A systematic review of the clinical application of platelet-rich plasma for peripheral neuropathic pain

This review evaluates the efficacy of PRP in treating peripheral neuropathies, including carpal tunnel syndrome (CTS), ulnar neuritis, common peroneal nerve palsy, and piriformis syndrome.Studies were identified through PubMed/Medline Mesh searches. A meta-analysis was conducted for prospective and retrospective studies, case series, and case reports examining the impact of PRP on peripheral neuropathic pain all articles, but statistical analysis was only conducted on CTS studies, given the paucity of literature pertaining to the other anatomical neuropathies. Statistical analysis included the changes in the mean values of the Visual Analog Scale (VAS) and Boston Carpal Tunnel Questionnaire Functional Status Scale (FSS) and Symptom Severity Scale (SSS) scores within and between treatment types. T-tests were conducted to determine a statistically significant difference in outcomes between intervention and control groups and pre- and post-intervention/control within groups.A PubMed/Medline search identified 123 articles that were reviewed by two independent reviewers to determine articles that met inclusion and exclusion criteria. A total of 13 studies were included in the study: Carpal Tunnel Syndrome (n = 11), Ulnar Neuritis (n = 2), Common Peroneal Neuropathy (n = 1), and Piriformis Syndrome (n = 1). Eleven studies were included in the analysis of the clinical application of PRP for CTS, in which there were 224 control subjects and 208 experimental subjects, totaling 432 subjects. Controls in this study include those who received injections (D5W, saline, or corticosteroid), splinting, medical therapy, or carpal tunnel release surgery. The PRP group exhibited significant improvements in VAS, FSS, and SSS scores compared to the control group at six-months (p < 0.001). While surgical intervention demonstrated superior FSS and SSS scores at six-months than PRP (p < 0.001), PRP shows promise in the non-surgical management of carpal tunnel syndrome, ulnar neuritis, common peroneal nerve palsy, and piriformis syndrome.This review suggests that PRP is a promising modality for managing peripheral neuropathic pain. PRP may serve as a valuable non-surgical alternative and potentially as an adjunct to more surgical interventions. Further research is needed to standardize PRP preparations and elucidate its long-term efficacy across various peripheral neuropathies.