Platelet-Rich Plasma (PRP) is a non surgical treatment that has been used to treat musculoskeletal injuries for over twenty years. In 2019 a group of researchers studied the effects of PRP on 67 patients with unresolved low back pain. PRP is made by drawing and spinning the patients blood to concentrate the platelets in a solution that is then injected into the injured area. PRP concentration can range from 1.7 to 18 times your normal platelet concentration, depending on the method of PRP preparation used.
Generally speaking, the more platelets the better. Platelets help heal in many ways: they contain over 30 bioactive proteins that help the body heal, secrete seven protein growth factors that trigger the process of wound healing and contain three types of proteins that allow cells to adhere to one another, another critical process of healing. In the above mentioned study, 67 people received either one PRP treatment or a series of two or three PRP treatments into the ligaments, muscle and fascia surrounding the lumbar spine.
Each treatment was given approximately 3 weeks apart (in my opinion, for strong PRP treatments this was too close together, 4-6 weeks apart would have been better). Baseline and post-treatment measures of resting pain, active pain, functionality and overall improvement were compared between the groups. People who received one treatment reported a statistically significant 36% overall improvement and reduction in active pain relief.
Patients who got a 2 or 3 treatments experienced significant reductions in resting and active pain and overall improvement. This study found that PRP is a viable, safe non-surgical option for low back pain and warrants further investigation. The authors did not clarify the concentration of platelets in their PRP solutions and this is critical as it is easy to appreciate how 1.7x baseline platelets would be very different from 18x baseline platelet solution.
Nonetheless, the study reinforces what I find in my practice, PRP helps low back pain among many other musculoskeletal injuries and pain, particularly when given with the accuracy and safety of ultrasound guidance.