Comparison of efficacy of intra-articular injection of platelet-rich plasma with bupivacaine and steroid combination in chronic shoulder pain

Background and Aims: Shoulder pain, often characterized by gradual progression and reduced glenohumeral joint mobility, can arise from inflammatory, traumatic, or degenerative causes. Treatment aims to relieve symptoms, improve joint mobility, and enhance quality of life. This study compared the effectiveness of platelet-rich plasma (PRP) injections with a combination of local anesthetic and steroid in patients with chronic shoulder pain, focusing on pain relief and functional improvement. Material and Methods: Fifty patients under 20 years old with shoulder pain unresponsive to 6 weeks of conservative treatment were randomly assigned to two groups. Group I received an injection of 3 mL of 0.25% bupivacaine and 1 mL triamcinolone, while Group II received 3 mL of PRP. Pain and function were evaluated using the Numeric Rating Scale (NRS), Shoulder Pain and Disability Index (SPADI), and patient satisfaction, with side effects monitored. Results: Demographic variables were comparable. Significantly lower pain scores were observed at half an hour, 2 weeks, and 1 month in group I, while in group II, reduced pain scores were observed at 2, 3, and 6 months ( P < 0.05). After 6 months, better patient satisfaction was observed in group II ( P < 0.05). SPADI was statistically comparable at all time intervals, except at half an hour, 2 weeks after injection, when it was significantly better in group I. Conclusions: Both interventions are safe and effective methods for the treatment of chronic shoulder pain, leading to pain relief and improvement in physical disability. However, intra-articular PRP injection offers a more sustained and longer-lasting improvement compared to corticosteroids and bupivacaine.