Platelet-Rich Plasma Injections: Pharmacological and Clinical Considerations in Pain Management

Curr Pain Headache Rep. 2022 Oct;26(10):741-749. doi: 10.1007/s11916-022-01082-2. Epub 2022 Sep 10.

Abstract

Purpose of review: Regenerative medicine through interventional pain procedures is evolving with data demonstrating efficacy for a number of pain states in recent years. Platelet-rich plasma (PRP), defined as a sample of plasma with a platelet concentration 3 to 5 times greater than the physiologic platelet concentration found in healthy whole blood, releases bioactive proteins which can restore anatomical function in degenerative states. PRP is dense in growth factors, such as platelet-derived growth factor, transforming growth factor-beta1, basic fibroblastic growth factor, vascular endothelial growth factor, and epidermal growth factors.

Recent findings: To date, well-designed case-control or cohort studies for the use of PRP have demonstrated efficacy in lumbar facet joint, lumbar epidural, and sacroiliac joint injections. At present, there is only level IV evidence indicating the need for larger and more carefully controlled prospective studies. PRP is utilized autogenously in order to facilitate healing and injection and has been studied in the long-term management of discogenic low back pain. In this regard, numerous studies have evaluated PRP to steroid injections in chronic pain states with favorable results. PRP represents an opportunity for a new strategy in the therapeutic treatment of degenerative states of spines, joints, and other locations throughout the body with evolving data demonstrating both safety and long-term efficacy.

Keywords: Chronic pain; Lumbar epidural; Lumbar facet joint; Platelet-rich plasma; Sacroiliac joint injections.

Publication types

  • Review

MeSH terms

  • EGF Family of Proteins
  • Humans
  • Intercellular Signaling Peptides and Proteins
  • Low Back Pain* / drug therapy
  • Pain Management / methods
  • Platelet-Derived Growth Factor
  • Platelet-Rich Plasma*
  • Prospective Studies
  • Steroids
  • Transforming Growth Factor beta1
  • Vascular Endothelial Growth Factor A

Substances

  • Transforming Growth Factor beta1
  • Vascular Endothelial Growth Factor A
  • Intercellular Signaling Peptides and Proteins
  • Platelet-Derived Growth Factor
  • EGF Family of Proteins
  • Steroids