An info series on Dr. Ursus Lüthi and Dr. Peter Schnorr

Chronic back pain is one of the most common health problems, and one of the most expensive to deal with. Even with advances in diagnosis, the exact structure causing the pain – tendons, muscles, nerves, joints, or spinal discs – is usually not clearly pinpointed. It therefore comes as no surprise that there are still no compelling or lasting treatments available. This makes for a frustrating treatment process in many patients.

PRP is extremely versatile in its mechanisms of action with the amplified biological signals in regenerative medicine predestined for treating back pain.

PRP is highly diverse in its mechanisms of action and is predestined for back pain treatment.
© BTI Biotechnology Institute

PRP predestined for treating back pain

PRP is extremely versatile in its mechanisms of action with the amplified biological signals in regenerative medicine predestined for treating back pain. Speciality conventions have seen encouraging results in repairing intervertebral disc cells and restoring their function, and in treating degenerative spine inflammation throughout the spine’s tissues. This involves enhancing fibroblast and osteoblast metabolism, reducing cell death, and stimulating neovascularisation.

Holistic therapy approach in PRP treatment: All the structures involved can be treated with extreme accuracy.

Holistic therapy approach in PRP treatment: All the structures involved can be treated with extreme accuracy.
© FIRST

Benefiting from a holistic approach to therapy

One of the major benefits of PRP therapy is its holistic approach, which ensures that all the structures involved can be treated with extreme accuracy. The American Society of Pain Medicine drew up comprehensive guidelines (Navani 2019) to apply these interventional treatments. We closely follow these guidelines with conviction. The references quoted include statistical proof of efficacy for various potential applications:

  • Disc treatment Level III (I shows the highest and V the lowest efficacy)

  • Facet and sacroiliac joint treatment, epidural application: Level IV

PRP therapy is extremely low risk even when applied to the spine but has not yet been recognised by health insurance so patients will be required to cover part of the cost of treatment.

At this point, the next edition of our series on PRP technology and practice will be covering some cases where these methods have been successfully applied at FIRST.

Studies, metastudies and papers

We have collected a series of current studies we see as especially groundbreaking:

A broad general meta-analysis of current literature from a group of expert assessors with relevant references

Sanapati, J. et al. (2018)

Pain Physician, 21, 515-540

An overview of clinical applications in a highly competent hospital (Hospital for Special Surgery, New York) shows early treatment with PRP to be a sensible course of action at the onset of disc pain. Effects lasting up to two years have been documented.

Mascarinas, A., Harrison, J., Boachie-Adjei, K. & Lutz, G. (2016)

27 (4), 1003-1017. doi:10.1016/j.pmr.2016.06.006

An excellent article with a wealth of information from applied biology to clinical application, including extremely clear examples from a leading Spanish expert group.

Anitua, E. & Padilla, S. (2018)

Regenerative Medicine, 13 (1), 55-72. doi:10.2217/rme-2017-0111

Some other studies with statistical proof of efficacy are highly informative, all of which point in the same positive direction with positive results.
PRP in cervical disc herniation with favourable long-term effects

Cameron, J. & Thielen, K. (2017)

Spine Research, 03 (02). doi:10.21767/2471-8173.100030

Information on safety in applying PRP to the back; signs of economic benefits in this form of therapy due to usually long-term pain relief and significant reduction in additional pain medication.

Navani, A., Ambach, M., Navani, R. & Wei, J. (2018)

Interventional Pain Management Reports, 2 (3), 111-118

The randomised prospective study has shown a favourable long-term effect on pain relief, function and patient satisfaction after a platelet-rich plasma therapy.

Tuakli-Wosornu, Y., Terry, A., Boachie-Adjei, K., Harrison, J., Gribbin, C. & LaSalle, E. et al. (2015)

PM&R, 8 (1), 1-10. doi:10.1016/j.pmrj.2015.08.010

A highly relevant cortisone study also showing reliable pain and inflammation relief compared to PRP, albeit with effectiveness limited to a few weeks.

Rannou, F., Nguyen, C., Boutron, I., Baron, G., Sanchez, K. & Palazzo, C. et al. (2017)

Osteoarthritis and Cartilage, 25, S172. doi:10.1016/j.joca.2017.02.297

An excellent description of pathological processes in disc degeneration and treatment using intradiscal PRP injections.

Akeda, K., Yamada, J., Linn, E. T., Sudo, A., & Masuda, K. (2019)

Journal of pain research, 12, 753–767. https://doi.org/10.2147/JPR.S153085

A new treatment with promising early results. PRGF in bone treatment has shown favourable results in disc complaints where conservative therapy shows no promise of a favourable outcome, even in advanced disc degeneration affecting the vertebral body (Modic II-III).

Kirchner, F., Pinar, A., Milani, I., Prado, R., Padilla, S. & Anitua, E. (2020)

Journal of Orthopaedic Surgery and Research, 15 (1). doi:10.1186/s13018-020-01605-w

Well networked

Cooperations and Congresses

ICRS - International Cartilage Regeneration & Joint Preservation Society
IARMES - International Regenerative Medicine Experts Society
TOBI - The Orthobiologic Institute
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