Too Good To Be True?
Some doctors are touting the benefits of using patients' own stem cells to heal injuries and relieve pain. But is the science there to back it up?
“We do a lot of biking and play a lot of tennis,” she says. “My knee kept bothering me and bothering me.” In 2012, Ibrahim treated her with injections of peripheral blood stem cells, found in the bloodstream, and PRP injections. Afterward, she was able to return to her active ways.
She says she has referred many people to Ibrahim, including a son who does a lot of climbing and has problems with his knees. Blumberg says he’s also doing better.
Aren’t patients such as Kevin Griffiths and Ina Blumberg evidence enough that the injections work? Robey says that while patients might say they feel better after treatment, there’s no evidence that the shots deserve the credit.
“It’s like science fiction,” Robey says. “One, there’s a huge placebo effect.” Patients regard stem cell therapy as cutting-edge medicine, so they think it must work, she says.
Griffiths counters that the placebo effect can’t explain why he feels better five months after treatment. “At some point,” he says, “the placebo effect goes away, and that has not happened.”
But, Robey says, the intensity of osteoarthritis fluctuates over time: “I have it myself in my hands. I’ve got good days and I’ve got bad days.”
Plus, most people who seek stem cell injections also try a variety of other treatments, any of which might make them feel better, Goldstein says. Griffiths, for example, is undergoing physical therapy and taking a dietary supplement that contains turmeric—a plant best known as the main spice in curry—which is thought to have anti-inflammatory properties.
Besides, Robey says, sometimes people are simply reluctant to admit that an expensive treatment didn’t work.
Norman Nicholson, who has also been treated by Friedlis, isn’t sure why his knee pain went away after getting stem cell injections.
“I fully understand why insurance doesn’t cover it,” says the 77-year-old Nicholson, a Silver Spring resident. “I’m well aware, as [Friedlis] is, that there is no clear clinical evidence in humans about A, whether this works reliably, and B, whether the specific techniques that are being used are the correct way to do it. The question is: Have they got it right? My case doesn’t prove that.”
Four years ago, a surgeon recommended knee replacement surgery for Nicholson. “I had developed quite a bit of pain in my left knee,” he says. “It was getting increasingly difficult for me to keep up with my exercise routine and do the sports things I wanted to do.”
A retired university professor and former USAID employee, Nicholson skis, figure skates, hikes and works out. Like many of Friedlis’ patients, he worried about the risks of surgery and how an artificial knee might prevent him from participating in some of his favorite activities.
He’d heard good things about Friedlis from one of his wife’s physicians, and made an appointment with him in the spring of 2012. He first tried three PRP injections, which he says led to a great improvement, but he still wasn’t where he wanted to be. So he and Friedlis decided to proceed with a stem cell injection that fall.
The lack of scientific evidence concerns him, Nicholson says, but he believes the procedure is relatively low risk: “The scariest thing he does is when he puts the needle in your hip to withdraw bone marrow,” Nicholson says.
He figures the stem cell injection has bought him at least two more years of skiing that he might not have had if he’d gone right to knee replacement surgery. He went cross-country skiing Presidents’ Day weekend in 2013, and a year later he skied downhill, although he stuck with cross-country skis to take the turns slower and subject his knees to less twisting.
By early last fall, however, Nicholson began to feel a little tenderness in his knee and received another PRP injection. “I’m doing a substantial amount of what I want to do, and I’m not in pain,” he says. “Something’s better, and if it’s all in my head, it’s cheaper than a shrink.” n
A former medical writer for USA Today, Rita Rubin lives in Bethesda and frequently writes for the magazine. To comment on this story, email email@example.com.
Editor's Note: This story has been updated to make some clarifications and a correction. In the original version, the story incorrectly said that Dr. Friedlis was wearing a shirt embroidered with the words "StemCell Arts." The shirt actually was embroidered with "National Spine and Pain Centers," a pain management practice that owns StemCell Arts.