During PRP treatments, healthcare professionals draw several tubes of the patient’s blood before running them through a centrifuge to activate and concentrate the platelets. The patient’s blood is sometimes combined with bovine thrombin, a cow-based enzyme that assists with blood clotting. The doctor then injects the activated platelets back into the injured or diseased body tissue to stimulate and increase the number of reparative cells produced by your body. 

Ongoing research continues to study the effectiveness of this experimental treatment. Professional athletes, such as Tiger Woods, have undergone this therapy and found pain relief, but research still reports mixed results when using PRP to treat injuries to the musculoskeletal system. Many insurance companies do not cover this treatment option.

Is PRP therapy an FDA-approved treatment option?

Currently, platelet-rich plasma therapy is not an FDA-approved treatment option; however, the FDA has regulations in place for this therapy to ensure the therapy remains a safe treatment option. The FDA considers this treatment a biological medication and has cleared the majority of devices used to make PRP. The FDA approved PRP treatment for some instances of orthopedic surgery and refractory diabetic ulcers but has not approved PRP treatment for sports-related injuries. FDA approval is pending for PRP injections to treat tendonitis. 

Platelet-rich plasma therapy is currently an off-label treatment option. Off-label medication usage involves using an FDA-approved drug for unapproved uses to treat a disease or medical condition. Examples of off-label use include:

• Using that treatment option for a disease or medical condition that it was not approved to treat
• Administering the medicine in a different way than it was approved, such as using a medicine approved as a capsule as an oral solution
• Administering a different dosage than what was approved

Off-label drug use has increased within the medical industry and tends to result from positive clinical study results. Medical professionals prescribe antidepressants, anticonvulsants, and antipsychotic medicines for chronic pain relief despite no FDA approval for this use. Tricyclic antidepressants are not FDA-approved for neuropathic pain but are often the first medicine prescribed.

Who are not candidates for PRP therapy?

Not everyone is an ideal candidate for this therapy. Individuals who should not partake are those who:

• Are pregnant or suspect they may be pregnant
• Are anemic or have certain blood or bleeding disorders 
• Are undergoing anticoagulation therapy
• have medical conditions that worsen with injections, such as an active infection, a metastatic disease, or some skin diseases
• Have allergies to cow products

Those taking blood thinners, non-steroidal anti-inflammatory drugs (NSAIDs), or immunosuppressant medication should talk to their doctor to see if this treatment is right for them.

Conditions treated

• Achilles tendon ruptures 
• Chronic tendon injuries 
• Male pattern baldness
• Mild to moderate osteoarthritis
• Shoulder pain caused by rotator cuff tears
• Soft-tissue injuries

Benefits

• Reduces need for medications such as anti-inflammatories or opioids
• Limited side effects from treatment

Procedure

This procedure cannot be performed if the patient has an active infection or symptoms of a cold, flu, or similar malady. If you experience these symptoms on the day of your procedure, you will need to reschedule your injections. Before your procedure, you should eat a meal to avoid lightheadedness. If your PRP therapy is for hair loss, you should wash your hair the day of the treatment but refrain from using any heat or hair products, such as hairspray or gel. You will need to bring a clean hat to the appointment to wear after the procedure. 

If you take any anti-inflammatory medication, you should stop taking these at least three days before the procedure. Your medical professional will discuss any medication changes in preparation for this procedure. You may need to stop taking any over-the-counter pain medication, vitamins, and supplements in addition to halting your immunosuppressant, steroids, or blood-thinning medicines. You should not consume tobacco, alcohol, herbs, or illicit drugs at least several days before the procedure.

During your platelet-rich plasma therapy appointment, your healthcare professional performing the procedure will draw a blood sample. The amount of blood drawn depends on how much is needed for the procedure. Once the medical professional has the desired amount of blood, they will place the specialized vials into a centrifuge to spin the blood until its components separate into three layers. Once the vials leave the centrifuge, they will have three separate layers: red blood cells on the bottom, white blood cells and platelets in the middle, and plasma with a low concentration of platelets on the top. This process takes about ten to fifteen minutes.

Your healthcare professional will then use imaging tools to guide them as they inject the PRP solution into the affected or injured area. You will not receive any local anesthetics, as these can inhibit the function of PRP. Once the doctor finishes the injections, you will remain in an observation room to ensure no complications or adverse reactions occur.

Recovery

Following the procedure, you may not resume taking any NSAIDs, such as naproxen, aspirin, and ibuprofen, for two weeks after your most recent injection. Your doctor will instruct you when you may resume taking aspirin if you take it for cardiac reasons. 

You may return home after the procedure and should rest the remainder of the day. You may or may not notice any immediate pain relief after your injections. Pain relief may take several weeks or months to occur, depending on how quickly your body heals. Your healthcare provider will provide you with a post-PRP rehabilitation protocol and instruct you not to use tobacco, alcohol, or other illicit drugs while recovering. Post-PRP drug usage and overuse of the affected area can impair the body’s natural healing process. 

You may experience pain, soreness, or bruising at the injection site. Your physician will instruct you on when you may ice or use heat therapy on the affected area and what medicines you may take to relieve any pain associated with the injections. You should avoid taking a shower for the first 24 hours after your injection and should not take a bath or use a jacuzzi or sauna for the first few days after your procedure.

If you received PRP therapy for hair loss, you may restart hair dye or other coloring treatments one week after your injections. Your healthcare professional will also inform you what hair products you may use while recovering. 

You may need a booster shot or several injections to feel pain relief. PRP therapy may be used in conjunction with other treatment options. 

Risk

While PRP is generally considered a safe treatment option, there are some risks associated with this treatment. Potential risks include

• Increased pain at injection site
• Infection, bruising, or bleeding at injection site
• Nerve injuries
• Pain and stiffness in location where PRP is injected
• Procedure does not relieve pain
• Tendon rupture during injections
• Tissue damage