Injections of a patient’s own blood could ease the agony of back pain.
The treatment uses injections of platelet-rich plasma, or PRP, a mixture of blood cells (called platelets) and plasma, the liquid element of blood.
Platelets not only help blood clot, but they also contain proteins called growth factors that aid the healing process and, in the case of back pain, appear to trigger the growth of new healthy cells and tissue. PRP injections have been used for a variety of conditions, including sports injuries and hair loss, since the 1970s.
Platelet-rich plasma injection, or PRP, may offer longer-lasting back pain relief than conventional methods
But new research also shows that for back pain it is more effective, in the long term, than conventional methods such as steroid injections, local anesthetic injections or radiofrequency ablation (where a hot needle is used to destroy the nerve endings that transmit pain signals).
At least three million people in the UK suffer from chronic and severe back pain. It is usually due to degeneration of the discs and bones and compression of the nerves, but the exact cause is often unknown.
Treatments include oral and injectable painkillers and sometimes surgery to relieve pressure on the nerves. But the latest study, from Kunming Medical University in China, suggests that PRP injections could be a more effective alternative.
A small sample of the patient’s blood is centrifuged to produce a liquid with a platelet concentration up to eight times higher than normal blood, which significantly increases the growth factor content. It is then injected into the patient.
Over the next few weeks and months, the healing proteins in the injection are thought to help repair the damaged tissue that is the source of the pain.
However, most of the evidence on PRP treatment comes from small studies, involving a couple of dozen patients. As a result, it is only available on the NHS for sports-related injuries and problems, such as tennis elbow.
For the latest research, data from four studies involving more than 150 patients with lower back pain were combined. The results, published in the Journal of Pain Research, showed that four weeks after treatment, 55 percent of patients who received PRP said they were virtually pain-free. This was not as good as lidocaine (local anesthetic) injections, which worked in 59.7 percent of patients, or steroid injections, in 67 percent. Radiofrequency worked in only 18 percent after four weeks.
But six months after treatment, nearly 80 percent of PRP-treated patients were pain-free, compared with 77 percent in the radiofrequency group, 42 percent of the lidocaine patients and less than 1 percent in the steroid injection group.
Researchers believe PRP speeds up long-term tissue repair and increases the amount of collagen, a fibrous material that strengthens tissue. Mike McNicholas, consultant orthopaedic and trauma surgeon at Liverpool University Hospitals, said: “As past president of the UK Biological Knee Society, I have been watching with interest the introduction of PRP as a therapeutic option.
‘These results are encouraging, but further independent, well-designed studies will be needed before PRP can be offered for the treatment of joint pain and back pain.’
