In recent years, the use of platelet rich plasma injections for the treatment of pain that is thought to originate from tendons, joints, and ligaments has become more promenant. It was first mentioned in the medical literature in 2006, which makes it a relatively new treatment for refractory musculoskeletal injuries. Given this, the research is promising and mounting, but not yet well established. The use of platelet rich plasma injections for pain is utilized from the elite athlete or the elderly person looking to decrease pain and improve function of a tendon, joint, or ligament that may be compromised.
Prior to determining whether someone is a suitable candidate for platelet rich plasma injections, a complete history and physical exam is required to clarify if the pathology that is causing you pain is indeed one that would benefit from the injections. It is best to have done a trial of high-quality rehabilitation as some musculoskeletal pathologies can improve with time and exercises. Once it has been established that you are a good candidate, you would be scheduled for a treatment (some may have the assessment and treatment on the same day)
The treatment process involves collecting a patient's blood, placing the whole blood sample in a centrifuge for a certain amount of time and at a pre-determined speed, which then concentrates the blood platelets (PRP), growth factors, and cytokins. These pro-healing substances are concentrated to a supra-physiologic done to modulate inflammation and promote healing. Of note, during the processing of your blood we would remove the red blood cells and sometimes try to modify your white blood cells as these can be quite aggravating to the injected tissue or joint. There is still much debate in the literatures and shifting as to the ideal concentration of platelets. When it comes time to inject the PRP back into your of injury, the procedure is completed using ultrasound-guidance to ensure safety, accuracy, and effectiveness. When injected, growth factors contained in the PRP initiates the body's natural healing process. Stimulation of your own healing response can result in improvements in recovery time and improved function.
Platelet Rich Plasma FAQ
Is the procedure painful?
The injections do cause some discomfort. Most people will feel stiff and sore for 3-7 days post-injection. Discomfort can be managed with over-the-counter analgesic medications like acetaminophen (Tylenol). However, ADVIL/IBUPROFEN/MOTRIN, ASPRIN/ASA, and CELEBREX should NOT be used. If taken, these medications will decrease the inflammatory process and reduce the effectiveness of PRP. Additional non-opioid pain medication can also be provided. Some patients can also benefit from taking an inhaled anesthetic for treatment pain, called Penthrox, that can be prescribed and administered on the day of your treatment. Don't hesitate to ask about this on the day of your assessment.
How many treatments will I need?
While some clients may only require one treatment, others may require up to three. Treatments are completed approximately 4 to 6 weeks apart. For optimal results, clients are encouraged to continue with progressive rehabilitation guided by physiotherapy over the course of their treatments. You may also find that a 'rescue' treatment may be required to treat any muscles that have become taut in reaction to the treatment.
Are there any risks?
Complications from injecting extremity joints are extremely rare. These can include, but are note limited to, skin infections, injuring arteries, veins, nerves, and organs. The use of ultrasound to guide each injection significantly reduces the risk of any complications.
What are the costs?
Platelet Rich Plasma Injections are not covered by Alberta Health. However, some private insurance plans may cover the cost. Otherwise, this is considered an uninsured medical service. The cost of PRP ranges from $500 to $850 per treatment session, depending on the treatment area and number/complexity of the injections.
What should I wear?
You will need to disrobe sufficiently to expose the area requiring treatment. A hospital gown is available if required.