Platelet Rich Plasma (PRP) is a treatment used to promote healing. Usually, treatment is performed in patients suffering from tendinosis, tendon tear or joint pathology. This treatment involves the injection of the patient’s own blood (Autologous Blood Injection [ABI]) into the injured tissue area in order to speed up and induce the body’s recovery process.
PRP concentrates the important factors in the blood so a more concentrated product is injected into the injured region. This form of treatment’s aim is to assist in the body’s healing of musculoskeletal injuries naturally, without subject to additional risks or adverse effects.
If only tendinosis is present, then Dry Needling (DN) alone may be performed while severe tendinosis or tendinosis not responding to other therapies and tendon tears can be treated with PRP.
Dry needling is commonly used to treat muscle or tendon injuries, by using a needle to target specific injured tendons or muscles which have been previously injured but are not responding to conservative methods of treatment. Depending on the issue Dry needling and PRP can be combined.
ABI/PRP and DN are thought to work on the basis that blood carries growth factors which trigger stem cell recruitment and fibroblast stimulation; cells which induce the healing cascade. These treatments are usually done in conjunction with strengthening exercises and physiotherapy.
The success rate is difficult to predict, with evidence suggesting that around 70-80% of patients see an improvement, which can be quite dramatic in many cases. It is important to note that the degree of response to treatment depends on several factors including:
If there is no clear improvement following the treatment, the procedure may be repeated if necessary. This follow up treatment is then usually performed 4-6 weeks after the initial procedure.
All anti-inflammatory medication should be ceased about 10 days before the procedure, including aspirin and ibuprofen.
All these procedures are performed under ultrasound control so that the injured region can be directly visualised and accurately injected. If you have not had a prior ultrasound, an expert musculo-skeletal sonographer or radiologist will usually first scan the area of concern to confirm the pathology and plan the treatment.
If PRP is being performed, a small cannula (similar to having a blood test) will be placed into a vein in an arm and left there for the duration of the procedure. If ABI/PRP is not to be performed, this step will be left out. For PRP about 10 ml of blood is taken. The skin is then cleaned with an antiseptic agent. Local anaesthetic is usually then injected into the skin and around the tendon to make the procedure more comfortable.
If dry needling alone is performed, this will be performed under ultrasound control. This consists of repeatedly passing a needle through the abnormal area of the tendon to cause small bleeds.
If ABI/PRP is to be performed, DN may be performed first to fenestrate the tendon. If PRP is to be performed, the blood will first be centrifuged which takes around 10 minutes. This causes the heavier components of blood, such as red blood cells, to be separated from the plasma or fluid component.
The degree of discomfort varies depending on:
Overall, however, the procedure is well tolerated and usually produces only minimal discomfort. There can be a slight increase in pain and stiffness in the area injected for a day or two afterwards, occasionally lasting up to a week.
We try to limit the use of ice-packs or anti-inflammatory (e.g., ibuprofen) medication after treatment for about 10 days. However, paracetamol-based products are acceptable for use.
The procedure is usually well tolerated and adverse reactions are rare.
Immediately post procedure, variable. From no discomfort to mild. Occasionally there can be quite significant discomfort that can last for up to 20-30minutes.
You may well experience initial pain relief due to the local anaesthesia provided prior to the procedure. There may be some subsequent mild discomfort for a couple of days. The maximum effect of the treatment usually occurs at the 4–6-week mark. What you will be able to do after the procedure will depend on the area injected and reason for the treatment.
Post procedure rehabilitation/ exercise regime is variable depending on the area/structure involved, degree of injury and the individual circumstances. This will usually be organised/ supervised by your referring doctor or physiotherapist. Usually, you will be asked to avoid strenuous activity during the first two weeks, with a gradual return to full activities.
If you have any questions or concerns after treatment please contact Independent Sports Imaging or your referring physician.
Download a patient information brochure:
Patient Fact Sheet on Autologous Blood Injections, Platelet Rich Plasma and Dry Needling
Comprehensive review article on Platelet Rich Plasma:
Review article on the use of Platelet Rich Plasma