Stem Cell Therapy for Neck Pain
Table Of Contents
In 2011, football quarterback legend Peyton Manning flew to Germany to undergo stem cell treatment derived from fat for a career-threatening cervical disc problem. The details of his treatment were never disclosed, but it is known that Peyton had undergone three unsuccessful surgeries before opting for stem cell therapy. Remarkably, this regenerative treatment enabled him to return to play and subsequently lead the Denver Broncos to a Super Bowl victory in 2016. At age 39, he became the oldest quarterback ever to win a Super Bowl, showcasing the potential power of regenerative treatments. This example underscores a key principle: the best healing is achieved by amplifying the body’s own healing mechanisms.
Most neck pain is due to cervical vertebral instability or enthesopathy (microtears in the attachments) of the neck or upper back muscle attachments. Ligaments that hold the cervical vertebrae in alignment can be damaged by sudden trauma, such as a football tackle or whiplash injury, or through the slow stretching of ligaments known as creep, often caused by prolonged poor posture in front of a computer or overuse of a smartphone. Regardless of the cause, this instability needs to be corrected to prevent a degenerative cascade, leading to subluxation (instability) of the vertebral joints and subsequent damage to the discs.
Neck and upper back problems are fairly common presenting complaints in my practice. I often see patients who have chronic neck issues and have either had surgery or have seen an orthopedic surgeon who has recommended surgery. Surgery on the neck is scary and of course, very invasive. My personal success rate using stem cells/PRP is about 85% to solve 80% of the pain and return the patient to a normal lifestyle. As with any other region, the key first step is to make the right diagnosis of the primary pain generators. The only way to do this properly and prioritize the relevant pain generators in order of importance is with a thorough palpation interrogation exam of the whole region. MRI can be misleading and show many abnormalities including disc issues but as always, the key is to think in terms of stability. Even if the patient has had surgery on the neck I can still work with them. Surgical approaches are anterior and I do my injections posteriorly so I can still inject and avoid any metal.
The body can actually heal disc protrusions but you must stop the cervical / thoracic spine instability. In most cases this is readily achievable with stem cell/PRP injections in the correct places. In cases of severe instability, one or two primer treatments with dextrose prolotherapy may lay the groundwork for the stem cells and PRP to work optimally.
As with all stem cell cases, follow up is important. If I have a cervical spine stem cell case that comes back after 6-8 weeks and reports less than 50% improvement I will reexamine the patient and usually recommend a PRP booster to help and accelerate the healing. The stem cells remain alive for at least 4 or 5 months as they do their healing. If improvements are sluggish at 8 weeks, the patient may benefit from a PRP booster to reignite the stem cells.
Cervical Instability and Its Implications
Vertebral and facet joint instability in the cervical region is a major cause of chronic neck pain, headaches, migraines, vertigo, ringing in the ears, and other symptoms associated with cervicocranial syndrome. Properly administered Regenerative Injection Therapy is the treatment of choice and offers a safe and effective option for resolving neck pain. By strengthening and tightening the ligament and tendon attachments in the neck, regenerative therapy addresses the root cause of instability.
A comprehensive treatment approach is necessary, targeting all surrounding ligamentous structures of the neck that may have been under additional stress. For severe degeneration, stem cells and PRP are generally used. For less severe damage, PRP or prolotherapy alone may be sufficient, though several treatments may be needed for complete healing. Stabilizing vertebral motion helps cervical discs recover and relieves any potential impingement on the cervical sympathetic ganglion, alleviating associated symptoms.
Importance of Levator Scapulae Attachments
In all cases of neck pain, it is crucial to check the levator scapulae attachments on the superior medial border of the scapulae with palpation interrogation. These attachments are very commonly damaged in association with neck injuries such as whiplash and they are also prone to degeneration due to poor posture. No matter the cause, they can become important pain generators. The good news is these tears and microtears at the attachments are fairly straightforward to be healed with stem cells and or Prolotherapy.
Mid-Back Pain: Addressing the Thoracic Spine
Mid-back pain, often overlooked in discussions of back pain, typically arises from thoracic vertebral instability or weakness at the costovertebral or costotransverse joints. A thorough palpation exam can usually identify problematic structures. I recently saw a patient with previous neck surgery who continued to have significant neck pain. The surgeons were talking about revision (another surgery) but on a palpation interrogation exam the patient had nothing that stood out with the cervical region but he did have significant “jump signs” in the thoracic spine. The patients major pain generators were in the thoracic spine, not the cervical spine area. In other words, the doctors had not correctly diagnosed the real root-cause of the problem and assumed the problem was further breakdown in the cervical region.
Don’t forget, due to biotensegrity, everything is connected. Where you feel the pain may not be where the root of the problem is located. Pain in the neck/upper back region can often be referred and a doctor needs to do a complete exam to properly diagnose the underlying root-cause of the problem. I am pleased to report that the patient above had a successful stem cell procedure that solved at least 80% of his pain.
Whiplash
Traumatic neck injury also known as “whiplash” is actually pretty common. Generally speaking, it is poorly understood and inadequately treated by the medical field. Inadequately treated whiplash injuries end up causing chronic headache, shoulder stiffness and arm pain in many patients. Because MRIs often miss the microtears in connective tissue which are far and away the root cause of the problem, in the past patients have been often accused of using whiplash for secondary gain and sent for psychological assessment. In my opinion, the majority of these patients have a serious problem but doctors don’t really understand ligament and tendon injuries and hence miss the true cause of the problem.
MRI is much better than x-ray in assessing whiplash but still falls short in a few critical areas (sound familiar?). Although an MRI may pick up a disc problem, as we have seen in other areas of the body, it fails to identify microtears at key ligament and tendon attachments and the attendant instability. These loose connective tissue structures leads to vertebral instability, which can pinch nerves and cause secondary muscle spasm as the supporting musculature attempts to splint and stabilize the area.
The second major shortcoming of MRI is everything is connected. Whiplash usually not only affects the cervical spinal and facets but also involves the shoulder and scapular structures. A proper treatment has to evaluate the whole area and regenerative injections need to be directed to all the weakened structures in the area that cause instability. That would include the suboccipital attachments on the skull, cervical facets, the vertebral capsules themselves, the levator scapulae attachments and other shoulder structures which help carry the load of the head. Remember, the head is like an eight pound bowling ball which is connected to the body through the neck.
So, how can we be more successful treating whiplash? Regenerative approaches should be the treatment of choice for this type of injury. As we have discussed throughout, small targeted injections of your own stem cells, PRP and Prolotherapy are the only way to regenerate microtears and rebuild damaged ligaments and tendons, which are at the heart of problem. As with other areas in the body, the key is to identify instability. If the cervical vertebrae are allowed to sublux this leads to nerves being pinched and muscles going into spasm to try and splint the area. Whether a patient decides to use stem cells and PRP or Prolotherapy depends on the severity of the injury and the timeline desired. Stem cells will be stronger and faster to heal an area but four or five Prolo primer sessions may very well achieve the same results, especially if the patient is younger and the damage not too severe.
As with the other areas we discuss, a good regenerative doctor should use palpation interrogation on the whole neck, upper back and shoulder region, properly identifying all the structures that are damaged. For example, very often involved are the levator scapula attachments on the scapula and the anterior coracoid ligaments on the coracoid process of the shoulder. Again, the whole circuit needs to be tested with palpation interrogation and injected with stem cells and PRP or dextrose solution primer to assist and accelerate healing and repair. In some cases, patients may need a PRP booster after stem cell PRP therapy or two or three Prolo boosters before the structures are strong enough and pain is relieved. Some patients may have immediate improvement and others may take four or six weeks before symptoms improve. Healing is a process that works differently, with different timelines in each patient.
TMJ sprain and arthritis
The temporomandibular joint (TMJ) is the hinge joint at the jaw that we use to eat and chew. If the TMJ syndrome is mild, patients notice intermittent pain in the joint in front of the ear or in the muscles around the joint when talking or chewing. The joint has four key components: the cartilage which cushion the bones where they meet, a meniscus disc, which acts as a spacer and guides the opening and closing of the jaw. Like any other joint in the body, the cartilage or spacer can be injured or become damaged due to wear and tear leading to painful arthritis. The next key component of the joint is the muscles that help to move it. These are powerful muscles that can develop trigger points like any other muscle—areas that are shut down and painful. These muscles also have tendons that attach to bone, so these areas can develop tendinopathy—or small tears and degeneration which can cause them to become painful. The final component, which is often overlooked by TMJ experts are the ligaments that stabilize the joint. Ligaments stabilize the joint by acting like pieces of tape that guide it and prevent motions for which it wasn’t designed. In addition, there is a tough ligamentous covering of the joint called the capsule.
Most TMJ doctors focus on the TMJ itself, forgetting that it’s a joint that lives in the ecosystem of the head and neck and can only work properly in concert with neighboring structures. Neck problems place more pressure on the TMJ joint and vice versa. In addition, if the neck is unstable because its ligaments have been injured or the small muscles that stabilize it are out of kilter, then the body attempts to use the TMJ muscles as accessory stabilizers of the neck. Given that the joint and its muscles aren’t designed to handle these extra loads, it eventually breaks down, and the muscles get overwhelmed.
A proper regenerative approach would inject the capsule of the TMJ but also assess the neck muscles and ligaments to try and heal the whole circuit. Using palpation interrogation, once we have identified the key structures that are damaged the patient can discuss with their doctor if they want to proceed with stem cell/PRP for a faster resolution or start with a Prolo primer and proceed incrementally.
Stem Cell Therapy for Neck Pain Recap
Most neck and mid-back pain can often be traced to issues of instability in the vertebral joints and their associated ligaments and tendons. Stem cells/PRP and Prolo is the treatment of choice for most patients and should be considered by all patients with significant issues and should definitely be carefully considered before pursuing surgical approaches.
As always it behooves patients to find an experienced regenerative specialist who can make the right diagnosis of the primary pain generators and inject them properly with the right kind of stem cells, properly prepared and follow up the patient with PRP boosters as required.
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