Autologous conditioned plasma (ACP) therapy is a form of autologous blood treatment using platelet-rich plasma for the management of painful inflammation of the facet joints or the sacroiliac joint (SIJ). The therapeutic concept is based on the activation and targeted use of the body’s own biological factors.

This regenerative approach is applied in selected patients with degenerative spinal conditions, particularly when inflammation-related pain persists despite conventional treatment strategies. For international patients evaluating non-surgical treatment options for chronic lower back pain, ACP therapy represents a biologically oriented intervention that utilizes endogenous repair mechanisms.

Facet Syndrome and Sacroiliac Joint Syndrome

Facet joint syndrome is classified as a degenerative disorder of the spine. It commonly develops as a consequence of intervertebral disc degeneration associated with disc height loss. As disc height decreases, mechanical load on the small vertebral joints increases. This leads to joint compression, progressive wear (spondylarthrosis), and an inflammatory reaction—comparable to osteoarthritis in larger joints such as the knee or hip.

Similar inflammatory and degenerative processes may affect the sacroiliac joint, resulting in what is termed sacroiliac joint (SIJ) syndrome. Both the facet joints and the SIJ are richly supplied with nerve fibers. Inflammatory irritation stimulates these nociceptive fibers, transmitting pain signals to the central nervous system.

The body responds by increasing regional muscle tension in an attempt to stabilize and protect the affected segment. However, sustained muscle contraction may intensify discomfort. Simultaneously, the immune system is activated. In some cases, this immunological response becomes excessive, potentially perpetuating inflammation rather than resolving it.

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Conventional Injection Therapy and Its Role

Standard interventional treatment for acute severe pain includes image-guided infiltration with corticosteroids and local anesthetics. These injections aim to reduce inflammation and provide rapid symptom relief. In acute inflammatory episodes, this remains a well-established therapeutic option.

When acute pain subsides and the therapeutic objective shifts toward longer-term modulation of inflammation and potential support of biological repair processes, autologous conditioned plasma therapy may be considered as an individualized treatment attempt.

Biological Mechanism of ACP Therapy

ACP therapy utilizes platelet-rich plasma derived from the patient’s own blood. Through a specialized separation process, concentrated plasma containing elevated levels of specific protein molecules—such as growth factors and endogenous anti-inflammatory mediators—is obtained.

These biological factors are then injected into the affected spinal structures, including the facet joints or the sacroiliac joint, under radiographic guidance. The therapeutic rationale is to stimulate the body’s intrinsic repair mechanisms and modulate inflammatory processes at the site of pathology.

Current medical literature suggests a potentially promising role for platelet-rich plasma in degenerative joint conditions. However, large-scale studies with unequivocal evidence of clinical benefit in spinal applications remain limited. Therefore, the effectiveness of ACP therapy cannot be predicted with certainty in individual cases. It is considered an innovative treatment approach applied within the framework of an individualized therapeutic trial.

Treatment Procedure

The procedure is performed on an outpatient basis and typically requires approximately 30 minutes.

  • First, a blood sample is obtained from a peripheral arm vein. The sample undergoes a centrifugation process to isolate concentrated autologous plasma components containing growth factors and anti-inflammatory proteins.
  • The prepared plasma is then injected precisely into the affected region—either the small vertebral joints or the sacroiliac joint—under fluoroscopic (X-ray) guidance to ensure accurate placement.
  • The treatment concept is personalized and tailored to the patient’s specific clinical findings, symptom pattern, and therapeutic objectives. As with all biological therapies, individual response may vary.

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