Treating The Spine and Nerves with PRP (Platelet Lysate) Epidural Injections

Sciatica, pinched nerves and stenosis are painful conditions of the spinal nerves. They can be caused by herniated discs, arthritis or other injuries of the spine.  Pain, numbness and weakness of the back, buttocks and legs are the most common symptoms. These can be disabling and difficult to treat, but luckily, a novel regenerative medicine treatment has emerged. Epidural injections with Platelet Rich plasma (PRP) are safe and effective in treating the pain and helping your body heal. 


Epidural injections consist of injecting a medication into the space around
the spinal nerves, also known as the epidural space. This is done under precise image guidance such as ultrasound or X-ray by highly trained physicians. Most epidural injections performed by pain physicians use steroids as the active medication. Unfortunately, the effectiveness of steroid injections can be limited, short lived and often wears off with repeated procedures. Steroids can also cause many unwanted side effects such as hormonal changes, increased blood sugar (diabetes), bone and muscle loss and increased blood pressure (1).

More recently, epidural injections are performed using state of the art
orthobiologics such as Platelet Rich Plasma (PRP). PRP is solution of concentrated
platelets made by spinning the patient’s own blood within a centrifuge.
Platelets are packed with growth factors that mobilize the immune system to start healing. They are also packed with anti-inflammatory proteins that can calm down inflamed nerves, spinal discs and joints. 

For epidural injections, a specific formulation of PRP is used, it is called Platelet Lysate. Platelet lysate (PL) is made by lysing (breaking up) the platelets to release their anti-inflammatory proteins and healing growth factors. This process also removes any cellular debris from the solution, thus making it safe to inject into the epidural space. Clinical trials of Platelet Lysate epidural injections have shown them to be safe and effective in providing long term results, without the side effects of steroids (2).

One study looked at a series of patients treated for disc herniations,
a common cause of low back and leg pain. They stated that “Lumbar injection
of platelet-rich plasma along with epidural injection of platelet lysate is
a novel therapeutic option that can initiate or expedite the resorption of
herniated lumbar disc material, which can facilitate the decompression of
the affected spinal structures.” (3)

Other studies comparing the two injections show that PRP epidural injections
can provide longer pain-relieving effects even in patients with complex
chronic low back pain. (4) 

For patients with simpler spinal pathology, we perform epidural injections
with platelet lysate to alleviate pain and improve function without the
long-term side effects of steroid injections. For those patients with more
complex pathology, we perform comprehensive Prolotherapy to the lumbar spine
and pelvis with PRP. This includes treatment of the spinal joints, supportive ligaments and tendons along with the epidural injections with Platelet Lysate. This
ensures that all the affected regions are appropriately treated to give our patients the best chance of success. 

Regardless of which treatment is most appropriate for your condition, it is best when combined with 1 on 1 physical therapy with licensed physical therapist. Often, state of the art Energy Modalities such as Laser and PEMF treatments are added as well to further support healing. 

If you are looking for an alternative to repeated epidural steroid
injections schedule your consultation today. 

References 
1: https://www.painphysicianjournal.com/current/pdf?article=MjUw&journal=11 
2: https://www.hindawi.com/journals/np/2021/5558138/ 
3: https://www.degruyter.com/document/doi/10.7556/jaoa.2020.032/html 
4: https://onlinelibrary.wiley.com/doi/10.1111/papr.12893

SWFL Low Back Pain Specialist

Southwest Florida's Chronic Pain Specialist

Dr. Sebastian Klisiewicz

D.O. Osteopathic Physiatrist, Board Certified in Physical Medicine and Rehabilitation