© 2016 CAPRI Central Alberta Pain & Rehabilitation Institute

Frequently asked questions

What exactly does BMAC (stem cell) therapy do? Can stem cell therapy grow new cartilage in my joint(s)?

Numerous animal studies have shown small amounts of immature cartilage regrowth as a result from stem cell therapy in small amounts. You are likely wondering, "If there isn't much regrowth, why are people claiming to get significant pain relief from treatments?". Recent literature suggests the reason for a patient’s reduction of pain and symptoms in areas treated may have more to do with a long-term anti-inflammatory response from stem cell injections and less to do with cartilage regrowth. Also, we find hematopoietic stem cells in bone marrow and these cells are included in the stem cell injections. Hematopoietic stem cells can initiate angiogenesis, which is the formation of new blood vessels. This is important because intra-articular joint spaces do not receive much blood flow. The formation of new blood vessels in areas of chronic degeneration may help those areas become more effective at healing themselves.

Will BMAC work for me even though I’m “bone on bone”?

Yes. Often, the root cause of osteoarthritic pain is from chronic inflammation. BMAC therapy is

thought to reduce chronic inflammation. We have successfully treated many patients who were

considered “bone on bone”.

Do you use stem cells derived from adipose (fat) tissue? Do you culture the stem cells?

No.  We use Mesenchymal stem cells derived from bone marrow.  Our method was derived after careful thought and consideration of many factors.  One of the main reasons we do not use adipose derived stem cells is because there is some uncertainty around whether the FDA/Health Canada will eventually rule that stem cells derived from adipose tissues is a drug due to the chemicals that must be added to the aspirate to isolate the stem cells. If that ruling comes, there are lengthy drug trials that would be required to offer the injections again. Mesenchymal stem cells from bone marrow are well researched and require no chemicals to isolate them. 

What kinds of injuries/diseases do you treat with stem cells?

Our team treats any injuries and degenerative diseases, like osteoarthritis that affect the musculoskeletal system.  This includes muscles, joints and connective tissue such as tendons and ligaments.

How long will the procedure take?

Approximately one hour.

How long until I will experience pain/symptom relief?

Depending on how you respond you may experience pain relief as soon as a few weeks after treatment. However, most patients notice significant pain relief between 2 and 4 months after the procedure.

How long is the recovery period?

The injected area may become inflamed and more painful than normal for a few days to a week. After this period, your pain should subside to the levels you felt prior to the procedure. Most of our patients start to see a reduction in pain in months 2 or 3 with maximal relief by month 6. Remember, we are using your stem cells to incite a natural healing response, which takes time. 

Is the procedure painful?

People experience varying degrees of discomfort but we endeavour to make you as comfortable as possible. We will freeze the back of the pelvis where we will take your bone marrow and you will feel limited pain when we introduce it. When we aspirate the bone marrow, there can be some discomfort. People have described the sensation as a deep cramp in their pelvis. This part of the procedure only lasts for a couple minutes. When we inject the stem cells back into you, there is some mild discomfort in the joint space, and moderate discomfort if we are injecting into a tendon or bursa. 

Am I administered anesthesia?

No, but we do offer Ativan prior to the procedure to calm you and can make Entonox (laughing gas) available during the procedure at your request. 

What is your success rate?

We’ve found our average patient notices 76% pain relief six months after the procedure.  Roughly 80% of the stem cell procedures we perform are successful.

How do you define if a procedure is successful?

We consider a procedure successful if a patient experiences at least a 50% reduction in pain/symptoms.

Do I need a referral from my doctor?

Yes. A referral is strongly recommended because we want your doctor to be aware of the treatment you are receiving from us. Also, through a referral, your doctor can also provide us with important medical information that can help us deliver better patient care.

 

If you are unable to get a referral from your doctor please call the clinic and we can discuss some options with you.  

Will I need to schedule a consult before the procedure?

Yes.  We require an in-house consult that will take approximately 30 minutes.  The consult involves a review of your health history as well as a physical assessment to identify any areas that may benefit from stem cell therapy.

I am traveling a long distance, may I schedule a consult and procedure for the same day?

Unfortunately, no. The initial assessment is where we confirm whether you will benefit from the treatment or not. If we book you in for an assessment and procedure on the same day and it ends up that a regenerative procedure wouldn't benefit you, we will have an open spot in the schedule that we won't be able to fill. If you are travelling out of province, we will typically book you in for the procedure the following day and have discounted rates with Microtel Inn & Suites in Blackfalds (10 min. drive), and Best Western Plus Lacombe Inn and Suites if you plan to stay overnight. Be sure to mention CAPRI Clinic when booking a room.

 

How long do I have to wait after a cortisone injection?

Cortisone will interfere with stem cell therapy, thus, you will have to wait three months after a cortisone injection to receive the therapy.

 

Can I take anti-inflammatory pain relievers?

We ask that you stay off anti-inflammatory medication (Advil, Aleve, Ibuprofen, Motrin, Aspirin) one week before and four to eight weeks after the stem cell therapy. For this procedure to be effective, we need the inflammation that will take place following the procedure to run its course. Tylenol and Tramadol are OK.  If unsure about any of your medications please contact your pharmacist.