Regenerative Medicine

Developed by George Hackett, MD, in the 1950s, prolotherapy was the first type of regenerative injection. Prolotherapy typically involves injecting a solution of dextrose (a form of sugar) and anesthetic into the affected ligaments, tendons or joint capsules. The goal is to promote long-term, often permanent pain relief by stimulating the body’s ability to repair itself.

Platelet-rich plasma (PRP) is a treatment for various musculoskeletal injuries that utilizes the body’s own healing potential. Our specialists perform this procedure by first drawing a patient’s blood and then putting it in a centrifuge. This small machine spins rapidly to separate the blood into layers. One of those layers contains platelets, which have growth factors that promote healing. We take the platelets and then inject them into the site of the injury. PRP is most often used for tendon injuries (tendinopathies) and joint injuries (cartilage thinning or osteoarthritis).

What to expect after a PRP injection

Patients may experience two to seven days of pain after treatment and can be prescribed pain medication if needed. Patients need to rest for a few days or weeks after the treatment to avoid pushing the injected tissue too quickly.

Typically, pain relief starts to occur within three to four weeks and continues to improve over a period of three to six months following an injection. The recovery time frame varies depending on the injury. Sometimes patients with arthritic joints respond much faster to these injections than those being treated for tendonitis. Physical therapy is frequently recommended after PRP injections to help facilitate healing and good body mechanics. This procedure may need to be repeated to achieve an optimal clinical response, which is different for each patient and may be injury specific.

Risks and benefits of PRP

Risks are typical of any musculoskeletal injection. Those risks include pain (expected) as well as infection and bleeding, which are both rare. We perform this procedure using sterile techniques. If the injection is done with ultrasound, it is easier to avoid any vascular structures. Patients on blood thinners may experience a hematoma (when blood collects outside of blood vessels) in the muscle, so we may recommend stopping these medications prior to receiving a PRP injection.

There is also a risk that the injection will not work. We collaborate with you to discuss the appropriate situations for its use. Benefits include improvement of pain and function. Often, the goal is to help patients return to physical activity.

Financial considerations

Platelet-rich plasma is rarely a paid benefit by health insurance. We will work with your insurance company to find out if this is a covered benefit. Payment is expected on the day of the procedure.

Preparation

Patients cannot take NSAID medications for two weeks before and six weeks after the platelet-rich plasma procedure. NSAIDs include ibuprofen (Advil), naproxen (Aleve), aspirin, meloxicam, diclofenac, celecoxib (Celebrex) or similar. Acetaminophen (Tylenol) may be used as an alternative.

We recommend taking 1,000 mg of acetaminophen one hour before the procedure to make post-procedure pain more tolerable. Hydrate well; drinking lots of water or other fluids before the procedure makes the blood draw easier.

Because we are using your blood as the treatment, we want it to be as healthy as possible for optimal outcomes. We recommend eating well in the weeks leading up to your PRP injection. For example, you may want to follow an anti-inflammatory diet (low carbohydrate or gluten free). This diet includes lots of fruits and vegetables, whole grains, plant-based proteins (like beans and nuts), fatty fish and fresh herbs and spices.