Introduction:
Arthritis pain of the lumbar spine is a common cause of lower back pain, especially in the mature population of Southwest Florida. It presents as pain and stiffness in the back that can radiate to the buttocks and hips. Spinal arthritis typically affects the facets joints of the spine, causing inflammation, joint space narrowing and bone spur formation. Common treatments involve anti-inflammatory medications or steroid injections, these can provide short term pain relief but come with many potential side effects.
Luckily, Platelet Rich Plasma (PRP) injections have emerged as a safe and effective treatment for back pain. PRP is a solution of concentrated platelets made from the patient’s blood. The platelets are packed with bioactive proteins that can decrease pain, resolve inflammation and stimulate tissue regeneration. PRP is natural and has the ability to improve the health and function of the spine. The study below demonstrates how PRP treatment can provide long term benefits in patients with spinal arthritis pain.
The Study:
In 2017, Dr. Wu and collogues published the results of his randomized controlled trial in the medical journal Pain Practice. Forty six patients with chronic back pain from lumbar spine facet arthritis were enrolled in the study. Half of the patients received X-ray guided PRP injections and the other half received X-ray guided steroid (cortisone) injections. The patients were blinded to which injection they received. After the injections, their back pain and function were assessed regularly for up to 6 months. Disability questionnaires were used to assess how badly their function was affected by their low back pain (lower score indicated less disability and better function).
The Results:
Both groups of patients achieved significant pain relief in the 1st month (~ 50% pain reduction). In the PRP group, the pain decreased even further at months 2, 3 and 6. On the other hand, in the steroid group, the pain slowly returned towards baseline over several months. A similar trend was seen in the improvement of function. The disability scores decreased in both groups in the 1st month and kept on improving in the PRP group during the study. In the steroid group, the disability scores slowly increased over the remaining 5 months of the study. There were no complications during the course of the study.
Conclusion:
Platelet Rich Plasma (PRP) injections are safe and effective treatments of lumbar spine arthritis. PRP can provide long term pain relief and improvement in function in patients with chronic back pain. PRP does not have the negative side effects that can be seen with steroids such as increased blood sugar, muscle and bone loss, hormonal imbalance, anxiety and insomnia. PRP has powerful anti-inflammatory and regenerative properties that can improve the health and function of the spine.
References:
- Wu, Jiuping, et al. “A prospective study comparing platelet‐rich plasma and local anesthetic (LA)/corticosteroid in intra‐articular injection for the treatment of lumbar facet joint syndrome.” Pain Practice 17.7 (2017): 914-924.
