Date of Award

2020

Degree Type

Selective Evidence-Based Medicine Review

Degree Name

Master of Science in Health Sciences - Physician Assistant

Department

Physician Assistant Studies

Abstract

OBJECTIVE: The objective of this selective evidence based medicine review is to determine whether or not “Are PRP injections effective at decreasing chronic low back pain in adults?”

STUDY DESIGN: Systematic review of two randomized control trials and one prospective clinical evaluation written in English, published after the year 2012.

DATA SOURCES: All three articles were found in peer review journals published via PubMed Database.

OUTCOME MEASURED: The primary outcome measured in each study is self-reported pain at baseline and 4 weeks following injection of PRP or the comparison. The visual analog scale and a generic numeric rating scale were used to measure pain.

RESULTS: 1 of the 3 studies found PRP injections to be statistically effective at decreasing low back pain in adults at the time period assessed. Wu et al found that, at 4 weeks post injection, pain scores on a scale of 0 to 10 were on average 3.84 points less when compared to baseline scores (p<0.05) and were significantly lower at all other time points as well (Pain physician. 2016;19(8):617. https://www.ncbi.nlm.nih.gov/pubmed/27906940). Singla et al found no significant difference in pain levels at 4 weeks post injection when compared to the steroid control group but found a 75% reduction in VAS at 4 weeks when compared to baseline scores (Pain practice: the official journal of World Institute of Pain. 2017;17(6):782-791. https://www.ncbi.nlm.nih.gov/pubmed/27677100. doi: 10.1111/papr. 12526). The Tuakli-Wosornu et al study also revealed no significant difference in pain at 4 weeks when compared to baseline (p=0.215), but participants did have significant improvement regarding pain, function, and patient satisfaction over 8 weeks (PM R. 2016;8(1):1-10. https://ezproxy.pcom.edu/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=jlh&AN=112177067&site=eds-live&scope=site. doi: 10.1016/ j.pmrj.2015.08.010).

CONCLUSIONS: This review finds conflicting evidence that PRP injections are more effective than other treatment for chronic low back pain. The 2 RCTs did not show significant decrease in pain at the 4 week follow up time assessed, and the remaining study had severe limitations. Regardless, all three studies did show statistically significant improvement by the end of each study, so this review finds stronger evidence to support PRP injections for adjunctive use in adults with chronic low back pain.

Download

Share

COinS