A recent study by the Chinese reveals that the usage of Methylene Blue, which is a common dye, when injected into the intervertebral discs may result in significant and permanent reduction of low back pain. The exact method of how this interaction occurs is unknown but the results reveal a 50% reduction in pain in the treated groups. The study involved 136 individuals, of which 72 were utilized for the study while the others were eliminated due to inconclusive discography results. Half of these patients had a sham injection of saline while the others received the Methylene blue. Results were obtained at two years out, which is standard for long-term studies. The statistical analysis of the data revealed that the results were indeed significant.
What does this mean? Is Methylene blue the cure all for disc related low back pain?
The hard thing with such data is understanding what a 50% reduction correlates to. A novice would think that everyone got half of his or her pain eliminated. In reality, it implies that of the people who received the Methylene blue the average improvement was 50%. Thus some people got no relief while others received much more relief. It is also important to note that the Placebo group has a 15% significant improvement rate. It is also important to note that when the scores were analyzed using Oswestry scales, which is a tricky tests that tries to eliminate bias or errors in the questioning, the results dropped to 35% improvement compared to the 15% for placebo.
So again, you ask, what does this mean?
It means that Methylene blue may be a treatment option for people with chronic low back pain secondary to degenerative disc disease. It also implies that between 35 and 50% of the people will get some degree of significant, permanent relief from the injection. Not bad for a fairly benign chemical. We have been injecting Methylene blue into selected patients for the past six months. Obviously, we do not have long term results at this time, but it appears that 50% of the people get some degree of significant pain reduction with the injection..
This isn’t the first intradiscal injection that has been tested. We have been injecting a mixture of Glucosamine, Chondroitin, and dextrose into the discs since 2004. The results with this injection I think have been better at around 65% improvement (65% of the patients get significant permanent improvement). We have also been injecting Ozone gas into the discs for the past two years. This is based on several studies from Europe that revealed that Ozone gas resulted in 90% success rates for patients with disc related pain. Our results don’t correlate with that and I believe the results are more 50-50 with half of the patients seeing some degree of significant improvement.
None of these injections is considered experimental since there have been studies on all of them. I generally utilize the Glucosamine mixture first, then either the Methylene blue or Ozone gas. I also utilize a discectomy first if it is feasible since there are many studies on discectomy for low back pain offering a 70% success rate.
Now what all this really means!
It means that discogenic or low back pain from degenerative disc disease is hard to treat but there are a multitude of treatment options. Unfortunately, none of them offer greater than a70% success rate. Even spinal fusions only offer a 50 to 70% success rate for disc related low back pain. So if you suffer from low back pain secondary to degenerative disc disease, you shouldn’t give up if one option doesn’t work since there are other options and the fact that one didn’t work doesn’t rule out the other from possibly being effective.
Let’s pray for a pain free world.