PRP vs Steroid Injections for Lower Back Pain

Recruiting at 1 trial location

Overseen By Zachary McCormick, MD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University of Utah

Must not be taking: Antibiotics, Immunosuppressants

Disqualifiers: Recent SIJ steroid, Pregnancy, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 2

Duration: 1 day

50 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to determine whether platelet-rich plasma (PRP) injections provide more relief than steroid injections for sacroiliac joint pain, a common cause of lower back pain. PRP uses a component of the patient's own blood that may aid in healing injuries, while steroids typically reduce inflammation. Participants will receive either PRP or steroid injections to assess which offers greater relief. The trial seeks individuals who have experienced sacroiliac joint pain for at least six weeks and have found some relief from previous diagnostic injections. As an unphased trial, this study presents an opportunity to explore innovative treatments for sacroiliac joint pain.

Will I have to stop taking my current medications?

The trial information does not specify if you need to stop taking your current medications. However, if you are using systemic immunosuppressants or are currently on antibiotic therapy, you may not be eligible to participate.

Is there any evidence suggesting that this trial's treatments are likely to be safe?

Studies have shown that platelet-rich plasma (PRP) is generally safe for treating back pain. It uses the patient's own blood, reducing the risk of allergic reactions. Research indicates that PRP injections can help reduce pain and improve movement over time. The studies have reported no major safety issues.

The steroid/anesthetic treatment is a common and well-known combination. It typically includes a steroid to reduce swelling and an anesthetic to numb pain. Some common side effects might include temporary pain at the injection site or mild swelling, but these effects usually resolve quickly.

Both treatments have safety records suggesting they are well-tolerated by most patients. Prospective trial participants should consult a healthcare professional about any concerns. ^{1 2 3 4 5}

Why are researchers excited about this trial's treatments?

Researchers are excited about Platelet-rich Plasma (PRP) treatments for lower back pain because PRP uses components from your own blood to potentially heal tissues and reduce inflammation naturally. Unlike traditional steroid injections, which offer temporary relief by reducing inflammation, PRP may promote long-term healing by releasing growth factors that encourage tissue repair. This approach is particularly intriguing because it could lead to more sustainable pain relief, tapping into the body's natural healing processes without relying on synthetic drugs.

What evidence suggests that this trial's treatments could be effective for lower back pain?

This trial will compare the effectiveness of platelet-rich plasma (PRP) injections with steroid/anesthetic injections for lower back pain. Studies have shown that PRP injections can reduce pain and improve movement in individuals with long-term lower back pain, including sacroiliac joint pain. PRP uses components of the patient's own blood to heal damaged tissues. Research indicates that PRP can significantly reduce pain and improve movement for up to six months post-treatment. In contrast, steroid injections often provide quick pain and swelling relief, but their effects may not last as long as PRP. Both treatments offer benefits, but PRP might provide longer-lasting relief. ^{1 2 3 5 6}

Who Is on the Research Team?

Miriam Peckham, MD

Principal Investigator

University of Utah

Are You a Good Fit for This Trial?

This trial is for adults with chronic sacroiliac joint pain, confirmed by a specific diagnostic block and lasting at least 6 weeks. Participants must have significant pain that isn't caused by other conditions like infections or inflammatory diseases. Pregnant individuals, those on immunosuppressants, or who've had SIJ steroid treatment in the last 6 months can't join.

Inclusion Criteria

I am an adult with confirmed SIJ pain referred for a therapeutic injection.

My pain was reduced by half or more after a small, targeted numbing shot.

My pain level is 4 or higher, lasting over 6 weeks, and not caused by other health issues.

Exclusion Criteria

I am currently taking medication to suppress my immune system.

Pregnancy

I am currently taking antibiotics for an infection.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

1 visit (in-person)

Treatment

Participants receive either platelet-rich plasma or steroid/anesthetic injection in the sacroiliac joint

1 day

1 visit (in-person)

Follow-up

Participants are monitored for safety and effectiveness after treatment

3 months

Multiple visits (in-person and virtual)

What Are the Treatments Tested in This Trial?

Interventions

• Platelet-rich Plasma (PRP)
• Steroid/Anesthetic

Trial Overview The study is testing if platelet-rich plasma (PRP) injections are more effective than steroid/anesthetic injections for treating sacroiliac joint pain. Patients will receive one of these treatments directly into the affected joint to compare their effectiveness.

How Is the Trial Designed?

Group I: Platelet-rich Plasma Experimental Treatment 1 Intervention

Patients will receive an intra-articular injection 3 mL of autologous platelet-rich plasma in the sacroiliac joint.

Group II: Steroid/Anesthetic Active Control 1 Intervention

Patients will receive an intra-articular injection 40 mg Depo-medrol mixed with 2 mL 0.25% bupivicaine in the sacroiliac joint.

Platelet-rich Plasma (PRP) is already approved in United States, European Union, Canada for the following indications:

Approved in United States as Platelet-rich Plasma for:

• Orthopedic conditions (e.g., tendonitis, osteoarthritis)
• Dermatological conditions (e.g., androgenic alopecia, wound healing)
• Sports medicine injuries

Approved in European Union as Platelet-rich Plasma for:

• Orthopedic conditions (e.g., tendonitis, osteoarthritis)
• Dermatological conditions (e.g., androgenic alopecia, wound healing)
• Sports medicine injuries

Approved in Canada as Platelet-rich Plasma for:

• Orthopedic conditions (e.g., tendonitis, osteoarthritis)
• Dermatological conditions (e.g., androgenic alopecia, wound healing)
• Sports medicine injuries

Who Is Running the Clinical Trial?

University of Utah

Lead Sponsor

Trials

1,169

Recruited

1,623,000+

Radiological Society of North America

Collaborator

Trials

27

Recruited

1,000+

Published Research Related to This Trial

In a study involving 124 patients with radicular pain from lumbar disc herniation, both platelet-rich plasma (PRP) and steroid injections showed significant improvements in pain and function over a 12-month period, with no complications reported.

The results indicated that PRP injections are as effective as steroid injections for treating this condition, suggesting that PRP could be a safer alternative for patients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Ultrasound-Guided Transforaminal Injections of Platelet-Rich Plasma Compared with Steroid in Lumbar Disc Herniation: A Prospective, Randomized, Controlled Study. Xu, Z., Wu, S., Li, X., et al.[2022]

A systematic review of five studies involving 242 patients found that both platelet-rich plasma (PRP) and corticosteroid injections are safe and effective treatments for lumbar spondylosis and sacroiliac arthropathy, with no major complications reported.

At long-term follow-up (three to six months), PRP injections showed more significant improvements in clinical outcomes compared to corticosteroids, suggesting that PRP may be a more effective option for these conditions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Platelet-Rich Plasma Versus Corticosteroid Injection for Lumbar Spondylosis and Sacroiliac Arthropathy: A Systematic Review of Comparative Studies. Ling, JF., Wininger, AE., Hirase, T.[2023]

Corticosteroid injections effectively modulate inflammation and maintain synovial homeostasis in shoulder pain, as shown by their regulation of pro-inflammatory and anti-inflammatory cytokines.

When combined with platelet-rich plasma (PRP), corticosteroids enhance the regulation of certain inflammatory markers without interfering with the corticosteroid's effects, suggesting a synergistic benefit in treating inflammation.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of corticosteroids and platelet-rich plasma on synoviocytes in IL-1ß-induced inflammatory condition. Yea, JH., Shin, S., Yoon, KS., et al.[2022]

In a study of 46 patients with lumbar facet joint syndrome, both autologous platelet-rich plasma (PRP) and local anesthetic/corticosteroid injections were effective in reducing pain and improving function, as measured by various scales over a 6-month period.

However, PRP showed superior long-term efficacy, with patient satisfaction and success rates increasing over time, while satisfaction with the LA/corticosteroid group declined after the first month, indicating PRP may be a better option for sustained relief.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A Prospective Study Comparing Platelet-Rich Plasma and Local Anesthetic (LA)/Corticosteroid in Intra-Articular Injection for the Treatment of Lumbar Facet Joint Syndrome. Wu, J., Zhou, J., Liu, C., et al.[2018]

In a study involving 50 patients with chronic lumbar spinal pain, both leucocyte-rich platelet-rich plasma (LR-PRP) and corticosteroid injections were found to be safe and effective treatments, with no reported complications at the 6-month follow-up.

LR-PRP demonstrated a longer-lasting pain relief and greater improvement in quality of life compared to corticosteroids, particularly noticeable at the 3- and 6-month follow-ups.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A Randomized Double-Blind Controlled Pilot Study Comparing Leucocyte-Rich Platelet-Rich Plasma and Corticosteroid in Caudal Epidural Injection for Complex Chronic Degenerative Spinal Pain. Ruiz-Lopez, R., Tsai, YC.[2021]

Autologous blood injections (ABIs) are more effective than corticosteroid injections for alleviating pain and disability in patients with tennis elbow, showing benefits in both the short and long term.

While platelet-rich plasma (PRP) injections also reduce pain, the improvement is not considered clinically meaningful compared to the effects of ABIs.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Do autologous blood and PRP injections effectively treat tennis elbow? Widstrom, L., Slattengren, A.[2018]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC10525951/

Systematic Review of Platelet-Rich Plasma for Low Back Pain Epidural PRP injections have demonstrated long-term safety and effectiveness, with platelet lysate injections leading to pain reduction and functional ...

2. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC10460651/

The Potency of Platelet-Rich Plasma for Chronic Low Back ... PRP injection significantly enhances chronic low back pain in the first, third, and sixth months after injection compared to controls.

3. brieflands.com brieflands.com/articles/ans-158643

Efficacy of Ultrasound-Guided Platelet-Rich Plasma (PRP) ... Platelet-rich plasma injection resulted in significant pain reduction and functional improvement for chronic SIJ pain over three months.

4. clinicaltrials.gov clinicaltrials.gov/study/NCT03122119

Effectiveness of Ultrasound Guided Platelet Rich Plasma ... This prospective study will be quantitatively analyzing the effectiveness of platelet-rich-plasma (PRP) injections into the sacroiliac (SI) joint in ...

5. orthopedicreviews.openmedicalpublishing.org orthopedicreviews.openmedicalpublishing.org/article/141416-platelet-rich-plasma-for-the-therapy-of-the-lumbar-facet-joint-syndrome-a-prospective-study-about-ct-guided-facet-joint-injections-with-prp-compared

Platelet Rich Plasma for the Therapy of the Lumbar Facet ... Data analysis revealed that both, PRP and local anesthetics had a pain reducing effect initially at week 2 after receiving the first PAT, but ...

6. sciencedirect.com sciencedirect.com/science/article/pii/S2666548425001283

platelet-rich fibrin vs steroid injection for sacroiliac joint pain CONCLUSIONS. Intra-articular PRF injection is a safe and effective treatment for SI joint pain, providing superior and sustained pain relief and functional ...