Lower back pain is one of the most common health conditions that is experienced in the US, with around 80% of people experiencing it at some point in their lives.
As we get older, this condition becomes even more common owing to our experiences of various traumas and accidents, lack of regular exercise, and also conditions like osteoporosis and disc degeneration.
For many years, doctors have been using steroid injections to reduce the inflammation around herniated or slipped discs but, recent years have seen a shift away from traditional medications to more natural treatments for all types of conditions, back pain included.
In this article we take a look at platelet-rich plasma injections for low back pain and see if they actually work or not.
What Is Platelet-Rich Plasma?
The sports world is often the first place to find those who are interested in trying out some of the latest treatments in the market. Pro athletes like Tiger Woods (golf), Alex Rodriguez (baseball), Tyson Gay (sprinting), and Rafael Nadal (tennis) are some of the more famous people who have used platelet-rich plasma therapy.
Platelet rich plasma injections (PRP) is a revolutionary treatment that is causing a stir in the healthcare world. Unlike more traditional back pain treatments like surgery, PRP is a natural treatment that is less invasive, doesn’t require much downtime and doesn’t carry the same risks that steroids and other medications do.
PRP is derived from your own blood and is seen as a much safer alternative when it comes to managing soft tissue injuries.
How Does Platelet Rich Plasma Treatment Work?
PRP is classified as a form of regenerative medicine. Regenerative medicine is a new way of treating injuries and diseases that uses specially-grown or harvested cells and tissues to restore normal functioning in the body.
Typically a PRP treatment lasts about 30 minutes. During the treatment blood is drawn from your arm and then the doctor uses a special centrifuge to separate platelet-rich plasma from the rest of your blood components.
The doctor will then inject the new platelet rich plasma into the area of your body that is affected by pain using either an ultrasound or fluoroscopy for accuracy and efficacy. Affected areas often include joints, tendons, bursa and spinal discs.
PRP treatment has even been touted for use in things like hair regrowth and non-invasive facelifts (called Vampire Facelifts!). The premise is that the enhanced plasma will jump start the body’s natural healing process.
How Does PRP Stimulate Healing?
PRP works by initiating an inflammatory response in the body's tissue so it is important to avoid using anti-inflammatory drugs (like ibuprofen or aspirin) for a couple of weeks before your treatment.
Platelets are one of the essential “building blocks” of blood and contain special growth factors - chemicals that play a major role in the healing process. Platelets also contain proteins that trigger stem cells (sort of like blank building blocks for the body) to move into the treatment area.
These stem cells, along with the growth factors, help the body to make new, healthy tissue, thereby healing and repairing the damaged tissue.
How Long Is The Recovery Time For PRP?
While inflammation and healing are processes that occur naturally in our bodies in response to injuries or other trauma, they don’t always happen at a level that is high enough for optimal repair. PRP gives a boost to a specific injury or area to ensure maximum results.
Typically patients are able to return to their normal activities directly following the procedure. For injections in the tendons, however, doctors often advise against any sort of strenuous activity for a few weeks, along with a physical therapy regimen.
Typically after a PRP treatment you might feel sore for a couple of days but most symptoms disappear after that. Recovery is generally fairly quick but as you can see, there can be situations where there might be some downtime.
What Does The Science Say About PRP?
So, now that you know some pretty famous people are doing it, what about us regular people? What does the science say and will it work for low back pain?
Unfortunately, right now, we still don’t really know. At the Ohio State University Wexner Medical Center, interventional pain physicians are currently using PRP to treat back pain and sacroiliac joint pain in place of traditional steroid injections.
Studies on PRP
Currently, most of the studies done on PRP for back pain have been conducted on animals. One systematic review of three studies did find PRP injections to be effective in “relieving pain and improving disabilities caused by discogenic lower back pain”.
Unfortunately the authors of the study also discovered that the “pain-reducing effect significantly manifests two or six months after the injections, but not after one month”. This means that patients may have to wait a considerable amount of time before fully feeling the benefits of this unique treatment.
A different study, published in 2017 in Asian Spine Journal found that after PRP, study participants reported less pain one month later, unfortunately this trial only had 14 subjects in it, so the results were somewhat limited.
More Recent Clinical Studies
More promising results, published in the Journal of Pain Research in 2019, suggested that PRP might be able to restore both structure and function in spines affected by disc degeneration.
A more recent clinical review published in August of 2023 in the journal Biomedicines looked at around 40 clinical studies investigating the effectiveness of PRP for low back pain.
The researchers found that 'PRP therapy offers a less invasive and safe alternative for the treatment of chronic low back pain' and that PRP 'also minimizes the risks associated with more invasive treatment options.'
Physicians there feel that the therapy is safer and provides longer lasting benefits to patients than steroids. The only downside to the treatment is that the effects often only last a few weeks - or a few months if the patient is lucky.
Since the cost of the treatments can range anywhere between $300 and $2,500, this can be a particularly expensive treatment and is out of the reach for many low back pain sufferers.
Is Platelet Rich Plasma Covered By Insurance?
Although PRP has been widely studied for the treatment of knee osteoarthritis, it is still considered to be an experimental treatment, especially for the treatment of low back pain.
What this means that PRP treatment isn’t covered by most insurance providers, leaving patients to pay for the full cost out of their own pockets. Since this treatment often requires more than one session, the costs can quickly add up.
It is important to know that, due to the lack of evidence for its effectiveness in treating certain conditions, such as low back pain, not all providers are willing to perform this procedure.
As more studies are conducted and published, however, many providers are hopeful that there will be more evidence to support PRP and that insurance companies may consider covering the treatment in the near future.
Conclusions
In this day and age, with so many people looking for more natural alternatives to wellness and healing, it is no surprise that PRP has been so readily accepted by so many people. The side effects are minimal and it certainly seems as if there are benefits to be gained through this treatment.
Hopefully more research will continue to be done and the results will convince insurance companies to add this to the list of reimbursable treatment options in the fight against low back pain.
While this treatment probably won’t be the preferred choice for everyone, having more scientifically-proven low back pain treatment options is a win for everyone who is suffering from this condition.