Understanding Routes, Biology, and Clinical Use

Patients considering stem cell therapy are often offered different routes of administration, most commonly local injection or intravenous (IV) infusion. These two approaches are sometimes presented as interchangeable, but biologically and clinically they are very different. Choosing the appropriate route is not a matter of convenience or marketing preference; it should be guided by the target condition, the intended biological effect, and patient-specific factors. Stem cell therapy—particularly with Umbilical Cord–Derived Mesenchymal Stem Cells (UC-MSCs)—works through biological signaling rather than physical tissue replacement. How and where the cells are delivered strongly influences which signals are activated and which tissues are affected

How Local Stem Cell Injection Works

Local injection involves delivering stem cells directly into or near a specific tissue, such as a knee joint, shoulder, tendon, ligament, or localized area of degeneration. The goal is to concentrate paracrine signaling in a defined anatomical space.

After local injection, UC-MSCs release cytokines, growth factors, and extracellular vesicles that interact with nearby immune cells, synovial tissue, cartilage surfaces, or connective tissue structures. This localized signaling can reduce inflammation, influence pain pathways, and support tissue repair mechanisms in that specific region.

Local injection does not mean the cells permanently integrate into the tissue. Most UC-MSCs remain biologically active for a limited period and are gradually cleared. Any benefit reflects changes in the local biological environment rather than structural replacement.

When Local Injection Is Typically Used

Local injection is most commonly considered for focal orthopedic conditions. These include mild to moderate osteoarthritis, tendinopathy, ligament injury, or localized soft-tissue degeneration. It may also be used as an adjunct to rehabilitation in selected musculoskeletal injuries.

Because the effect is localized, local injection is generally not intended to address systemic inflammation, immune dysregulation, or multi-organ conditions. Its benefit depends heavily on disease stage, mechanical alignment, and ongoing physical load on the affected structure.

What IV Stem Cell Infusion Does Differently

Intravenous infusion introduces UC-MSCs into the systemic circulation. Once infused, many cells pass through the lungs and interact with immune cells in vascular and lymphoid tissues. Rather than targeting a single anatomical site, IV infusion aims to influence systemic immune and inflammatory signaling.

The primary goal of IV UC-MSC therapy is immunomodulation. The cells release signaling molecules that can reduce excessive inflammatory responses, influence immune cell behavior, and modulate cytokine networks throughout the body. This makes IV infusion more relevant for conditions characterized by widespread inflammation rather than isolated tissue damage.

Systemic Effects vs Local Concentration

The key distinction between the two routes is scope. Local injection delivers high local concentration with minimal systemic effect. IV infusion delivers broad systemic signaling with less concentration at any single site.

This distinction explains why IV therapy is often discussed in the context of autoimmune conditions, neuroinflammatory states, post-viral syndromes, or generalized inflammatory aging, while local injection is favored for joint- or tissue-specific problems.

Neither route is inherently superior. They serve different biological purposes.

Why IV Stem Cells Do Not “Go Everywhere” Equally

A common misconception is that IV stem cells circulate freely and selectively “find” damaged tissues throughout the body. In reality, many infused MSCs are transiently trapped in the lungs or cleared by the immune system. Their therapeutic effect comes primarily from signaling interactions rather than direct tissue engraftment.

Some cells may migrate toward inflamed tissues in response to chemokine signals, a process known as homing, but this occurs at low efficiency. This is why IV therapy is best understood as systemic immune modulation rather than targeted tissue repair.

Differences in Recovery and Side Effects

Recovery profiles differ slightly between the two approaches. Local injections may cause temporary soreness, swelling, or stiffness at the injection site. These effects usually resolve within days and reflect localized immune activation.

IV infusion may be followed by transient fatigue, headache, or flu-like sensations in some patients. These symptoms are generally mild and short-lived. Serious adverse reactions are uncommon when therapy is delivered within regulated medical settings.

Can the Two Approaches Be Combined?

In some treatment strategies, local injection and IV infusion are used together. The rationale is to combine local tissue-focused signaling with systemic immune modulation. This approach is sometimes considered in complex cases, but it should be guided by clinical judgment and evidence rather than routine protocol.

Combination therapy is not necessary for most patients and should not be presented as a default or superior option without clear rationale.

EDNA Wellness Clinical Perspective

At EDNA Wellness, route of administration is selected based on biology and indication, not convenience. Local injection is considered when the goal is focused musculoskeletal support. IV infusion is considered when systemic immune or inflammatory modulation is the primary objective. Patients are counseled on why one route is recommended over another and what that choice realistically implies.

Local stem cell injection and IV stem cell infusion are not interchangeable treatments. Local injection concentrates biological signaling in a specific tissue, while IV infusion targets systemic immune and inflammatory pathways. Understanding this distinction helps patients avoid mismatched expectations and supports informed, evidence-based decisions.

Stem cell therapy is most effective when the route of administration aligns with the underlying biology of the condition being treated.

About EDNA Wellness

EDNA Wellness is a private Stem Cell Clinic and Regenerative Medicine Center in Bangkok, Thailand, specializing in Umbilical cord–derived Mesenchymal Stem Cells (UC-MSCs) for knee osteoarthritis and joint pain, stroke and other neuro-related conditions, and stem cell IV infusions for longevity and healthy aging. All treatments are doctor-designed and performed in a sterile clinical setting

For more information or to book a consultation:

LINE: @ednawellness

WhatsApp: +66 (0) 64 505 5599

Website: www.ednawellness.com

References

• Pittenger MF et al. Mesenchymal stem cell biology and clinical applications. Cell Stem Cell.
• Caplan AI, Correa D. The MSC: an injury drugstore. Cell Stem Cell.
• Galipeau J, Sensébé L. Mesenchymal stromal cells: clinical challenges and opportunities. Cell Stem Cell.
• Squillaro T et al. Clinical trials with mesenchymal stem cells: an update. Cell Transplantation.
• Wang Y et al. Systemic versus local effects of MSC therapy. Stem Cell Research & Therapy.