Platelet-rich plasma versus corticosteroids in facet joint syndrome: A controlled, randomized, double-blind study

• Low back pain is common in adults in the world • PRP is a well-tolerated and increasingly popular treatment for tendinous and peripheral joint pathologies • To date, only four studies have compared PRP injections to CTC for low back pain secondary to facet joint syndrome, with encouraging results. • Among patients with facet joint syndrome, this study did not demonstrate the superiority of intra-articular PRP injections over corticosteroid injections for pain relief using the current protocol. However, given the methodological limitations, further well-designed trials are warranted to better assess the potential benefits of PRP in this context, particularly in patients with contraindications to corticosteroids. Objectives: The primary objective of the study was to demonstrate the superiority of Platelet-Rich Plasma injections in treating facet joint syndrome, compared to corticosteroid injections. Secondary objectives were to assess the efficacy of PRP compared to CTC on pain, functional impact, tolerance, and healthcare utilization following the initial infiltrative management. Methods: Patients were randomized (1:1) to receive intra-articular injections into the painful facet joints with either PRP or CTC under radiographic guidance. The primary outcome measure was a 50% improvement in the NRS (from 0 to 10) for spontaneous lumbar pain at 6 months. Study design: Superiority, controlled, randomized (1:1), prospective, double-blind study. Results: A total of 76 patients were included, at 6 months, 6 patients in the PRP group and 5 in the CTC group showed a 50% improvement in spontaneous NRS. No statistically significant differences were found in pain at 3, 6, or 12 months. Regarding functional evaluation, a statistically significant difference was observed in the PRP group at 3 months according to the ODI. No significant differences were found between groups in terms of satisfaction. Four patients experienced transient adverse effects, only 1 in the PRP group. Conclusion: In patients with facet joint syndrome, PRP injections did not demonstrate superiority over CTC injections in terms of pain relief or clinically significant functional improvement at 6 months. These results do not support the use of PRP injections for facet joint syndrome.