What is Platelet Rich Plasma (PRP) Therapy?
Platelet Rich Plasma (PRP) therapy is a Regenerative Medicine treatment used to repair chronic degenerative joints, ligaments and tendon injuries. PRP is a blood product concentration of the platelets, growth factors and other healing cells derived from your own blood.
The concentrated platelets found in PRP contain huge reservoirs of bioactive proteins, including growth factors, that are vital to initiate and accelerate tissue repair and regeneration. These bioactive proteins initiate connective tissue healing in bone, tendon and ligament, stimulate regeneration and repair, promote development of new blood vessels, and new collagen formation to stimulate connective tissue and cartilage repair.
What conditions can be treated with PRP?
- Overuse injuries to joints including ankles, knees, hips and shoulders
- Overuse injuries of muscle tendons and ligaments
- Joint arthritis
- Spine arthritis
- Persistent neck, mid-back, and low back pain
- Pain associated with degenerative disc disease of the spine
- Tennis elbow (lateral epicondylosis)
- Golfer’s elbow (medial epicondylosis)
- Carpal tunnel syndrome
- Knee ligament tears
- Shin splints
- Partial thickness rotator cuff tears
- Plantar fasciitis
- Patellar tendinitis or tendonopathy
- Achilles tendonitis
- IT band syndrome
- Hip bursitis (greater trochanter pain syndrome)
PRP injections are performed with ultrasound guidance to precisely target the treatment at specific areas of damage in the injured tissue(s).
How does PRP work?
PRP is a non-surgical and non-invasive effective treatment that works on a very simple principle. Injecting concentrated platelets containing specific growth factors can wake up your body’s own natural healing response and repair mechanisms. Platelet Rich Plasma (PRP) targets the source of pain while healing and regenerating injured tissue.
How is PRP made for the procedure?
Platelet Rich Plasma (PRP) is is formed by drawing a small amount of blood from your arm, similar to a blood donation if you have ever donated blood. The amount of blood drawn varies depending on the tissue to be treated, but is commonly less than a third of what you would typically donate.
The blood is then put in a centrifuge machine that separates out the activated platelets, growth factors and the healing cells to obtain platelet rich plasma (PRP) and platelet poor plasma (PPP). The PRP produced is injected back into your body the same day.
Why is PRP so effective for healing old injuries?
When injuries occur, the area may not heal completely due to inadequate length of the time for the injury to heal completely, poor blood supply or possibly from improper treatment. Ligament and tendon injuries can take a significant amount of time to heal. If activity is resumed to quickly before complete healing has occurred, the damaged ligaments or tendons can remain loose, allowing dysfunctional loading of the joints causing pain and eventually arthritis.
Arthritis can develop in the joints and spine as a result of instability in the ligaments and the supporting structures. This is where PRP can be used to intervene and stabilize the structures, decreasing the progression of pain as well as rapid aging of the joint.
When stretched, small nerve fibers in these damaged ligaments can also transmit pain impulses to the brain. Through a subconscious reflex, the surrounding muscles go into a tight and painful spasm in an attempt to stabilize the joint. This causes the region to feel tight and you may feel stiff, aching, burning, tingling, numb, fatigued, and painful. You may experience painful knots within the affected muscles.
These muscles become tight and painful as they try to compensate for the weak and damaged underlying tissue structures. The spasms reduce proper blood flow through the muscle tissue and can cause more pain. Not only are these symptoms felt locally, but they are often referred through nerve pathways into the legs and feet, arms and hands, and head (headaches).
With PRP we are harnessing your body’s ability to heal, and accelerate the repair and rebuilding of healthy tissue. This will lead to stronger and more supportive muscle, tendon, ligament, and joint structures, in time less pain, and significantly improved function.
How is PRP administered?
It is injected percutaneously (through the skin) into and around the tissues to be treated. A “peppering technique” with the needle is used to distribute the PRP at multiple sites along the injured tissue. Another method sometimes used is a percutaneous tenotomy procedure. After numbing the area with anesthetic (lidocaine), this technique uses direct needling of the injured tissue, prior to injecting the PRP into the tissue irritated by the tenotomy needling technique.
How many injections are given with each treatment?
Often a patient will receive between 5-20 injections depending on the area(s) being treated.
How many procedure are typically needed?
Typically 2-5 injection visits are anticipated depending on the injury. Some patients with minor issues may not require as many injections, while others with more extensive issues may require more than this average.
Do the injections hurt?
You will feel a small pinch to numb the sites for the injection with anesthetic (lidocaine), and then the PRP injections are typically very well tolerated by most patients.
Do I need to be put to sleep for the procedure?
No, only local anesthetic is used for the procedure. You will be awake and talking with the doctor throughout the procedure.
What is the recommended frequency of treatment for PRP?
The frequency of treatment is typically every 4-6 weeks. Prior to initiating PRP injections, a thorough consultation and examination is performed, including possibly imaging tests (x-rays, musculoskeletal ultrasound, CT, MRI), for pre-procedure planning.
What is the expected length of treatment for PRP?
Typically it is 4-5 months, but could be longer in certain cases.
What are the objective signs of successful PRP treatment?
Decreased pain, decreased use of pain medications, increased functional activities should be seen as the patient improves.
What are the positive benefits of Platelet Rich Plasma (PRP) injections?
Benefits include improving the collagen content of the ligaments, tendons, and capsular tissues at the cervical facets, and improving the health of the joints or spine. Collagen acts to reinforce tissue making it more resilient and able to withstand more force through the structure. This allows higher levels of functional activity with less pain.
Will PRP cure my arthritis?
While there is no cure for osteoarthritis, PRP treatment of instability should help decrease the excess motion in the joints that can lead to worsening of arthritis. Treatment with PRP could slow the development or progression of arthritis and should make flares of the tissue less frequent. This treatment aims to treat the cause of the arthritic pain, instability in the joint or poor strength in the support structures, and is not just covering up the symptoms as is the aim of many commonly used arthritis “treatments”.
Am I a candidate for PRP?
Not every condition or problem can be treated with PRP.