July 10th 2018 | article by Richard Lowes
There are times when stem cell related therapies would seem to be the panacea for all ills, but could stem cell therapy soon become commonplace in relieving the symptoms of CRPS? As we discuss below, if you have the hard cash, there are already private clinics offering the treatment.
San Francisco research
We have considered previously the work being undertaken at the University of California, San Francisco, into using stem cells to overcome the neurological effects of peripheral nerve damage, including pain. Their method involves transplanting into the spinal cord, Cortical GABAergic Precursor Cells, which are derived from stem cells.
In the words of their research lead, Professor Allan Basbaum, this study “is revealing an entirely new perspective on the circuits that process the injury messages that generate acute and persistent pain and on novel approaches to therapy.”
Professor Basbaum describes neuropathic pain as “a disease” of the central nervous system. Nerve damage causes pain and to alleviate it, the nerve damage must be treated. Traditional drug therapies, he says, often provide only a temporary benefit and usually go hand-in-hand with side effects, which in themselves impact tremendously on a person’s quality of life. In repairing nerve damage through stem cell therapy, their approach is entirely different. Their research suggests that following the transplanting of stem cell, neuropathic pain is decreased without side effects.
In addition to CRPS, among those conditions which he believes may in due course benefit from stem cell therapy are Trigeminal Neuralgia and Multiple Sclerosis. However, whilst the results in San Francisco have been encouraging, they have yet to reach the human trial stage.
In the meantime, a human case study from Pennsylvania involving stem cell therapy for the treatment of CRPS, has been published in the American Journal of Thermology. The author reports that:
“A female Registered Nurse presented to the our clinic with a chief complaint of left lower extremity pain after suffering from a complex, medial malleolar fracture that required operative repair and internal fixation. Post-operatively she experienced allodynia and was diagnosed with CRPS/RSD. Despite many months of aggressive therapy she was still unable to ambulate with any weight bearing on the left leg. In addition to using a knee scooter for mobility she had clear trophic skin changes. Both vaso and sudomotor findings were present.
“As a result of the findings local injection including posterior tibial nerve block, sciatic nerve block, lumbar epidural steroids, and L5S1 facet region injections were tried. Blocks were followed with proliferative injection into the medial deltoid and tibial-calcaneal ligaments. Medication changes including the addition of clonidine to aid in vasodilatation, non-narcotic analgesics, and muscle relaxers. Nutritional recommendations were made and restorative therapy was prescribed. Variable success was achieved.”
Following discussion, a decision was taken to proceed with stem cell therapy. Cells were harvested from her hip and transplanted into her calf, with a platelet rich plasma (PRP) booster given 30 days later. The results were reported as follows:
“At two week follow up trophic skin changes already showed signs of lessening. The patient had also begun to weight bear on the left leg and reported less allodynia. By the time the 30 day PRP booster was performed she was no longer using adaptive aids to walk however compensatory gait persisted. Six weeks after the stem cell procedure trophic skin changes, sudo and vasomotor instability, and allodynia had dramatically improved.”
Interestingly, a quick internet search reveals that a number of private clinics have wasted no time in offering stem cell therapy for CRPS, one of them citing this recent case study. Whilst, understandably, this will be of huge interest to anybody suffering the torment of CRPS, it must be remembered that, certainly as far as CRPS is concerned, stem cell therapy remains a largely experimental treatment. There do not seem to be any recognised treatment protocols in place.
Also, the facts available from the Pennsylvania case study indicate that the subject’s CRPS had remained localised in the lower part of her left leg. That does beg the question as to just how effective stem cell therapy might prove to those whose CRPS has spread elsewhere in the body.
Clearly, there’s a great deal of optimism for stem cell therapy going forward, but perhaps the outcome of more wide-ranging human clinical trials is needed before it’s considered a mainstream ‘fix’ for CRPS.
Source: article published with permission of BLB Solicitors