From the Research
Epidural platelet-rich plasma (PRP) injections are recommended over intradiscal PRP for the treatment of low back pain suspected to be of disc origin, as they provide modest yet significant improvements in pain and disability that last at least 12 months, with a lower risk of complications such as discitis. The choice between epidural and intradiscal PRP injections depends on the primary pain generator, with epidural PRP being more suitable for conditions involving nerve compression or inflammation, and intradiscal PRP being more suitable for internal disc disruption, degenerative disc disease, or contained disc herniations without significant nerve compression. Some key points to consider when deciding between these approaches include:
- The typical dose of PRP for epidural injections ranges from 3-5ml, while intradiscal PRP typically uses a smaller volume of 1-3ml injected precisely into the nucleus pulposus.
- Epidural PRP provides more widespread distribution along the posterior spinal elements and nerve roots, while intradiscal PRP concentrates healing factors directly at the site of disc pathology.
- Recovery time is generally shorter for epidural injections (1-2 days) compared to intradiscal procedures (3-7 days), and patients may require 1-3 treatments spaced 4-6 weeks apart for optimal results with either approach.
- A study published in 2024 1 found that epidural PRP injections provided significant improvements in pain and disability that lasted at least 12 months in patients with low back pain suspected to be of disc origin.
- Another study published in 2025 2 found that PRP therapy, including both epidural and intradiscal injections, promoted tissue regeneration and modulated inflammatory response in degenerated discs, with benefits including pain reduction, improvement of functionality, and low risk of adverse events.
- A randomized controlled trial published in 2023 3 found that epidural PRP injections yielded superior results to triamcinolone in treating single-level lumbar herniated disc, with statistically and clinically significant reductions in leg pain and disability at 6,12, and 24 weeks.
- A meta-analysis published in 2021 4 found that intradiscal PRP injections were effective in relieving pain and improving disabilities caused by discogenic lower back pain, but the pain-reducing effect significantly manifested two or six months after the injections, but not after one month.