Platelet-rich plasma (PRP) offers a potential long term, corticosteroid-free, therapy for selected patients with facet-mediated spinal pain. This narrative review examines lumbar and cervical clinical studies and provides an expert perspective. Several comparative studies report pain and functional improvement, with some suggesting sustained lumbar benefit beyond that of corticosteroids. Cervical studies also show encouraging outcomes. However, recent randomized trials have not consistently demonstrated superiority, and preparation variability complicates interpretation. PRP merits continued clinical investigation and individualized consideration, with transparent counseling, image-guided delivery, and standardized outcome assessment. Symptomatic improvement should not be equated with proven joint regeneration.
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