Authors' objectives: To determine whether there is any evidence on the efficacy/effectiveness of platelet-rich plasma (PRP) in treating lumbar disc herniation or facet joint pain.

Authors' results and conclusions: Fifty-eight published studies were identified from the search. Upon examination of the titles and abstracts of these 58 studies, 11 studies were thought to be relevant and were retrieved in full for further appraisals. Of these 11 studies that were retrieved in full, two studies were in the form of expert reviews (level of evidence 5), were traced for their potentially relevant primary studies and, hence, will not be discussed further. Three further primary studies were identified from these manual searches. Overall, there were 12 primary studies were relevant and were included in this systematic review. Of the 12 primary studies included in this systematic review, eight studies were in the form of small (n from 2 to 37) case series or case report (level of evidence 4). Although all these eight case reports or small case series reported improvement, across different assessment time frames, in the patients’ visual analog score (VAS) pain, Oswestry Disability Index, Roland Morris Disability Index, Straight Leg Raising Test degrees, Functional Rating Index and/or Patient Satisfaction Index, it has been noted that it was not clear how these patients were selected and reported in these studies. In a small (n total=46) randomized controlled trial (RCT) (level of evidence 1), investigating the effect of triamcinolone vs. PRP injection in patients with lumbar disc herniation, patients aged between 18-60 years old diagnosed with lumbar disc herniation and not reposing to conservative management was randomized into receiving triamcinolone (n=23) or receiving PRP (prepared according to HARVEST Smart prep method). Another small (n total=30; 15 on each treatment group) RCT (level of evidence 1), compared the effect of triamcinolone and PRP injection among patients with a lumbar herniated disc. A small (n= 63 on the steroid injection with n=61 on the PRP injection groups), RCT (level of evidence 1. Appendix 1), investigated the effect of steroid vs. PRP injection among patients diagnosed with MRI or CT imaging of postero-lateral lumbar disc herniation at L4/L5 or L5/S1 segment and conformed clinically. A small (n=29 in PRP group vs. n=18 in contrast injection group) RCT (level of evidence 1) investigating the effect of a single PRP injection in improving patient pain and function affected by lumbar disc protrusion was reported. At present, there is some low-level low-quality evidence as well as some high-level low-quality evidence on the efficacy/effectiveness of PRP in treating facet joint pain and/or lumbar disc herniation. However, the available evidence must be interpreted with caution since the effect of bias and chance as well as some confounding cannot be excluded from affecting the results. Further, there was significant heterogeneity in the way the PRP was prepared and administered.

Authors' methods: A comprehensive and systematic literature search was conducted on January 30, 2025. The search was done on commercial medical literature databases employing a combination of key words. No limitation, such as on the language or year of publication, was implemented in this search. A manual search was also done on the references of the articles that were retrieved in full.

Project Status: Completed

URL for project: https://www.worksafebc.com/en/about-us/research-services/evidence-based-medicine-and-systematic-reviews

Year Published: 2025

URL for published report: https://www.worksafebc.com/en/resources/health-care-providers/guides/platelet-rich-plasma-in-treating-disc-herniation-or-facet-joint-pain?lang=en&origin=s&returnurl=https%3A%2F%2Fwww.worksafebc.com%2Fen%2Fforms-resources%23sort%3DDate%26q%3DPlatelet%2520Rich%2520Plasma%2520in%2520Treating%2520Disc%2520Herniation%2520or%2520Facet%2520Joint%2520Pain%26f%3Alanguage-facet%3D%5BEnglish%5D%26tags%3DGuide%7C2d7eb4b30f6a4a319e0d40565c9abbab%2CHealth%2520Care%2520Provider%7C13468b0b3f074f6bade3f57ac3cdfb8e%2CSystematic%2520Review%7Cf78c29d570c14ec3b5a394385905df70&highlight=Platelet%20Rich%20Plasma%20in%20Treating%20Disc%20Herniation%20or%20Facet%20Joint%20Pain

English language abstract: An English language summary is available

Publication Type: Mini HTA

Country: Canada

Organisation Name: WorkSafeBC

Contact Address: 6591 Westminster Highway, Richmond, BC, V7C 1C6 Canada. Tel: 604-231-8417; Fax: 604-279-7698

Contact Name: ebpg@worksafebc.com

Contact Email: ebpg@worksafebc.com

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