As a back pain specialist in the Spine Program at Kaiser Permanente, I frequently discuss treatment options like the PRP epidural injection with my patients. I also remind them that there are two types of people in the world—those with issues at L4/L5 and those with issues at L5/S1. Of course, there are occasional disc protrusions at other levels, but by far, these two levels account for the majority of back pain and radiating leg pain that I see in practice.
Steroids vs. PRP: Which is better?
The typical treatment for radiating leg pain from a protruding disc is an epidural steroid injection. In my experience these treatments tend to help in the short term but are less effective in the long run. Steroids may temporarily reduce inflammation, but they often do not address the underlying cause of the problem.
This highlights a key difference—steroids manage symptoms, while PRP works to heal the underlying condition.
A recent meta-analysis of randomized controlled trials1 compared epidural steroid injections with a PRP epidural injection for herniated disc treatment. Platelet-Rich Plasma (PRP), derived from your own blood, contains growth factors that promote healing and tissue repair.
Steroid injections provided better pain relief for one month. However, patients who received PRP experienced continued improvement over time. By six months, the PRP group reported significantly lower pain levels compared to those treated with steroids.
Precision Matters: Image-Guided PRP Injections
At Oregon Regenerative Medicine, we specialize in advanced regenerative procedures, including PRP epidural and facet joint injections. These treatments are performed using fluoroscopic guidance (live X-Ray), which allows for precise placement of the injection. This level of accuracy is critical for both safety and effectiveness, ensuring that the PRP is delivered exactly where it is needed.
Is PRP Right for Your Back Pain?
For patients dealing with persistent back pain or radiating leg pain, PRP offers a non-surgical option focused on healing—not just symptom management.
At ORM, we are one of the few clinics in the Portland metro area that provide PRP epidural injections and facet injections under the gold-standard of treatment guidance— a technique involving live scan x-ray, also known as fluoroscopy. If you or someone you care about is struggling with ongoing spine-related pain, our team is here to help you explore whether regenerative treatments like PRP are the right fit for your recovery.
Dr. Kristian Flores, MD, ND, began his medical journey as a Naturopathic Doctor. He then earned his Medical Degree, completing an Internal Medicine internship as well as a residency in Physical Medicine and Rehabilitation (also known as Physiatry). As a Board-Certified Physiatrist, Dr. Flores specializes in the prevention, diagnosis, and rehabilitation of people disabled by disease, disorder, or injury. He works extensively with patients suffering from acute and chronic pain conditions such as spine pain and sports injuries. His practice also includes helping patients with disabling conditions such as brain injury, Long-COVID, and hypermobility disorders.
Source
- Ermawan R, Corrigan H, Fachreza MS, Mercy G, Angeline A, Jiwandono BS, Yudistiro I, Abdulhamid M. Epidural Platelet-Rich Plasma Long-Term Outcome Is Better Than Steroid for Prolapsed Lumbar Intervertebral Discs: A Meta-Analysis of Randomized Controlled Trials. Spine Surg Relat Res. 2025 Apr 19;10(1):36-42. doi: 10.22603/ssrr.2025-0007. PMID: 41695894; PMCID: PMC12902210.
FAQ
What is sciatica?
Patients—and even healthcare providers—often use the term sciatica as if it were a specific diagnosis. But it’s not. It just means that you are having pain down your leg. The reason for which the sciatic nerve is irritated could be central or peripheral, it could be arthritic facet joints, facet cysts, disc protrusion, disc extrusion or a broad disc bulge. The irritation could be at the neural foramen or the lateral recess. It could be central stenosis causing neurogenic claudication, multifidis syndrome, piriformis syndrome, gluteal syndrome, sacroiliac joint irritation, pelvic instability….the list goes on.
What is a PRP epidural injection for a herniated disc?
A PRP epidural injection uses platelet-rich plasma from your own blood to promote healing around a herniated disc and irritated nerves. It is designed to reduce pain and support tissue repair.
Is PRP better than steroid injections for back pain?
Steroid injections may provide faster short-term relief. However, studies show that PRP epidural injections can provide better long-term improvement in pain and function.
How long does it take for PRP epidural injections to work?
PRP may take several weeks to start working, as it stimulates the body’s natural healing process. Improvement typically continues over several months.
Are PRP epidural injections safe?
Because PRP is made from your own blood, it is generally considered safe. When performed under fluoroscopic guidance, accuracy and safety are further improved. However, PRP is strictly contraindicated for anyone with an active infection or cancer.
Who is a good candidate for PRP epidural injections?
Patients with herniated discs, radiating leg pain, or chronic lower back pain who want to avoid surgery or repeated steroid injections may be good candidates.
