scholarly journals Platelet-Rich Plasma Releasate versus Corticosteroid for the Treatment of Discogenic Low Back Pain: A Double-Blind Randomized Controlled Trial

2022 ◽  
Vol 11 (2) ◽  
pp. 304
Author(s):  
Koji Akeda ◽  
Kohshi Ohishi ◽  
Norihiko Takegami ◽  
Takao Sudo ◽  
Junichi Yamada ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Platelet Rich Plasma ◽  
Controlled Trial ◽  
Controlled Clinical Trial ◽  
Walking Ability ◽  
Low Back ◽  
Disability Score ◽  
Double Blind ◽  
Discogenic Low Back Pain

Clinical application of platelet-rich plasma is gaining popularity in treating low back pain (LBP). This study investigated the efficacy and safety of platelet-rich plasma releasate (PRPr) injection into degenerated discs of patients with discogenic LBP. A randomized, double-blind, active-controlled clinical trial was conducted. Sixteen patients with discogenic LBP received an intradiscal injection of either autologous PRPr or corticosteroid (CS). Patients in both groups who wished to have PRPr treatment received an optional injection of PRPr eight weeks later. The primary outcome was change in VAS from baseline at eight weeks. Secondary outcomes were pain, disability, quality of life (QOL), image analyses of disc degeneration, and safety for up to 60 weeks. The VAS change at eight weeks did not significantly differ between the two groups. Fifteen patients received the optional injection. Compared to the CS group, the PRPr group had a significantly improved disability score at 26 weeks and walking ability scores at four and eight weeks. Radiographic disc height and MRI grading score were unchanged from baseline. PRPr caused no clinically important adverse events. PRPr injection showed clinically significant improvements in LBP intensity equal to that of CS. PRPr treatment relieved pain, and improved disability and QOL during 60 weeks of observation.

scholarly journals A Randomized, Double-Blind, Active-Controlled Trial of Fluoroscopic Lumbar Interlaminar Epidural Injections in Chronic Axial or Discogenic Low Back Pain: Results of 2-Year Follow-Up

2013 ◽  
Vol 5;16 (5;9) ◽  
pp. E494-E504
Author(s):  
Laxmaiah Manchikanti
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Disc Herniation ◽  
Local Anesthetic ◽  
Controlled Trial ◽  
Low Back ◽  
Discogenic Pain ◽  
Double Blind ◽  
Epidural Injections ◽  
Discogenic Low Back Pain

Background: Chronic low back with or without lower extremity pain is extremely common, expensive, and disabling. Although it is responsible for a very small proportion of patients, disc herniation is the primary focus of modalities of treatments. In fact, chronic low back pain without disc herniation is common. Multiple modalities of treatments are utilized in managing axial or discogenic pain without disc herniation including surgery, intradiscal therapies, and epidural injections. There is, however, continued debate on the effectiveness, indications, and medical necessity of all modalities of treatments in managing axial or discogenic pain in the lumbar spine. Objectives: To assess the effectiveness of lumbar interlaminar epidural injections in managing chronic axial or discogenic low back pain with epidural injections of local anesthetic with or without steroids. Study Design: A randomized, double-blind, active-controlled trial. Setting: A private practice, specialty referral, interventional pain management practice in the United States. Methods: In this study, a total of 120 patients were randomly allocated to one of 2 groups of 60 patients receiving either local anesthetic alone or local anesthetic with steroids. The primary outcome measure was at least a 50% improvement in the numeric rating scale (NRS) and Oswestry Disability Index (ODI). Outcomes were assessed at 3, 6, 12, 18, and 24 months post treatment. Results: Significant pain relief and functional status improvement, defined as a reduction in scores from baseline of at least 50% or more, were observed in 72% of patients receiving local anesthetic alone and 67% of patients receiving local anesthetic with steroids. Opioid intake was reduced from the baseline in each group for 2 years. Limitations: The results of the study are limited by the lack of a placebo group. Conclusion: Lumbar interlaminar epidural injections of local anesthetic with or without steroids are effective in patients with chronic axial low back pain of discogenic origin without facet joint pain, disc herniation, and/or radiculitis. Key words: Lumbar disc herniation, axial or discogenic pain, lumbar interlaminar epidural injections, local anesthetic, steroids, controlled comparative local anesthetic blocks

scholarly journals Effect of age on outcomes after allogeneic disc tissue supplementation in patients with chronic discogenic low back pain in the VAST trial

2021 ◽  
Author(s):  
Corey W Hunter ◽  
Richard Guyer ◽  
Mark Froimson ◽  
Michael J DePalma
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Controlled Trial ◽  
Young Patients ◽  
Functional Improvement ◽  
Low Back ◽  
Disc Tissue ◽  
Discogenic Low Back Pain ◽  
Post Hoc ◽  
Significant Functional Improvement

Aim: To explore the effects of viable allogeneic disc tissue supplementation in younger patients with discogenic chronic low back pain (CLBP). Patients & methods: VAST was a randomized placebo-controlled trial of disc allograft supplementation in 218 patients with discogenic CLBP. We conducted a post hoc analysis of change from baseline to 12 months in Oswestry Disability Index (ODI) and visual analog scale for pain intensity scores stratified by patient age. Results: Patients aged <42 years receiving allograft experienced greater improvement in ODI (p = 0.042) and a higher ODI response rate (≥10-, ≥15- and ≥20-point reductions in ODI) than those receiving saline (p = 0.001, p = 0.002 and p = 0.021, respectively). Conclusion: Young patients with discogenic CLBP may have significant functional improvement following nonsurgical disc allograft supplementation.

Effects of elastic tape in pregnant women with low back pain: A randomized controlled trial

2020 ◽  
pp. 1-9
Author(s):  
Matchimamart Chamnankrom ◽  
Nuttaset Manimmanakorn ◽  
Apiwan Manimmanakorn ◽  
Kiattisak Kongwattanakul ◽  
Michael J. Hamlin
Keyword(s):  
Low Back Pain ◽  
Placebo Group ◽  
Back Pain ◽  
Pregnant Women ◽  
Lower Back Pain ◽  
Controlled Trial ◽  
Low Back ◽  
Disability Score ◽  
Kinesio Tape ◽  
Lower Back

BACKGROUND: Low back pain is a common problem in pregnant woman. Elastic tape is an alternative method that may reduce low back pain. OBJECTIVES: To compare the effect of elastic tape to placebo tape in the treatment of low back pain in pregnant women. METHODS: Forty pregnant women were allocated into two groups: elastic group (n= 20) and placebo group (n= 20). All participants were taped by either stretched (elastic group) or non-stretched (placebo group) Kinesio tape at the lower back area for one week. RESULTS: After the application of stretched elastic tape, lower back pain was significantly reduced by 29.4% (p= 0.003) immediately post-taping and by a further 75.4% after wearing the tape for a week. Compared to the placebo group, lower back pain was significantly reduced in the elastic group after one week of wearing the tape (p< 0.001). Compared to placebo, the application of elastic tape significantly reduced the disability score (Roland-Morris Disability Questionnaire) after one week of wearing the tape (p= 0.018). Taping to the back improved walking speed (immediately and after one week) in both the elastic (p< 0.001, p< 0.001) and placebo groups (p< 0.001, p= 0.001); however, the application of either tape had little effect on posture change. CONCLUSION: Elastic tape reduced back pain and improved physical function in pregnant women compared to the placebo tape.

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