It might be unsurprising, but low back pain is just par-for-the-course for most adults. Defining the region affected and the exact cause of the pain is a different story. Generally, both low back health and low back pain is related to the spine which contains a system of nerves. Any pain we experience in our back will be communicated along the spinal nerves and our central nervous system. However, most of the time, chronic low back pain (back pain that is not a result of recent acute injury) signals a malfunction in the spine.
In the American Journal of Neuroradiology American Journal of Neuroradiology, Dr. Brinjikji gives a brief overview of low back pain by stating that, “[l]ow back pain affects up to two-thirds of adults at some point in their lives. Back pain–related disability has significant economic consequences due to consumption of health care resources and loss of economic productivity. Increased use of MR imaging and CT in the evaluation of patients with back pain consumes a large amount of health care resources. Imaging findings such as disc bulge and disc protrusion/extrusion are often interpreted as causes of back pain, triggering both medical and surgical interventions” (2015). With the prevalence of low back pain being so high in most adults (roughly two-thirds, as stated by Dr. Brinjikji) it would seem that our attention should focus on the health of the spine– namely the health of its discs.
Determining the health of the discs and the various conditions they could be in would only be the first step– however, it is a crucial step. Dr. Brinjikji continues to not only emphasize determining disc health but recognizes that disc bulges may be the highest contributing factor for low back pain: “Disc findings, including disc bulge, disc degeneration, and disc extrusion and protrusions, had significant associations with low back pain . . . One surprising finding from our study was that disc bulge had a strong association with low back pain. Because of the high prevalence in the asymptomatic population, disc bulges are often considered incidental findings and not associated with low back pain. The prevalence of disc bulges in asymptomatic populations ranges from 20% in young adults to >75% in patients older than 70 years of age”. Because some patients with disc bulges are asymptomatic to back pain and disc bulges are overlooked, many go untreated or are unable to find the care they need to treat the pain. Many are left unaware and uneducated on the relation between disc bulges and low back pain.
Dr. Oktay, in a study examining the regression of the spine and pathogenesis of disc bulges determined that, “. . . the exact mechanisms of regression still remain unclear. There are three hypotheses proposed in the literature: dehydration of herniated disc, retraction of herniated disc, and inflammation‑related resorption theories” (2019). Initially, herniated discs are a result of age and degradation, and most people cannot pinpoint a specific instant to attribute to the condition.
In addition to the herniated disc, there are three regressive mechanisms to which Dr. Oktay goes into further detail and explains that,“[t]he first theory includes the gradual dehydration and shrinkage of the herniated nucleus pulposus. The second theory proposes that the herniated disc may retract back into the intervertebral disc space, but this theoretically only occurs if the herniated disc has protruded through the annulus fibrosis without separating from it. The third theory states that the herniated nucleus pulposus, once extruded into the epidural vascular space of the spine, is recognized as a foreign body by the autoimmune system and induces an inflammatory reaction. This inflammatory reaction would lead the bulging disc to neovascularization, enzymatic degradation, and macrophage phagocytosis. In our opinion, the third theory may play a key role in the process of spontaneous regression . . .”. It is, of course, difficult to determine the condition of our back, its spine, or its discs. So, finding treatment solutions after learning how complex the spine can be can feel like an insurmountable task. Patients may feel that their low back pain will never end but they can have hope that Orthagenex has a solution through high dose platelet rich plasma.
Before patients risk surgery to alleviate low back pain, another treatment to consider is High Dose PRP, high dose platelet-rich plasma with Orthagenex. High dose platelet rich plasma treatment for bulging disc pain, while increasing in patient use, is still considered to be an unconventional treatment but quickly becoming mainstream as the processes become standardized and the data of treatment outcomes is more refined. High Dose PRP works to target and heal nerve/tissue damage in the spine, not only caused by disc bulges but other causes of nerve damage as well, but what exactly is high dose platelet-rich plasma and how can it treat bulging disc pain?
In a study of high dose platelet rich plasma conducted by the China-Japan Union Hospital of Jilin University, physicians found that, “[p]latelet-rich plasma (PRP) is a platelet concentrate extracted from autologous blood by centrifugation, which is a kind of bioactive substance” (Wang 2022). But, what does all this mean? In our own (autologous) blood, we are able to take platelets in a concentrated form. When blood is taken from us and put in a centrifuge, it is spun around quickly to separate red blood cells from white blood cells as well as concentrate the number of platelets together. These concentrated platelets, once extracted and applied, act as a treatment that can be used to target nerve-damaged areas. These damaged areas include nerves damaged through bulging discs in the spine– regardless of their current pathogenesis. High dose platelet rich plasma even has the potential to heal and regrow damaged tissue around the back joints and is even favored among those patients who have suffered acute injuries. We’ve all witnessed the human body’s incredible capability to heal injuries. A scraped back will bleed, scab, and scar in a number of days and a broken bone will reset itself in a matter of weeks. These healing processes work through the cells in our body activating and targeting the affected areas. With nerve damage, the process of treatment is more complicated. However, the healing capability of our body works in much the same way.
Our body contains the capability to heal nerve damage through the application of high dose platelet rich plasma. Orthagenex now has the ability to apply that in concentration to nerves affected by bulging discs and the application is safe. Wang continues with his evaluation of high dose platelet rich plasma by stating that, “[t]he application of PRP comes from the body, there is no immune rejection reaction . . . it is, therefore, widely used in various clinical fields”. With Orthagenex’s high dose platelet rich plasma, patients don’t need to worry about a foreign or unidentified substance entering or affecting their body with adverse and uncontrollable side-effects. By targeting problematic bulging discs with this concentration, the application of high dose platelet rich plasma to affected areas is an assistance to the body’s natural healing process. According to a 2017 study evaluating the high dose platelet rich plasma treatment process, doctors Sanchez and his associates concluded that the six pieces of evidence that support nerve regeneration include: “1) neuroprotection and prevention of neuronal apoptosis, 2) stimulation of vascular regeneration, 3) promotion of axonal regeneration, 4) regulation of inflammatory response in the microenvironment, 5) alleviation of nerve collateral muscle atrophy, and 6) improvement of human nervous system parameters” (2017). With the benefits of this natural application of healing platelets in mind, patients struggling with disc bulge pain are more and more likely to seek this type of treatment every day they have to live with the condition