PRP Injection For Disc Herniation | Platelet Rich Plasma Epidural Injection
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- เผยแพร่เมื่อ 7 มี.ค. 2022
- Dr Musson, Interventional Pain and Regenerative Medicine Specialist, discusses the use of platelet rich plasma for disc herniations as an alternative to the standard of care.
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The information, including but not limited to, text, graphics, images and other material contained on this video are for informational purposes only. No material on this video is intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health care provider with any questions you may have regarding a medical condition or treatment and before undertaking a new health care regimen, and never disregard professional medical advice or delay in seeking it because of something you have seen on this video.
Helpful video thank you
Thanks for your feedback!
Most doctors apply ozone therapy to the disc or paravertebral muscles. On the other hand, they apply PRP treatment for joints. Can you explain?
What about. Bulging discs? Have you tried this on those aswell?
I known prp injections hurt a lot since Iv had them for other issues I almost don’t want to think about the pain after an injection into a disc. Usually the injection site is way more fragile afterwards too, for many months.
Is numbness in a leg really nerve damage if it comes and goes? Can it also just be pressing on a nerve that can be fixed easily?
I get that from something’s else that the one particular spot I’m thinking of and it depends on my posture , also Iv heard of people injecting prp into damaged nerves to heal them, hard to find docs who specialize in these things tho, Iv just read web md articles
Have you seen any reduction of herniation size after injection? Particularly a 2 year out central nonfragmented dehydrated bulge..
I appreciate what you are doing here, but in my case I had a scoliosis which destroyed my L5S1 over 30 years so fusion was my only option.
ALIF/PLIF L5S1 fusion 6 months ago and I am at 100% now.
Good to hear. PRP is by no means a cure all. Severe issues do not respond to PRP. If there is a significant compression injury to a nerve or spinal cord, surgery is needed. If there is significant instability, surgery is needed. I refer to neurosurgery almost on a weekly basis. Glad you're doing well.
So it gives blood and healing to the torn anulus, what about the nucleus, and is the sealed anulus as strong a before?
Very good question. Often in medicine we don't understand all the details but we have theories that may be confirmed or disproven down the road. My opinion is that it provides a variety of growth factors and signals to help with pain. So when we study this we look at outcomes and pain and function. It's harder to assess disc quality after procedure. MRI is helpful but not perfect. There have been some studies showing an improvement on MRI of disc height and fluid signal. I don't think we're quite at a point where we're seeing dramatic "healing" of the disc or returning the disc to normal. We also know that the disc can be significantly damaged and still not be painful. So current goal is to minimize pain and improve function. The true long term effect on the quality of the disc has yet to be really studied. In a perfect world we would remove the disc and dissect it and look at it under the microscope to assess accurate status of the disc.
Hi Doctor, good video but i'm trying to understand the use of PRP instead of the steroid injection or even getting surgery. I've been told PRP is anti-inflammatory which would help ease the pain, but will this actually benefit the site of injection to help offer a better healing affect whereas the steroid injection just masks the pain. Secondly, i've had surgery before on my L5 disc and i was 95% back to normal. Unfortunately, i have hurt the same area again but not as severe as last time. I'm considering PRP as my option but if it came down to it, would getting surgery again be a major problem? Thanks for reading and would appreciate any feedback.
That's a good question. You're right, corticosteroids only provide pain relief with hopes that things improve on their own with time. Corticosteroids do come at a cost of negatively affecting bone health and altering your cortisol levels. PRP for a simple epidural injection has been shown to be comparable to steroid injections with possibly longer lasting relief. Theoretically, we would hope PRP may stimulate recovery with the growth factors and cytokines in the platelets. One other bonus with PRP is we can also use it to address ligament issues, like the iliolumbar ligament, which in my experience are always involved with disc injuries. Sometimes surgery is needed, but if you're in a spot where non-surgical options would be doable, I'd definitely start there as surgery isn't a long term "fix". It comes with it's own long term complications. Best of luck!
Hello, I am a 34 year old active male and I have a 3mm annular tear and a herniated L5-S1 disc along with degenerative disc. I have nerve pain down my right leg that fluctuates with active movements like jogging or jumping. It’s been about 1.5 years since the injury and I’ve recovered enough to be able lift weights up to about 35lbs and do elliptical and stair master for about 45 minutes. But if I jog or lift heavy I get inflammation and dull aching pain in my low right back and down my leg. Would PRP be beneficial for me to try and heal whatever potential joints and damage I have in the area? Could my SI joint be the problem as well?
Sorry to hear Justin! Often we see injuries like yours in combination with damaged ligaments. So we often have to treat the disc, nerve, and ligaments. Many folks in your situation will start to feel better but when they start to push activities like running or squatting things flare up again which is likely due to ligaments that haven't healed. Check out some of our iliolumbar ligament videos. Everybody is different though so it's hard to really comment too much with being able to see you imaging or examine your back.
Av just had prp 2 days ago suffered with herniated disc for 24 years I will let u no how it goes but no word of a lie the pain feels like it has gone already
Where is this office located? Is insurance accepted? I have a ton of injuries and don't want more cortisone injections anymore
Hey Brenda, we're located in Corvallis Oregon. We take most insurances and they cover consultation but most insurance companies do not cover this yet. Procedure cost is cheaper than the travel costs if you're out of state.
Hello Doc, Is it possible to send you my LSS Mri online to check for any nerve compression that is causing pain radiating to my thigh
Because, It seems that it could be due to my SI Joint, as I’m having posterior pain in the buttock whenever I do the FABER test
But many other tests like the thigh thurst or the hip distraction tests are negative for me so I’m really confused on what to do and I don’t wanna take more time off the gym as not to lose muscle mass, I would really appreciate the help !
Hey @woah1887, sorry to hear about your pain. It's easy to send a report of your MRI. Accessing images is a little tougher, typically if a patient has an MRI from an outside facility that I can't access we'd have them send a CD of the images. But feel free to send over whatever you have and we can take a look!
@@BlackStonePhysicalMedicine is there a way I can send the CD files the DICOM files to you through a link or something like that
Also thanks alot for the response
@@woah1887 Ya, anything that you could get to work. Our email is blackstonecorvallis@gmail.com. You can send link there. Or do google drive shared file or drop box or something.
@BlackStonePhysicalMedicine 2:29
Hello...I am from Germany I have herniated disc problem in lower back...I also had injections for the treatment but it was of no use because the pain is not going ....not even I am not able to perform everyday tasks...can you assist me in this regard...please reply whether PRP treatment is good for me or not....and is it possible that you check my MRI reports? Please reply
Hi doctor I'm 31 years old i have disc bulge with l4-5s1 without compressor nerve roots if i get prp that make my discs normal
Hey Ryanne, you may not need PRP in the disc. If your disc was painful and damaged it would help. It's possible there may be another problem going on. Check out my videos on the iliolumbar ligament. If that's damaged, it can allow more wear and tear in the L4-L5 and L5-S1 discs. Whenever I treat the discs I always treat the ligaments too. There have been studies showing improvement in the quality of the discs on MRI after regenerative injections but we're not getting them back to totally normal discs yet.
Would u do epidural injection first if the patient is in horrible pain then do PRP 2 months later. But how does PRP help nerve pain?
Hey @Joshua Apple, I have this conversation very often. Recently just this morning. Technically the corticosteroid injection will provide faster pain relief than the PRP. Really depends on severity and situation. But steroid first followed by PRP in future isn't a bad idea. Nice thing with PRP is we can also injection the supporting ligaments, which may be the primary issue. Anecdotally we also see PRP epidurals do a better job keeping people from ending up with surgery. PRP does seem to have an anti-inflammatory effect on an irritated nerve. It has also been shown to help nerve damage when injected directly into the nerve. I need to see more studies backing that before I try it. Ha.
Dr. Please reply. I have a upper cervical pain in the neck would PRP injections be helpful with pain and dizziness? I want to avoid the steroid injection
Possibly. Really depends on what the problem is. Your symptoms could be due to instability if you've had any injuries to your neck. Sometimes flexion/extension view xrays can show instability. A better option is digital motion xray. That shows better the upper cervical spine and any potential instability.
@@BlackStonePhysicalMedicine Thank you so much Dr for taking the time to reply. I had no injuries. Symptoms of neck pain, dizziness, instability started showing 4 months ago when I woke up one day. Out of nowhere.. I did MRI and X-rays. Can I send them to you please? I'm in a small town and looks like nobody has a clue on what's going on with me.
@@livelaughandlove299 Ya, you bet. Reach out to us via email and we can let you know how to get those images to us. Blackstonecorvallis@gmail.com
Hi Doc, thanks for such an informative video.
I herniated my C6 C7 disc about two months ago and the pain it caused me was unbearable. However, after four weeks I started to feel better and spent week five and six with no pain but the pain came back in week seven and it’s hurting again but not to the extent it was hirting before. It has weakened my right triceps to the point I can’t even push a 10lb dumbbell with it. I used to press 110lb before.
I am thinking about doing PRP. Do you think it would help with pain relief, nerve and strength recovery? Did you see any great results in your patients? Thank you!
In the right setting PRP can be helpful for the neck too. If you're having weakness I'd recommend getting seen by a doc and hopefully an MRI. PRP can't fix a compressive lesion, or it can't unpinch a nerve.
@@BlackStonePhysicalMedicine thanks doc! I have been waiting to get a call from a specialist. Hopefully soon 🤞
@@BlackStonePhysicalMedicine also, I got my MRI done and I have a c6c7 moderate disc herniation and that’s why i have no strength in my right triceps and chest. It’s three months already
Do you know of any offices that do this in las vegas
Regenexx (one in Hendersen) seems to be pretty standardized across its locations nationwide. Good trained docs but like any doc everyone has different training and experience.
is epidural steriod injection for the L5 disc the same as PRP? sorry i just need my friend to understand it isnt the same
Hey, they are different. Sometimes we just call them "epidural" injections but that doesn't specify what you're injecting. The typical epidural injection uses a corticosteroid like dexamethasone. With the PRP we put it in the same epidural space sometimes and call it then an epidural PRP injection. Hope that helps!
@@BlackStonePhysicalMedicine thanks where are you based how do i book in
@slair5948 We're based in Corvallis Oregon. You can email us to get the process going: blackstonecovallis@gmail.com
And hoe many shots u need for heirnated discs
Typically I only do one and see how they do over a 3-6 month period.
hi doctor, is it possible to reconstruct the disc with stem cells and prp?
So far, what we see with PRP or BMAC injection of the discs is that pain improves and the fluid signal of the disc improves. Possibly slight improvement in height. Still a ways to go to really normalize the disc. I'm seeing cases showing that intra-osseous injections adjacent to the disc may improve the quality of the disc even further.
link for studys?
@@michaelleonard1277 pubmed.ncbi.nlm.nih.gov/37118707/
@@BlackStonePhysicalMedicine Hi Doctor,Can PRP treatment help ingunial hernia?
Hello mild disc prolab epidural injection is better?
Epidural masks the pains while the damage is increasing and does not treat the problem at the roots.
Will disc cure with physiotheraphy or Ayurveda
It's always a good start to begin conservatively. PT can be helpful. Sometimes even just giving it time will allow the disc herniation to resorb.
Hai sir
This prp injection is no side effects
Hello, any time we do an injection there is a risk of infection. We want to be extra cautious when we're injecting into a disc or the epidural space. Theoretically you could injure a nerve root with the needle if done improperly. Post procedure increased pain is quite common, particularly when injecting tendons or ligaments.
Is this a permanent or temporary fix
That's a good question. Technically this is not a fix. There's not a lot we do that's a fix in musculoskeletal medicine. Even surgery isn't technically a fix. Trying to keep this response relatively brief. There's multiple issues being addressed with these types of procedures. First, treating the ligaments which stabilize the problem segment. That is more a permanent or lasting treatment, unless reinjured. Second, for the nerve pain/irritation that is temporary improvement which is all that is needed as we're hoping with time things settle down and some of the disc herniation is resorbed. Third, when we treat discs, it seems it helps with pain but only minimal if any structural improvement of the disc. So definitely not a "fix" but pain will often improve. Still more progress needed to really help regenerate the discs. I hope that is helpful
@@BlackStonePhysicalMedicine okay thanks so in your opinion is there such a thing as a permanent fix for Herniated discs
Cuz I got a friend that broke almost every bone in his body and he got healed with an inversion table I have another friend that was healed with ozone therapy so I want to give myself hope for the future because I plan to go back to work someday
You know that's a tricky question. Most injuries don't really have permanent fixes. So the disc will never be the same prior to the disc herniation. But a person can become pain free and no issues related to the disc. But the disc will have wear and tear, loss of disc height, and likely a change of the substance of the disc. But we see folks all the time with degenerative changes in joints or discs and they don' t have any pain. The goal is to eliminate or minimize pain while allow people to return to regular activity.
Don't ever give up hope. Keep looking and seeking from all areas of medicine and alternative therapies. Best of luck!
H̤i̤ i̤a̤m̤ v̤e̤n̤k̤a̤t̤e̤h̤w̤a̤r̤ R̤e̤d̤d̤y̤ 29 y̤e̤a̤r̤s̤ o̤l̤d̤ o̤n̤e̤ y̤e̤a̤r̤ a̤g̤o̤ o̤n̤e̤ a̤c̤c̤i̤d̤e̤n̤t̤ s̤p̤i̤n̤a̤l̤ i̤n̤j̤ṳr̤y̤ 12 l̤e̤v̤e̤l̤ p̤r̤e̤s̤s̤i̤n̤g̤ n̤e̤ṳr̤o̤ p̤l̤e̤a̤s̤e̤ h̤e̤l̤p̤ m̤e̤ d̤o̤c̤t̤o̤r̤ t̤o̤w̤ l̤e̤g̤s̤ i̤s̤ n̤o̤ s̤e̤n̤s̤e̤
Hey Venkatesh, sorry to hear about your injury. These videos are good for some general information. It is hard sometimes finding a local doctor to properly diagnose and treat these injuries. Look for doctors in your area that do platelet rich plasma, prolotherapy, or regenerative medicine. Best of luck!
Personally I think , no I know ! It time to Legalize Medical Marijuana Nationwide…it about time
It is about time....
New peer reviewed studies contradict and warn against medical Marijuana for many types of chronic pain issues. Post surgery symptoms of withdrawal are presenting in patients who use Marijuana on a regular basis and don't realize anesthesia can cause a bad reaction from the combination of medical drugs and pot and its not predictable who will react badly which complicates even dental surgery.
Studies also show a heightened pain response in some particular patients called hyperalgia, just like opioid usage causes.
I'm not at all against legalized drugs, but there must be medical and scientific evidence, Qualified resources and education available to everyone thinking about choices of pain management including medical marijuana,because it's become a powerful drug with positive And negative effects
@@karenshelters8197
Your quite brilliant, we are sort of in agreement actually. After ten years of opioids which were clearly killing me and everyone else as a matter of fact. I stopped altogether all medications as long as I could. Then medical Marijuana became legal and I was hesitant but I tried it. Long story short it saved my life almost like a resurrection… Really!
I have no doubt that God answered my prayers and i hope the same for others…
Peace be with you
A very risky, unapproved experimental out-of-pocket treatment with no proven long term efficacy benefit!… unless you happen to be the doctor’s accountant
I would personally prefer a PRP epidural than an epidural steroid injection, like Depo-Medrol.
Wongjarupong A, Pairuchvej S, Laohapornsvan P, Kotheeranurak V, Jitpakdee K, Yeekian C, Chanplakorn P. "Platelet-Rich Plasma" epidural injection an emerging strategy in lumbar disc herniation: a Randomized Controlled Trial. BMC Musculoskelet Disord. 2023 Apr 28;24(1):335
These made me much worse, and they cost me a fortune!
@EpicPain I'm sorry to hear about your experience. Sadly nothing in medicine is 100% successful 100% of the time. We do see around a 20% failure rate even with appropriate candidates. Sorry to hear it cost you a fortune. Every clinic is different. We often lose money doing regenerative procedures in attempt to allow a patient to afford it. Hope you find something that helps.
@@BlackStonePhysicalMedicine Thanks, but I have been permanently damaged, my days as a lab-rat are over.
L4L5S1 disc herniation with annular tear. PRP Renex didn't work for me. Waste of money.
@Ed K sorry to hear. Regenerative medicine isn't 100% successful, nor are any medical procedures. Very frustrating when things don't go as hoped. One challenge with the back is pinpointing the diagnosis. A great treatment in the wrong spot won't do any good. Best of luck with your back and hopefully you can get some good relief.
@@BlackStonePhysicalMedicine
I received approx 15 fluoroscopic guided prp injections inside the discs and around the facets (two levels-both sides). They targeted exectly all the affected areas. I am not sure about other people but my case shows that annular tear doesn't heal with prp months after the treatment.
@@edk4619 Very frustrating for sure. Regenerative medicine for disc pain is still relatively new. We have folks that do very well and others that don't. Our success rate is about 80% of folks have at least 50% relief. That leaves around 20% of folks that don't improve. We don't know all the reasons why someone doesn't recover as well as someone else. With regenerative medicine, particularly with discs, the details on outcomes are not clear. Not a lot of studies to demonstrate how things structurally improve after PRP like with MRI or under microscope in animal model. It's possible that we're improving pain but not necessarily "healing" the tear. Most of regenerative medicine treatments do not actually reverse the degenerative process. I'm sorry to hear the PRP didn't work for you. Hopefully you can find a path to improve your pain.
@@edk4619 have you tried rhisotomy needles to burn out the worst areas of tormented flaring nerves? I had my thoracic area done over 3 years ago and still have no returning issues even though they told me nerves eventually grow back. Insurance covered it. Downtime was a day or 2. Now I'm addressing degenerative lumbar but can't tolerate anymore anesthesia injection involved in the 24 hour mapping process. My body over reacts to the longer acting pre-procedure, so going for the PRP in hopes that it will at least slow down some of the old damage from 2 car accidents. 🤞 Acupuncture has also been very effective for overall core muscles and natural endorphins which beats drugs anyday.
If you have an annular tear it cannot be fixed, it will continue to flare up and cause problems most likely. I had viadisc which is the best intradiscal injection currently available, unfortunately the cells leaked through the tear. I moved on to disc replacement lp-esp in Germany, no regrets pain gone!