At some point, you will almost assuredly encounter an injury involving a muscle, tendon, ligament or joint, and you may want to consider a platelet-rich plasma therapy (PRP) to help accelerate the recovery process.  You may have heard about this emerging treatment because world-class athletes like Tiger Woods and Rafael Nadal have used it to expedite healing.

While platelet-rich plasma therapy has not been approved for medical use by the FDA, the science behind it is conceptually simple and very promising.  PRP therapy merely collects the platelet-rich part of the blood which contains high quantities of human growth proteins, and injects it into the injured tissue.  Because the patient’s own blood is used, there is no risk of rejection or contamination.

A growing number of studies on platelet-rich plasma therapy have demonstrated that there is significant improvement in healing rates, but many other studies show no detectable enhancement.  That is why researchers are planning more intensive studies as well as modifying current treatment modalities to improve efficacy.  Once the kinks are worked out of platelet-rich plasma therapy, it could provide effective pain relief for many conditions including osteoarthritis.

The Science Behind PRP Therapy

The science supporting platelet-rich plasma therapy is based on research into how wounds heal.  Basic medicine explains that damaged tissue heals faster if more blood is circulated through the injured area.  More specifically, injured tissue heals faster if more platelets pass through it because of the higher concentration of growth factors and secretory proteins in platelet-rich plasma.

How Platelet-rich Plasma Therapy Works

These growth factors and proteins have been linked to enhanced cartilage growth and vascularization (growth of new blood vessels), but they have also been linked to detrimental processes like cell migration or cell death. This combination of regenerative and inhibitory actions by platelet-rich plasma may explain why some studies with higher concentrations of plasma have proven less effective than moderate concentrations.

The procedure for platelet-rich plasma therapy is quick and straightforward. It usually involves the following steps:

  • Your doctor will collect some blood from you; usually, the amount is about 20 millimeters.
  • The blood will then be placed in a centrifuge and spun for about 15 minutes.  This will separate the blood into three layers: platelet-rich plasma, platelet-poor plasma and red blood cells.
  • The platelet-rich plasma is collected and placed into an injector.
  • Using an ultrasound imaging device, your doctor will then inject the platelet-rich plasma into the injured area.

How Successful Is PRP Therapy?

The entire procedure should take less than an hour.

There is still much debate about the efficacy of platelet-rich plasma therapy.  Some studies show marked improvement in recovery rates, while others suggest that there is no such improvement.  However, it is difficult to compare one study with another, as most therapies use various amounts and concentrations of platelet-rich plasma to treat a variety of health conditions. 

Potential Complications

There is considerable hype surrounding platelet-rich plasma therapy, which is why highly recognizable athletes have used this treatment.  While there is a growing amount of supporting research, many of these studies are not rigorous enough for widespread adoption in the medical community.  It may take quite some time before a definitive verdict is available.

Although PRP therapy is not subject to cross-reactions and tissue rejection because the harvested materials come from the patient, there are some potentially harmful side effects that may occur. Not all of these side effects have been confirmed, but many researchers theorize that they are possible with certain PRP therapies. These risks may include

  • Infection
  • Bleeding
  • Nerve damage (if the needle injures a nerve)
  • Nausea
  • Loss of consciousness
  • Dizziness

Availability of PRP Therapy

It should also be noted that platelet-rich plasma therapy is an experimental treatment so there remain unknown risks.  Some medical authorities have criticized PRP therapy because higher concentrations of growth factors raise the risk of cancer. That is why most clinicians recommend waiting to use this therapy until after FDA approval.

Although platelet-rich plasma therapy has not yet earned FDA approval, many physicians around the United States do offer this treatment for a variety of health conditions including hair loss and joint healing.  This is allowed because the devices used to prepare PRP injections is very similar to previously approved products. You should know, however, that each clinic has their own method of preparing PRP treatments, including amount injected and platelet-rich plasma concentrations.  There is, as yet, no standardized methodology in the health care industry, so results are likely to vary. You should discuss in detail with your physician your expectations as well as possible outcomes.

There is considerable variation in the cost of PRP injections.  Some pricing authorities peg the cost at between $200 and $600 per injection; most patients only require two or three injections to expedite healing.  Unfortunately, many insurers will not cover PRP therapy because it has not earned final FDA approval; if you are considering PRP therapies, you should ask your insurer in advance if they are covered under your health plan. If not, you should work out a payment plan with your physician.

Should You Consider PRP Therapy?

If you are a professional athlete and worried that platelet-rich plasma therapy may be considered “doping,” there is some good news.  Many athletic doping authorities, including the World Anti-Doping Agency no longer consider PRP therapy a performance enhancing violation.  This is a change from the past because more doping authorities now believe that although PRP therapy may accelerate healing, it does not boost actual performance.

Given the lack of concrete proof that platelet-rich plasma therapy is an effective treatment, it can be difficult to decide if it is worth taking a chance on.  Here are some things to consider

  • There are minimal risks involved.
  • May produce long term pain relief and health improvements.
  • PRP therapy may provide unique benefits for ligament conditions.
  • As with any new therapy, platelet-rich plasma therapy may hold unknown risks.
  • If speedy healing is a priority, PRP therapy may be a good option.

Article written by: Dr. Robert Moghim – CEO/Founder Colorado Pain Care

M.D. Disclaimer: The views expressed in this article are the personal views of Robert Moghim, M.D. and do not necessarily represent and are not intended to represent the views of the company or its employees.  The information contained in this article does not constitute medical advice, nor does reading or accessing this information create a patient-provider relationship.  Comments that you post will be shared with all visitors to this page. The comment feature is not governed by HIPAA and you should not post any of your private health information. 

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