Emerging Biologics in Lumbar Disc Degeneration: PRP, Stem Cell Therapy, and Pharmacotherapy in Mobility Restoration and Rehabilitation

Author(s): Andre Aabedi, Devendra K. Agrawal

Lumbar disc degeneration is a leading contributor to chronic low back pain and functional limitation worldwide, driven by progressive extracellular matrix breakdown, disc dehydration, inflammation, and cellular senescence. Conventional treatments—including pharmacotherapy, physical rehabilitation, and surgery—primarily address symptoms rather than the underlying degenerative cascade and often fail to restore disc structure or long-term mobility. Emerging biologic therapies have gained attention for their potential to modify disease progression and promote regeneration. This narrative review examines current evidence surrounding platelet-rich plasma, mesenchymal stem cell therapies, peptide analogs, and evolving pharmacologic agents in the management of lumbar disc degeneration, with particular emphasis on mobility restoration and rehabilitation integration. platelet-rich plasma and mesenchymal stem cell-based interventions demonstrate moderate improvements in pain and functional outcomes with generally favorable safety profiles, though durable structural regeneration remains unproven. Peptide analogs and molecular agents show promising preclinical regenerative and anti-inflammatory effects but lack robust human data and regulatory approval. Pharmacologic strategies targeting inflammatory and catabolic pathways may complement biologic therapies but remain largely investigational. The integration of biologics with structured rehabilitation and progressive loading appears critical for optimizing functional recovery. Despite encouraging advances, significant limitations persist, including heterogeneous protocols, limited high-quality randomized trials, and insufficient long-term data. Future research should prioritize standardization, comparative effectiveness studies, and multimodal treatment models to clarify the role of biologic therapies in restoring mobility and function in lumbar disc degeneration.