Skip to main content
Top

Open Access 08-06-2024 | Back Pain | Chronic Pain Medicine (O Viswanath, Section Editor)

The Role of Platelet Rich Plasma in Vertebrogenic and Discogenic Pain: A Systematic Review and Meta-Analysis

Authors: Saurabh Kataria, Jeremiah Hilkiah Wijaya, Utsav Patel, Kevin Yabut, Tawfiq Turjman, Muhammad Abubakar Ayub, Nihar Upadhyay, Moinulhaq Makrani, Hisham Trujman, Ahmed Mostafa Abdalla Mohamed, Alan D. Kaye

Published in: Current Pain and Headache Reports

Login to get access

Abstract

Purpose of Review

The present investigation evaluates clinical uses and roles of platelet rich plasma in the management of vetrebrogenic and discogenic mediated pain states.

Recent Findings

Back pain is a common and significant condition that affects millions of people around the world. The cause of back pain is often complex and multifactorial, with discogenic and vertebrogenic pain being two subtypes of back pain. Currently, there are numerous methods and modalities in which back pain is managed and treated such as physical therapy, electrical nerve stimulation, pharmacotherapies, and platelet-rich plasma. To conduct this systematic review, the authors used the keywords “platelet-rich plasma”, “vertebrogenic pain”, and “discogenic pain”, on PubMed, EuroPMC, Who ICTRP, and clinicaltrials.gov to better elucidate the role of this treatment method for combating vertebrogenic and discogenic back pain. In recent decades, there has been a rise in popularity of the use of platelet-rich plasma for the treatment of numerous musculoskeletal conditions. Related to high concentration of platelets, growth factors, cytokines, and chemokines, platelet-rich plasma is effective in reducing pain related symptoms and in the treatment of back pain.

Summary

Platelet-rich plasma use has evolved and gained popularity for pain related conditions, including vertebrogenic and discogenic back pain. Additional well-designed studies are warranted in the future to better determine best practice strategies to provide future clinicians with a solid foundation of evidence to make advancements with regenerative medical therapies such as platelet-rich plasma.
Appendix
Available only for authorised users
Literature
1.
2.
go back to reference • Tuakli-Wosornu YA, Terry A, Boachie-Adjei K, Harrison JR, Gribbin CK, LaSalle EE, et al. Lumbar Intradiskal Platelet-Rich Plasma (PRP) injections: A prospective, double-blind, randomized controlled study. PM and R. 2016;8:1–10. https://doi.org/10.1016/j.pmrj.2015.08.010. This article provides excellent understanding of the use of Platelet rich plasma in the form of autologous injections and its significant role in reduction of the intradiscal pain. • Tuakli-Wosornu YA, Terry A, Boachie-Adjei K, Harrison JR, Gribbin CK, LaSalle EE, et al. Lumbar Intradiskal Platelet-Rich Plasma (PRP) injections: A prospective, double-blind, randomized controlled study. PM and R. 2016;8:1–10. https://​doi.​org/​10.​1016/​j.​pmrj.​2015.​08.​010This article provides excellent understanding of the use of Platelet rich plasma in the form of autologous injections and its significant role in reduction of the intradiscal pain.
3.
go back to reference • Singla V, Batra YK, Bharti N, Goni VG, Marwaha N. Steroid vs. Platelet-Rich Plasma in ultrasound-guided sacroiliac joint injection for chronic low back pain. Pain Practice [Internet]. 2017;17:782–91. https://doi.org/10.1111/papr.12526. This article provides an insight of comparison between steroid and PRP in the management of pain by using ultrasound and VAS.CrossRefPubMed • Singla V, Batra YK, Bharti N, Goni VG, Marwaha N. Steroid vs. Platelet-Rich Plasma in ultrasound-guided sacroiliac joint injection for chronic low back pain. Pain Practice [Internet]. 2017;17:782–91. https://​doi.​org/​10.​1111/​papr.​12526. This article provides an insight of comparison between steroid and PRP in the management of pain by using ultrasound and VAS.CrossRefPubMed
4.
go back to reference Xu Z, Wu S, Li X, Liu C, Fan S, Ma C. Ultrasound-guided transforaminal injections of Platelet-Rich Plasma compared with steroid in lumbar disc herniation: a prospective, randomized, controlled study. Neural Plast. Hindawi Limited; 2021. https://doi.org/10.1155/2021/5558138. Xu Z, Wu S, Li X, Liu C, Fan S, Ma C. Ultrasound-guided transforaminal injections of Platelet-Rich Plasma compared with steroid in lumbar disc herniation: a prospective, randomized, controlled study. Neural Plast. Hindawi Limited; 2021. https://​doi.​org/​10.​1155/​2021/​5558138.
5.
go back to reference • Won SJ, Kim DY, Kim JM. Effect of platelet-rich plasma injections for chronic nonspecific low back pain: a randomized controlled study. Medicine 2022;101:E28935. February 25, 2022. https://doi.org/10.1097/MD.0000000000028935. A randomized controlled study showing the effectiveness of PRPin chronic nonspecific low back pain at 4 weeks, 3 and 6 months. • Won SJ, Kim DY, Kim JM. Effect of platelet-rich plasma injections for chronic nonspecific low back pain: a randomized controlled study. Medicine 2022;101:E28935. February 25, 2022. https://​doi.​org/​10.​1097/​MD.​0000000000028935​. A randomized controlled study showing the effectiveness of PRPin chronic nonspecific low back pain at 4 weeks, 3 and 6 months.
7.
go back to reference • Akeda K, Takegami N, Yamada J, Fujiwara T, Ohishi K, Tamaru S, et al. Platelet-Rich Plasma-Releasate (PRPr) for the treatment of discogenic low back pain patients: long-term follow-up survey. Medicina (Lithuania). 2022;58. https://doi.org/10.3390/medicina58030428. Authors report that the use of PRPr in the management of Low back pain is significantly effective and showed improvement in pain without hindering daily life activities for up to 5 years after the treatment period. • Akeda K, Takegami N, Yamada J, Fujiwara T, Ohishi K, Tamaru S, et al. Platelet-Rich Plasma-Releasate (PRPr) for the treatment of discogenic low back pain patients: long-term follow-up survey. Medicina (Lithuania). 2022;58. https://​doi.​org/​10.​3390/​medicina58030428​. Authors report that the use of PRPr in the management of Low back pain is significantly effective and showed improvement in pain without hindering daily life activities for up to 5 years after the treatment period.
8.
go back to reference • Akeda K, Ohishi K, Takegami N, Sudo T, Yamada J, Fujiwara T, et al. Platelet-Rich Plasma Releasate versus Corticosteroid for the treatment of discogenic low back pain: a double-blind randomized controlled trial. J Clin Med. 2022;11(2):304. https://doi.org/10.3390/jcm11020304. A randomized, double-blind, active-controlled clinical trial showing that the PRPr group had a significantly improved disability score at 26 weeks and walking ability scores at four and eight weeks, and PRPr treatment relieved pain, and improved disability and QOL during 60 weeks of observation. • Akeda K, Ohishi K, Takegami N, Sudo T, Yamada J, Fujiwara T, et al. Platelet-Rich Plasma Releasate versus Corticosteroid for the treatment of discogenic low back pain: a double-blind randomized controlled trial. J Clin Med. 2022;11(2):304. https://​doi.​org/​10.​3390/​jcm11020304. A randomized, double-blind, active-controlled clinical trial showing that the PRPr group had a significantly improved disability score at 26 weeks and walking ability scores at four and eight weeks, and PRPr treatment relieved pain, and improved disability and QOL during 60 weeks of observation.
9.
go back to reference • Zielinski MA, Evans NE, Bae H, Kamrava E, Calodney A, Remley K, et al. Safety and efficacy of platelet rich plasma for treatment of lumbar discogenic pain: a prospective, multicenter, randomized, double-blind study. Pain Physician [Internet]. 2022;25:29–34. http://europepmc.org/abstract/MED/35051141. In this RCT authors clearly describes the use of PRP and its impact on lumbar discogenic pain and the outcomes suggesting a significant reduction in the patient group rather than the control group. • Zielinski MA, Evans NE, Bae H, Kamrava E, Calodney A, Remley K, et al. Safety and efficacy of platelet rich plasma for treatment of lumbar discogenic pain: a prospective, multicenter, randomized, double-blind study. Pain Physician [Internet]. 2022;25:29–34. http://​europepmc.​org/​abstract/​MED/​35051141. In this RCT authors clearly describes the use of PRP and its impact on lumbar discogenic pain and the outcomes suggesting a significant reduction in the patient group rather than the control group.
10.
go back to reference Mohi Eldin M, Salah Eldin A, Baraka M, Khorshied M. intradiscal injection of autologous platelet-rich fibrin versus platelet-rich plasma in discogenic lumbar pain an applied comparative study. J Orthop Trauma Surg Relat Res. 2020;15:18–24. Mohi Eldin M, Salah Eldin A, Baraka M, Khorshied M. intradiscal injection of autologous platelet-rich fibrin versus platelet-rich plasma in discogenic lumbar pain an applied comparative study. J Orthop Trauma Surg Relat Res. 2020;15:18–24.
13.
go back to reference • Lam KHS, Hung CY, Wu TJ, Chen WH, Ng TKT, Lin JA, et al. Novel ultrasound-guided cervical intervertebral disc injection of Platelet-Rich Plasma for cervicodiscogenic pain: a case report and technical note. Healthcare 2022;10(8):1427. https://doi.org/10.3390/healthcare10081427. This report presents a novel ultrasound-guided needle placement technique to the cervical intervertebral discs using a more medial approach between the trachea/thyroid gland and the carotid sheath. • Lam KHS, Hung CY, Wu TJ, Chen WH, Ng TKT, Lin JA, et al. Novel ultrasound-guided cervical intervertebral disc injection of Platelet-Rich Plasma for cervicodiscogenic pain: a case report and technical note. Healthcare 2022;10(8):1427. https://​doi.​org/​10.​3390/​healthcare100814​27. This report presents a novel ultrasound-guided needle placement technique to the cervical intervertebral discs using a more medial approach between the trachea/thyroid gland and the carotid sheath.
15.
go back to reference • Muthu S, Jeyaraman M, Chellamuthu G, Jeyaraman N, Jain R, Khanna M. Does the intradiscal injection of Platelet Rich Plasma have any beneficial role in the management of lumbar disc disease? Global Spine J. SAGE Publications Ltd; 2022. Vol. 12(3), p. 503–14. https://doi.org/10.1177/2192568221998367. A meta-analysis of 13 studies involving 319 patients to evaluate whether intradiscal Platelet Rich Plasma(PRP) injection has any beneficial role in the management of lumbar disc disease. • Muthu S, Jeyaraman M, Chellamuthu G, Jeyaraman N, Jain R, Khanna M. Does the intradiscal injection of Platelet Rich Plasma have any beneficial role in the management of lumbar disc disease? Global Spine J. SAGE Publications Ltd; 2022. Vol. 12(3), p. 503–14. https://​doi.​org/​10.​1177/​2192568221998367​. A meta-analysis of 13 studies involving 319 patients to evaluate whether intradiscal Platelet Rich Plasma(PRP) injection has any beneficial role in the management of lumbar disc disease.
16.
go back to reference • Akeda K, Fujiwara T, Takegami N, Yamada J, Sudo A. Retrospective analysis of factors associated with the treatment outcomes of intradiscal platelet-rich plasma-releasate injection therapy for patients with discogenic low back pain. Medicina (Lithuania). 2023;59(4):640. https://doi.org/10.3390/medicina59040640. This study depicts to evaluate the changes in the imaging of Intervertebral disc degenratiion and different outcomes in its association with PRP. • Akeda K, Fujiwara T, Takegami N, Yamada J, Sudo A. Retrospective analysis of factors associated with the treatment outcomes of intradiscal platelet-rich plasma-releasate injection therapy for patients with discogenic low back pain. Medicina (Lithuania). 2023;59(4):640. https://​doi.​org/​10.​3390/​medicina59040640​. This study depicts to evaluate the changes in the imaging of Intervertebral disc degenratiion and different outcomes in its association with PRP.
22.
go back to reference • Lutz C, Cheng J, Prysak M, Zukofsky T, Rothman R, Lutz G. Clinical outcomes following intradiscal injections of higher-concentration platelet-rich plasma in patients with chronic lumbar discogenic pain. Int Orthop (SICOT). 2022;46:1381–85. https://doi.org/10.1007/s00264-022-05389-y. This retrospective study included 37 patients who received intradiscal injections of higher-concentration (> 10 ×) PRP and findings from this study suggest that clinical outcomes can be optimized by using PRP preparations that contain a higher concentration of platelets. • Lutz C, Cheng J, Prysak M, Zukofsky T, Rothman R, Lutz G. Clinical outcomes following intradiscal injections of higher-concentration platelet-rich plasma in patients with chronic lumbar discogenic pain. Int Orthop (SICOT). 2022;46:1381–85. https://​doi.​org/​10.​1007/​s00264-022-05389-yThis retrospective study included 37 patients who received intradiscal injections of higher-concentration (> 10 ×) PRP and findings from this study suggest that clinical outcomes can be optimized by using PRP preparations that contain a higher concentration of platelets.
23.
go back to reference • Patel A, Koushik S, Schwartz R, Gritsenko K, Farah F, Urits I, et al. Platelet-rich plasma in the treatment of facet mediated low back pain: a comprehensive review. Orthop Rev. 2022;14(4):37076. https://doi.org/10.52965/001c.37076. This comprehensive review indicates that PRP injections for facet mediated or modulated pain are an alternative to conventional pharmacotherapies and interventional injections/radiofrequency. • Patel A, Koushik S, Schwartz R, Gritsenko K, Farah F, Urits I, et al. Platelet-rich plasma in the treatment of facet mediated low back pain: a comprehensive review. Orthop Rev. 2022;14(4):37076. https://​doi.​org/​10.​52965/​001c.​37076. This comprehensive review indicates that PRP injections for facet mediated or modulated pain are an alternative to conventional pharmacotherapies and interventional injections/radiofrequency.
24.
26.
go back to reference • Andia I, Atilano L, Maffulli N. Moving toward targeting the right phenotype with the right platelet-rich plasma (PRP) formulation for knee osteoarthritis. Ther Adv Musculoskelet Dis. 2021;13. https://doi.org/10.1177/1759720X211004336. Authors thoroughly highlight the use of PRP in OA patient by focusing on mechanism of actions, future directions along with the right phenotype. • Andia I, Atilano L, Maffulli N. Moving toward targeting the right phenotype with the right platelet-rich plasma (PRP) formulation for knee osteoarthritis. Ther Adv Musculoskelet Dis. 2021;13. https://​doi.​org/​10.​1177/​1759720X21100433​6. Authors thoroughly highlight the use of PRP in OA patient by focusing on mechanism of actions, future directions along with the right phenotype.
Metadata
Title
The Role of Platelet Rich Plasma in Vertebrogenic and Discogenic Pain: A Systematic Review and Meta-Analysis
Authors
Saurabh Kataria
Jeremiah Hilkiah Wijaya
Utsav Patel
Kevin Yabut
Tawfiq Turjman
Muhammad Abubakar Ayub
Nihar Upadhyay
Moinulhaq Makrani
Hisham Trujman
Ahmed Mostafa Abdalla Mohamed
Alan D. Kaye
Publication date
08-06-2024
Publisher
Springer US
Published in
Current Pain and Headache Reports
Print ISSN: 1531-3433
Electronic ISSN: 1534-3081
DOI
https://doi.org/10.1007/s11916-024-01274-y