Background and aims Lumbar pain is treated with epidural injections (EI). Platelet rich plasma (PRP) is a novel option. The objective was to compare the efficacy of EI with and without PRP in patients suffering from lumbar pain.

Methods 51 patients were included. Controls of 26 patients (EI group) received an epidural injection of methylprednisolone 80 mg, bupivacaine 5 mg. The intervention group (PRP+EI), comprised of 25 patients, received the same solution, along with 8 ml of autologous PRP on multiple facet joint levels. All received another epidural injection 2 weeks after. Outcomes were pain scores (VAS 0–10), clinical improvement at 2 weeks and at 3 and 6 months.

Results After 2 weeks, clinical improvement was 55% (VAS 4 to 2.3; p<0.001) and 47% (VAS 6 to 4; p<0.001) in intervention and control groups, respectively. After 3 months 62% (VAS 4 to 2; p = 0.002) vs. 45% (VAS 6 to 4; p<0.001). After 6 months improvement returned to 53%, VAS 2 ± 1.7 as 2 weeks after injections in PRP +EI group. Reduced improvement, increased VAS were presented in EI group 38%, VAS 4.5 ± 2.3, p<0.001. After 6 months presence of back stiffness decreased in PRP+EI group with reduction by 61% (p=0.02) vs. 28% (p=0.3) in EI group. Presence of night pain, tingling, numbness did not show intergroup differences. In PRP+EI group more often persistent pain changed to periodical (p=0.0006).

Conclusions EI combined with PRP injections on facet joins might demonstrate better improvement in patients with low back pain.