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Regenerative medicine is broadly based on the body’s essential ability to heal itself, by supplementing the innate repair mechanisms with homologous or autologous biologic agents. Regenerative therapy shows a great amount of promise in improving musculoskeletal conditions and providing patients with an effective treatment option for their chronic pain. One such biologic agent is platelet-rich plasma (PRP), a concentrate made from whole blood centrifuged to remove red blood cells, which contains a variety of growth factors. Four types of PRP can be formulated, depending on the white blood cell counts and fibrin architecture. PRP has demonstrated the most efficacy in treating inflammatory states, such as arthritic conditions. Mesenchymal stem cells (MSCs) are another currently available biologic agent. MSCs are unspecialized progenitor cells, capable of division and self-renewal for long period of time, and can give rise to specialized cell lines. Their medicinal potential is based on their ability to secrete bioactive factors that promote tissue healing, and ability to induce endogenous stem cell activity. The differentiation of MSCs is susceptible to local paracrine influence, and low levels of inflammation are necessary to achieve desired anabolic regenerative effects. As a result, MSCs are most effective in degenerative diseases, such as repair of bone and cartilage in discogenic disease and osteoarthritis. Current literature establishes biologic agents as a cost-effective approach, more beneficial than standard, non-interventional care, and guidelines suggest they be considered upon initial failure of conservative therapy. Several contraindications are known, and must be acknowledged, including blood dyscrasias, infections and malignancy. Potential adverse events include infection, tissue rejection, and transient worsening of the pain. Interventional pain guidelines specifically have recommended that it be used independently or in conjunction with other treatment modalities, following diagnostic evidence of a need for biologic therapy. [ABSTRACT FROM AUTHOR]

Preclinical and clinical pain related science have since long suffered from lack of joint ventures that, as securely as possible, have approached problems that are relevant for the understanding of clinical pain phenomenologies and treatment (Yezierski & Hansson, 2018), the core of translational pain medicine. The uncoupling of the two has led to loss of momentum and few novel efficacious treatment remedies where needed the most, that is, in long-term pain states. Here, the area of translational pain medicine is craving for a road map so that preclinical and clinical scientists can walk hand in hand into the future with a common agenda on how to approach the search for much needed improved treatment strategies.Perhaps it would be timely to make a full stop to get peer agreement on guidelines recommending how to move on regarding choice of animal models, relevant testing procedures, etc., to optimally explore neuropathic pain conditions for the benefit of the pain suffering patients. To keep doing what has been largely unsuccessful for decades seems to be a waste of animal lives, funding and hard labour by dedicated colleagues. To create a novel and hopefully more successful approach in agreement between academia and industry is not wishful thinking for the future; it is an immediate demand by the suffering patients. [ABSTRACT FROM AUTHOR]