Frequently Asked Questions About PRP
What exactly is platelet-rich plasma (PRP) Therapy?
PRP therapy involves taking the patient's own blood and placing it in a machine called a centrifuge which separates the blood into several components, which include plasma (the fluid in the blood) and the platelets. Platelets contain many growth factors which are essential with regard to healing. The process of centrifuging (spinning the blood sample at high speeds) concentrates these platelets so that they are present in much higher numbers than what would typically be found in the bloodstream. That platelet-rich plasma is then collected injected at the site of the injury to induce and potentially accelerate the body's natural healing process.
Is PRP New?
The technology has been used for years in surgical applications and wound care. The use of PRP for musculoskeletal injuries is fairly new and evolving into a promising treatment for both acute and chronic injuries. There are a number of medical studies supporting the use of PRP for tendon and ligament injuries.
Do I have to worry about the use of blood products?
No. The patient's own blood is used for the procedure so there are no transfusion risks or blood borne infection from a donor.
How Long Does it Take?
As a rule, a PRP injection requires an initial visit to see if the painful area would benefit from such treatment, then a follow-up visit for the treatment itself is scheduled. The actual injection process takes about 1 hour and a majority of that time involves drawing and processing the patient's blood for the injection.
What conditions can be treated with PRP?
There have been many research studies performed, and many more still ongoing, which look at the effectiveness of PRP treatment. The most promising results to date have been with soft tissue injuries, including tendonitis, tendon tears, ligament sprains or tears, loose ligaments, and muscle tears. PRP has also been effective in treating cartilage degeneration such as arthritis. In some cases it can be used in conjunction with a surgical procedure.
It should be noted that this is one of the treatments of choice for professional athletes (NBA, NFL, MLB, et.al.) More than a few athletes have stated that PRP was a major factor in extending their athletic careers.
What conditions can be treated with PRP?
Shoulder: Rotator cuff tendinitis or tear, rotator cuff impingement syndrome or bursitis, bicipital tendinitis, labrum tear, arthritis, instability
Elbow/wrist/hand: Tennis elbow, golfer's elbow, DeQuervain's tenosynovitis, trigger finger, arthritis, other wrist and finger tendinitis
Knee: Patellar tendinitis, partially tom or strained major ligaments of knee, meniscus cartilage) tears, chondromalacia, arthritis, knee instability, ''runner's knee".
Ankle: Achilles tendinitis, peroneal tendinitis, ankle sprain, instability, other foot or ankle tendinitis
Spine: Degenerative disc disease, bulging discs, spondylosis, sacroiliac joint pain and facet joint pain in the back.
How do I determine if I'm a good candidate for PRP?
Here are some general guidelines to consider PRP:
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Pain with duration of 2-6 months or longer
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Persistent pain despite physical therapy, activity modification, taking pain pills (e.g. anti inflammatories, Tylenol, narcotics, etc.)
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If you wish to pursue alternatives to surgical treatment or discontinue pain medications.
How long will the recovery take?
Post procedure pain and activity progression can vary among patients. Regular range of motion at the site of injection is started immediately and patients typically progress to regular activities and light aerobic activity within the first few days to 2 weeks, depending on the site treated.
Rehabilitation should done under the supervision of physical therapy and specific home exercises are tailored for patient progress. It is common for the patient to feel increased pain immediately following the injection which resolves typically between 2-3 days.
Is PRP Painful?
Patients typically tolerate the procedure well, although post-injection soreness is expected given the PRP-induced inflammatory response, in some cases. The physician will talk to you in detail about medications that can be taken and prescribed for any post-procedure pain.
How many treatments do you need?
Typically, one to three treatments depending on the degree of injury and how long the injury has been there. Our protocol, based on experience of what works well, is to do one treatment and then a booster treatment six weeks later, and then evaluate progress a few weeks after that.
Are there any conditions that would rule someone out from getting PRP?
​Sure, but only a few: Severe anemia, low platelet count, abnormal platelet function, active systemic infection or active cancers are all reasons not to consider PRP.
How long does it take to work?
Most patients notice some element of improvement by 3 to 6 weeks after the treatment. Total improvement can take weeks to months, but by around six weeks post injection, most people have a good idea of the direction their recovery is going.
Does Insurance Cover PRP?
Insurance companies, in general, including Medicare, are slow to realize the tremendous gain in cost-effectiveness that PRP offers them. Many practitioners of PRP thus must charge their patients on a cash / fee-for-service basis, until the insurers understand the obvious benefits and cover the treatment in time.