New Systematic Reviews Support Use of PRP in Low Back Pain

Samuel G Oltman, ND, RMSK

Evidence continues to mount that Platelet Rich Plasma (PRP) consistently and durably improves low back pain. Two new systematic reviews of 28 different randomized controlled trials (RCTs) suggest that PRP demonstrates consistent and long term improvement in the most common forms of low back pain. The studies were not related to each other and came to similar conclusions: PRP provides relief within a month and lasts for up to 12 months in cases of degenerative/arthritic pain even when nerve impingement (radiculopathy) was present.  

Study 1 From Europe (1): 

• Review of 13 RCTs, about 1,000 total patients

• Spines had facet arthritis, stenosis, and/or radiculopathy 

• Cortisone provided short term relief but PRP consistently provided greater improvement at 3-6 months

Study 2 From China (2):

• Review of 15 RCTs, about 1,000 total patients

• Spines had both disc-related and non-disc-related pain

• PRP showed significant improvement at 1, 3, 6, and 12 months post treatment

• Improvement was stronger in non-disc-related pain but still significant in disc-related pain

*A note about “disc pain” in spine cases: Disc abnormalities are extremely common in the pain-free population (3). Just because you have an MRI showing a disc abnormality, doesn’t mean you have disc pain. It follows a certain pattern that is diagnosed using a combination of imaging and exam.

Injections into discs have much less consistent results and are much more invasive/risky. Moreover, low back pain is often a combination of causes, one of which can be disc-related, but includes other factors that are directly treatable. 

Low back pain can come in many forms and patterns: centrally located, left or right sided, radiation into the butt/hip, tightness, sharp pain with bending over, etc. It is clear from the evidence that despite the specific pattern, the underlying issue may be effectively addressed for the long term with PRP therapy. When spine surgery is too risky and another 3 months of physical therapy doesn’t seem to be addressing the issue, consider PRP. Reach out today and learn more about how we address the gap between PT and surgery for low back pain. 

References:

1. Zhang RE, Aurangzeb A, Sirisena D. Platelet-rich plasma and stem cell therapies for spondylosis: a systematic review of randomized controlled trials. Eur Spine J. Published online May 16, 2026. doi:10.1007/s00586-026-09997-9

2. Pei X, Liu C, Wang J, et al. Platelet-rich plasma therapy for low back pain: A comprehensive systematic review and meta-analysis. J Back Musculoskelet Rehabil. Published online May 9, 2026:10538127261448983. doi:10.1177/10538127261448983

3. Brinjikji W, Luetmer PH, Comstock B, et al. Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. AJNR: American Journal of Neuroradiology. 2015;36(4):811. doi:10.3174/ajnr.A4173