• David J Allison, Sanam Ebrahimzadeh, Stephanie Muise, Steven Joseph, Alexandria Roa Agudelo, Arden Lawson, Nicole Billias, John Tran, Ashley Smith, and Eldon Loh.
• Lawson Research Institute, London, Ontario, Canada David.Allison@sjhc.london.on.ca.
• Reg Anesth Pain Med. 2024 Nov 14.

ObjectiveThe 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.MethodsA 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.ResultsLow-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).ConclusionBoth 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.© American Society of Regional Anesthesia & Pain Medicine 2024. No commercial re-use. See rights and permissions. Published by BMJ.

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