Study: Early improvements not sustained in patients treated with PRP injection for facet joint arthropathy

Early gains in pain relief, behavioral markers and function were not sustained in patients treated with platelet-rich plasma (PRP) injection for facet joint arthropathy, new research shows. Results were available at the 31st Annual Meeting of the American Academy of Pain Medicine.

The study caps two years of investigation based on research showing PRP could promote progressive improvement and even repair for painful conditions such as elbow tendonitis and "tennis elbow." The research team from Stony Brook, N.Y., investigated whether PRP might also prove an effective alternative to corticosteroid injection or radiofrequency ablation for cervical and lumbar facet arthropathy. Arthropathy is a collective term for joint disease that can encompass many types of specific and non-specific pathologies or injuries and affects all age groups.

"It was our hope, based on other indications, that we might actually heal a joint," or observe long-term (up to a year) improvement, said Marco Palmieri, D.O., the lead study author, who specializes in interventional techniques in the Chronic Pain Division of the Center For Pain Management At Stony Brook. "Unfortunately, we haven't seen that in our results."

Palmieri stressed, however, that the treatment has promise, and further work should focus on identifying proper treatment protocols and subgroups that might benefit most from the therapy.

The researchers examined pain and functional outcomes for 24 PRP patients, extracted from medical records with institutional review board approval. They found that pain intensity levels decreased in months one and three compared to baseline (p≤0.01) but returned to baseline in months six and 12. Similarly, measures of function and disability decreased in the first month (both p<0.01) but returned to baseline afterward.

Behavioral markers measured by PROMIS tools, developed through the National Institutes of Health, found less anger, anxiety, pain interference and pain behavior in the first month (all p≤0.03). The patients also reported higher physical function and satisfaction with social roles (p≤0.03) in the first and third months.

Palmieri said part of the follow-up research would entail determining the optimal intervals between injections and other particulars that have not been clearly delineated to date.