A randomized controlled trial comparing transforaminal injections of Platelet-rich plasma versus steroid for lumbar herniated disc

Background: Transforaminal steroid injections are a standard treatment for lumbosacral radiculopathy but primarily offer short‐term anti‐inflammatory benefits. Concerns regarding the limited duration of steroids have prompted interest in biological alternatives like PRP, which may promote tissue healing and provide longer‐lasting relief. Methods: Study was registered under CTRI (Registration no. CTRI/2025/10/096579). 107 patients with symptomatic, MRI‐confirmed single‐level lumbar herniated disc failing six weeks of conservative treatment were randomized. Group A received 1 mL triamcinolone (steroid), 40 mg/mL with 2 mL 0.25% bupivacaine. Group B received 3 mL autologous PRP prepared via a double‐spin protocol. Primary and secondary outcomes were 10‐point Visual Analog Scale (VAS) and Oswestry Disability Index (ODI), assessed at baseline and 1, 3, 6, and 12 weeks post‐injection. Results: Both groups showed significant improvement from baseline. At 1 and 3 weeks, the steroid group demonstrated significantly lower VAS and ODI scores. However, at 6 and 12 weeks, the PRP group exhibited superior outcomes; specifically, the 12‐week mean VAS score was significantly lower in the PRP group compared to the steroid group. No complications were reported in either cohort. Conclusions: While transforaminal steroid provides rapid short‐term relief, autologous PRP injections demonstrate superior and more sustained clinical and functional outcomes at 12 weeks.