Kobe Bryant did it. Alex Rodriguez did it. Golfer Fred Couples did it, even the late Pope John Paul II did it. There’s a new, yet unproven treatment for pain that people will pay out of pocket for and then travel to Germany where the treatment is not obstructed by FDA regulations. It’s called Regenokine and it’s one type of a group of treatments called “biologic medicine” in which a person’s own tissue is collected, processed in a particular way, and then placed back into the body. Biologics are based on the philosophy of using the body’s own healing power to cure, but despite its growing popularity among professional athletes and ‘weekend warriors,’ the benefits – and safety – of the treatments are far from proven.
Regenokine is used to relieve lower back pain and the pain caused by osteoarthritis. At the time Fred Couples received treatment he was suffering from severe arthritic back pain. But when he won the PGA Senior Players Championship in 2011 he attributed the victory to Regenokine, saying he felt better than he had in a decade. The Regenokine treatment involves extracting the blood and then slightly heating it. The heat creates a kind of “fever” for the blood, inducing the inflammation that is a normal healing mechanism for the body. The blood is then put in a tube and spun in a centrifuge which separates the blood into its constituent parts. A layer of red blood cells collect at the bottom of the tube, a yellowish layer forms above it. The yellowish serum contains the good stuff, now-concentrated cytokines that fight inflammation and proteins that promote good health and block pain. After being injected back into the patient, the serum brings immediate pain relief to most patients. In others it can take several weeks. The feel good effects are effective in about 75 percent of patients and typically last two to four years.
All of this is according to the very small group of physicians that administer Regenokine.
Drs. Peter Wehling and Jens Hartmann run a practice in Düsseldorf, Germany that is the premiere source for the treatment. Wehling, a spinal surgeon, developed the Regenokine program in collaboration with scientists and physicians in the US and Europe. It has not received FDA approval in the US yet due to a requirement that body tissues be “minimally manipulated,” lest they become classified as drugs and subject to much more strict regulations. Despite this, however, there is at least one physician trying his luck in the US. Chris Renna, who runs a pair of clinics, one in Dallas and one in Santa Monica, offers Regenokine to his patients, only “slightly concerned” that the FDA would take action against him.
The comparatively laissez-faire regulations of Europe means people like Wehling and Hartmann are free to provide one more option to chronic pain patients who have tried everything. The 75 percent effectiveness rate would definitely sound like a miracle to patients for which drugs, physical therapy, acupuncture, etc. doesn’t work. But could Regenokine’s potency come more from patients’ wishful thinking than from anti-inflammatories? Could the pain relief really be just a placebo effect?
The following video shows how the experimental procedure is believed to work.
Another, more popular biologic treatment therapy, is platelet rich plasma (PRP) therapy. Like Regenokine, PRP therapy involves spinning the patient’s blood, but instead of anti-inflammatories PRP therapy reaches for the platelets. After a wound occurs, platelets not only dam up to stop our bleeding, they also secrete chemicals that induce the wound to heal. So if we concentrate these little healing specialists and re-inject them into the body, we should heal faster, right?
As with Regenokine, PRP therapy is strong on logic, weak on evidence. One study performed in 2010 compared the ability of the platelet rich plasma injections and placebo injections of saline to heal people with achilles tendinopathies. Importantly, it was a double-blind study so neither the patients nor the doctors knew which injections were platelets and which were saline. Twenty-four weeks after injection the PRP therapy was no better than saline at relieving the patients’ pain or improving physical function. A year after injection the PRP therapy-treated group still fared no better than the saline group.
But just to make things less clear, a previous study had shown that PRP therapy was more effective than placebo at lessening the pain of patients with tennis elbow. Due to regulations, however, the research team was not able to blind the patients to treatment.
But you wouldn’t know these biologic therapies were unproven to look at the faith that professional athletes have in them. In 2009 Tiger Woods received four PRP injections, each one right before playing in the four golf majors that year. That same year two Pittsburgh Steelers – Hines Ward and Troy Polamalu – received PRP injections before going on to win the Superbowl. Last July Kobe Bryant flew to Düsseldorf, Germany to seek out Dr. Wehling and his treatment to see if it could do something for the osteoarthritis plaguing his right knee. After receiving an initial round of Regenokine treatment, the NBA star returned in October for another treatment. Bryant, who turns 34 this summer, is playing almost five minutes more per game this year than last year.
So impressed with the results, Bryant suggested Regenokine to his friend, Yankee slugger Alex Rodriguez. No stranger to boosting performance through questionable treatments, Rodriguez took the trip to Germany to have the procedure performed on his shoulder and knee.
So I guess we’ll just have to wait for clinical trials to see if Regenokine is the real deal, an expensive placebo or, as some suggest, even gives athletes an unfair advantage. Whether Regenokine’s benefits are based on biology or psychology, those with the reason – and the means – to try anything to up their game will continue to test it for us.
