Author: Mr Oliver Eaton BSc (Hons), PG.Cert – Orthopaedic Specialist
Reviewed by: Mr William Sharples BSc (Hons) – Pain Management Expert
Last Updated: September 2025
In this article, you will learn everything you need to know about bone marrow and the most effective ways to repair it, including an advanced treatment called Prolotherapy.
Introduction
The spongy tissue inside some of the body’s bones, such as the hip and thigh bones, is known as bone marrow. Bone marrow is a soft tissue found in the center of most bones, surrounded by spongy bone and protected by the outer layer of compact bone. The outer layer of bones is called compact bone, which provides structural support and protection, while spongy bone is found at the ends of bones and houses the bone marrow. Immature cells or stem cells are found in the bone marrow. Bone marrow plays a crucial role in producing blood cells, including red blood cells, white blood cells, and platelets, which are essential for overall health. However, when bone health deteriorates or conditions like osteoarthritis arise, individuals may experience symptoms such as pain and inflammation. These issues can lead to what is commonly referred to as ‘bone on bone knee symptoms,’ where the cartilage has worn away and the bones are in direct contact, causing discomfort and restricted movement.
Many people who have blood cancers, including leukemia and lymphoma, sickle cell anemia, and other life-threatening disorders, depend on their bone marrow to survive. Bone marrow stem cells can also be harvested from donors to repair knee cartilage damage.
To live a healthy life, healthy bone marrow and blood cells are needed. As cancer causes it to stop working properly, a bone marrow transplant may be the only recovery option.
What is bone marrow?
Bone marrow is a soft, gelatinous tissue that occupies the cores of bones (the medullary cavities). There are two main types: red bone marrow (myeloid tissue) and yellow bone marrow (fatty tissue). Red bone marrow makes blood cells throughout childhood and continues to produce blood cells in adulthood, though at a reduced rate. The primary function of bone marrow is to produce blood cells, and both types are highly vascularized and produce more than 200 billion fresh blood cells daily.1
Stem cells
There are two groups of stem cells in the bone marrow: mesenchymal and hematopoietic.
- Hematopoietic stem cells (in red marrow) form blood cells.
- Mesenchymal stem cells (in yellow marrow) synthesize muscle, cartilage, and bone.
Stem cells are immature cells capable of differentiating into a variety of cell types. Hematopoietic stem cells can become myeloid or lymphoid cells, which include monocytes, neutrophils, macrophages, basophils, erythrocytes, eosinophils, dendritic cells, megakaryocytes (platelets), B cells, T cells, and natural killer cells.2
Some stem cells are multipotent, oligopotent, or unipotent, depending on the number of cell types they can generate. Pluripotent hematopoietic stem cells can regenerate themselves and differentiate into more mature cells through hematopoiesis. These stem cells are essential for bone marrow transplantation and ongoing blood cell production.
Blood cells have a finite lifespan (red blood cells: 100-120 days), so the body must continuously generate new, healthy blood stem cells. Only mature blood cells can exit the bone marrow and enter the circulating blood, where they perform their functions throughout the body.
Red bone marrow’s stem cells mature into three main types of blood cells:
- Red blood cells (erythrocytes): Transport oxygen throughout the body.
- White blood cells (leukocytes): Support the immune system and fight infection.
- Platelets (thrombocytes): Aid in blood clotting after injury.
Mesenchymal stem cells in the marrow can become:
- Chondrocytes (cartilage)
- Osteoclasts and osteoblasts (bone)
- Adipocytes (fat tissue)
- Macrophages
- Myocytes (muscle)
- Fibroblasts
- Endothelial cells
Red bone marrow
In adults, red marrow contains red blood cells, platelets, and about 60-70% of lymphocytes. Some lymphocytes mature in lymphatic tissues like the thymus, spleen, and lymph nodes. Red marrow, along with the spleen and liver, helps remove old red blood cells.3
Yellow bone marrow
Yellow marrow primarily stores fat, providing sustenance and maintaining optimal bone function. In cases of severe blood loss or fever, yellow marrow can revert to red marrow to increase blood cell production. Yellow marrow is found in the central cavities of long bones, surrounded by a layer of red marrow.
Timeline
Bone marrow begins to mature in the clavicle near the end of fetal life and becomes operational before birth. By 32-36 weeks of gestation, it takes over from the liver as the primary hematopoietic organ. In children, bone marrow is mostly red due to high blood cell demand, but as we age, much of it is replaced by yellow fat tissue. Adults have about 2.6 kg (5.7 lbs) of bone marrow, with half being red.4
Red marrow is most abundant in the vertebrae, hips, sternum, ribs, skull, and ends of long bones (humerus, femur, tibia). Yellow marrow fills other spongy bones and the central cavities of long bones.
Function
Blood cell development occurs as hematopoietic stem cells in red marrow differentiate into red blood cells, platelets, and most white blood cells. Yellow marrow produces muscle, cartilage, and bone. White blood cells live a few hours to days, platelets about 10 days, and red blood cells about 120 days, so the body must recycle and replace them constantly.
Certain conditions, such as blood loss, anemia, or low oxygen, trigger the kidneys to release erythropoietin, a hormone that stimulates the bone marrow to produce more red blood cells. Infections or bleeding increase white blood cell and platelet production, respectively. In severe blood loss, yellow marrow can convert to red marrow to boost blood cell output.
Prolotherapy
In recent years, Prolotherapy has built its reputation within the medical community for its clinically proven ability to repair bone marrow. Published research has proven its pain-relieving, anti-inflammatory, and regenerative benefits.5
Prolotherapy involves injecting a natural regenerative solution with tiny needles. This has been shown to stimulate the production of collagen cells, the small cells needed to repair the damage and help bone marrow. As prolotherapy is helping the bone marrow, it is deemed to be a permanent fix, preventing the symptoms from returning.
Disclaimer: The information provided in this section is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Prolotherapy may not be suitable for everyone, and outcomes can vary. Always seek the guidance of a qualified healthcare professional regarding your specific medical condition or treatment options. Never disregard professional medical advice or delay seeking it because of information you have read here.
Bone Marrow Transplant
A bone marrow transplant is a life-saving medical procedure designed to replace bone marrow that has been damaged or destroyed by disease, infection, or chemotherapy. The main goal of a bone marrow transplant is to restore the body’s ability to produce enough healthy blood cells—red blood cells to carry oxygen, white blood cells to prevent infection, and platelets to stop bleeding.
There are two primary types of bone marrow transplants: allogeneic and autologous. In an allogeneic transplant, healthy stem cells are collected from a donor whose tissue type closely matches the patient’s. These donor stem cells are then infused into the patient to help rebuild their blood and immune systems. In an autologous transplant, the patient’s own stem cells are harvested, stored, and later returned to their body after intensive treatment. Both approaches aim to replenish the bone marrow with healthy blood-forming cells, giving patients the best chance to recover from conditions like leukemia, lymphoma, and other serious blood disorders.
Bone marrow transplants are complex procedures that require careful matching and preparation, but they offer hope for many people whose bone marrow can no longer produce healthy blood cells on its own.
Stem Cell Transplant
A stem cell transplant is a specialized form of bone marrow transplant that uses stem cells to regenerate healthy bone marrow and restore normal blood cell production. Stem cells are unique because they can develop into all the different types of blood cells the body needs, including red blood cells, white blood cells, and platelets.
The stem cells used in a transplant can come from the patient’s own body (autologous transplant) or from a compatible donor (allogeneic transplant). The transplant process involves several key steps: first, the patient undergoes conditioning with chemotherapy or radiation to eliminate diseased or cancerous cells from the bone marrow. Next, the collected stem cells are infused into the patient’s bloodstream, where they travel to the bone marrow spaces and begin producing new, healthy blood cells.
This process is critical for patients whose bone marrow has been compromised by disease or treatment, as it allows the body to rebuild its blood and immune systems. Stem cell transplants are used to treat a variety of conditions, including blood cancers, severe anemia, and immune deficiencies, offering a chance for renewed health and recovery.
Risks and Complications
While bone marrow transplants can be life-saving, they also come with significant risks and potential complications. One of the most serious is graft-versus-host disease (GVHD), which can occur after an allogeneic transplant when the donor’s cells recognize the patient’s body as foreign and begin to attack healthy tissues. This can lead to damage in organs such as the skin, liver, and intestines.
Another major risk is infection. Because the transplant process suppresses the immune system, patients are more vulnerable to bacteria, viruses, and fungi until their new bone marrow produces enough white blood cells to defend against infection. Organ damage is also a concern, as the high doses of chemotherapy and radiation used to prepare the body for transplant can affect the heart, lungs, liver, and kidneys.
Other complications may include anemia (low red blood cell count), bleeding or bruising due to low platelet levels, and thrombocytopenia. Close monitoring and supportive care are essential to manage these risks and help patients recover as safely as possible.
Preparation for Transplant
Preparing for a bone marrow transplant is a detailed and carefully managed process that begins with a thorough evaluation of the patient’s overall health and the extent of their disease. This includes a series of tests to ensure the patient is strong enough to undergo the procedure and to identify the best source of stem cells—either from the patient’s own body or from a matched donor.
The next step is conditioning, which involves high-dose chemotherapy and sometimes radiation to destroy any remaining cancer cells and make space in the bone marrow for new stem cells. Once conditioning is complete, stem cells are collected and then infused into the patient’s bloodstream, where they migrate to the bone marrow and begin producing new, healthy blood cells.
Recovery from a bone marrow transplant can take several weeks to several months, during which time patients require close monitoring for complications and support for their immune system. Eating a healthy diet rich in iron—such as lean meats—and maintaining a balanced lifestyle can help support the production of healthy blood cells and overall recovery. Patients and families can also access valuable resources and information from organizations like the National Cancer Institute and the National Heart, Lung, and Blood Institute to guide them through the transplant process and beyond.
Case Studies
Case Study 1: Bone Marrow Regeneration in Osteoarthritis
Background: A 62-year-old with severe knee pain and bone-on-bone symptoms.
Treatment: Prolotherapy and stem cell therapy.
Outcome: Significant pain reduction and improved mobility within 3 months.
Case Study 2: Bone Marrow Repair After Chemotherapy
Background: A 45-year-old leukemia survivor with low blood counts post-chemotherapy, where chemotherapy was used to eliminate diseased cells from the bone marrow.
Treatment: Prolotherapy and nutritional support.
Outcome: Improved blood cell counts and energy levels within 2 months.
Case Study 3: Bone Marrow Support in Sickle Cell Anemia
Background: A 30-year-old with chronic pain and anemia due to sickle cell disease.
Treatment: Prolotherapy and supportive care.
Outcome: Reduced pain episodes and improved quality of life.
Frequently Asked Questions
What is the main function of bone marrow?
Bone marrow produces red blood cells, white blood cells, and platelets, which are essential for oxygen transport, immune defense, and blood clotting.1
How can bone marrow be repaired or regenerated?
Bone marrow can be repaired through healthy lifestyle choices, stem cell therapy, bone marrow transplants, and regenerative treatments like prolotherapy.5
What conditions affect bone marrow health?
Blood cancers (leukemia, lymphoma), anemia, sickle cell disease, infections, and autoimmune disorders can all impact bone marrow function.
Is prolotherapy safe and effective for bone marrow repair?
Yes, prolotherapy is considered safe when performed by experienced practitioners and has shown positive outcomes for pain and tissue regeneration in clinical studies.5
When should I see a specialist for bone marrow or pain issues?
If you have persistent pain, unexplained fatigue, frequent infections, or abnormal blood counts, consult a specialist for assessment and treatment.
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Author Bio
Having performed over 10,000 procedures, Mr Oliver Eaton is one of the UK’s leading practitioners in the field of treating pain, with patients travelling to see him from across the UK, Europe, and the Middle East.
With over 12 years of clinical experience, Oliver is dedicated to helping patients understand their symptoms associated with pain and providing effective treatment options to alleviate them.
He qualified in Prolozone Therapy and Prolotherapy in America with the American Academy of Ozonotherapy. He continued on to complete further qualifications at the Royal Society of Medicine, Charing Cross Hospital in London, Keele University’s Anatomy & Surgical Training Centre, and the medical department of Heidelberg University in Germany.
Mr Eaton’s expertise has been featured in many national news and media publications, including The Telegraph, The Daily Mail, The Daily Express, Women’s Health Magazine, and The Scotsman.
Over the years he has had the privilege of treating many elite-level athletes, including both Olympic and Commonwealth medallists.
Connect with Oliver Eaton on LinkedIn
References
- Morrison SJ, Scadden DT. The bone marrow niche for haematopoietic stem cells. Nature. 2014;505(7483):327-334. View Study
- Weissman IL. Stem cells: units of development, units of regeneration, and units in evolution. Cell. 2000;100(1):157-168. View Study
- Orkin SH, Zon LI. Hematopoiesis: an evolving paradigm for stem cell biology. Cell. 2008;132(4):631-644. View Study
- Palis J, Yoder MC. Yolk sac hematopoiesis: the first blood cells of mouse and man. Exp Hematol. 2001;29(8):927-936. View Study
- Rabago D, Slattengren A, Zgierska A. Prolotherapy in Primary Care Practice. Prim Care. 2010;37(1):65-80. View Study
Disclaimer: This article is for informational purposes only and does not substitute for professional medical advice. Always consult your healthcare provider before making treatment decisions.