From the Research
Epidural platelet-rich plasma (PRP) injections are not a proven treatment for reversing disc bulges, and their effectiveness in reducing disc bulges is currently limited and inconclusive. While some small studies suggest PRP may help reduce inflammation and promote healing in degenerative disc disease, there is insufficient high-quality research demonstrating that PRP can physically reverse or reduce disc bulges 1. PRP therapy involves concentrating platelets from the patient's own blood and injecting them into the epidural space near the affected disc. The theoretical mechanism is that growth factors and cytokines in platelets may stimulate tissue repair and reduce inflammation.
Some key points to consider:
- A pilot study with one-year follow-up found significant improvements in pain and disability in patients with low back pain suspected to be of disc origin who received PRP epidural injections 1.
- However, the evidence is still limited, and more established treatments for disc bulges include physical therapy, oral anti-inflammatories, conventional epidural steroid injections, and in severe cases, surgical intervention.
- The American Society of Interventional Pain Physicians (ASIPP) guidelines suggest that regenerative therapy, including PRP, may be provided to patients following diagnostic evidence of a need for biologic therapy, but emphasize the need for caution and further research 2.
- Other studies have shown promising results with intradiscal PRP injections, but the evidence is not yet strong enough to support its use as a standard treatment for disc bulges 3, 4.
In terms of treatment protocols, a typical protocol might involve 2-4 ml of autologous PRP injected under fluoroscopic guidance, with treatments potentially repeated at 1-3 month intervals. Patients considering this treatment should understand that while some may experience pain relief, this doesn't necessarily correlate with structural changes to the disc bulge itself. PRP remains an experimental approach that may complement but should not replace evidence-based treatments for disc pathology.