PRP (PLATELET RICH PLASMA) THERAPY FOR PAIN OR INJURY TREATMENT
If damaged or injured tissues fails to heal with rest and conservative treatment, a clinician may recommend a course of platelet rich plasma (PRP) treatments. It has been established that the natural healing properties found in platelets and plasma facilitate healing and repair in damaged tissues.
When treating a damaged tendon for example with platelet rich plasma, the clinician injects PRP directly into the affected area with the goal to:
• Reduce pain
• Improve joint function
• Repair damage to tendon tissue
• Repair damage to the tissue
Tendon Injury and Pain
Tendons are strong tissues that connect muscle to bone. Tendon degeneration can be caused by multiple factors - such as previous injuries, ageing, stress, and/or overuse. Tendon injury or damage is commonly referred to as tendinitis, tendinosis, or tendinopathy. Tendinitis is an associated with tissue inflammation, and over time a breakdown of the structural composition (e.g. the amount of essential collagen a tendon contains), strength, and stability can occur. In some cases this tissue degeneration results in chronic pain, disability, or tendon tears.
How Can PRP Therapy Relieve Joint Pain?
Experts predict that the PRP has the ability to:
Stimulate healing, including stimulating the production of new tissue.
Contain proteins that alter a patient’s pain receptors and reduce pain sensation
What are Platelets and is Plasma?
Platelet rich plasma is derived from our blood. A blood sample from the patient is processed using medical equipment to produce a therapeutic injection that contains plasma with a higher concentration of platelets than is found in normal blood.
Platelets are a normal component of blood, just like red and white blood cells. Platelets release substances called growth factors and other proteins that regulate cell division, stimulate tissue regeneration, and promote healing. Platelets also help the blood to clot.
Plasma refers to the liquid component of blood. It is mostly water but also includes proteins, growth factors, nutrients, glucose, and antibodies, among other components.
How Is PRP Made?
The most common way to prepare PRP involves centrifuging a patient’s blood sample. A vial of blood is placed in a centrifuge, where it is spun at intensely high speeds. The spinning causes the blood to separate into layers:
Red blood cells
White blood cells and platelets form a thin middle layer, called a buffy coat, which comprises less than 1 percent of the centrifuged blood.
“Platelet-poor” plasma, or plasma with a low concentration of platelets, makes up the remaining top layer, about 55 percent of the centrifuged blood sample.
Once the centrifugation process is complete the clinician will remove the vial from the centrifuge, extract the necessary blood components for PRP, and prepare the PRP solution for injection. PRP therapy can be used as part of a larger treatment plan to reduce pain and improve function.
PRP Treatment Plan
PRP injections are one element in a multi-factorial rehabilitation treatment plan that may include:
• Relative Rest from painful activities
• Strengthening and stability exercises
• Stretching and mobility exercises
General guidelines for rehabilitation after PRP treatment can vary depending on the condition and the severity.
Advantages of Platelet-Rich Plasma (PRP) Therapy
People diagnosed with tendon injures may consider PRP therapy for several reasons:
Other traditional treatments may have failed
PRP is derived from the patient’s own blood, and the injections carry few risks.
Other treatments have side effects or drawbacks
Physical therapy is often effective but does not always satisfactorily relieve symptoms or improve function.
Cortisone injections can temporarily reduce pain; however, symptoms can recur. In addition, tendons exposed to cortisone may weaken, making the injury worse.
Non-steroidal anti-inflammatory medications (NSAIDs) such as ibuprofen may effectively reduce pain, but habitual use can cause or aggravate stomach problems, blood pressure, and heart problems.
Minor surgeries to treat tendon damage and degradation, such as arthroscopic debridement, do not always work, tend to carry more risks, and have longer recovery times.
Treating Tendinitis with PRP
There is no definitive criteria for deciding when and to whom to recommend PRP injections, but some suggestions are below:
• Tendon pain affects daily activities
• Physical therapy has not adequately improved function and reduced pain
• Other non-surgical treatments have failed or been eliminated
• The patient is sensitive to anti-inflammatory medications (NSAIDs) such as ibuprofen.
• Surgical treatment is not optional or not desired.
Contraindications for PRP Therapy
Platelet rich plasma injections may not be appropriate for a patient who:
Has a medical condition that could worsen or spread with injections, such as an active infection, a metastatic disease, or certain skin disease
Has certain blood and bleeding disorders
Is undergoing anticoagulation therapy (and cannot temporarily suspend treatment)
Is anaemic
Is pregnant
PRP Pre-Injection Precautions
The American Academy of Orthopaedic Surgeons recommends patients avoid or discontinue certain medications prior to injection:
Avoid steroid medications for 2 weeks prior to the procedure
Stop taking non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or aspirin 1 week prior to the procedure
Do not take anticoagulation medication for 5 days before the procedure (done only under doctor supervision)
In addition, patients are advised to drink plenty of fluids the day before the procedure.
Platelet-Rich Plasma Injections, Step-by-Step
This is an in-office procedure that involves a blood draw, preparation of the PRP, and the injection:
Blood is drawn from a vein in the patient’s arm into a syringe
The blood is processed using a centrifuge machine
Preparation of platelet-rich plasma for injection
The affected area is cleansed with disinfectant
Using a syringe and needle, a small amount of platelet-rich plasma is injected into the affected area
The injection area is cleansed and bandaged
The platelet rich plasma typically stimulates a series of biological responses, including mild inflammation.
After the PRP Injection: Immediate Follow-up Care
Platelet rich plasma injections may cause temporary inflammation and mild discomfort. Patients are often advised to take it easy for a few days and avoid putting strain on the affected joint.
It is recommended that a patient
Avoid anti-inflammatory pain medication
Take it easy on the treated area
If the patient does not have a physically demanding job, he or she can usually go back to work the next day. Patients can usually resume normal activities the following day after the injections. Patients should not begin taking anti-inflammatory medications until approved.
Physical Rehabilitation Therapy
The patient will likely be prescribed post-injection physical therapy thats focused on building and maintaining joint strength and flexibility.
Efficacy of Platelet-Rich Plasma Injections
PRP has been used in surgeries to promote cell regeneration since 1987 and a growing body of evidence shows it is a successful treatment for chronic tendinitis, injury and osteoarthritis. Nearly all of the research investigating the use of PRP to treat osteoarthritis and other cartilage defects has been done since 2000, and the vast majority of research articles on the topic have been published since 2010.
Platelet Rich Plasma (PRP) Therapy for Arthritis
A growing number of people are turning to PRP injections to treat an expanding list of orthopaedic conditions, including osteoarthritis. It is most commonly used for knee osteoarthritis, but may be used on other joints as well.
When treating osteoarthritis with platelet rich plasma, a clinician injects PRP directly into the affected joint. The goal is to:
• Reduce pain
• Improve joint function
• Possibly slow, halt, or even repair damage to cartilage
Here at Dynamic Regenerative Medicine in Solihull and Birmingham we believe in the beneficial effects of PRP treatment and offer this treatment for a wide range of conditions whether it be related to sports injury of general occupation.
For further information please contact us info@dynamicregenmedicine.co.uk or
01564 330 773.