Ultrasound-guided platelet-rich plasma myofascial injection for chronic low back pain: a retrospective study.

OBJECTIVE

Retrospective cohort study to evaluate the efficacy and safety of ultrasound-guided myofascial platelet-rich plasma (PRP) injection for myofascial pain syndrome (MPS)-induced chronic low back pain.

METHODS

Fifty-eight patients treated between May and December 2024 received a single ultrasound-guided PRP injection (n = 32) or two weekly normal saline injections (n = 26), and both groups underwent myofascial hydrodissection targeting trigger points in the longissimus lumborum. Pain intensity was assessed via Visual Analog Scale (VAS), functional disability by the Oswestry Disability Index (ODI). Surface electromyography (sEMG) measured neuromuscular activity through root mean square (RMS) and median frequency (MF). Statistical analyses used SPSS v.27.

RESULTS

Both groups showed significant VAS reduction at 12 weeks (p < 0.001), with greater improvement in the PRP group (r = 0.501). PRP also yielded significant ODI improvement (r = 0.611) exceeding the minimum clinically important difference. RMS values decreased markedly in the PRP group (p = 0.001) and modestly in the NS group (p = 0.006). MF demonstrated a transient decline at week 4 (p = 0.014). No adverse events occurred.

CONCLUSIONS

Ultrasound-guided myofascial PRP injection effectively reduces pain, enhances function, and modulates MTrPs activity in MPS at short-term follow-up, with good safety. These results support further randomized trials to validate the rehabilitative benefits of PRP for chronic low back pain.