How can stem cells fix a disc?

A low back disc is made up of an inner part which is filled with a gel like substance (NP- nucleus pulposis) and an outer part which acts as a layered, tough fibrous container for the gel (AF- annulus fibrosis).  The problem is that as we age, the gel dries out because the cells that make the gel start to die off.  As this happens, the disc becomes a poor schock absorber.  In addition, the whole structure can weaken and the gel can bulge out through the tough outer covering.  The problems start when the bulge starts to press on a nerve causing sciatica.  Surgery can weaken the disc by cutting out parts of the outer covering, which leaves less of the tough fibrous annulus to contain the dried out gel.  Is there a better way?  Yes, we’ve demonstrated that your own stem cells injected into this disc using a special procedure (Regenexx procedure) can in fact make the disc bulge smaller (by repairing the tears in the annulus).  In addition, we’ve also seen evidence on MRI of the inner part of the disc regaining the ability to hold onto water and becoming a shock absorber again.  The FDA has taken a funny position on your own stem cells.  In the interim, you can use your own cells to fix your back!

Can Knee Surgery Lead to Lumbar Spine Pain?

Can knee surgery lead to lumbar spine pain?  As a spine doctor, I think the question should be the other way around: Can low back pain lead to knee pain?  Why?  Everyday in the clinic we see patients with knee pain who really have a back problem and nothing wrong with their knee.  Many of these patients get surgery due to an incidental finding on an MRI showing a meniscus tear.  After the surgery fails to help, they notice their back hurts.  Since it was their back that was causing the knee pain in the first place, it’s not a stretch to see why their back eventually hurts.  How is this possible?  Meniscus tears in the knee are normal findings in 60% of the patients.  Yes, that’s right, 6 in 10 patients with meniscus tears in their knees have something seen on MRI that is normal and not causing their pain. 

How do I really know this to be true?  Besides seeing patients everyday like this, I am a fellow low back-knee patient.  Ten years ago at a medical conference I did allot of sitting and all of sudden my knee hurt.  I limped around the office for months, got an MRI which was thankfully normal (or I would have had an unnecessary surgery) and was miserable.  It wasn’t until a bright medical provider treated my back that my knee pain went away.  When he first suggested my back was leading to my knee pain, I thought he was crazy because my back didn’t hurt. 

How does this happen?  The upper lumbar nerves (L2, L3, L4) refer their pain to the front of the knee and thigh muscle.  In addition, SI joint pain can also refer in that same area.  My own experience with chronic intermittent L5 and S1 pain tells me that S1 refers pain to the back and outside of the knee that can at times travel down to the outside of the ankle and that L5 goes to the outside (sometimes inside) knee that can also at times go down to the big toe. 

Look at the low back nerve map below (dermatomes).  Follow the L2, L3, L4 nerves down to the thigh area.  Follow L5 to the outer knee. 

Can knee surgery lead to lumbar spine pain

So when you have pain in your knee and your back hurts, don’t believe the MRI until your back is ruled out as a cause.  And yes, changes in walking style and bio mechanics can lead to low back pain when you have a bum knee, but it’s usually the other way around.  I’ve posted two videos below that might be of interest: