Chronic low back pain is a common condition that can significantly reduce the quality of life. The degeneration of the intervertebral disc is one cause for low back pain, and there is no therapeutic intervention that effectively reverses this type of degeneration. Both non-surgical and surgical treatments that are currently used for chronic low back pain aim to help the symptoms associated with the condition but do not address the underlying cause. Recently, however, researchers have begun to explore the ways in which stem cells may be used to help regenerate the intervertebral disc to restore functioning and eliminate low back pain over the long-term. A review of the relevant literature was recently published in Translational Pediatrics.
The intervertebral disc does not have a large potential to regenerate itself, so it is a challenge to find the best cell sources to facilitate such regeneration. Adult mesenchymal stem cells, which are found most often in bone marrow and also in fat, or adipose, tissue are attractive candidates for this type of regeneration given their high capacity to proliferate and to differentiate into different types of cells. In addition, they can self-renew, are highly accessible, and unlike some other types of stem cells, there are no ethical issues associated with their retrieval.
Given the success of mesenchymal stem cell transplantation in preclinical studies of intervertebral disc degeneration, the use of these cells has progressed to clinical trials. Autologous bone marrow mesenchymal stem cells – meaning stem cells taken from the bone marrow of the patients themselves – have been reported in the treatment of disc degeneration in patients with leg and back pain. Reduced pain has been observed at one and two years after transplantation. Importantly, the clinical trials investigating the use of stem cells in intervertebral disc regeneration have provided evidence that the relevant procedures are not only effective but also clinically safe. Future research will help to clarify if and how these and other types of stem cells may be used to reverse intervertebral disc regeneration and the associated chronic low back pain.
Reference: Wei, A. et al. (2014). Mesenchymal stem cells: potential application in intervertebral disc regeneration. Translational Pediatrics, 3(2), 71-90.
Multiple sclerosis (MS) is a debilitating neurological condition. MS causes nerve cells to become dysfunctional. The symptoms of multiple sclerosis vary from person to person and over time; however, one of the most common symptoms of MS is muscle spasticity. More than 80% of patients with MS have some degree of muscle spasticity.
Muscle spasticity causes increased muscle tone. Affected muscles contract even though the person is not trying to contract them. Patients may also experience uncontrollable muscle jerking and spasms. These muscle contractions can be quite painful and interfere with daily activities. In fact, about one in 20 multiple sclerosis patients with muscle spasticity are completely disabled because of it.
It can be difficult to treat muscle spasticity in patients with multiple sclerosis. Physicians may prescribe baclofen, tizanidine, or dantrolene for muscle spasticity; however, these treatments are only mildly effective and may cause troubling or serious side effects. Baclofen may cause muscle weakness, tizanidine may cause severe dry mouth, and dantrolene is toxic to the liver, for example. Researchers are continuously looking for ways to help multiple sclerosis patients to reduce muscle spasticity.
Cannabinoids are the biologically active chemicals found in the cannabis plant. Cannabinoids have been used successfully for various medical purposes. For example, these agents have been used to treat nausea caused by chemotherapy and to stimulate appetite in patients with cancer. Patients with multiple sclerosis have reported that hemp extract helps relieve symptoms. Moreover, research studies have shown cannabinoids can protect nerve cells against damage. Based on these findings, researchers conducted a clinical trial to study the effect of cannabinoids on muscle spasticity in patients with multiple sclerosis.
A total of 630 patients with multiple sclerosis and muscle spasticity received the hemp extract or placebo for 15 weeks. The researchers then performed a number of objective tests to assess muscle spasticity. Patients who received the cannabinoids had fewer symptoms and less muscle spasticity at the end of the clinical trial compared to patients taking the placebo. The greatest benefit appeared after 40 weeks of treatment. Indeed, patients felt that cannabinoids helped manage their condition. Importantly, no major safety concerns were reported.
These clinical trial results suggest long term cannabinoids treatment is safe and may help people with Multiple Sclerosis control symptoms of muscle spasticity.
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Reference: Zajicek et al. (2005). Cannabinoids in multiple sclerosis (CAMS) study: safety and efficacy data for 12 months follow up.Journal of Neurology, Neurosurgery, and Psychiatry. 2005 Dec;76(12):1664-9.