PRP is an abbreviation for Platelet Rich Plasma. PRP is a restructured version of plasma that includes a higher concentration of platelets than regular plasma. Plasma is the liquid portion of blood that contains red and white blood cells, and platelets. Usually, platelets are only 10% of the blood’s cellular component, but PRP contains 90%. PRP therapy is used to speed the healing of injuries, which in many cases are related to athletics.

What is PRP Therapy and What Conditions Does it Treat?
PRP is used in sports medicine and orthopedics as a healing treatment. It is a non-surgical procedure and uses injections to stimulate and enhance the body’s healing. PRP alters a person’s blood in a way that triggers it to produce higher doses of its own natural healing properties. When more “growth factors” are produced, the body heals faster. PRP is used to treat soft tissue injuries including tendinitis, tendonosis, tendon tears, loose ligaments, ligament tears and sprains, and muscle tears. There is also evidence it is effective for treating arthritis and labrum tears in joints.

PRP is a part of an emerging health sector known as Orthobiologics. The goal of Orthobiologics is to combine the most cutting edge medical technology with a patient’s body’s natural ability to heal itself. This creates the most efficient healing possible. In the case of PRP, blood is enhanced outside of the body and re-injected to create an optimal healing environment.

What is the science behind PRP? Blood is made from red blood cells, white blood cells, plasma, and platelets. Platelets are sea sponge-like structure and when activated, release healing proteins known as growth factors. Growth factors have a variety of responsibilities, including accelerating the healing of tissue. When the number of platelets in blood is increased near the site of injury, healing occurs more quickly. Essentially, PRP treatment creates “super blood” that is able to repair and regenerate healthy tissue. There is also evidence growth factors can be isolated even more to reduce inflammation at an injury site, so PRP will be even more effective and feature fewer side effects.

Specific injuries and parts of the body that are treated with PRP include:

  • Back and Spine injuries including arthritis, whiplash, ligament sprain, instability
  • Torso injuries including rib problems
  • Shoulder injuries including rotator cuff impingement syndrome, bursitis, tendinitis, or tear bicipital tendinitis, labrum tear, instability, arthritis
  • Knee and Ankle injuries including patellar tendinitis, partially torn and strained major ligaments (ACL, MCL, LCL), instability, meniscus tears, chondromalacia, arthritis, Achilles tendinitis, peroneal tendinitis, and sprains
  • Hip injuries including iliotibial band tendinitis (ITB Syndrome), greater trochanteric bursitis, psoas tendinitis and bursitis, labrum tears, arthritis, sacroiliac joint dysfunction
  • Arm and Hand injuries including tennis elbow*, golfer’s elbow, DeQuervaine’s Tenosynovitis, trigger finger, arthritis, other wrist or finger tendonitis

*Our clinic is part of an FDA-approved trial on tennis elbow to determine if PRP is safe and effective.

Answers to frequently asked questions

How do Doctors Administer PRP Treatment?

The process begins with the collection of a patient’s blood. It is spun in a centrifuge to separate the various parts. This allows doctors to concentrate the platelets in the blood. The process takes about an hour and is done during the same appointment as the injection.

While the blood spins, the patient is given topical and injected anesthetic to the area that will be treated. Once the blood is processed, the needle is inserted and located in real time under musculoskeltal ultrasound (MSKUS) guidance until the problem area is reached. This ensures there is precise placement of PRP. The PRP flows into the affected region within 2mm of the injury site.

PRP enhances the body’s natural healing process, so it is more than just a “band-aid.” Unlike cortisone shots that only mask the pain, PRP actually speeds healing. Patients report minor discomfort and soreness following the procedure, but there is typically no pain during the procedure.

Once PRP is injected, growth factors go to work in large quantities targeting the site of the injury. This induces an inflammatory reaction that triggers a powerful wave of healing. Growth factors stimulate blood flow, which promotes matrix formation, considered the groundwork of all soft tissue. This also restores tendon and ligament proteins and strengthens cartilage so it is firmer and more resilient.

Patients usually experience healing in one to three treatments, depending on the severity and age of the injury. Occasionally, additional treatments are needed. Treatment is usually scheduled every four to six weeks, which gives patients and their doctors the time to determine if the previous treatment has accomplished its healing goals before additional treatment is ordered.

Most patients experience some swelling and mild discomfort for about 48 hours after PRP treatment. Patients are prescribed pain medication and encouraged to ice the treatment area. For most, these side effect symptoms resolve within five days. Exercise should be avoided for several days following treatment, but patients can begin physical therapy within a few weeks after treatment. A follow-up appointment is schedule about a month after treatment to determine if the injury is healed and whether more treatments are needed.

Most patients experience only mild soreness as a side effect of PRP. However, if PRP is performed without image guidance there can be nerve or vessel damage. In some cases, pain and stiffness remain after several weeks, but eventually ease up.

PRP is an effective treatment for many people. It has been in use for approximately a decade and is popular for treating sports injuries. However, patients with severe anemia, abnormal platelet function, low platelet count, active systemic infection, or active cancer are discouraged from undergoing PRP treatment.

Patients undergoing their first PRP treatment typically see improvement within two to six weeks. Symptoms can be slow and subtle and many experience soreness from injections in place of the dull, chronic or injury-related pain they sought to treat. As time passes, patients typically notice there are fewer pain days and more pain-free days. Pain intensity also decreases progressively and patients notice improved strength and endurance. Patients might continue to experience improvement up to six to nine months after an initial treatment. This is to be expected since bone and soft tissue injuries heal in stages.

No. Insurance companies consider PRP an experimental treatment and are unwilling to cover it at this time. As more research is done on the procedure, it could eventually be viewed as a mainstream treatment and be covered just as medication or physically therapy is.

Many patients have found PRP very effective for healing injuries that have caused pain for years. In addition to anecdotal evidence, there are several animal studies that suggest PRP treatment improves healing in soft tissue and bone. Studies show PRP increases the numbers of healing cells and improves tendon strength in Achilles injuries. There is also evidence of improved muscle regeneration in calf muscle injuries. Early-stage clinical studies in humans are also promising, but so far, there are limited human studies.

One of the most promising areas of PRP treatment is in treating chronic tendon issues, including tennis elbow and tendinosis. Both of these affect the Achilles tendon. Some reports state there is no difference between PRP and placebo injections, but anecdotal evidence proves otherwise. One small study involving PRP treatment for osteoarthritis in the knee showed it to be more effective than hyulauronic acid treatment.

PRP is created from a patient’s own blood and triggers more efficient natural healing. For this reason, it is considered fairly low risk. More studies are needed to prove specific effectiveness and create a more mainstream attitude to PRP, but for patients who suffer chronic pain or miss out on things they enjoy because of injury, PRP can be life changing. It gives a biological boost to natural healing.

PRP is receiving more and more attention in the medical community, as well as in the mainstream media. Many professional athletes have undergone PRP treatments, including NFL players and golfer Tiger Woods. As more people develop an interest in PRP, research will begin to explore the area more and might even discover more ways that PRP can serve as an effective healing treatment.

Are you coping with chronic pain or a sports injury? Do you think PRP might be right for you? Contact Interventional Spine and Sports Medicine PC for more information about PRP and to schedule a consultation that could put you on the path to a healthier life.

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