OBJECTIVE: The study's primary objective was to compare the effectiveness of intra-articular platelet-rich plasma injections versus corticosteroid injections for the treatment of cervical facetogenic pain. Secondary aims were to compare self-rated disability, pain self-efficacy, and the safety of the procedure between groups.
METHODS: A single-site randomized double-blind controlled trial with 40 participants assigned to receive either leucocyte-poor, low-concentrate platelet-rich plasma injections or corticosteroid injection without local anesthetic into the cervical facet joint under fluoroscopy. Outcomes were collected via telephone at 1, 3, and 6 months to determine treatment effectiveness.
RESULTS: Low-concentrate platelet-rich plasma and corticosteroid injections had similar effects on cervical facetogenic pain intensity over a 6-month period post injection as demonstrated by a non-significant group-by-time interaction for Numeric Rating Scale scores (p>0.05). However, both groups showed a statistically significant decrease in cervical facetogenic pain intensity 1 month post treatment compared with baseline (p=0.02), while the platelet-rich plasma group also demonstrated a clinically significant decrease in pain intensity at the same time point. There was a significant interaction at 1 month post intervention for pain self-efficacy (p=0.04), with the platelet-rich plasma injection group showing a larger increase in pain self-efficacy compared with the corticosteroid injection group. No significant interaction was observed for self-rated disability; however, significant reductions were shown at 3 and 6 months post treatment compared with baseline in both groups (p<0.01). No significant differences between groups were reported for adverse events; however, those receiving platelet-rich plasma injection reported significantly less procedural pain (p=0.02).
CONCLUSION: Both platelet-rich plasma and corticosteroid injections induced similar improvements in cervical facetogenic pain intensity (1 month post) and self-rated disability (3 and 6 months post). Pain self-efficacy demonstrated a significant interaction with platelet-rich plasma injection showing greater improvement 1 month post. Additionally, both treatments exhibited a similar low prevalence of adverse events; however, those receiving platelet-rich plasma injection reported less procedural pain.
| Discipline Area | Score |
|---|---|
| Physician |  |
Physician rater
Patient populations were too small to make definitive conclusions and they were highly selected - picked from those with greater than 50% relief in pain on dual cervical medial branch blocks. Thus, they had already responded to injections. Moreover, invasive treatment was selected without first trying physiotherapy that has shown to be effective and should be used according to current recommendation (i.e., neck muscle exercising with supporting manual therapy).
, McMaster University