Platelet-Rich Plasma Injections for Chronic Low Back Pain

Marc Darrow MD, JD. Thank you for reading my article. You can ask me your questions using the contact form below. 

We have published a new study on PRP for chronic low back pain. The study appears in the journal Cogent Medicine.(1)

This research gives an insight into what level of treatment success we can have with certain back pain conditions and how many treatments the patient should expect towards achieving their treatment goals.

Let’s get to our study: 

In our research, Treatment of Chronic Low Back Pain with Platelet-Rich Plasma Injections, we wrote:

  • Platelet-Rich Plasma (PRP) is a non-invasive modality that has been used to treat musculoskeletal conditions for the past two decades. Based on our research, there were no publications that studied the effect of PRP on unresolved lower back pain. The aim of this study was to report the clinical outcomes of patients who received PRP injections to treat unresolved lower back pain.

Methods: 

  • 67 patients underwent a series one, two, or three PRP injections into the ligaments, muscle, and fascia surrounding the lumbar spine.
  • Patients who received two treatments received injections a mean 24 days apart and patients who received three treatments received injections a mean 20.5 days apart.
  • Baseline and post-treatment outcomes of resting pain, active pain, lower functionality scale, and overall improvement percentage were compared to baseline and between groups.

Results: 

  • Patients who received one PRP injection reported 36.33% overall improvement and experienced significant improvements in active pain relief. These same patients experienced improvements in resting pain and functionality score, yet these results were not statistically significant.
  • Patients who received a series of two and three treatments experienced significant decreases in resting pain and active pain and reported 46.17% and 54.91% total overall improvement respectively. In addition, they were able to perform daily activities with less difficulty than prior to treatment.

The learning points of our study:

  • Our results demonstrate that PRP injections may be a viable conservative approach to treat lower back pain.
  • Quickly return to everyday activities:
    • Our study demonstrated that one, two or three PRP treatments were effective in significantly reducing active pain in the lower back. Additionally, functionality scores were significantly increased showing that patients were able to quickly return to everyday activities.
  • An immediate clinical benefit:
    • Patients experienced an improvement in resting pain and functionality score after the one treatment, however, statistical significance was demonstrated only after the second and third treatments. Yet, self-reported mean total improvement was 36.33%, 46.17%, and 54.91% at the first, second and third treatments, respectively, suggesting an immediate clinical benefit.

Our explanation of how PRP works

  • PRP is fast, non-invasive procedure that has been studied as an alternative treatment for low back pain and musculoskeletal injuries in the recent decade.
  • The treatment invokes immunomodulatory effects (it activates the immune and repair response  and as well as angiogenic (formation of new blood vessels) properties that facilitate healing.
  • The exact mechanism of PRP is not known, but current research points to cytokines (small cells that set up communications between cells to coordinate the healing response), growth factors and other proteins as the main medium through which PRP works.

To learn more about PRP visit our page PLATELET RICH PLASMA PRP 

Demonstration of PRP treatment

There is no sound on this video. The video demonstrates PRP injection into the lower back. The procedure is well tolerated, simple and in the hands of an experienced physician is a multiple injection treatment given in rapid succession. In our many years of experience, this type of PRP treatment offers the patient reliable and effective results such as those demonstrated in our study above.

There is no sound on this video. The simplicity of the injection treatment is demonstrated. By injecting PRP into the muscles, ligaments, and fascia surrounding the lumbar spine, we can improve the stability of your spine. This has been shown not only in the research discussed in this article, but in additional published studies. PRP injections can relieve lower back pain and may prevent future spinal disc problems.

Supportive research on PRP for low back pain

New research in the Journal of spine surgery (2) featured these findings which may help confirm that PRP injections are a viable option to low back pain.

  • Clinical studies presented in this research clearly demonstrate the growing interest in offering PRP injections for treating back pain
  • These same studies used PRP injections as a therapy for discogenic low back pain and reported good results overall.
  • A major and notable advantage of the therapy is the safety of the autologous PRP itself, which does not cause any major complications.
  • Because autologous PRP is obtained from the patient’s own blood, PRP therapy carries low risks of disease infection and allergic reaction.

Clinical benefits reported:

  • Research on PRP therapy has demonstrated remarkable improvements in pain intensity according to a variety of pain scores.
  • The clinically-beneficial effects have enabled patients to return to normal physical activity.

Clinical concerns reported:

  • PRP therapy will be more efficient if applied before disc degeneration reaches an advanced stage.

Conclusion of this research:

“(the authors of this study) described clinical evidence from the literature and presented an update on the use of PRP therapy for the treatment of discogenic low back pain. It is evident from our review that PRP is a safe, effective and feasible treatment modality and is evolving as a powerful therapy for the treatment of discogenic back pain. Considering the remarkable progress made already, and the other potential aspects which remain for further investigation, PRP therapy undoubtedly offers new and exciting prospects for the treatment of degenerative disc disease and other musculoskeletal disorders.”(2)

PRP injections not into the disc but into the supporting spinal ligament structures

In our own recently published and companion research: Treatment of Lower Back Pain with Bone Marrow Concentrate (3) we discuss the injections of bone marrow cells not directly into the discs, but into the supportive spinal ligaments. This is what we documented:

  • The patients in the present study were injected with Bone Marrow Concentrate into the muscles, fascia, and ligaments surrounding the lumbar spine.
  • It has been well documented in literature that stem cells and platelets in the concentrate enhance tendon and ligament healing.
  • In patients who were diagnosed with ligament and fascial (connective tissue) sprains, we hypothesize that we can reduce patients’ low back pain by strengthening these anatomical areas.

Treating these structures with Bone Marrow Concentrate we were able to report:

  • at one-year follow-up, 100% of (4) patients in this study experienced a decrease in resting and active pain in addition to performing daily activities with less difficulty.
  • All four patients experienced sustained or increased improvement at annual follow-up compared to short-term follow-up.
  • On average, patients reported an 80% decrease in resting pain, a 78% decrease in active pain, and a 41% increase in functionality score.

Are these treatments right for you?  We have more than 20 years experience in helping patients with low back pain and we have seen many different types of low back pain. Knowing if these treatments are right for you begins with a conversation:

Are you a candidate for treatment? Ask Dr. Darrow


A leading provider of stem cell therapy, platelet rich plasma and prolotherapy
11645 WILSHIRE BOULEVARD SUITE 120, LOS ANGELES, CA 90025

PHONE: (800) 300-9300

References:

1 Marc Darrow, Brent Shaw, Schmidt Nicholas, Xian Li & Gabby Boeger | Tsai-Ching Hsu (Reviewing editor:) (2019) Treatment of unresolved lower back pain with platelet-rich plasma injections, Cogent Medicine, DOI: 10.1080/2331205X.2019.1581449
2
Marc Darrow, Brent Shaw BS. Treatment of Lower Back Pain with Bone Marrow Concentrate. Biomed J Sci&Tech Res 7(2)-018. BJSTR. MS.ID.001461. DOI: 10.26717/ BJSTR.2018.07.001461.
Mohammed S, Yu J. Platelet-rich plasma injections: an emerging therapy for chronic discogenic low back pain. J Spine Surg. 2018;4(1):115-122. 1263