What are Platelets?
Platelets are responsible for the first stages of healing when your body is injured. They do two things in your body:
- Form a clot and prevent you from bleeding to death when injured.
- Release growth factors which create many biological responses related to healing and tissue regeneration.
The PRP process involves drawing your blood then spinning it in a centrifuge. This separates it by weight. The plasma is the lightest and ends at the top. Part of the plasma layer with the most platelets is then injected back in your body.
FAILURE TO ADHERE TO THE FOLLOWING INFORMATION WILL RESULT IN SUB-OPTIMAL TREATMENT OR EXCLUDE YOU FROM IT ALTOGETHER!
We cannot tell whether your plasma is unacceptable until the blood is drawn and spun. At this point you will not have to pay the full amount for treatment but will still be responsible to cover the costs of supplies. Take your health and healing into your own hands by preparing well and giving yourself the best chance you can with this amazing treatemnt option.
Contraindications – Don’t get PRP if you have:
- Active cancer
- Abnormal platelet function
- Active systemic infection
- Low-platelet count
- Severe anemia
- An unwillingness to accept the risk
Instructions to Prepare for Treatment
- DO NOT use any NSAID (anti-inflammatory / anti-swelling) drugs for AT LEAST 2 weeks before. They make the treatment useless. Speak with your prescribing doctor if needed.
- No corticosteroids (cortisone and other steroid injections) 4 – 6 weeks before.
- Detoxing leading up to the procedure can be a good idea
- High-dose vitamins through IV 5-7 days before treatment can add effectiveness
Five days before treatment take Nitric Oxide (NEO40) tablets, one in the morning and one in the afternoon
- On the day of the treatment…
- Be hydrated and eat before coming. However, stay away from junk – particularly fatty foods and caffeine
- Exercising before your blood is drawn can increase your platelet count
- Arriving early to do PEMF therapy helps make for a better blood draw
Instructions Following Treatment
Expect some pain at the site for a few days. This pain is due to the inflammation generated as part of the healing response and it’s normal.
- Drink plenty of water.
- Do your rehab and go for walks. Listen to your body and don’t push it.
- No NSAIDs for AT LEAST 2 more weeks. You may use Tylenol/Acetaminophen (if needed), but do not take more than 3,000 mg of Tylenol in 24 hours.
- For pain relief use ice, heat, epsom salt baths, TENS, and Tylenol (if needed). Avoid narcotics if at all possible. NO STEROIDS.
- Keep up with the treatment plan: Come in for follow up appointments to get adjusted, ozone, etc.
- After the first 2 – 3 days, the pain will lessen. You will have some days where the pain is worse and others when it is improved. This is a good response. The improvement is progressive over time.
- Avoid deep tissue work of the area soon after
- Avoid hot tubs and swimming pools for 48 hours afterwards
- Don’t use narcotics if you don’t need them. You can use Tylenol
- NOTE: Some narcotic drugs have Tylenol in them. They will need to be included in the 3,000 mg total.
A Few More Considerations
DO NOT USE NON-STEROIDAL ANTI-INFLAMMATORY DRUGS (NSAIDs). See the list below. This is very important and will negate the effects of the PRP by preventing the inflammation needed for repair, to start the healing process. (If you take low dose Aspirin (81 mg per day) for a heart condition, you should continue this).
- Don’t Smoke!
- Physical Activity
- For the first couple days plan on reducing your regular intensity.
- Motion is lotion. Move the joint through full range of motion without resistance. This is different from just stretching! Move it around.
- After the first week (or when you feel comfortable) begin doing eccentric exercises (AKA negatives). This means applying resistance while the muscle is lengthening, and no resistance while the muscle is shortened. Gradually increase resistance as you can each day.
- It is vital to move to stimulate proper healing, but too much too soon will take you backwards. Cross train for cardio as you are able.
- Follow up varies. Some like a repeat PRP injection soon (a month and a half). Some try their luck with just one treatment. We recommend 3 applications of PRP with a 2-3 month gap in between. More frequent follow ups with ozone are highly encouraged.
Frequently Asked Questions
PRP May Be For You If...
- You are dealing with an injury to a tendon or ligament
- You want healing as quickly as possible
- You can afford it (although one prp treatment is less expensive than many alternatives)
- You have tried cortisone without resolution
- You have tried ozone but haven’t had enough healing as a result
- You are trying to avoid surgery
- You are missing out on your goals due to pain
What Are NSAIDs?
- Non-steroidal anti-inflammatory drugs (NSAID) have the following in them:
- Ibuprofen (Motrin, Advil)
- Naproxen (Aleve, Anaprox, Naprelan, Naprosyn)
- Indomethacin (Indocin)
- Diflunisal (Dolobid)
- Etodolac (Lodine)
- Diclofenac (Cambia, Cataflam, Voltaren-XR, Zipsor, Zorvolex)
- Ketoprofen (Active-Ketoprofen, Orudis)
- Ketorolac (Toradol)
- Nabumetone (Relafen)
- Mobic, Mobicox
- Oxaprozin (Daypro)
- Piroxicam (Feldene)
- Salsalate (Disalsate, Amigesic)
- Sulindac (Clinoril)
- Tolmetin (Tolectin)
- Also wise to avoid anticoagulant and anti-inflammatory herbs/supplements (Turmeric, Curcumin, and Fish Oil)
What are the Expected Outcomes of PRP?
Nothing in medicine can ever be certain. Variables are seemingly infinite. Yet, the hope and expectation is to enjoy pain-free, normal living after treatment. Our goal is to help your body heal your injury and stop your pain at the source. You’ll start noticing improvement after a few weeks. Then it will continue to get better and better.
Studies and research have shown that pain relief is both effective and lasting. Ultrasounds and MRI results show that the pain relief comes from true healing (the tissues are actually repaired). With repaired tissues and little to no pain, you should be able to avoid surgery and disability, especially if you get the PRP treatment before the damage to your tissues becomes irreversible.
It also needs to be noted that results depend upon far more than what we can give. The active care you can do for yourself is paramount. If we hit you with a magic wand that would 100% heal the issue and then you go back to the same lifestyle that caused the injury you may think the treatment was unsuccessful.
How can I get the best results from PRP?
Since the “medicine” used is your own blood you will want to provide the best quality which comes from being in the best health. Your response to (any) treatment may depend on the answer to this question. ARE YOU HEALTHY? Here are some more specific questions:
- Do you get adequate sleep?
- Are you getting enough exercise?
- Are you overweight?
- What is your diet like? Are you eating excessive carbs (pasta, wheat, potatoes, bread and sugar)? Do you take in a lot of “fake foods” such as soda, chips, margarine, sugar replacements like aspartame, or other processed foods? Are you getting enough fresh fruits and veggies, protein, and healthy fats?
- Are you living with a whole body health care approach?
- Physical, mental, spiritual, emotional and social
- Do you take supplements to support what you miss in your diet?
- How many medications are you on? What are they and how long have you been on them? *Talk with your prescribing doctor before terminating a medication.
- Do you drink more than one glass of alcohol a day?
- Do you smoke (vaping included) or use tobacco products?
- Are you struggling to deal with stress in your life?
How quickly will PRP work?
You should see your first results in 2-6 weeks. However, combining ozone and other modalities can shorten this time. As time passes, most find that the pain lessens with every passing week. Healing takes time but it is a beautiful thing.
How many PRP treatments will I need / Does it work long-term?
Hopefully one! At the end of the day it depends. Everyone is different, has a different history, and a different potential to heal. There are an infinite number of variables to be considered. The biggest predictor of improvement comes down to your ability to 1) Stop hurting it and 2) Do things that help and strengthen it.
How long does the procedure take?
We usually schedule out about 1 hour for the whole process.
Will my insurance cover PRP?
PRP is still considered to be an experimental treatment and most insurance companies do not cover it. With time we trust that the results will speak for themselves and insurances will pay based on value.
Does PRP hurt?
Most patients find that the procedure is not very painful, and they tolerate it well. However, getting poked with a needle can always bring discomfort and it’s common for the inflammatory response (Yes, inflammation is a product of PRP – which is why you are to abstain from anti-inflammatories) to produce soreness after the injection.
Expect soreness and possibly swelling for at least the first 48 hours after your injection. You can take pain medication to help alleviate any discomfort as long as it’s not anti-inflammatory. You can also use heat to soothe the pain (avoid ice since it will mess with the good inflammatory process). However, the BEST option is to move and do your rehab!!! MOTION is LOTION.
Does PRP always work?
No one treatment works for everyone! Otherwise, there wouldn’t be so many. The biggest detriments to success are not following the suggestions and protocols, or not maintaining health in general. Remember that true health is not to be found at the end of a needle tip.
We have unfortunately had multiple people produce plasma that was unusable for treatment because they were not well prepared. This is the biggest consideration to make.
I already had surgery. Can I still get PRP?
Yes! Unfortunately this is the population that we work with quite a bit. Hopefully we’ll be able to shift the numbers and catch more before the surgery even happens – with your help we can.
However, the reality is that surgery creates limitations on what we can achieve. Surgery disrupts the normal architecture and replaces normal tissue with extensive scar tissue (even when it’s just a scope to “clean things up”. There is only so much our treatments can do to help this – but improvement is possible.
What are the risks of PRP injection?
Complications are rare. It’s a great benefit of using your own blood! Soreness and bruising are probably the most common. Infection is highly unlikely but is possible.