low back pain and sciatica are incredibly common and extremely difficult to treat
people suffering from back pain are often desperate to look for treatments that relieve
pain so in this video i'm going over the latest clinical trial data looking
at whether steroid injections or epidural injections work i'm also going to answer the
question does prp work for low back pain and sciatica let's get started
now if this is the first time you're watching one of my videos my goal is to help each and every one
of you live an active and healthy lifestyle so if that's something you're interested in please
consider subscribing to my channel low back pain is extremely common with some studies suggesting
up to 25 of the us population reporting low back pain at least once in the prior three months low
back pain is also a leading global cause of years lived with disability so it makes sense that
clinicians are always looking for new and better treatment options for such a disabling condition
now for the longest time the go-to non-surgical treatment option for chronic low back pain
that has not responded to exercise therapy and medication management has been an epidural steroid
injection but now there is more data coming out about the potential long-term side effects
of corticosteroid injections specifically when steroids are injected into joints
they can degrade articular cartilage and cause worsening arthritis so researchers
are revisiting whether epidural corticosteroid injections truly help one of the best databases
available for evidence-based medicine comes from the cochrane library their aim is to make
the results of well-conducted controlled trials available for a variety of medical conditions
they published their review article two years ago titled epidural corticosteroid injections for
lumbosacral radicular pain according to the review the goal of epidural corticosteroid injections is
to deliver medication into the epidural space with the aim of reducing the local inflammatory process
and consequently relieving the symptoms of lumbosacral radicular pain this radicular pain
is also what we call sciatica or pain that shoots down from the back down the hips and into the leg
they included 25 clinical trials which compared epidural steroid injections to placebo injections
and after their analysis they report that epidural steroid injections were probably slightly more
effective compared to placebo in reducing leg pain and disability at short-term follow-up but
the authors go on to conclude that the available evidence still provides only limited support
for the use of epidural steroid injections in people with lumbosacral radicular pain
as the treatment effects are small mainly evident as short-term follow-up
and may not be considered clinically important by patients and clinicians and for something that has
been long touted as an excellent treatment option corticosteroid injections may not provide as much
relief as we think notice the author's choice of words here and let's read between the lines
they say steroids are probably and slightly more effective and that whatever differences
between steroid and placebo may not even be considered clinically important because
the effects are so small and this is exactly why clinicians are looking for other options
we've known now that corticosteroids provide only small short-term relief can we find anything else
that has more of a sustained response prp injections work incredibly well for knee
arthritis in providing short-term and sustained long-term relief so does prp work for low back
pain and sciatica this study was a randomized double-blind controlled study comparing prp
injection to epidural steroid injection patients were randomized into either getting prp or steroid
injection and then evaluated at one month three months and six months post-injection researchers
were looking at pain levels and quality of life at these follow-up time points they found that at
one month patients who got the steroid injection had better pain reduction when compared to the prp
group however the authors found that the pain and quality of life scores were much better in the prp
group at 3 months and 6 months follow-up let's look at another study this study compared prp
injection to steroid injection for the treatment of lumbar facet joint syndrome they too evaluated
patients up to six months after treatment and compared pain and patient satisfaction just like
in the other study these authors found that the steroid injection group had better pain levels
at one month when compared to the prp group but both pain and patient satisfaction were much
better in the prp group at three months and six months follow-up now let's look at a study for the
sacroiliac joint another common problem in those suffering from low back pain this study compared
prp injection to steroid injection for the treatment of si joint dysfunction they followed
patients out to three months and compared pain and functional limitations they found that again
steroid injections had a temporary improvement in pain that was not sustained they state that
the intensity of pain was significantly lower in the prp group at six weeks and three months
when compared to the steroid group when looking at functional improvements the steroid group improved
initially for up to four weeks but deteriorated further at three months while scores for the prp
group continue to improve up to three months the results from these clinical trials are consistent
with what we have seen when we compare prp to steroid injections for other conditions
such as tennis elbow plantar fasciitis gluteal tendinopathy and knee arthritis steroids work
fast and then they wear off prp has much more sustained effect on long-term pain and quality
of life now it's important to point out that these are only three smaller trials the problem is there
are just not that many clinical trials looking at the use of prp for low back pain so until more
trials are done and then subsequent systematic reviews and meta-analysis are performed we won't
truly know if prp works for low back pain or sciatica with that said if you have chronic low
back pain and epidural steroid injections has only provided short-term relief or perhaps has not even
provided any relief then a prp injection seems like a safe and potentially great option to try
lastly if you're interested in learning more about prp check out my video where i answer
some of the most common questions that i get about platelet-rich plasma thanks for watching