Lumbar instability as an etiology of low back pain and its treatment by prolotherapy: A review

BACKGROUND: Low back pain is a significant spinal disorder that affects much of the population at some point during their lives. OBJECTIVE: While proper diagnosis is key, diagnosing the underlying cause of low back pain may often be unclear. METHOD: In this review article, we discuss lumbar instability as an etiology of low back pain and its treatment by prolotherapy. RESULTS: Spinal ligaments may be an underlying culprit in the development of lumbar instability with resultant low back pain and associated disorders. CONCLUSION: In these cases, adequate treatment consisting of non-biologic prolotherapy or cellular prolotherapy, including platelet rich plasma (PRP), can be beneficial in restoring spinal stability and resolving chronic low back pain.

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Platelet-rich plasma injections: an emerging therapy for chronic discogenic low back pain

Journal of Spine Surgery ◽

10.21037/jss.2018.03.04 ◽

2018 ◽

Vol 4 (1) ◽

pp. 115-122 ◽

Cited By ~ 15

Author(s):

Suja Mohammed ◽

James Yu

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Platelet Rich Plasma ◽

Low Back ◽

Discogenic Low Back Pain ◽

Emerging Therapy

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Personalized multitarget biologic injection in the spine: prospective case series of multitarget platelet-rich plasma for low back pain

Regenerative Medicine ◽

10.2217/rme-2021-0019 ◽

2021 ◽

Author(s):

Edilson S Machado ◽

Mary A Ambach ◽

José MP Caldas ◽

Jason J Wei ◽

Markus Bredemeier

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Platelet Rich Plasma ◽

Case Series ◽

Pain Scale ◽

Roland Morris Disability Questionnaire ◽

Low Back ◽

Visual Analog Pain Scale ◽

Paravertebral Muscles ◽

Disability Questionnaire

Aim: To evaluate the use of a multitarget platelet-rich plasma (PRP) injection approach for the treatment of chronic low back pain (LBP). Materials & Methods: Forty-six patients with more than 12 weeks of LBP who failed conservative treatments were injected with PRP into the facet joints, intervertebral discs, epidural space and/or paravertebral muscles. Visual analog pain scale and Roland-Morris Disability Questionnaire scores were measured at baseline and predefined intervals. Results: Mean visual analog pain scale was reduced from 8.48 to 5.17 and mean Roland-Morris Disability Questionnaire from 18.0 to 10.98 at 12 weeks (p < 0.001). These statistically significant improvements were sustained over 52 weeks. No adverse effects were observed. Conclusion: Our PRP approach demonstrated clinically favorable results and may be a promising treatment for chronic LBP.

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Use of Ultrasound-Guided Platelet-Rich Plasma Injection of the Sacroiliac Joint as a Treatment for Chronic Low Back Pain

Military Medicine ◽

10.1093/milmed/usz398 ◽

2019 ◽

Vol 185 (7-8) ◽

pp. e1312-e1317

Author(s):

Devin Y Broadhead ◽

Hannah E Douglas ◽

Laurie M Bezjian Wallace ◽

Patrick J Wallace ◽

Sarah Tamura ◽

...

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Chronic Low Back Pain ◽

Sacroiliac Joint ◽

Functional Disability ◽

Platelet Rich Plasma ◽

Common Source ◽

Low Back ◽

Ultrasound Guided ◽

Long Term Treatment

ABSTRACT Back pain and its associated complications are of increasing importance among military members. The sacroiliac joint (SIJ) is a common source of chronic low back pain (LBP) and functional disability. Many patients suffering from chronic LBP utilize opioids to help control their symptoms. Platelet-rich plasma (PRP) has been used extensively to treat pain emanating from many different musculoskeletal origins; however, its use in the SIJ has been studied only on a limited basis. The patient in this case report presented with chronic LBP localized to the SIJ and subsequent functional disability managed with high-dose opioids. After failure of traditional treatments, she was given an ultrasound-guided PRP injection of the SIJ which drastically decreased her pain and disability and eventually allowed for complete opioid cessation. Her symptom relief continued 1 year after the injection. This case demonstrates the potential of ultrasound-guided PRP injections as a long-term treatment for chronic LBP caused by SIJ dysfunction in military service members, which can also aid in the weaning of chronic opioid use.

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Poster 332 Ultrasound-guided Injections for Low Back Pain: Botulinum Toxin-A and Platelet-rich Plasma: Case Series

PM&R ◽

10.1016/j.pmrj.2011.08.360 ◽

2011 ◽

Vol 3 ◽

pp. S288-S288

Author(s):

Gordon D. Ko ◽

Annie Hum

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Botulinum Toxin ◽

Platelet Rich Plasma ◽

Botulinum Toxin A ◽

Case Series ◽

Low Back ◽

Ultrasound Guided ◽

Toxin A

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Pregnancy in Patients With Low Back Pain

International Clinical Neuroscience Journal ◽

10.15171/icnj.2019.16 ◽

2019 ◽

Vol 6 (3) ◽

pp. 79-82

Author(s):

Afsoun Seddighi ◽

Amir Saied Seddighi ◽

Shiva Jamshidi ◽

Hesam Rahimi Baghdashti

Keyword(s):

Physical Activity ◽

Low Back Pain ◽

Back Pain ◽

Clinical Presentation ◽

Review Article ◽

Weight Lifting ◽

Present Review ◽

Pelvic Girdle Pain ◽

Low Back ◽

Low Education

Pregnancy-related lumbopelvic pain has been a serious and common problem since ancient time. The present review article focuses on terminology, types, clinical presentation, and management of these problems. There are two entities regarding pregnancy-related lumbopelvic pain: pelvic girdle pain (PGP), and pregnancy-related low back pain (LBP). There are multiple mechanisms behind these disabilities. Age, multiparty, heavy weight lifting, hard physical activity, previous LBP, and low education increase the prevalence. About one-half of women with pregnancy-related lumbopelvic pain have PGP, one-third LBP, and one-sixth have both conditions. Overall, the literature reveals that PGP deserves serious attention from the clinical and economic standpoints.

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Intradiscal Injection of Autologous Platelet-Rich Plasma Releasate to Treat Discogenic Low Back Pain: A Preliminary Clinical Trial

Asian Spine Journal ◽

10.4184/asj.2017.11.3.380 ◽

2017 ◽

Vol 11 (3) ◽

pp. 380-389 ◽

Cited By ~ 38

Author(s):

Koji Akeda ◽

Kohshi Ohishi ◽

Koichi Masuda ◽

Won C. Bae ◽

Norihiko Takegami ◽

...

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Platelet Rich Plasma ◽

Low Back ◽

Discogenic Low Back Pain ◽

Intradiscal Injection ◽

Autologous Platelet Rich Plasma ◽

The Mean ◽

Autologous Platelet

<sec><title>Study Design</title>Preliminary clinical trial.</sec><sec><title>Purpose</title>To determine the safety and initial efficacy of intradiscal injection of autologous platelet-rich plasma (PRP) releasate in patients with discogenic low back pain.</sec><sec><title>Overview of Literature</title>PRP, which is comprised of autologous growth factors and cytokines, has been widely used in the clinical setting for tissue regeneration and repair. PRP has been shown <italic>in vitro</italic> and <italic>in vivo</italic> to potentially stimulate intervertebral disc matrix metabolism.</sec><sec><title>Methods</title>Inclusion criteria for this study included chronic low back pain without leg pain for more than 3 months; one or more lumbar discs (L3/L4 to L5/S1) with evidence of degeneration, as indicated via magnetic resonance imaging (MRI); and at least one symptomatic disc, confirmed using standardized provocative discography. PRP releasate, isolated from clotted PRP, was injected into the center of the nucleus pulposus. Outcome measures included the use of a visual analog scale (VAS) and the Roland-Morris Disability Questionnaire (RDQ), as well as X-ray and MRI (T2-quantification).</sec><sec><title>Results</title>Data were analyzed from 14 patients (8 men and 6 women; mean age, 33.8 years). The average follow-up period was 10 months. Following treatment, no patient experienced adverse events or significant narrowing of disc height. The mean pain scores before treatment (VAS, 7.5±1.3; RDQ, 12.6±4.1) were significantly decreased at one month, and this was generally sustained throughout the observation period (6 months after treatment: VAS, 3.2±2.4, RDQ; 3.6±4.5 and 12 months: VAS, 2.9±2.8; RDQ, 2.8±3.9; <italic>p</italic><0.01, respectively). The mean T2 values did not significantly change after treatment.</sec><sec><title>Conclusions</title>We demonstrated that intradiscal injection of autologous PRP releasate in patients with low back pain was safe, with no adverse events observed during follow-up. Future randomized controlled clinical studies should be performed to systematically evaluate the effects of this therapy.</sec>

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Physical Therapy and Maternity Support Garment: Influence on Core Stability and Low Back Pain during Pregnancy and after Delivery

Baltic Journal of Sport and Health Sciences ◽

10.33607/bjshs.v3i86.274 ◽

2018 ◽

Vol 3 (86) ◽

Author(s):

Pavelas Zachovajevas ◽

Brigita Zachovajevienė ◽

Jūratė Banionytė ◽

Arvydas Siaurodinas

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Physical Therapy ◽

Muscle Activation ◽

Core Stability ◽

Transversus Abdominis ◽

Spinal Stability ◽

Low Back ◽

Diastasis Recti ◽

Transversus Abdominis Muscle

Research background and hypothesis. Transversus abdominis muscle experiences extraordinary overstretching during gestation period and thus the ability of this muscle to stabilize spine decreases. These changes can cause chronic low back pain during pregnancy and after delivery. In order to solve this problem it is essential to apply proper and effective treatment methods. Hypothesis: physical therapy exercises are more effective than maternity support garment in low back pain treatment and core stability during pregnancy and after delivery.Research aim was to evaluate the influence of physical therapy and maternity support garment on spinal stability and low back pain during pregnancy and after delivery.Research methods. Study sample comprised 40 pregnant women. The assessments were made twice: at 28–35 weeks of gestation and 8–9 weeks after delivery. The low back pain was evaluated using SAS, core stability and transversus abdominis muscle activation were objectively tested using special device stabilizer and the presence of diastasis recti was tested as well. Research results. Physiotherapy is 42.4% more effective than maternity support garment in low back pain control during pregnancy and after delivery (p < 0.05). The best results of transversus abdominis muscle activation were observed in physiotherapy group with maternity support garment whereas participants without physiotherapy could not properly activate this muscle. The diastasis recti after delivery occurred only in control group, and in the group with maternity support garment it occurred 36.7% less frequently than in the group where women did not use this garment.Discussion and conclusions. 1. Perceived low back pain after delivery was less expressed in women wearing maternity support garment both among women attending and not attending physiotherapy exercises. Nevertheless, physical therapy was more effective in reducing low back pain than maternity support garment during pregnancy and after delivery. 2. Core stability after delivery improved among women attending physical therapy exercises, but in case of maternity support garment it improved better. In contrast, in case of not attending physiotherapy the spinal stability after delivery improved only for women wearing maternity support garment. 3. Core stability during pregnancy and after delivery was better among women attending physical therapy but not wearing maternity support garment compared to women not attending physical therapy but wearing maternity support garment. 4. Physical therapy and maternity support garment improves core stability during pregnancy and has a positive effect on activity of rectus abdominis muscles following delivery.Keywords: obstetrics, transversus abdominis muscle, exercises.

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Evaluation of osteopathic manipulative treatment in pain reduction in pregnant women during third trimester and postpartum: Review Article

Scholar: Pilot and Validation Studies ◽

10.32778/spvs.71366.2021.22 ◽

2021 ◽

Vol 2 (2) ◽

pp. 19-21

Author(s):

Oscar Abramovich ◽

Cylie Alflen ◽

Sawyer Bawek ◽

Bianca Marrara ◽

Stephen Stein ◽

...

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Review Article ◽

Osteopathic Manipulative Treatment ◽

Low Back ◽

Physiological Changes ◽

Pharmaceutical Treatment ◽

Third Trimester ◽

Analog Scale ◽

The Third

Abstract The female body undergoes physiological changes during pregnancy that often lead to low back pain (LBP). To assess a non-pharmaceutical treatment option for LBP, a literature review was conducted comparing research trials using Osteopathic Manipulative Treatment (OMT) and its effect on LBP experienced in the third trimester and postpartum. Research studies using the Visual Analog Scale (VAS) to rate pain were used and the effects of OMT was analyzed. It was found that, compared to usual treatment for LBP, OMT provided significant relief of pain for patients. While research conducted in pregnant populations is limited, further research is required to assess OMT technique models on individuals and the effect on pain throughout pregnancy through the postpartum period.

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