The Future of Pain Management: Regenerative Medicine Explained

These cells can differentiate into cartilage, bone, or muscle cells and secrete signalling molecules that activate local healing. For pain conditions like knee osteoarthritis, spinal disc degeneration, and post-injury recovery, stem cell therapy offers significant potential—but it remains under clinical evaluation. 

In South Africa, only a small number of centres are currently authorised to perform stem cell procedures, and they must comply with South African Health Products Regulatory Authority (SAHPRA) guidelines. Ethical oversight is crucial, as unregulated “stem cell tourism” remains a global problem. It is currently something the Pain Collective is investigating, but it is not yet something offered in our clinics. 

Prolotherapy 

Prolotherapy is an older but well-studied regenerative method that involves injecting a mild irritant—often dextrose—into ligaments or tendons to trigger a healing response. 

This technique stimulates local inflammation, encouraging new tissue growth and collagen production. South African physiatrists and interventional pain specialists sometimes use prolotherapy for chronic back pain, sacroiliac instability, or tendon laxity, particularly when traditional injections or physiotherapy have not achieved lasting relief. It is currently something the Pain Collective is investigating, but it is not yet something offered in our clinics. 

Emerging Orthobiologics and Scaffold Therapies 

Research is ongoing into next-generation biologic materials, including cartilage scaffolds, hyaluronic acid–based injectables, and exosome therapies. These use bioengineered materials or cell-derived messengers to stimulate repair and restore function. 

While still largely experimental in South Africa, clinical trials abroad show potential for cartilage regeneration and long-term joint preservation. With growing local research interest in regenerative orthopaedics, these innovations could soon reach South African clinics under strict regulatory conditions. 

Conditions That May Benefit from Regenerative Approaches 

Regenerative medicine is being studied for several pain-related conditions common among South Africans, including: 

These treatments are most effective in early-to-moderate stages of degeneration, when there is enough tissue integrity left for regeneration to occur. 

The Scientific Rationale Behind Regeneration for Pain Relief 

Chronic pain often stems from tissue damage, inflammation, and nerve sensitisation. Regenerative medicine targets these underlying mechanisms by delivering bioactive molecules—such as growth factors, cytokines, and anti-inflammatory mediators—directly to the injured site. 

By promoting cell repair, collagen synthesis, and reduced inflammation, regenerative treatments can restore stability and function. In turn, this relieves pain, not by numbing it, but by addressing the biological cause. 

This approach represents a major shift from “pain control” to “tissue restoration”—a difference that is especially important for conditions caused by mechanical wear and cellular degeneration. 

What Does the Research Say So Far? 

The evidence is steadily growing, though still developing: 

In South Africa, most regenerative therapies are offered as adjunctive treatments within pain clinics rather than standalone cures—reflecting an evidence-based, integrative approach. 

Benefits and Limitations of Regenerative Treatments 

Potential Benefits 

Limitations 

Who Is (and Isn’t) a Good Candidate 

Good candidates include those with mild to moderate degeneration, healthy tissue structure, and realistic expectations. 
Patients with severe joint destruction, active infection, uncontrolled diabetes, or autoimmune flare-ups are generally not ideal candidates. 

Access, Safety, and Regulation in South Africa 

In South Africa, regenerative treatments fall under the oversight of the South African Health Products Regulatory Authority (SAHPRA). Clinics offering PRP or stem cell therapy must adhere to medical ethics, safety standards, and laboratory regulations for biological materials. 

Autologous (self-derived) PRP is permitted for clinical use when performed by trained professionals in sterile, licensed settings. 
Stem cell treatments, however, remain under restricted clinical use pending SAHPRA-approved trials or applications. 

Patients should be cautious of unverified claims or clinics promoting “miracle cures.” Always confirm that your provider is medically registered, can explain the treatment process clearly, and offers informed consent documents referencing regulatory compliance. 

The Road Ahead: What Might the Future Hold? 

South Africa is increasingly part of the global conversation in regenerative medicine. Local orthopaedic and pain specialists are participating in research collaborations and clinical trials exploring biologic and cell-based therapies. 

The future likely includes: 

As technology matures, regenerative therapies could become a cornerstone of non-surgical pain management—especially in a country where access to complex surgery remains limited for many.