31 million Americans experience low back pain at any given time. Pain can be classified into three main categorizes: acute, chronic and neuropathic. Chronic back pain can be extremely debilitating and lower quality of life. There are a variety of conditions that can cause back pain, including degenerative disc disease, a bulging disc, spondylosis, sarcoiliac joint pain and facet joint pain.
Our team of physicians at OPTIMAL Pain & Regenerative Medicine is dedicated to returning patients to a pain free life through regenerative therapies. OPTIMAL offers PRP spinal injections to treat patients suffering from chronic back pain living in the Dallas, Arlington and Ft. Worth communities.
Anatomy of the Spine
The spine is a made-up of 33 vertebra (7 cervical, 12 thoracic and 5 lumbar) that are stacked on top of one another. The vertebra are separated in the front by discs and in the back by facets. The natural alignment of the spine creates two forward curves called kyphosis and two backward curves called lordosis. Together, these two curves balance each other.
The facet joints are located at the back of the spine (posterior). Each vertebra has two sets of facet joints – one pair faces upward and the other downward. Between each vertebral body is a disc that acts as a shock absorber between adjacent vertebrae.
Which Conditions are Treated with PRP Spinal Injections?
Back pain can be caused for a number of reasons. For conditions that have not improved with other forms of treatment, PRP spinal injections may be an option for treating conditions associated with the neck, mid-back and lower back. Patients with the below conditions may see improvement with PRP treatment:
Degenerative Disc Disease
To understand degenerative disc disease, it is important to know the anatomy of the disc. The appearance of the disc is similar to a jelly filled donut. In the center of the “donut” is jelly (the nucleus) that helps with impact absorption of the spine. The outer part of the donut (the annulus) consists of rings or collagen that create a tough outer layer.
Over time, the discs can get tears in the disc, known as annular tears. The symptoms of annular tears can range from extremely debilitating to unknown. These annular tears can cause the nucleus to seep into the pain nerves that run through the spine. The nucleus is toxic to the nerves and aggravates them. This process is typically what starts degenerate disc disease.
A variety of conditions can develop depending on the type of tear in the disc.. When there is a complete tear in the disc, causing the nucleus of the disc to squeeze out of the back of the disc, it is classified as a herniated disc. The nerve root sits at the back of the disc and damage to the nerve root can lead to leg pain.
The disc can degenerate in other ways. When the disc back wall fails due to annular tears, it can create a bulging disc which can also lead to leg pain. A bulging disc can continue to degenerate leading to the disappearance of the nucleus leaving the patient without a shock absorber. Patients who suffer from this condition may suffer from chronic back pain and tend to stay away from impact activities.
Spondylosis happens when the disc between the two vertebra wears out and the facets in the back of the spine erode. When the facet joints become worn, it allows the affected top vertebra to move forward onto the vertebra below, creating a narrowing of the spinal canal. When the spinal canal narrows, it can impact the nerves and cause pain to the back, buttocks and legs.
These degenerative changes can ultimately lead to painful instability with bending and twisting. The degeneration of the vertebra can happen in the neck, mid-back and lower back, but is most commonly seen in the lower back at the L4-L5.
Sacroiliac Joint Pain
The sacroiliac joint, commonly referred to as a SI joint, is located in the pelvis and links the pelvis bone to the lowest part of the spine above the tailbone. The SI joint is made of two different types of joints combined into one. The SI joint is a common area of pain.
Facet Joint Pain
The lumbar facets are the joints in the back of the vertebra that are paired and hook the rear of the top vertebra to the back of the vertebra below. The facets are joints similar to the hip or knee and have cartilage that allows the joints to glide smoothly. When there is misalignment of the vertebrae, it can cause the facets to rub, degenerating the cartilage and causing arthritis. Facet joint pain can cause nerve compression in the spine that manifests as buttocks and leg pain.
How are PRP Spinal Injections Used to Treat Chronic Back Pain?
Platelet rich plasma (PRP) spinal injections are a non-surgical treatment option to treat chronic back pain caused by degenerative disc disease, bulging discs, spondylosis, sacroiliac joint pain and facet joint pain in the back. PRP injections combine modern technology with the body’s own abilities for accelerated healing. The spine naturally has a poor blood supply, which makes platelet rich plasma injections an effective treatment option. PPR spinal injections are recommended to patients suffering from chronic lower back pain when treatments such as medications, physical therapy, chiropractic treatment and steroid injections have failed to relive pain.
One of the four main components of a human’s blood is platelets. Platelets initiate tissue repair by releasing growth factors. These growth factors are a naturally occurring substance capable of stimulating cellular growth, proliferation, healing and cellular differentiation of chronic tendon injuries, acute ligament and muscle injuries.
To begin treatment, one of our trained physicians will remove approximately 30 milliliters of blood. This blood is then spun in a machine, called a centrifuge, that uses high speeds to separate the four main components of the blood. Once the components are separated, the platelet rich plasma is removed. The plasma is then injected into the site of pain in the neck or back releasing three to five times the growth factors compared to normal human blood. This allows the growth factors to recruit and increase the proliferation of reparative cells. In some cases, thrombin or calcium chloride will also be added into the injection as an “activating agent”.
The entire process takes less than 15 minutes. Response to treatment will vary with each patient. Most patients will require 1-3 sets of PRP injections. Each set of treatments is spaced 4-6 weeks apart. As PRP is obtained from your own blood, the risk of reaction is low. As with any injection, there is a small risk of injury to any structures in the area as well as a very small risk of infection.
If you have chronic back pain that has not be relieved with other forms of treatment, you may be a candidate for PRP spinal injections. Please contact OPTIMAL Pain & Regenerative Medicine at 817-472-2140 for an initial consultation. We serve the Dallas, Arlington and Fort Worth areas.