Jul
18
2022

Stem Cell Therapy Is a New Way to Treat Osteoarthritis

By | Arthritis, back pain, chronic pain, osteoarthritis, Pain, regenerative medicine, stem cells

Traditional treatment for osteoarthritis is not very successful, but stem cell therapy is a new way to treat osteoarthritis.

Traditional treatment of osteoarthritis

Osteoarthritis is a common degenerative type of arthritis. Wear and tear are diminishing the hyaline cartilage that coats joint bones. The lubrication of synovial fluid is diminishing as well. The end result is that the patient suffers pain from bone rubbing on bone in affected joints with swelling of the synovial membranes. The physician usually prescribes diclofenac topical solution for the affected joints and also gives anti-inflammatory drugs by mouth (diclofenac or ibuprofen). Unfortunately, the patient may develop side effects of the anti-inflammatory medication, such as kidney damage and gastritis. The end result after years of suffering is that the joints turn stiff and the joint pain becomes unbearable.

Joint replacement surgery

This is when the doctor refers the patient to an orthopedic surgeon, and an artificial hip or a knee joint replacement is the next suggestion. These surgical procedures are not without dangers. Postsurgically blood clots can develop and cause pulmonary emboli. Infection and sepsis can also develop. Often the surgery does not solve all of the problems and leaves the patient with a permanent limp.

Stem cell therapy to treat osteoarthritis

Regenerative medicine has developed an alternative to the conventional treatment of osteoarthritis. I described this new approach to osteoarthritis before here.

Stem cells are harvested from fatty tissue of the patient and injected into the affected joint. Stem cell stimulators like platelet rich plasma and low-dose laser therapy activate the stem cells that were lying dormant in the fatty tissue. These type of stem cells are mesenchymal in origin, so they go by the name of mesenchymal stem cells. When injected into a joint with osteoarthritis they can transform into any tissue that is needed to repair the damage of the joint. A defect of the hyaline cartilage is covered by stem cells transforming into cartilage cells and fixing the hyaline cartilage defect.

What stem cells do

Stem cells fix any meniscal degeneration in the knee joint by mending what is degenerated.  They can form new tissue that over-bridged mini tears in the meniscus. If the synovial membranes that produce joint lubrication are damaged, the stem cells rejuvenate the old tissue and joint lubrication normalizes. The end result following stem cell treatment is that the osteoarthritic joint becomes regenerated with normal function. Stem cell treatment normalizes the osteoarthritic process in the joint, and down the road no joint replacements are necessary. This is a huge advantage in comparison to the conventional treatment of osteoarthritis.

My own experience with stem cell therapy for osteoarthritis of my left knee

I have experienced mild left knee arthritis for 5 years. It was not severe enough to treat with anti-inflammatory pills. I used higher amounts of fish oil capsules, which helped somewhat. I heard that Dr. Michael Weber from Lauenförde, Germany treats osteoarthritis with stem cell therapy.

He had treated my back successfully on several occasions in the past. I had previous stem cell treatment 4 years earlier as summarized here.  Part of this was stem cell therapy for my left knee. During the Covid time I could not go to the gym for a period of time. Instead, I went for long walks on a nature trail that was bumpy and had many roots. This flared up my previous problem with my left knee. But in early June 2022 I made my way back to Dr. Weber’s clinic for more stem cell therapy.

The following summarizes how he treated my left knee with stem cells.

Liposuction to harvest stem cells for treatment

The doctor used a local anesthetic to freeze the skin and subcutaneous tissue on the right flank. Subsequently a solution of normal saline that contained adrenaline and bicarbonate was injected. This allowed Dr. Weber to withdraw fatty tissue easier 20 minutes after the normal saline injection. The generous portion of fatty tissue harvested was brought to a cell separator, which separated stem cells, fat cells and connective tissue. The stem cells were counted by a technician. They were found to be 100% viable and there was a total of 980 million stem cells.

Intravenous stem cells

Dr. Weber administered one portion of the total stem cell harvest intravenously. I was told that this ensured that stem cells would be delivered to tissues that needed renewal through stem cell therapy. There are several methods to stimulate stem cells. One of these methods is to give oxygen intravenously with a device with the name Oxyven (from Swiss Medica) . This procedure took 20 minutes. A second method to stimulate stem cells is with low-dose laser therapy. Dr. Weber used intravenous red, green, blue and yellow lasers, for 20 minutes each.

The laboratory kept the rest of the stem cells overnight at room temperature. Dr. Weber told me that it would have been a mistake to keep the stem cells in the refrigerator overnight as the cold temperature kills all of the stem cells!

Targeted stem cell therapy

The following day I received treatments with my stem cells harvested the day before. The doctor drew blood up first, which underwent centrifugation. The interface between the red blood cell portion and the plasma contains PRP (platelet rich plasma). Dr. Weber mixed PRP in with the stem cells. PRP is a powerful stimulator of stem cells.

Dr. Weber inserted a needle into my left knee and injected stem cells (and PRP) into the left knee. Following this he inserted a thin sterile fiberglass applicator. This served to introduce four laser lights into the knee, namely red, green, blue and yellow low-dose laser beams. Dr. Weber connected each for 20 minutes. He explained that the laser light activates the stem cells, similar to PRP and to oxygen (Oxyven, Swiss Media).

Lower cervical spine, upper thoracic spine and lower lumbar spine also treated

I get monthly chiropractic manipulations to my spine to stabilize it. My chiropractor told me that it would help to have stem cell therapy in the C4 to T4 area of the upper spine and in the L4 to S1 region in the lower spine. Dr. Weber concentrated his treatments on exactly these levels of my spine. He placed interstitial needles over the facet joints bilaterally in the lower cervical spine, upper thoracic spine and lower lumbar spine. Subsequently he injected the stem cell/PRP mix and followed this up with the four laser lights for 20 minutes each.

Follow up after the stem cell treatments

There was a lot of swelling in my left knee during the first two days after the stem cell treatment. I also experienced pain with walking. But on the third day the swelling disappeared completely. After 1 week the previous mild left knee pain improved significantly. After 1 month the left knee no longer ached with stairs or uneven ground. Presently I am still completely pain-free. My back pain also disappeared within 2 to 3 weeks.

Stem Cell Therapy Is a New Way to Treat Osteoarthritis

Stem Cell Therapy Is a New Way to Treat Osteoarthritis

Conclusion

When it comes to the treatment for osteoarthritis, conventional medicine offers topical and oral anti-inflammatory medicine. Usually, the physician also recommends active exercises and heat applications by a physiotherapist. When anti-inflammatories no longer work and bone rubs on bone in a hip or knee joint, total hip or total knee replacement by an orthopedic surgeon is usually the next step. Unfortunately, these surgical procedures have a certain complication rate. They often do not lead to perfect end results with residual pain and possibly a limp

Stem cell therapy is usually not what a family practitioner recommends. But when the physician does stem cell therapy at an early stage, the success rate is good and as in my case you can always do another stem cell therapy to improve the knee or hip joint further. There are three procedures that help to stimulate stem cells: platelet rich plasma (PRP), intravenous oxygen (Oxyven, Swiss Media) and low-dose laser activation. In my case Dr. Weber applied all of these methods together with stem cell therapy. Improvement in my case was very rapid, and it was a delight to witness the result of stem cell therapy as a patient.

Oct
22
2016

Arthritis Drugs Can Cause Heart Failure

By | Arthritis, Cardiovascular disease, Heart Disease, Inflammation, osteoarthritis, Prevention

The British Medical Journal has published a research articles in Sept. 2016 showing that arthritis drugs can cause heart failure. This occurs particularly in elderly patients around the age of 77 years and older. This is an age where arthritis is often causing pain, and people regulate the pain with over-the-counter pills. These anti-arthritis drugs belong into the group of anti-inflammatory drugs, called NSAIDs. This stands for “non-steroidal anti-inflammatory drugs”. The study was entitled “Non-steroidal anti-inflammatory drugs and risk of heart failure in four European countries…”

Arthritis drugs can cause heart failure shows study

The researchers followed adult patients above the age of 18 who started 27 different types of NSAIDs between 2000 and 2010. There were 92,163 hospital admissions for heart failure; the controls consisted of 8,246,403 patients not taking NSAIDs. 4 countries shared in this study providing 2.2 million patients from the Netherlands, 7.5 million from Italy, 13.7 million from Germany and 11.1 million from the United Kingdom.

Results of study

NSAID use of up to 2 weeks prior to assessment had a risk of 19% of resulting in a hospital admission for heart failure. A control group of patients who had not taken NSAIDs for at least 6 months or more had no hospital admission risk.

Seven traditional NSAIDs led to hospital admissions for heart failure. They were: diclofenac (brand name Voltaren), ibuprofen (brand name Motrin), indomethacin (brand name Indocin), ketorolac (brand name Toradol), naproxen (brand name Naprosyn or Aleve), nimesulide (brand name Mesulid and many others), and piroxicam (brand name Feldene). In addition two COX 2 inhibitors, etoricoxib (brand name Arcoxia) and rofecoxib (brand name VIOXX) were also having the same side effects.

Different risks of causing heart failure for different NSAID’s

The risk for heart failure was not the same for every NSAID. The risks ranged from 1.16-fold to 1.83-fold. Specifically ketorolac had a risk of 1.83-fold, indomethacin 1.51-fold, piroxicam 1.27-fold, diclofenac 1.19-fold, ibuprofen 1.18-fold, and naproxen 1.16-fold. Translated into common language it means that ketorolac had a risk of 83% of causing a hospital admission due to heart failure. In the case of ibuprofen it was only an 18% risk.

Some NMSAID’s doubled risk for heart failure

The risk for heart failure doubled for diclofenac, etoricoxib, indomethacin, piroxicam, and rofecoxib when used at very high doses. Doubling the risk means a 200% risk. Typically, when an arthritis patient has a flare-up of pain, the patient increases the NSAIDs dose. The patients usually take the higher dose for a longer time. Some NSAIDs had a significant risk for heart failure even at a medium dose. This was the case for indomethacin and etoricoxib. The good news was that celecoxib (brand names Celebrex and Celebra) at usual doses did not lead to an increased risk of heart failure.

Dose-response curves for toxicity of NSAID’s (exception: celecoxib, brand names Celebrex and Celebra)

Dose-response curves were obtained where possible. Here the researchers looked at the effect of low, medium, high and very high doses of NSAIDs in patients. Again heart failure occurrence was studied among those patients. The result clearly showed that low and medium doses of NSAIDs were fairly safe, but high and very high doses of NSAIDs caused heart failure. Etoricoxib, Piroxicam and Rofecoxib were particularly toxic in higher doses. Indomethacin was toxic at medium and high doses. An important exception to the rule was celecoxib (brand names Celebrex and Celebra), which did not cause heart failure, either at low doses or high doses. This is one of the most used NSAIDs, so it is fortunate that it does not cause heart failure.

Discussion of study

The authors of this study discussed why they believe heart failure is developing in patients who take NSAIDs. They argued that NSAIDs inhibit prostaglandin synthesis and the enzymes COX1 and COX2. This is how inflammation and pain gets inhibited, which is a good thing. But at the same time blood supply to the kidneys is reduced, kidney function is impaired, and sodium is retained. This is a bad thing as it leads to fluid retention and fluid overload of the heart resulting in heart failure. As the prostaglandin inhibition is dose-dependent, the authors said this is the reason that the heart failure rate is also dose-dependent when measured in large populations, as was done in this study. A noted exception, as already mentioned, is the popular celecoxib, which does not cause heart failure, even at high and very high doses.

Arthritis Drugs Can Cause Heart Failure

Arthritis Drugs Can Cause Heart Failure

Conclusion

This publication has a lot of statistical power as it was based on research in 4 European countries. It also involved almost 10 million subjects. The researchers compared them to an equally large control population. Because of the size of the study population it was possible to calculate risk ratios for NSAIDs causing heart failure for 27 different types of NSAIDs. Furthermore, the authors succeeded in quite a few cases to calculate risk factors for different concentrations of NSAIDs used. This statistical method is called a dose-response curve. It is a powerful pointer to toxicity when high doses cause heart failure, but low doses don’t.

The physician can use the information from this publication to select one of the NSAIDs that is least harmful. This would be a drug like celecoxib (brand names Celebrex and Celebra). The physician would tell the patient to use the least amount possible to minimize side-effects. Many aging arthritis sufferers will benefit from this. Hopefully the FDA will review this material and shut down the use of some of the more dangerous NSAIDs or force the manufacturer to attach a black box warning about the drugs that belong into this category. You should review what your favorite NSAID is and discuss this with your physician. Perhaps print a copy of this review and take it with you to your health provider. He may not have heard yet about the study.

Jun
01
2005

Mixing Medications With Herbs Spells Trouble

By | Health, Prevention, Vitamins and supplements

It is generally accepted that prescription medications may have side effects, and there is also the belief that herbal medicines are more desirable, as they cannot possibly have dangerous side effects.
An anonymous survey of rheumatology patients in the United Kingdom shed some light into the use of over-the-counter herbal remedies: nearly half of the patients (40%) had used herbal remedies in the past six month in the hope of enhancing their health. Trouble started for one in ten patients who took an herbal remedy that could negatively interfere with their traditional medicines. Dr. Wendy Holden of the Nuffield Orthopedic Center in Oxford, the author of this study, reported that the risk is especially high for rheumatology patients who take anti-inflammatory drugs in combination with herbs. The traditional medicines do have a risk for gastrointestinal bleeding, however the additions of herbs like ginkgo biloba, ginger, devil’s claw and even garlic can increase the anticoagulant effect and bleeding may be the consequence. Some patients who reported the use of Echinacea were increasing the risk of a liver disease. Of those patients who took a potentially harmful treatment combination 92% were unaware of the risk. Less than half had mentioned to their physicians that they used herbal medications in combination with their prescription medications.

Mixing Medications With Herbs Spells Trouble

Mixing Medications With Herbs Spells Trouble

Herbal medicines are powerful and their effects and side effects have to be taken into consideration. It is important for the patient to mention every medication, even the seemingly harmless over-the-counter herbal remedies, to the treating physician, as the mix may be not a winning combination, but one that is hazardous.

Reference: The Medical Post, May 10, 2005, page 8

Last edited December 12, 2012