In recent years, medical professionals have further embraced the notion that the body has the ability to fully heal itself. Between platelets, stem cells, and a host of other growth factors, the body has all the necessary building blocks to restore any damage it may suffer.
Though the raw materials needed to heal after an injury are present, they may be dormant or impotent if the injury is severe enough. This is where regenerative medicines such as Platelet Rich Plasma injections come in.
This idea of our bodies having all the necessary materials to reconstruct any injury is at the heart of regenerative medicine. Platelet-rich plasma therapy is a form of regenerative medicine that can harness those abilities and amplify the natural growth factors your body uses to heal tissue.
What is plasma and what are platelets?
Plasma is the liquid portion of whole blood. It is composed largely of water and proteins, and it provides a medium for red blood cells, white blood cells and platelets to circulate through the body. Platelets, also called thrombocytes, are blood cells that cause blood clots and incite necessary growth healing functions. Platelet activation plays a key role in the body’s natural healing process.
What is platelet-rich plasma (PRP) and what are PRP injections?
Platelet-rich plasma (PRP) therapy uses injections of a concentration of a patient’s own platelets to accelerate the healing of injured tendons, ligaments, muscles and joints. In this way, PRP injections use each individual patient’s own healing system to improve musculoskeletal problems.
These injections are an in-office procedure. The entire PRP procedure from start to finish takes 30 minutes or so. During a PRP injection we take a sample of blood from your arm. That blood is placed into a special canister and then it is placed into a centrifuge. The centrifuge separates blood into various components.
There is a layer that forms when the tube is spun in the centrifuge. That layer has the platelets in it. We are then able to remove the layer that has the platelets and other larger cells (stem cells) in it. That layer containing the platelets is then injected into the joint, tendon or ligament that is injured. Depending on the area being injected an ultrasound machine might be used to guide the needle to its proper position.
What are the purposes of PRP injections?
Researchers are trying out PRP injections for many different applications. Examples of these include:
PRP when used alone will not heal a meniscus tear. However, at the time of surgery, when surgeons repair the meniscus using sutures, they will often inject PRP around the repair site. The current thinking is that PRP might have a role at improving the chance that the repaired meniscus will heal after suturing.
Rotator cuff injuries:
Many people with bursitis or inflammation of their rotator cuff might respond to a PRP injection. PRP can reliably decrease inflammation. That is the main goal of PRP. These injections will not reliably heal a rotator cuff tear without surgery.
Similar to a meniscus tear, doctors may inject PRP in the area after they repair the rotator cuff. Again, the thought is that this might improve the chance that the rotator cuff tear will heal quicker. In cases of bursitis without a tear, the PRP is often effective at alleviating the pain due to inflammation of the bursa.
One of the most common uses for PRP is to treat osteoarthritis of the knee, and less commonly of the shoulder and hip. PRP will not reverse or cure the arthritis. The main goal of the PRP is to decrease the inflammation within the joint
Knee ligament injuries:
PRP seems to be most useful for injuries to the medial collateral ligament (MCL). Most MCL injuries heal on their own within 2-3 months. Some MCL injuries become chronic. That means that the inflammation and swelling last well beyond the normal expected recovery time. PRP injections in this setting have been demonstrated to improve healing and minimize the chronic inflammation.
Doctors have injected PRP into the scalp to promote hair growth and prevent hair loss. PRP injections are effective in treating androgenic alopecia, which is also known as male pattern baldness.
Note that patients will be asked to refrain from taking over the counter anti-inflammatory medications like aspirin or naproxen for a short period of time before the PRP procedure. This is because these medications interfere with platelet function and therefore the effectiveness of the treatment.
Why PRP and not Cortisone?
Traditionally cortisone shots have been injected into patients for pain relief. Modern studies are coming out to suggest that PRP injections are more effective than cortisone shots which simply mask inflammation and have no healing capabilities.
What is the PRP Injection Recovery Time?
After getting PRP injections, you may experience some mild swelling or discomfort in the affected area – the same as you would for any other injection or shot.
You should be aware that because PRP injections are used to promote speedier healing and tissue growth, you will see more gradual results over the next couple of weeks as opposed to seeing an immediate change on the same day that you have the procedure performed.
Long term, PRP injections are designed to alleviate pain through speeding up the healing process. While you may see some initial improvement a few weeks out, the real value of the procedure may lie in getting back to normal activities as well as being able to engage in physiotherapy and exercise more quickly than you would otherwise and helping to treat and heal damaged tissues before the condition or injury worsens.
This is why PRP treatment may be advised for both chronic conditions like tendonitis or osteoarthritis as well as a way to help heal more acute injuries like shoulder fractures and rotator cuff tears.
Since the recovery time for PRP injections is so minimal and the procedure is so low risk, you may be recommended to have a course of several injections scheduled for around two to three weeks apart.
Post-PRP Injection Aftercare Instructions
With the varying applications for PRP injections there are different instructions on how to handle each one.
Typical Post PRP Injection Instructions for Face and Hair:
PRP therapy for dermatological issues like hair loss, anti-aging, or acne scar removal usually expects any post-procedure reaction to last for only a day or two. Here are some of the aftercare steps to follow for faster PRP injection recovery time.
- Calm the swelling by applying ice on the treated area.
- Keep your skin and scalp protected from direct sunshine.
- Do not use any chemical cleansers or makeup on your skin for at least a couple of days. In case you’ve opted for micro needling, the toxins can seep into your bloodstream and cause complications.
- Avoid going for swimming or steam and sauna baths that can expose the skin to hot temperatures.
- Your skin may feel dry and flaky. Nourish it with organic, chemical-free moisturizers as directed by your dermatologist.
- Expect to see results at 4 to 6 weeks after the session. If needed, your doctor will ask you to get follow-up sessions.
PRP Injection Aftercare for Joint Pain and Osteoarthritis:
- Restrict strenuous activity for 24 to 48 hours after the injections.
- Use crutches, slings, braces, walking canes, and other aids to lower the stress on your joints and keep them immobile.
- Your doctor will likely recommend a progressive physical therapy program. In the initial few days, perform only light stretching and gentle movements.
- Over the next 3 to 4 weeks, as your joints start to recover, your physical trainer will increase the range of motion and perhaps, add strength training and other forms of exercise like using a treadmill or stationary bike.
- After 4 weeks, you can go back to performing weight training and running or jogging.
- You may be asked to ice the affected area for 10 to 20 minutes several times a day.
- Under the direction of your doctor, you can use warm packs for deep aches as long as they don’t aggravate the discomfort.
What to Expect After PRP Injection for Ligaments and Tendon Damage:
- While you can move around and do light tasks around the house and work, doctors typically recommend that you rest the treated area for at least 2 weeks. It is best that you avoid excessive activities that can strain the damaged ligament and interfere with the healing.
- For injections in the knee or heel, you may want to use crutches to keep the weight off while the ligament heals.
- Use braces or compression wraps to support the ligament.
- Your doctor will allow you to take Acetaminophen (Tylenol), but the dosage is limited to 4,000 mg or less per day.
- Using ice and heat packs alternatively can also help with the healing and lower discomfort levels.
- You can expect that the ligament will start to heal in the interval of 2 to 6 weeks after the treatment. By week 12, you should see major improvements.
- Depending on the recovery and the condition of the ligament before treatment, your doctor might ask you to come in for follow-up injections to maintain the recovery.
PRP injections and related treatments are still in their infancy, but they hold a lot of promise when it comes to relieving chronic pain from tendon injuries and associated damage, as well as further potential for helping to hasten the healing process and minimize recovery time from injuries and other procedures.