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Month: June 2017

We no longer offer PRP and Stem Cell procedures until further scientific evidence of its efficacy. We do PROLO Therapy for specific orthopedic conditions.

Platelet-Rich Plasma in the Treatment of Low Back Pain caused by Degenerative Disc Disease

The efficacy of platelet-rich plasma (PRP) in the treatment of low back pain remains largely unknown. Up until now, very few studies have looked at whether PRP can effectively treat low back pain caused by degenerative conditions. When considering back pain that is caused by a degenerating disc, common treatment options standardly include physical therapy, medications such as non-steroidal anti-inflammatory (NSAIDs), corticosteroid injections, radiofrequency ablation and in some cases, surgery. Unfortunately, while these treatment modalities may lessen the severity of clinical symptoms, none target the underlying pathology or as we all are looking for, reverse the aging and degenerative process.

A prospective, double blind randomized control trial published by Taukli-Wosornu et al (2016) analyzed 47 patients (27 in treatment group, 18 in control group) with degenerative disc disease as confirmed by provocative discography. Those in the treatment arm of the study received a single injection of platelet rich plasma (PRP) versus the control group who received an injection of a contrast agent into the painful disc. PRP (1-2 mL) was injected in discs determined to have concordant pain. Outcomes were based on the Functional Rating Index (FRI), Numeric Rating Scale (NRS) for pain, SF-36 (pain and physical function domains), and the modified North American Spine Society Outcome Questionnaire (NASS). Data was collected at baseline, one week, four weeks, eight weeks, six months and one year. The follow-up rate was reported to be 92%. No adverse of events including infection, neurologic injury or progressive herniation was reported.

After eight weeks of follow-up, the treatment group that received PRP injections, had statistically significant improvements in regards to pain, function, and overall satisfaction when compared to the control group. Functional scores remained significantly improved through 1 year of treatment. It should be noted that follow-up of the control group was only 8 weeks. No follow-up radiologic studies were conducted to determine if there were any morphologic changes.

While this study does provide data suggesting PRP as safe, efficacious option for those who suffer from low back pain due to degenerative disc disease, this was a relatively small sample size and the three questions of who is an appropriate candidate for this treatment, what PRP concentration is needed to have a therapeutic effect, and how many injections are needed, remain to be answered.

Tuakli-Wosornu YA1Terry A2Boachie-Adjei K3Harrison JR4Gribbin CK5LaSalle EE6Nguyen JT7Solomon JL8Lutz GE9.
Lumbar Intradiskal Platelet-Rich Plasma (PRP) Injections: A Prospective, Double-Blind, Randomized Controlled Study.
PMR. 2016 Jan;8(1):1-10; quiz 10. doi: 10.1016/j.pmrj.2015.08.010. Epub 2015 Aug 24.