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PRP 101: Answers to your questions about platelet-rich plasma therapy

Our body has a remarkable ability to heal itself. Cuts close. Bones mend. Muscles repair. When our body identifies a problem, it kicks systems into gear that restore damage.

But some injuries aren’t so quick to heal, like chronic tendon problems, where inflammation and overuse can hinder recovery and leave the body unable to catch up. Ignored long enough, a once manageable situation can require surgery to remove damaged tissue and get healing back on track.

Now, a newer regenerative therapy called platelet-rich plasma injections, or PRP, is gaining ground. Used in combination with early interventions like physical therapy, it’s giving people with tendon pain an opportunity for natural healing.

We had some of the same questions you may have about PRP, so we spoke with OhioHealth sports medicine physician Joseph Ruane, DO, about why tendons can be troublesome and how platelet-rich plasma can help.

What causes the pain of tendon injuries?

Injuries to tendons are generally caused by overuse during work or sports. Tendon pain in arms and legs is commonly diagnosed as tendonitis, or inflammation of the tendon. But what people often have is tendinopathy, or tendon damage, which does not respond to the usual treatments of ice and anti-inflammatory medicines. Tendon damage can take a long time to heal, and even worsen over time if not addressed. We use platelet-rich plasma injections on tendons that are not healing on their own. 

What is platelet-rich plasma?

Platelet-rich plasma involves two components of your blood: platelets, which are the cells in blood that stimulate the healing process, and plasma, which is the liquid part of your blood, made up of water and proteins. When we give people PRP therapy, we concentrate the platelets in the plasma to five to eight times the amount normally found in the same volume of blood.

How do the platelet-rich plasma injections work?

The whole treatment process is an outpatient procedure that takes about an hour. First, we draw some of your blood and spin it in a centrifuge to concentrate the platelets and separate them from the plasma. We transfer those platelets to a syringe and use ultrasound equipment to guide the injection precisely into the damaged tissue of your tendon. The injections are designed to concentrate the healing power of your body and focus it in into a single spot to stimulate healing. We encourage people to rest their tendon for a couple of days after the procedure, and we gauge their return to full activity based on their individual circumstances.

Which tendons can you use PRP injections on?

We can use PRP for just about any tendon pain:

  • Tennis elbow, which is pain on the outside of the elbow.
  • Golfer’s elbow, or pain on the inside of the elbow.
  • Jumper’s knee, or kneecap pain.
  • Achilles tendon pain near the heel.
  • Rotator cuff pain in the shoulder.
  • Hip pain caused by tendon injury.

How do I know whether platelet-rich plasma injections will work for me?

We generally recommend physical therapy as the first and best treatment for most tendon problems. It’s very important to identify the source of tendon pain, correct imbalances and focus on root causes. Platelet-rich plasma injections are a supplement to that. If someone isn’t putting in the work to get better, PRP isn’t going to replace that effort.

A conventional treatment sequence for tendon pain is over-the-counter pain and anti-inflammatory drugs, physical therapy, cortisone shots, and surgery. Recent research suggests multiple cortisone injections are bad for tendons because they break down the tissue and can even lead to poor surgical outcomes. When surgery is needed, the surgeon creates access to the tendon, then cuts away diseased portions to stimulate bleeding and healing. Although these surgeries can be quite successful, they do not always work and can have long recovery times.  The best thing is to try not to get to that point.

In my practice, I find that most tendons respond well to one PRP treatment; occasionally a second is needed. If we assess your condition and determine PRP is an option for you, it can be a safe alternative to surgery that gives your body the chance to fix the problem on its own.

When is the right time to consider PRP injections?

If you’re working or exercising through pain, your body is telling you something. The overuse injuries we see are often due to chronic stresses on the tendon that have been ignored. If you have pain that lasts more than a month, that interferes with your ability to work or exercise, get it checked out before it becomes a bigger problem. It’s always easier to treat tendon problems sooner rather than later. 

To discuss platelet-rich plasma injections for your tendon pain, call Dr. Ruane at (614) 566.3810.

 

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