Q: Are stem cell injections a good idea for treatment of sciatica due to a herniated disc?

A: Yes and no.

Epidural stem cell injections for herniated discs are considered both an experimental and controversial treatment option. I am not aware of any scientific evidence to support their effectiveness, and their safety and long-term outcomes were not well-established at that time.

But it is a great idea.

I will tell you why. In theory herniated discs can cause pain and discomfort due to pressure on nerves in the spine. However, in my experience as a neurosurgeon the real pain from a herniated disc is in cases where there is a lot of inflammation. Growth factor and stem cell injections are about guiding inflammation toward the healing side. So, the approach is both logical and hopeful.

You cannot help but notice that epidural steroid injections, where corticosteroids are injected into the epidural space, are temporarily effective in managing sciatica pain from herniated discs. In theory growth factors would be even better.

It is important to note that stem cells do not do anything. The hope of the “stem cell” approach is that the growth factors inside stem cells will have a good effect. We know that because cells lyse (blow up) when they are injected. There are presently amnion derived growth factors for injection available. Any pain management doctor could inject them through the same approached used for transforaminal epidural injection.

BUT again, the use of stem cells for herniated discs had not been thoroughly studied, and there were concerns about the safety and effectiveness of this approach.

If you or someone you know is considering epidural stem cell injections for a herniated disc, look online for a pain management doctor who meets Best Practice Certification for epidural injection but is interested in amnion derived growth factor injection. I would not consider interlaminar injection but would try transforaminal as well.