Lumbar Myofascial Pain

Evidence: Promising, Mixed Evidence — ASPN 2024: Level II-2 · Grade C

CAUSES

• Muscle overuse or strain from poor lifting mechanics
• Prolonged poor posture
• Repetitive movement patterns at work or in sport
• Deconditioning and core muscle weakness
• Trauma

SYMPTOMS

• A dull, aching regional pain in the low back
• Palpable tight, tender bands or “knots” in the muscle
• Pain that can travel to the buttock or hip when the trigger point is pressed

IMAGING

X-rays or MRI can be ordered for cases with red-flag symptoms or that don’t improve with treatment to rule out other causes of low back pain like torn discs.

CAN PRP HELP?

Ultrasound-guided PRP directly into the affected muscles has shown pain and function gains at three and six month followup.

Leukocyte Preparation: Leukocyte-Poor

Dosing: Short Series (3–4 sessions, several weeks apart)

ASPN 2024 CONSENSUS GUIDELINE

This falls under ASPN’s broader “myofascial pain / trigger points” category, added in the 2025–2026 literature update rather than the original 49 consensus points, and graded Level II-2, Grade C. The guideline calls it “the most encouraging of this round’s new-indication evidence,” with the caveat that it’s still built on retrospective case series rather than randomized trials — though no adverse events were reported in the series reviewed.

Sources: D’Souza et al. (ASPN Consensus), Journal of Pain Research, 2024 · Chen et al., BMC Musculoskeletal Disorders, 2026 · Ai et al., World Journal of Clinical Cases, 2025

FREQUENTLY ASKED QUESTIONS

What are trigger points, and how is this different from a disc or joint problem in the back?

Trigger points are tight, tender bands of muscle and connective tissue that cause a dull, regional low back ache, often referring to the buttock or hip when pressed. This is a muscular source of pain, not one coming from a spinal joint or disc, which is why imaging isn’t used to diagnose it.

Does PRP work better than a simple saline injection for chronic low back muscle pain?

One comparative study found ultrasound-guided PRP outperformed saline hydrodissection for chronic low-back myofascial pain. Large pain and function gains were seen at three to six months when injected directly into affected muscles like the quadratus lumborum or erector spinae.

What is the evidence behind PRP for lumbar myofascial pain?

Level II-2, Grade C. The guideline calls it “the most encouraging of this round’s new-indication evidence.” Evidence still rests on retrospective case series rather than randomized trials, though no adverse events were reported in the series reviewed.