Fulzele, S. (2016). Therapeutic potential of mesenchymal stem cell based therapy for osteoarthritis. Clinical and translational medicine, 5(1), 27. https://doi.org/10.1186/s40169-016-0112-7
Mohammed, S., & Yu, J. (2018). Platelet-rich plasma injections: an emerging therapy for chronic discogenic low back pain. Journal of spine surgery (Hong Kong), 4(1), 115–122. https://doi.org/10.21037/jss.2018.03.04