PRP vs Steroid for SIJ Pain: Prospective Randomized PROBE Study
Singla V · Pain Medicine (2017)
DOI: 10.1093/pm/pnw262This PROBE-design study compared ultrasound-guided leukocyte-free PRP versus methylprednisolone injection for sacroiliac joint pain in 40 patients with chronic low back pain. The steroid group achieved faster initial relief at 2 weeks, but PRP demonstrated a progressive improvement pattern that surpassed steroid outcomes by 4-6 weeks and maintained superiority at 3 months.
Clinical Relevance
Supports PRP as a longer-lasting alternative to corticosteroid for SIJ pain. The delayed onset means patients need counseling about the 4-6 week timeline to benefit.
Key Takeaways
- Steroid faster at 2 weeks; PRP superior at 4 weeks through 3 months
- PRP showed progressive improvement (delayed onset, sustained benefit)
- Corticosteroid showed typical early peak then plateau
- Used leukocyte-free PRP with calcium chloride activation
- Ultrasound-guided SIJ injection in both groups
- 40 patients (small but randomized)
- Pattern consistent with PRP vs steroid in other conditions
Key Findings
40 patients randomized to PRP vs steroid for SIJ pain. Steroid provided faster short-term relief (2 weeks). PRP showed modest early results at 2 weeks but superior improvement at 4-6 weeks and 3 months.
Clinical Context
Study Design
Prospective Randomized Open Blinded Endpoint (PROBE)
Condition
Chronic Low Back Pain from SIJ Pathology
Sample Size
40 patients
Follow-up
3 months
Control Group
Methylprednisolone (40mg/mL) + lidocaine
Primary Outcome
VAS, MODQ, SF-12
PRP Protocol & Intervention
Leukocyte Status
Leukocyte-free PRP
Activation Method
Calcium chloride
Injection Volume
3 mL
Injection Frequency
1 injection(s)
Guidance Method
Ultrasound-guided