Maryland Pain Specialists

Platelet Rich Plasma (PRP) Injections

Mary Ann Anthony, MSN, CRNPHow can you get your body to heal itself?

When injured, your body attempts to heal itself. Whether it’s a cartilage, tendon, or disc injury the first response of the body is to bring the repair mechanisms to the area that is injured. That means cells like platelets, white blood cells and fibroblasts. They work to remove damaged tissue and build healthy new tissue. The cells know to come to the injured area because your body sends out chemical signals to attract the right cells to repair the damage. These signals are small chemicals called growth factors and cytokines. Unfortunately, sometimes the signal is too weak and acts too slowly or not at all and then you don’t heal. PRP injection is a new therapy that amplifies and improves the healing signal and can get you back on your feet.

Mary Ann Anthony, MSN, CRNPWhat is PRP ?

PRP is an abbreviation for platelet rich plasma. PRP is simply some of your own blood, but concentrated 10 fold. Whole blood contains red blood cells suspended in plasma along with white blood cells and platelets. When blood is spun down in a high speed centrifuge the red blood cells move to the bottom leaving the plasma, platelets, and white blood cells on top. Platelet’s primary function is to stop bleeding by creating a clot in response to injury. They also contain many important growth factors and cytokines, like platelet derived growth factor, fibroblast growth factor-beta, transforming growth factor-beta, vascular endothelial growth factor and epithelial growth factor-beta. These natural chemicals attract other healing cells to stimulate, augment, and accelerate your natural healing process. If you injure yourself, you’ll have some platelets at the injury site now. By concentrating these factors into a small volume we can inject them exactly where you need them and further stimulate the natural healing process.

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What is PRP used for ?

PRP is used to treat musculoskeletal injuries. Its use has exploded with professional athletes looking for the fastest natural way to get back to competition. PRP has been used in professional football, baseball and basketball. PRP has been tested and shown to be effective for hamstring tendonitis, tennis elbow or elbow tendonopathy and plantar fasciitis. PRP has also been shown to be effective for arthritis pain in the hip and knee with promising new data for shoulder and sacroiliac arthritis as well. Historically, these conditions have been treated with steroid injections. These may still be appropriate, but multiple steroid injections weaken the tissues over time while PRP can strengthen them.

Consider PRP for:

  • Hip arthritis
  • Knee arthritis
  • Shoulder Arthritis
  • Hamstring tendonitis
  • Elbow tendonitis, AKA Tennis elbow, chronic extensor tendonitis
  • Plantar Fasciitis
  • Rotator Cuff tendonitis
  • Sacroiliac joint pain

Our PRP protocol

First, you need to come in for evaluation. In consultation with our board-certified physicians you’ll decide if PRP is the right choice for you. We will consider your pain condition, diagnostic tests and prior treatment history. We will ensure that you have tried usual conservative care before going to PRP as PRP is not considered first line therapy. If you decide on PRP then you will be scheduled to come in for an image guided injection. Image guidance is crucial. If the PRP is not injected into the correct location perfectly then it will not work as effectively. Creating the PRP is equally crucial and requires highly specialized equipment. We have partnered with the Ruxton Surgi-Center and use a state of the art Magellan ISTO autologous platelet separator. You will come in to the center and have a sample of blood drawn, typically 30-60 ml. The PRP is extracted from your blood in about 20 minutes. Lastly the PRP is injected into the area that you need using sterile technique. The injection is not very painful, numbing the skin is usually the worst part of the process. You must stop any NSAIDs for 14 days before and after injection. These are drugs like Motrin (ibuprofen), Aleve (naproxen), Celebrex (celecoxib), Mobic (meloxicam) and aspirin. There are many more of them so please ask us if you are not sure. NSAIDs work by inhibiting platelets and we need those platelets to work for you after the injection. We also ask you not to eat for 6 hours prior to injection. What you eat and drink can make your PRP fatty and potentially make it less effective.

How long is recovery? 

Ligament and tendon injuries are usually treated with a single PRP injection, while arthritis in the hip and knee usually needs 3 injections done over 3 weeks. After the injections, you should rest for 14 days, avoiding all exercise and allow the platelets to create a gel and recruit your body’s healing machinery. In the third week you can resume gentle range of motion exercises with your physical therapist but no more than that. Joint mobilization and range of motion is the focus until week 8. Only gentle strengthening exercises under the guidance of your physical therapist is allowed. No jumping or high intensity exercise. After week 8, you will return to exercise and sport gradually. PRP has been used in dental procedures for years. However, its use for musculoskeletal problems is new. Because of that, most insurance companies consider it an uncovered benefit. MPS and the Ruxton Surgi-Center have worked to offer PRP at a reasonable, all-inclusive price.