Platelet-rich plasma (PRP) Treatment
Whether you're an athlete sidelined by chronic pain from a muscle or tendon injury, or an active individual suffering from painful osteoarthritis, there may be a safe alternative to surgery to help relieve your pain. An injection of platelet-rich plasma (PRP), may help to jumpstart the healing process, and athletes like Tiger Woods, Steph Curry, and Rafael Nadal have all credited these treatments for accelerating their return to competition.
Plasma is the liquid portion of our blood, and platelets are one of the cellular components. Although you probably know them for their importance in causing blood to clot, platelets also contain abundant growth factors which help us heal after injuries. By concentrating the platelets from our own blood, we can also concentrate the growth factors, and inject them into injured tissues to stimulate the biologic healing response. This type of treatment holds great promise, and many studies now show that these injections have better results than other nonsurgical options, and can often help patients avoid surgery.
PRP injections can be done in an exam room, and take less than an hour. Your own blood is first drawn, then placed in a centrifuge to separate out the platelets. With the guidance of an ultrasound machine, the platelet-rich plasma is then injected into the arthritic joint, or the damaged portion of the tendon. Patients return home after the procedure, and are encouraged to rest the area for one to two weeks. This is followed by a program of physical therapy involving gradual progression of activities, targeting a full return to normal activity by three months.
What is platelet-rich plasma?
Platelet-Rich Plasma (PRP) is plasma, the liquid component of our blood, with concentrated platelets. These platelets, best known for causing blood to clot, also contain a huge reservoir of growth factors and other bioactive proteins that orchestrate the key biologic processes required for healing.
What conditions are treated with prp?
Many acute and chronic soft-tissue injuries can be treated with PRP injections, but below is a list of the most common conditions treated with PRP:
- Osteoarthritis (knee, hip, shoulder)
- Lateral epicondylitis (tennis elbow)
- Achilles tendinitis
- Hamstring injuries
- Plantar fasciitis
What does the process involve?
A consultation with one of the specialists at O+F is the first step to determine if treatment with PRP injections is an option for you. The injection(s) will likely be scheduled during a follow-up visit 1-2 weeks later.
- First, about 30-60cc of blood is drawn from the patient (1-2 ounces).
- The blood is placed in a centrifuge, which spins the blood to separate the platelets and plasma from the other cells. This process takes about 15 minutes.
- The injection site is sterilized, and local anesthetic is used to reduce discomfort.
- The PRP is then injected into the site of injury (ultrasound guidance may be used in some cases to precisely localize the site of injection). The growth factors then get to work accelerating your body's own healing process.
What can i expect immediately following the procedure?
Unlike cortisone injections, an injection of PRP provides no instant pain relief.
Anesthetic is used to numb the skin, and this wears off in 1-2 hours. Mild pain and swelling may occur at the injection site at this time. An inflammatory reaction occurs that varies from mild to severe, and lasts 3-5 days.
Rest, icing, and elevation are recommended during this time. A small amount of pain medication will be prescribed, in case the pain is severe. Anti-inflammatory medications (nSAIDs) such as ibuprofen and naproxen should not be taken, as they may reduce the effectiveness of the treatment.
Patients typically report gradual improvements in their function and reduction of symptoms over the first 2-6 weeks.
What are the possible complications?
Infection is a rare, but serious complication of any injection. It can take several days to develop, resulting in pain, swelling and redness at the site as well as fever and chills. If you experience these symptoms contact us immediately.
Bleeding at the site of the injection can occur, but usually subsides within a short period of time. Direct pressure can help if excessive bleeding persists.
These injections contain your own blood plasma and cells, so there is no risk of an allergic reaction.
How much down time is required after the injection?
This varies, based on your activity level and your response to the injection. You should allow 5-7 days for the inflammatory reaction to subside prior to resuming vigorous exercise. Light conditioning by walking, swimming, or riding a stationary bike, should be gradually increased prior to returning to higher-impact athletics.
How many prp injections will i need?
Acute muscle or tendon injuries may respond to 1 or 2 injections, but most chronic issues like osteoarthritis and tendinopathy require 2-3 injections, typically spaced 6-12 weeks apart.
Does my insurance cover this treatment?
Insurance coverage varies, but most plans do not cover PRP injections. We can assist you with documentation if you plan to submit your bill for reimbursement from your insurance plan, but you will be responsible for the full payment for the procedure. O+F employs financial counselors who can advise you regarding insurance and coverage issues.