What is PRP therapy?
Platelet rich plasma therapy or PRP, is a regenerative therapy option.  PRP was initially developed 20 years ago for heart surgery to aide with wound healing and blood loss.  Its benefits are now being applied to a wide range of musculoskeletal problems.  PRP therapy is a treatment option for non healing tendons including tennis elbow, achilles tendonitis, rotator cuff, plantar fasciitis and knee tendonitis. PRP focuses on healing the damaged tissue.  This is in contrast to surgery, in which often cases, there is no option other than removing the damaged tissue.  PRP creates an optimal healing environment by providing nutrients, proteins, and growh factors to stimulate the tissue repairing process.  In PRP therapy, the patients own blood is used to specially isolate their own patelets which are then concenterated many times higher than present in the blood.  Following the preparation, the PRP therapy is then injected into a non healing tendon area under ultrasound guidance. The entire procedure can be performed within a single office visit.  If your symptoms have not responded to traditional conservative treatements such as anti-inflammatory medications, physical therapy etc., PRP therapy may be an option for you before considering surgery. 

How is PRP different from Cortisone Shot?
While the technique to inject PRP is sometimes similar to getting a cortisone (or corticosteroid) shot, the treatment is much different. While cortisone is a great pain reliever, it essentially does nothing to heal the condition. In fact, some argue that it can slow the healing process or can weaken the tendons if injected at a wrong spotwhile pain usually improves significantly; often this is transient, as the pain tends to return. So, if you have had cortisone injection for your condition in the past, and your pain was relieved, but for only a short period of time, PRP might be the right treatment for you.
How is PRP injection done?
Typically, PRP injection is done in our clinic. The patient comes in for an office visit; just as (s)he would any other doctor’s office. Our staff draws the patient’s blood after checking in and moving into one of our state-of-the-art clinic rooms. The blood is spun down in a centrifuge, which takes 10-20 minutes, depending on the type and volume of PRP being injected. While this is happening, we locally anesthetize (or “numb”) the area to be injected with a small needle injection. This is not terribly different or more painful than an immunization shot or cortisone shot. After that, there is very little to no pain. The PRP is then brought in, and injected into the injured area.
In our clinic, we believe that putting the treatment in exactly the right place is the key to our success. For this reason, we use Musculoskeletal Ultrasound to guide our injections and actually see the injury of interest. We then use the same instrument to help guide our needle to exactly that point. Because of this, we can inject very small amounts of treatment, and achieve substantially positive patient outcomes. Notably, of the research studies that have been conductedusing PRP, the studies that utilized Musculoskeletal Ultrasound guidance for injections have the best patient outcomes.

What happens after I get my PRP injection?
After an injection, the site is usually bandaged with a simple adhesive bandage. It should stay dry for at least 24 hours. We typically advise patients to expect to be sore for short period (2-5 days) following the procedure. It is advisable to not to take anti-inflammatory pain medications (like Ibuprofen or Aleve) for at least 2 weeks following an injection, becausecertain amount of inflammation actually helps the initial healing processes. Acetaminophen (Tylenol) may be used, and sometimes a prescription pain reliever for a very short period is required. We generally have patients decrease their activity drastically for a couple of days (again typically 2-5) following a procedure, and may less frequently immobilize a joint for a similar time period. Patients are generally back to baseline as far as pain within a week or less, and can return to normal activities at that point as well. If involved in a physical therapy or rehabilitation program for the injury, we usually advise 2 weeks rest from the program before starting again.
In the weeks that follow injection, pain will typically gradually reduce from a patient’s normal everyday pain from the injury, hopefully to a pain free state. A 50-75% pain reduction in a patient’s pain is considered a successful outcome.

Is PRP injection covered by insurance?
As of 2012, PRP is considereda new and innovative treatment, by most insurance companies, and therefore may not be covered by your insurance company.  This is despite the fact that many invasive surgeries for the same conditions actually have less scientific evidence than PRP injection.  While some insurance plans do not pay for PRP (call our clinic or the number on the back of your insurance card for information), it is relatively inexpensive when compared to even the co-pay for most patients’ insurance on a much more invasive and costly surgery for the same condition.