You may have heard about Platelet-Rich Plasma (PRP) Therapy, but it can be unclear what, exactly, it is. It does involve an injection of your own blood, but it’s not the same as the Vampire Facelift. Though there are reports of celebrities from Courtney Love to Angelina Jolie using PRP treatments to boost facial collagen production, PRP is much more commonly used to treat injuries. In fact, the use of PRP stems from the treatment of orthopedic injuries. In the last 4 decades, several thousand studies have been published on its use in treating acute and chronic injuries such as tennis elbow, Achilles tendonitis, knee osteoarthritis, and many more.
Athletes throughout the world of professional sports have used PRP to come back more quickly from both acute injuries (like a sprained knee) and chronic ones (like tendonitis). These kinds of conditions are usually treated with medication, physical therapy, and in extreme cases, surgery, but some look to PRP as a much less invasive, natural way to harness the body’s own healing power. Pro athletes including golfer Tiger Woods, basketball star Kobe Bryant, Hines Ward who helped the Steelers win the Superbowl in 2009, top tennis players Rafael Nadal and Maria Sharapova, and many more have received PRP therapy — but you don’t need to be a professional athlete to reap its benefits. Read on to learn more about what PRP is, how it works, and the conditions it can potentially help.
What Is Platelet-rich Plasma (PRP)?
Your blood is made up of multiple components: Though it’s mainly liquid (called plasma), blood contains tiny solid cells called red blood cells, white blood cells, and platelets. When it comes to healing, you probably think of white blood cells first — they’re key to your body’s immune response when you catch a virus or encounter an allergen. Platelets are usually thought of as just a clotting factor — if you nick yourself shaving, platelets are what stop the bleeding. But platelets also contain hundreds of proteins — in particular, growth factors — that are crucial to the healing of injuries. To continue the example, in addition to clotting, they’re also what helps that shaving nick to heal.
PRP works on that same principle, but instead of healing surface injuries, it is most commonly used to help repair damaged tissue inside the body. PRP takes your body’s natural healing response — platelets’ growth factors — and intensifies them. Platelet-Rich Plasma itself is plasma with a much higher concentration of platelets (usually 5 to 10 times greater) than what is normally found in blood. The PRP that is used to treat you is made from your own blood. This means that there is no risk of transmissible infection and an extremely low risk of allergic reaction. After blood is drawn (don’t worry, it’s not a large amount — think lab test sample), it is spun in a specialized centrifuge. This separates out the components of blood by weight, allowing the platelets to be collected. This concentration of platelets is what is then injected at the site of injury.
How Does PRP Work?
The exact mechanism by which PRP works is conjectural at this point — we understand how platelets work, and why PRP should be beneficial. Laboratory studies have shown that the increased concentration of growth factors found in PRP has the potential to speed up the healing process, and in general the research that has been done thus far looks quite promising. The effectiveness of PRP has been found to vary, because there are many different factors that impact the injury being treated. The patient’s overall health — which in itself includes a myriad of factors — is a biggie. The area of the body being treated, and whether the injury is acute or chronic, can also make a difference in the treatment’s efficacy.
As described above, your body’s first response to any soft tissue injury is to deliver platelets to the affected area. The platelets initiate the repair, and attract stem cells — the body’s most critical cells for rejuvenation and repair — to the injury. Platelets contain packets of growth factors called alpha granules. The growth factors in alpha granules include platelet-derived growth factor, transforming growth factor-beta, vascular endothelial growth factor, epidermal growth factor, insulin-like growth factors I and II, and fibroblast growth factor. These promote the formation of extracellular matrix, granulation tissue, and epithelial tissue as well as stimulating cell growth and proliferation, angiogenesis, and cell migration. The hope is that coordinated use of these growth factors will accelerate the removal of necrotic tissue and speed tissue regeneration and healing. For example, when PRP is injected at the site of injury (for example, into a swollen and inflamed Achilles tendon). If you imagine an injury as being like a natural disaster (say an earthquake), the platelets your body first sends are the local first responders. PRP is like calling in the National Guard. Calling in those reinforcements has the potential to speed healing and get everything back to normal more quickly.
What Conditions are Treated with PRP?
PRP has been used to treat a wide range of conditions that affect the body’s soft tissue (though it has been used in a limited fashion to treat fractures, the impact on bones doesn’t seem to be as strong). Studies have shown that PRP is most effective in treating chronic tendon injuries, including tennis elbow, ACL injuries, jumper’s knee, Achilles tendonopathy, plantar fasciosis, and other forms of tendonitis.
Most of the examples of athletes being treated with PRP involve acute sports injuries like sprains or pulled muscles. Ankle sprains, knee sprains, ligament sprains, plantar fasciitis, or pulled hamstring muscles have all been treated with PRP. Though the evidence for PRP is more anecdotal in this area, there’s a considerable amount of endorsement from big-name athletes who’ve used the treatment to get back in the game.
PRP is also sometimes used in conjunction with surgery, particularly for joint or tendon injuries. In these cases, the treatment is performed at the time of the operation. Examples of areas where PRP has been used include rotator cuff tears and torn ligaments. It is still too soon to conclude how effective PRP is in speeding healing in these cases.
How Long Does PRP Therapy Take?
PRP Therapy usually takes just 45 minutes, including the preparation and recovery time. It helps to speed healing and reduce pain without the risks of surgery or general anesthesia, a hospital stay, or a prolonged recovery. Most patients can go back to their normal, everyday activities after the PRP Therapy has been completed.
The number of treatments you will need will vary, depending again on individual factors. One-on-one consultation with Dr. Tang will help to determine your course of treatment. In general, up to three PRP injections can be given within six months. Many patients find that they experience relief of their symptoms after just one or two injections.
What Results Can I Expect from PRP?
It takes time for your body to repair itself — though there are now many more platelets to do the job, repairing and replacing damaged tissue is still a big task! Usually, patients will see initial improvement within a few weeks that gradually increases over time as the healing progresses. In some cases, patients experience an initial intensification of pain due to the actual injection, but this generally goes away within a week.
This treatment is so new that we do not yet have firm evidence on how long results last, but given that the goal is to relieve pain through healing — not to simply mask the pain, as with a corticosteroid injection — many believe that the long-term results look promising. Evidence from both MRI and ultrasound imaging has shown tissue repair after PRP therapy. Additionally, the risks associated with it are minimal. Though increased pain at the injection site can occur, the incidence of other side effects (infection, tissue damage) are no different than with traditional therapies like cortisone injections. In addition, because the blood is taken from you, there are no risks of adverse blood reactions. For many patients, the potential benefits outweigh the risks — after all, who can really put a price on relief from chronic pain?
Interested in learning more about PRP, and finding out whether it may be helpful in treating an existing injury? Call Rejuvé today at 408-740-5320 to set up a consultation with Dr. Tang.
