Date of Award
Selective Evidence-Based Medicine Review
Master of Science in Health Sciences - Physician Assistant
Physician Assistant Studies
Laura Levy, DHSc, PA-C
Objective: The objective of this selective EBM review is to determine whether or not PRP injections are more effective in decreasing chronic lower back pain as compared to epidural injections in young adults.
Study Design: Systematic review of three English language randomized controlled trials (RCTs), all published after 2012.
Data Sources: Two double-blind RCTs and one randomized open blinded end point (PROBE), which analyzed the effectiveness of PRP and epidural injections in young adults with chronic lower back pain. All studies were found using PubMed.
Outcome(s) Measured: Each of the articles analyzed the pain relief and function ability stated by the patient post PRP injections and epidural injections. These outcomes were measured using the visual analog scale score (VAS), the average of Numeric Rating Scale (NRS), the Oswestry Disability Index (ODI), the Modified Oswestry Disability questionnaire (MODQ), and the Functional Rating Index (FRI). Significance was determined using p-values for all three studies.
Results: Manchikanti et al. (2014) found that there was no significant difference between the use of local anesthetic alone compared to local anesthetic and steroid when treating chronic lower back pain in regards to pain and function measured by NRS and ODI scores. Singla et al. (2017) found that the pain significantly decreased at 6 weeks in patients treated with PRP injections compared to the group treated with steroid injections. This study also showed that the efficacy of PRP injections at 3 months was 90% compared to only 25% in the group with steroid injections. Tuakli-Wosornu et al. (2016) found that patients treated with PRP injections showed statistically significant improvements in pain and function 8 weeks post-procedure in regards to NRS best pain and FRI score.
Conclusions: the results from the three randomized controlled studies demonstrated that PRP injections are more effective in decreasing chronic lower back pain compared to epidural steroid injections by having less procedures, less adverse effects and providing lasting pain relief.
Leones, Linda M., "Are Plasma Rich Platelets More Effective In Decreasing Chronic Lower Back Pain As Compared To Epidural Injections In Young Adults?" (2019). PCOM Physician Assistant Studies Student Scholarship. 472.