Injections of the patient’s own blood could relieve back pain.
The treatment consists of injections of platelet-rich plasma, or PRP: a mixture of blood cells (called platelets) and plasma, the liquid component of blood.
In addition to helping blood clot, platelets contain proteins called growth factors that aid in the healing process. In the case of back pain, these appear to stimulate the growth of healthy new cells and tissue. PRP injections have been used since the 1970s for a number of conditions, including sports injuries and hair loss.
Injecting platelet-rich plasma, or PRP, may provide greater long-term relief from back pain than conventional methods
However, new research also shows that in the long term it is more effective for back pain than conventional methods such as steroid injections, local anesthetics or radiofrequency ablation (which uses a heated needle to destroy the nerve endings that transmit pain signals).
At least three million people in the UK suffer from severe, chronic back pain. It is usually caused by degenerating discs and bones, and pinched nerves, but the exact cause is often unknown.
Treatments include oral and injected painkillers and, occasionally, 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 spun in a centrifuge to produce a fluid with up to eight times the platelet concentration of normal blood, significantly increasing the growth factor content. This is then injected into the patient.
It is thought that the healing proteins in the injection help repair damaged tissue that is the source of the pain over the following weeks and months.
However, most of the evidence for PRP treatment comes from small studies involving a few dozen patients. As a result, it is only available on the NHS for sports-related injuries and problems such as tennis elbow.
The latest study pooled data from four studies involving more than 150 patients with lower back pain. The results, published in the Journal of Pain Research, showed that four weeks after treatment, 55 percent of PRP patients reported being largely pain-free. This was not as good as lidocaine (local anesthetic) injections, which worked for 59.7 percent of patients, or steroid shots, which worked for 67 percent. Radiofrequency worked for only 18 percent after four weeks.
But six months after treatment, nearly 80 percent of patients treated with PRP were pain-free, compared with 77 percent of patients in the radiofrequency group, 42 percent of patients given lidocaine, and less than 1 percent of patients in the steroid injection group.
Researchers believe that in the long term, PRP speeds up tissue repair and increases the amount of collagen, a fibrous material that increases tissue strength. Mike McNicholas, a consultant trauma and orthopaedic surgeon at Liverpool University Hospitals, said: ‘As a former president of the UK Biological Knee Society, I have followed the introduction of PRP as a therapeutic option with interest.
‘These results are encouraging, but more independent, well-designed studies are needed before PRP can be marketed as a treatment for painful joints and back pain.’