Review Article of Platelet-Rich Plasma and Facet-Mediated Mechanical Low Back Pain

Facet-mediated mechanical low back pain is a common contributor to chronic disability worldwide. While platelet-rich plasma (PRP) has demonstrated efficacy in discogenic low back pain, its role in facet joint-mediated pain remains less clearly defined. This narrative review aimed to evaluate the existing clinical evidence on the use of PRP for lumbar facet-mediated mechanical low back pain.

A comprehensive PubMed search was conducted in October 2024 for studies published between 2014 and 2024, with one additional eligible study published in 2025 included subsequently. Eligibility included clinical studies evaluating intra-articular or periarticular PRP directed at lumbar facet-related pain. Because the original search was limited to a single database and the review was not conducted under a prospectively registered systematic-review protocol, the present article is explicitly framed as a structured narrative review rather than a systematic review.

Six studies were identified: one randomized controlled trial, one prospective controlled nonrandomized study, two prospective case series, one retrospective observational study, and one small case series. The most direct comparative evidence suggests that PRP may provide longer-lasting benefit than local anesthetic/corticosteroid injection, while the 2025 prospective nonrandomized study suggests longer-term improvement compared with local anesthetic. However, several studies used multiple spinal injection targets, and the evidence is further limited by small samples, heterogeneous PRP formulations and treatment protocols, variable diagnostic criteria, and incomplete safety reporting.

Overall, current evidence supports PRP as a promising but not established treatment for lumbar facet-mediated low back pain. Nevertheless, the overall quality of evidence remains limited, underscoring the need for larger, standardized, and long-term controlled studies.