Following PRISMA guidelines, we performed a comprehensive literature search across electronic databases to identify relevant studies up to October  2024. The primary outcome was the Visual Analogue Scale (VAS) pain score at 4, 6, 12, and 24 weeks. Secondary outcomes included functional improvement, assessed by the Oswestry Disability Index (ODI) at the same time intervals. Standardized mean difference (SMD) before and after treatment with 95% CIs were used for continuous variables.

Seven studies, including five randomized controlled trials (RCTs), one non-RCT, and one observational study, met the inclusion criteria. The meta-analysis revealed that PRP led to significantly greater improvements in VAS pain scores compared to steroid injections at all follow-up periods, except at 4 weeks, where no significant difference was observed [SMD (95% CI): 4 weeks: 0.42 (-0.32, 1.16), p < 0.27; 6 weeks: -0.81 (-1.60, -0.02), p < 0.05; 12 weeks: -0.74 (-1.40, -0.08), p < 0.03; 24 weeks: -1.00 (-1.88, -0.11), p < 0.03]. No significant differences in ODI were found between the groups, except at 24 weeks, where PRP showed a significant improvement [SMD (95% CI): -0.53 (-0.96, -0.10), p < 0.02].