A Prospective Study Comparing Platelet-Rich Plasma and Local Anesthetic (LA)/Corticosteroid in Intra-Articular Injection for the Treatment of Lumbar Facet Joint Syndrome

Pain Pract. 2017 Sep;17(7):914-924. doi: 10.1111/papr.12544. Epub 2017 Feb 22.


Objectives: To compare the effectiveness and safety between autologous platelet-rich plasma (PRP) and Local Anesthetic (LA)/corticosteroid in intra-articular injection for the treatment of lumbar facet joint syndrome.

Methods: Forty-six eligible patients with lumbar facet joint syndrome were randomized into group A (intra-articular injection with PRP) and group B (intra-articular injection with LA/corticosteroid). The following contents were evaluated: pain visual analog scale (VAS) at rest and during flexion, and the Roland-Morris Disability Questionnaire (RMQ), Oswestry Disability Index (ODI), and modified MacNab criteria for pain relief and applications of post-treatment drugs. All outcome assessments were performed immediately after and at 1 week, 1, 2, 3, and 6 months after treatment.

Results: No significant difference between groups was observed at baseline. Compared with pretreatment, both group A and group B demonstrated statistical improvements in the pain VAS score at rest or during flexion, the RMQ, and the ODI (P < 0.01). And there were significant differences between the 2 groups on the above-mentioned items (P < 0.05). For group B, subjective satisfaction based on the modified MacNab criteria and objective success rate were highest (80% and 85%) after 1 month, but only 50% and 20% after 6 months. However, for group A, they increased over time. In addition, there were no treatment-related complications in either group during follow-up.

Conclusions: Both autologous PRP and LA/corticosteroid for intra-articular injection are effective, easy, and safe enough in the treatment of lumbar facet joint syndrome. However, autologous PRP is a superior treatment option for longer duration efficacy.

Keywords: LA/corticosteroid; intra-articular injection; low back pain; lumbar facet joint syndrome; platelet-rich plasma.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adrenal Cortex Hormones / administration & dosage*
  • Adult
  • Aged
  • Anesthesia, Local / methods
  • Anesthetics, Local / administration & dosage*
  • Female
  • Humans
  • Injections, Intra-Articular
  • Low Back Pain / diagnostic imaging*
  • Low Back Pain / therapy
  • Lumbar Vertebrae / diagnostic imaging*
  • Male
  • Middle Aged
  • Pain Measurement / methods
  • Platelet-Rich Plasma*
  • Prospective Studies
  • Range of Motion, Articular / drug effects
  • Syndrome
  • Treatment Outcome
  • Zygapophyseal Joint / diagnostic imaging*


  • Adrenal Cortex Hormones
  • Anesthetics, Local