Mesenchymal Stem Cells as a Regenerative Treatment for Musculoskeletal Pain

Mesenchymal stem cells (MSCs) have become a focus of regenerative medicine research due to their potential utility in treating a variety of musculoskeletal disorders. Multiple qualities make them an ideal candidate to address musculoskeletal structural degeneration and inflammation, including their multi-lineage differentiation capacity, relative ease of extraction, and paracrine signaling capabilities. This narrative review examines the literature surrounding MSC-related therapies in musculoskeletal disorders, with a particular emphasis on mechanical and cellular factors affecting therapeutic efficacy. Multiple clinical and preclinical studies find that MSCs bolster tissue repair through a combination of extracellular matrix remodeling, inflammatory modulation, and regenerative signaling pathways. In addition, mechanotransduction signaling pathways have been discovered that convert mechanical tensile shear stress, compression, and strain forces into regulatory signals for matrix remodeling and tissue proliferation. Additional studies suggest that MSC efficacy and optimization are greatly influenced by a cell’s mechanical environment within the body. Further understanding of these mechanical factors can greatly bolster emerging regenerative therapies increasingly being utilized for musculoskeletal conditions.