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Platelet-Rich Plasma for the Treatment of Low Back Pain: a Comprehensive Review

  • Hot Topics in Pain and Headache (N Rosen, Section Editor)
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Abstract

Purpose of Review

Back pain is a growing problem worldwide, incurring enormous economic costs and disability. Current treatment modalities often provide adequate relief but fail to address underlying conditions. Regenerative cellular modalities aim to restore anatomical function in degenerative conditions which may cause low back pain. Platelet-rich plasma (PRP) consists of an increased concentration of autologous platelets suspended in a small amount of plasma. PRP can be administered via injection or topically and is prepared using various techniques.

Recent Findings

While a unifying mechanism of action is not well understood, biochemical and cellular changes involved in inflammation and mechanical structure have been detected in both in vitro and in vivo studies. At a higher level, PRP injection research utilizing animal models and patient data have provided insights into pain relief, chondroprotection, and factors that impact the therapy’s efficacy. Recently, a small number of studies have promoted PRP injection as a relatively safe means of treating patients with degenerative disc disease who have failed other means of managing their lower back pain. PRP injections for sacroiliac joint–related pain are not an accepted or common treatment modality; the evidence for their efficacy remains to be seen outside of small RCTs and case reports. A small number of prospective trials have suggested there may be some benefit to using PRP injection in the treatment of pain or functional decline caused by facet joint arthropathy.

Summary

These commonly used modalities require further study to improve quality of evidence and to investigate the safety and efficacy of PRP injections for various common causes of chronic low back.

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Authors and Affiliations

  1. Department of Anesthesia, Critical Care, and Pain Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA, 02215, USA

    Ivan Urits & Vwaire J. Orhurhu

  2. Valley Anesthesiology and Pain Consultants, Phoenix, AZ, USA

    Omar Viswanath

  3. Department of Anesthesiology, University of Arizona College of Medicine-Phoenix, Phoenix, AZ, USA

    Omar Viswanath

  4. Department of Anesthesiology, Creighton University School of Medicine, Omaha, NE, USA

    Omar Viswanath

  5. Georgetown University School of Medicine, Washington, D.C., USA

    Annemarie C. Galasso

  6. University of Massachusetts Medical School, Worcester, MA, USA

    Emily R. Sottosani

  7. Harvard Medical School, Boston, MA, USA

    Keenan M. Mahan

  8. Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA

    Christopher M. Aiudi

  9. Department of Anesthesiology, Louisiana State University Health Sciences Center, New Orleans, LA, USA

    Alan D. Kaye

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  1. Ivan Urits
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Correspondence to Ivan Urits.

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Ivan Urits, Omar Viswanath, Annemarie C. Galasso, Emily R. Sottosani, Keenan M. Mahan, Christopher M. Aiudi, and Vwaire J. Orhurhu declare no conflict of interest.

Alan D. Kaye discloses that he is on the Speakers Bureau for Depomed, Inc., and Merck.

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Urits, I., Viswanath, O., Galasso, A.C. et al. Platelet-Rich Plasma for the Treatment of Low Back Pain: a Comprehensive Review. Curr Pain Headache Rep 23, 52 (2019). https://doi.org/10.1007/s11916-019-0797-6

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