We apologize in advance to the engineers, we know you’re going to hate this answer. While stem cell therapy likely will reduce your pain and increase your activities of daily living and quality of life, it most likely will not lead to improvements in your X-ray or MRI. And we’re OK with that. To us, success is being able to normally walk down a flight of stairs, keep up with the grandkids, or go surfing. We really don’t care about the before and after pictures.

In the evaluation of pain, we consider “the subjective” and “the objective”. The subjective is the pain the person reports and the objective are “the pictures”; the diagnostic imaging such as X-ray and MRI. You would think that the two would be directly correlated; the worse the pictures, the worse the pain. But it turns out, it has been proven they are not directly correlated. What this means is how bad the pictures look, does not predict how much pain the person reports. There have been conducted large, scientific studies looking at people with no back pain, and they frequently have abnormal spine MRI’s. We see it all the time in the clinic when we X-ray knees; frequently, the one that looks like “the bad one” doesn’t hurt much, and the one that looks like “the good one” is excruciating. Just because it looks bad, doesn’t mean it’s painful and just because it looks normal, doesn’t mean there’s no pain. How is this? We can think of our bodies in terms of macro-environments and micro-environments. Macro-environment is anatomy that shows up in X-ray or MRI (bones, joints, ligaments, tendons). Micro-environment is the microscopic anatomy that cannot be seen on X-ray or MRI, such as tiny nerves, tiny blood vessels, and collagen fibers. Macro-environments are not the pain generators. Micro-environments are the pain generators. When we inject stem cells into an area, we are treating the micro-environment by growing robust collagen and healthy blood vessels, but most often, we are not altering the gross anatomy.