Clinical Trials Show PRP Effective on Main Causes of Chronic Low Back Pain
Chronic lower back pain is a common complaint of many older Americans. When physical therapy and chiropractic treatment are not enough to help relieve pain, platelet-rich plasma (PRP) treatments are important for a patient to consider before surgery. Learn more, and see results of clinical studies that show how PRP procedures help patients with chronic lower back pain.
Defining Chronic Lower Back Pain
The term “lower back pain,” or LBP, is nonspecific and can refer to any pain, dull or sharp, constant or returning, occurring in the lower back. Lower back pain is very common in the United States, especially among older Americans, Americans who are overweight, or Americans who work physically demanding jobs (1). What separates acute (short-term) lower back pain from chronic (long-term) lower back pain is how long the patient’s symptoms have occurred. Back pain that persists for 12 weeks or longer, even after treatment, is considered to be chronic (1).
Traditional Approaches to Chronic Lower Back Pain Treatment
Often the first step in the treatment for patients who are suffering from lower back pain is to see a primary care physician (PCP). Usually the PCP would first recommend physical therapy for the patient. Physical therapy treatment consists of targeted exercises designed to help decrease painful lower back pain symptoms and improve function of the lumbar spine (2). This treatment can be beneficial for some patients, particularly those whose chronic lower back pain results from conditions such as sciatica, for example (2). However, since physical therapy is often not enough to relieve pain for some patients.
Often the next option for chronic lower back pain treatment is chiropractic treatment. Chiropractors typically treat lumbar back pain through the method of manual manipulation, which means that they apply pressure using their hands to the abnormal parts of the spine in order to improve spine mobility and even reduce muscle tightness around the area (3). Chiropractic treatment can be beneficial for patients, but for those who suffer from particularly persistent chronic lower back pain, it still may not be enough.
However, chiropractic treatment and physical therapy may be much more successful when integrated in a patient’s treatment plan post-PRP injections. While a patient should abstain from chiropractic care or physical therapy for 10-14 days after PRP treatment for chronic lower back pain, reinstating those treatments after the waiting period may be helpful for the patient to regain flexibility and improve spine function (4).
PRP Treatment for Chronic Lower Back Pain
Platelet rich plasma is a non-invasive, regenerative treatment option for many different types of injuries and pains. In a PRP treatment, a doctor extracts a sample of the patient’s blood. We use this blood to prepare an injection of highly concentrated platelet rich plasma containing the growth factors isolated from the patient’s own blood.
The platelet rich plasma is injected under image guidance into the treatment site.. Also, Platelet Lysate is often recommended for back and spine treatments, specially in the epidural space, due to its fast release of healing enzymes which will also help reduce inflammation.
Two Main Suspected Causes of Chronic Lower Back Pain
1. Disc-Related Conditions
Herniated discs or degenerative disc disease are both common disc-related conditions that can cause lumbar back pain. Intervertebral discs sit between each vertebrae of the spine, and they help absorb shock and allow for spine mobility at each individual joint (7). Multiple problems can occur with these discs – the discs can degenerate, bulge, or become herniated, as shown in the image below. Many of these issues can cause chronic lower back pain, termed “discogenic” back pain if the pain results from a disc problem (8).
Clinical Studies Showing PRP Effective for Discogenic Lumbar Back Pain
A March 2018 Mohammed et. al. article examines the current clinical studies on the use of PRP treatment for discogenic lumbar back pain (8). In treating disc degeneration, the platelets used in PRP treatments help to heal degenerated discs by pulling the edges of the torn disc together (8). Clinical evidence already exists that deems PRP a safe and effective treatment for degenerative disc disease (8). A 2011 Akeda et. al. study shows a significant decrease post-PRP-injection in the mean pain score of patients who suffered from chronic lower back pain (8).
2. Atrophying Multifidus
Another common cause of chronic lower back pain is an atrophying multifidus muscle. The multifidus is a thin muscle that spans the entire length of the spine (5).
Muscular atrophy is when a muscle degenerates, or starts to break down, often because of aging. An atrophying multifidus can cause back pain located in the lumbar region, since that is where the muscle is widest, that gradually gets worse over time as the muscle continues to degenerate (5).
Clinical Trials Show PRP Effective for Low Back Pain Stemming From the Multifidus Muscle
In March 2016 Hussein et. al. studied the effect of PRP treatment on the atrophied lumbar multifidus muscle in patients who suffered from chronic lower back pain (6). Patients were asked to rate their pain on the numerical rating scale (NRS), on which the number 0 means ‘no pain at all’ and the number 10 means ‘the worst pain ever possible.’ Of 104 patients treated, only 30 showed no improvement after the treatment, but the other 74 reported lessened back pain after the follow-ups (6). The mean NRS back pain score prior to the treatment was about 8.81 with a standard deviation of 0.86, and 24 months post-injection, the mean back pain was rated a 3.5 with a standard deviation of 2.92 (6). Overall, PRP treatment was proven to be a safe and effective method for treating chronic lower back pain (6).
Patient Outcomes
Regenexx keeps a database of procedure outcomes from all of its member clinics. Among just under 10,000 patients who receive Regenexx PRP treatment for pain in the lumbar spine report an average of 4.8 on the NRS scale prior to treatment (9). One month after the Regenexx treatment, the average pain is rated 3.4, a decrease of 30% (9). Pain levels continue to decrease as time goes on.
See Regenexx Patient Outcomes Data here.
If you’re suffering from chronic lower back pain and think PRP might be an effective treatment for you–Tap the “TALK TO AN EXPERT” BUTTON below.
Sources
- https://www.ninds.nih.gov/health-information/disorders/back-pain
- https://www.spine-health.com/treatment/physical-therapy/physical-therapy-low-back-pain-relief
- https://www.dukehealth.org/blog/should-you-see-chiropractor-back-pain
- https://integrativespineandsports.com/are-you-not-getting-any-results-and-want-to-avoid-surgery-try-prp/#:~:text=Physical%20therapy%20or%20chiropractic%20care,2%20weeks%20after%20starting%20therapy.
- https://centenoschultz.com/multifidus-pain-a-new-free-study-for-patients-with-ongoing-low-back-pain/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4849261/
- https://centenoschultz.com/prp-for-herniated-disc/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5911760/
- https://regenexxpittsburgh.com/patient-outcome-data/
