Study Evaluating the Safety and Feasibility of Platelet-rich Plasma to Treat Facetogenic Low Back Pain

Inclusion Criteria: * Clinical and radiographic (MRI, CT or lumbar x-ray) evidence of symptomatic facet arthropathy involving the bilateral bottom two facets (e.g., L4-5 or L5-6 and L5-S1 or L6-S1). * Positive response, defined according to current clinical standards for the diagnosis of facet-mediated low back pain as greater than or equal to 75% pain improvement (as reported by patient) to diagnostic medial branch nerve blocks, one block with lidocaine and the other with bupivacaine. * Low back pain VAS score of greater than or equal to 5 at the clinical visit just prior to the first medial branch nerve block. Exclusion Criteria: * Prior facet related procedure (intraarticular corticosteroid injection, radiofrequency ablation (RFA)) in last 6 months or prior fusion in the bottom two facets. * Current opioid use of greater than 50mg oral morphine milligram equivalents per day. * No advanced imaging (MRI, CT or lumbar x-ray) of the lumbar spine within the last 6 months. * BMI \> 34.99 (WHO class I obesity). * Active systemic or local infection as evidenced by fever \>100.4 degrees Fahrenheit, or any other clinical signs or symptoms of infection within 24 hours of the procedure. * On anticoagulation drug and has been on hold for less than 7 days prior to the investigational procedure. * Imaging evidence of high likelihood of failure for intra-articular injection in the opinion of the PI or delegate review of MRI, CT or lumbar x-ray imaging. * History of chronic thrombocytopenia (or pre-operative platelet count less than 195,000 per μl). * Undergoing chemotherapy at time of injection. * Pregnant or breastfeeding. * Use of illicit drugs within 30 days prior to study entry. * NSAID use during the pre-procedural period (one week before Treatment Day 0). * Preoperative hematocrit less than 36%. * History of hemodynamic instability or inability to maintain stable oncotic pressure. * History of prolonged clotting times. * Prior history of lumbar procedure. * Redness, swelling, rash or other concerning lesions at the injection site just prior to the procedure. * Prior history of allergy to lidocaine or other local anesthetic agent.