Aching Kiwis have long wait for what loosened up the Pope
A potentially ground-breaking form of arthritis treatment developed in Germany and making waves in other countries is all but unknown in New Zealand.
Still regarded as being in an experimental stage, the treatment is at least ten years away from being available to 300,000 New Zealand arthritis sufferers.
It is called Regenokine, and it has proven poplar with sports stars such as Kobe Bryant, Alex Rodriguez and Vijay Singh.
The late Pope John Paul II also underwent the treatment.
It involves injecting a patient's joints with their own cells to reduce inflammation.
Until recently, it was only available in Germany where the process was developed by Professor Peter Wehling in Dusseldorf.
The New York Times describes Dr Wehling's practice as "almost a pilgrimage site for athletes trying to prolong careers that have tested the limits of their bodies".
A doctor in Santa Monica, USA, now offers it, too, although it has not been approved by the federal drug administration (FDA).
The treatment, however successful, is not cheap.
American volleyball player Lindsay Berg paid $US7400 out of her own pocket when she travelled to Dr Wehling's clinic before the London Olympics as a last resort.
She had already tried surgery and cortisone injections, which were unsuccessful.
Golfer Vijay Singh swears by it, saying the results were "incredible".
"It's like somebody put oil all over your body. it lubes you up, and you're able to move more freely, especially pain free," he told the New York Times.
Perhaps the high cost is worth it to well-paid athletes who rely on mobility for their livelihood, but could it be a realistic option for everyday folk?
How it works
Regenokine is not a medicine or a drug, according to its website.
Rather, it is a "programme" which involves drawing some of the patient's blood, processing it so the blood cells product proteins which reduce inflammation and stimulate cellular growth, and then injecting that back into the patient's joints.
In theory, the patient's body should not reject it because it is recognised as its own.
In The Atlantic, Dr Lloyd Sederer, medical director of the New York state office of mental health, describes his own experience with Regenokine, which he underwent at Dr Wehling's offices with his mother-in-law.
"We had blood drawn, about 100cc [100mls] and were given a precise time to return the next day and the three days thereafter for our treatments.
"A naturally occurring anti-inflammatory protein in everyone's blood was isolated from our samples and processed by a technique Wehling developed.
"Our respective proteins were replicated thousands of times overnight. By the time we returned the next day, each of our individual anti-inflammatory proteins were in a concentrated solution and ready to be injected into our joints."
Dr Sederer says the procedure took less than 15 minutes and six weeks later he was on a 10-day hike.
The effect lasted about three years, after which he needed a "booster".
NBA Lakers star Kobe Bryant also underwent the treatment for his arthritic knee, after which he said he felt "a lot stronger and a lot quicker."
Although at 34, his basketball career is probably nearing the end of its life anyway.
When will it be available in New Zealand?
Probably not for at least 10 years, and that is optimistic, says Arthritis NZ ceo Sandra Kirby, who told NBR ONLINE the treatment is still considered experimental.
"We wouldn't be able to start recommending it until we see much more evidence around its effectiveness."
However, she says treatments for osteoarthritis, such as Regenokine, are badly needed.
"Treatments for osteoarthritis have fallen way behind treatments for others, such as rheumatoid arthritis.
"Most of the treatments for osteoarthritis at the moment are about pain relief, rather than changing the course of the disease," Ms Kirby says.
"The treatment for osteoarthritis is symptom control until you can't do that any longer, and then joint replacement.
"If you equate it to heart disease, it would be like saying, 'we manage your heart disease with aspirin until we can't any longer and then we give you a heart transplant'."
The incredible results of Regenokine could, Ms Kirby says, be a placebo effect, which is why much more testing is needed.
A placebo effect is common with new treatments, so widespread trials would need to be done globally to know how effective the treatment truly is, Ms Kirby says.
However, if it is successful such a treatment would be groundbreaking.
Osteoarthritis, the most common form of arthritis which affects about 300,000 New Zealanders, is caused by the wearing down of cartilage between the joints.
This causes the bones to rub together, resulting in painful swelling.
Conversely, rheumatoid arthritis, which affects about 40,000 Kiwis, is inflammatory; the body has an auto-immune reaction resulting in too much synovial fluid around the joints, causing swelling.
Ms Kirby says treatments for rheumatoid arthritis have leapfrogged those for osteoarthritis.
"The treatments for rheumatoid arthritis had huge advancements with the advent of the biologic drugs such as Humira and Enbrel, which have been available in New Zealand increasingly over the past five or six years.
"They have been life changing drugs for people with inflammatory arthritis.
"They are not a cure, but we have gone from being able to manage symptoms to actually stopping the disease in its tracks."
Ms Kirby expects the biggest gains in the treatment of osteoarthritis will be in stem cell treatments.
As for Regenokine, it is not clear how, or even if, its use will spread globally.
Dr Chris Renna runs a clinic in Santa Monica, California, which uses Dr Wehling's process, but other than this Regenokine remains relatively unavailable.
In any case, Ms Kirby says treatments for arthritis seem to be moving from relieving pain to treating the underlying cause of the disease.