Interventional pain physicians at The Ohio State University Wexner Medical Center are utilizing platelet-rich plasma (PRP) injections to treat sacroiliac (SI) joint pain and back pain. Also called orthobiologic injection-based therapy, the treatment has been widely studied and used for knee osteoarthritis. Physicians have now expanded into using the therapy to treat other joints, particularly in the spine.
“We use platelet-rich plasma therapy in place of steroid injections,” says Whitney Luke, MD, an interventional pain physician at Ohio State Spine Care. “Studies have shown PRP therapy to provide longer-lasting benefits than steroids, which may only last a few weeks or months. PRP therapy also has fewer risks and side effects than steroids and is safe for continuous use.”
How the platelet-rich plasma procedure works
Platelet-rich plasma comes from the patient’s own blood, so the treatment doesn’t involve other medications that could have effects on hormones or other functions of the body.
The PRP procedure takes about 30 minutes and begins with drawing some of the patient’s blood, then uses a centrifuge to isolate platelets containing healing proteins. Ohio State Spine Care’s advanced system allows physicians to customize the therapy to each patient’s needs, adjusting the blood volume, cell content and platelet concentration as needed. The platelets are then injected into the affected area of the spine.
“PRP promotes anti-inflammatory and growth factors to help decrease inflammation within joints and potentially heal or regrow tissue,” Dr. Luke explains.
She notes that PRP is often confused with stem cell therapy, but they are different treatments.
“Stem cell therapy is not currently recommended because there’s not enough evidence that it works,” she says.
There aren’t many downsides to PRP, Dr. Luke adds.
“Every treatment carries some risk, but the risks are fairly minimal like we see with other injections.”
PRP for back pain
Dr. Luke says many other medical institutions don’t offer the treatment, particularly for patients with back pain. Ohio State Spine Care provides multidisciplinary evaluations to patients with back pain. This is essential because many patients with back pain are misdiagnosed.
“We want to make sure we’re targeting the correct etiology of pain,” she says. “SI joint pain is a major cause of back pain that often gets attributed to something else, like a pinched nerve or sciatic nerve pain. We’re using PRP mainly for these patients, along with those who have had previous back surgery or spinal fusion.”
Pain relief from PRP therapy can last six months to a year, and possibly longer. Dr. Luke says she has seen some patients who experienced pain relief for more than two years.
“Often, patients have gotten short-term relief from steroid injections in the SI joint or other joints in the spine, but they don’t experience longer-lasting pain relief,” she says. “Many are looking for a treatment that offers longer-term pain relief and improved function for activities of daily living.”
PRP therapy can work for patients of all ages. Dr. Luke says patients must discontinue the use of anticoagulation therapy, including aspirin, for a short period before and after treatment. Patients who have active cancer, an infection or a blood disorder likely would not be good candidates for PRP, she adds.
PRP research at Ohio State Spine Care
Because PRP is still considered an experimental treatment, it isn’t covered by most insurance providers. However, Dr. Luke and her colleagues are investigating data trends to determine the PRP’s efficacy. The hope is that, with more published data, insurance companies will reconsider covering the treatment.
When to refer a patient for PRP therapy
“Many people complain about back pain, and there are so many reasons for it,” Dr. Luke says. “If a provider has a patient with back pain who’s been through other treatments without long-term relief, it may be worth referring them to see if PRP could be utilized.”