What is Neuropathic Pain?

Neuropathic Pain, also known as Neuralgia but much more commonly known as Nerve Pain, this is the sensation of;

  • Burning
  • Tingling
  • Numbness
  • Hot & Cold flushes
  • Pins and Needles
  • Electric shocks, and more;

These sensations occur when the neural system is impacted by injury or disease. The nerves within that system cannot work to transmit sensation to the brain. Neuropathic pain does not start abruptly or resolve quickly; it is a chronic condition which leads to persistent pain symptoms. Although neuropathic pain is often thought to be associated with diabetes or spinal stenosis, it can also occur due injuries to localised joints, the brain, and the spinal cord.

(Patient.info, 2017)

neuropathic

Is it Nociceptive or Neuropathic Pain?

Nociceptive pain

This is caused by damage to tissues. For example, a cut, a burn, an injury, pressure or force from outside the body, or pressure from inside the body (a tumour) can all cause nociceptive pain. The reason we feel pain in these situations is because tiny nerve endings become activated or damaged by the injury, and this sends pain messages to the brain via nerves.

Neuropathic pain

This type of pain is caused by a problem with one or more nerves themselves. The function of the nerve is affected in a way that it sends pain messages to the brain. In simple terms, neuropathic pain can occur without a correlating issue, whereas nociceptive pain occurs due to a current issue your body needs to address.                (Patient.info, 2017)

When it comes to treating patients with either disc bulges, disc herniations or neuropathic pain in general, their symptoms are the initial target which show improvements. This specifically relates to the level of pain the patient is suffering from.

How Do Stem Cells Treat Neuropathic Pain?

The SVF cells have the potential to;

  1. Target and fight off inflammation
  2. Repair damaged nerve cells
  3. Reduce FGF1, GFAP and TNFα expressed proteins
  4. Counter nerve cell death
  5. Differentiate to the matching tissue type (in this scenario: nerve cells)
  6. Soften scar tissue formation

(Condé-Green et al., 2016) (Wu et al., 2013) (Gibbs et al., 2015) (Jo et al., 2014) (Michalek, 2015) (Sacerdote et al., 2013) (Vickers et al., 2014) (Forouzanfar et al., 2017)

Inflammation is the common pathway for these cells.  When your body is not able to resolve new onset damage (acute inflammation), this can progress to chronic inflammation. Inflammation is good and bad; It is necessary for our bodies to identify areas that require repair but it can be destructive and slow down or stop repairs on a cellular level.

These stem cells are able to target and resolve the inflammation around the nerves which will restore normal function. Nerve cells which are damaged have the potential to be repaired; however nerve cells which are completely dead and not functional will not be inflamed, therefore they will not attract stem cells.

Additionally, by resolving the inflammation around the damaged nerves, this allows the resident neural stem cells around the area of damage to re-start the repairing process.

This has been confirmed with patient studies of Trigeminal Neuralgia.
(Vickers et al., 2014)

Further Published Documents

There have been many studies utilising Stem Cells in treating damaged nerves. This new study has provided us with strong results. Details are listed below.

Publication Date: 26th of September 2017
European Journal of Pain

Methods

The study has analysed adipose-derived mesenchymal stem cells (stem cells taken from body fat)  and fibroblast growth factor 1 gene on chronic constriction injury. This study utilised the von Frey filament, radiant heat and acetone drop tests.

The study observed;

  • Mechanical and thermal hypersensitivity
  • Histopathological changes
  • Apoptotic changes
  • FGF1, GFAP and TNFα protein levels

For further clarification: apoptotic changes or “apoptosis” is the death of cells which occurs as a normal  part of an organism’s development.

Results

Administration of these stem cells along with fibroblast growth factors reduced the mechanical and thermal hypersensitivity. Spinal structural alterations and apoptosis were decreased. Increased genetically engineered cells were counted in the injured sciatic nerve and the elevated levels of growth factors were detected in the spinal tissue. Stem cell therapy lead to a decrease in the level of the neuropathic pain induced TNF-α and GFAP protein levels. [1]

Conclusion

The intravenous administration of adipose derived stem cells could be considered as a potential treatment for the management of neuropathic pain.[1]

[1] Study Ref: Forouzanfar, F., Amin, B., Ghorbani, A., Ghazavi, H., Ghasemi, F., Sadri, K., Mehri, S., Sadeghnia, H. and Hosseinzadeh, H. (2017). New approach for the treatment of neuropathic pain: Fibroblast growth factor 1 gene-transfected adipose-derived mesenchymal stem cells. European Journal of Pain.

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