What is Platelet-Rich Plasma or PRP?
When you spin blood in a centrifuge, it separates into three main components: the heavy red blood cells at the bottom, then the white blood cells and lastly the lighter plasma at the top. This top layer contains platelets which will lead to the release of growth factors and other healing substances when injected back into the body. This in turn results in a proliferation of cells needed for healthy healing and tissue regeneration. Your own blood is withdrawn, just like having a blood test at the lab, and then it is spun down to create these three layers. Part of the plasma layer with the most platelets is then injected back in your body a few minutes later, in the affected joint or tissue which is causing your pain, to begin the healing process.
Avoid anti-inflammatories 1 week prior and 1 week after PRP
Avoid corticosteroids (eg cortisone injections) 4 - 6 weeks prior to the PRP
You can take Tylenol/Acetaminophen prior to coming
Come hydrated and having eaten prior to the procedure
Bring a driver if you have far to go afterwards - you can be stiff and sore!
Wear appropriate/stretchy clothing
Bring something to do while the blood is centrifuging
Avoid massage and deep tissue work for the first two weeks afterwards
Avoid hot tubs and swimming pools for 48 hours afterwards
Use ice, heat, epsom salts in the bath, tylenol or medications prescribed if needed
Light exercise as your body allows such as going for short walks
How many PRP treatments will I need?
Usually one or two, rarely more. It does vary from person to person, as it depends on individual healing responses. Sometimes due to degeneration/aging/injury follow up treatments are needed months or years later. For facial regenerative platelet-rich plasma, more treatments can be given to maintain its effect (people choose PRP to help reverse the effects of aging skin).
What if I am taking anti-inflammatory medication like Celebrex or Advil?
You should discontinue the use of anti-inflammatories at least one week before and a minimum of one week after the injection, except for cardiac patients taking baby aspirin (81 mg daily). Anti-inflammatories include Ibuprofen/Advil, Naprosyn/Aleve, Celebrex, Voltaren, Mobicox, Arthotec and many others. Prednisone is also anti-inflammatory. Herbs/natural substances that are also in this category include Turmeric/Curcumin, and Fish Oil.
Does PRP hurt?
Having any injection can hurt! Local anesthetic is injected into the skin (or ice applied) prior to injecting the PRP and this prevents you feeling the skin puncture. Anesthetic cannot be used in the deeper tissues because it inactivates the PRP. Most people feel the injection as a deep-seated but short-lived pain. We suggest you take some Tylenol prior to coming in for your appointment (or even Tylenol 3 if you are bringing a driver), and eat and drink prior to coming. For those people who have a lot of anxiety about any injections, you can take medication to help you relax (if you are bringing a driver). You will be offered a prescription for pain medication and most often patients hold on to the script, only filling it if they feel it is necessary. Epsom salt baths and heating pads can also help. We can discuss this at the time of your assessment appointment. NOTE: Injections into the knee joint probably hurt the least of all.
Does PRP always work?
No one treatment works for everyone! It would be wonderful if we could guarantee 100% success, but this is not a realistic expectation. Our experience is that PRP is effective at reducing pain 80% of the time. If done for the correct diagnosis many experience a significant reduction in pain. Some of the reasons for not being as successful as possible include the inadvertent use of Advil, Aspirin or other such pills the week prior to or the week after injecting, smoking, use of narcotic medication (which in itself worsens musculoskeletal pain by the breakdown products effecting tissue functioning), steroid medication, or any other condition causing immune system dysfunction or weakness. The immune system can be adversely affected by stress, lack of sleep, poor diet etc.
What are the risks of PRP injection?
Complications are rare. Some may experience bruising and a there is a very low risk of infection. Remember, experiencing pain for a few days post-injection is not a complication but in fact the desired effect of inflammation starting the healing process.
What is the cost?
Platelet-rich plasma injections are not a covered insured service. Please ask us about the fee and payment is expected prior to the injection. Your HSA or HRA may cover the PRP procedure.