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. Platelets are responsible for the first stages of healing when your body is injured. They release growth factors which create many biological responses related to healing and tissue regeneration.
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 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.
- 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
- Detoxing leading up to the procedure can be a good idea
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.
- Do your exercises and go for walks. Listen to your body and don’t push it.
- No NSAIDs for 2 more weeks. You may use Tylenol/Acetaminophen, but do not take more than 3,000 mg of Tylenol in 24 hours.
- Use ice, heat, epsom salt baths, and Tylenol if needed. Avoid narcotics if at all possible.
- Come in for follow up appointments to get adjusted, ozone, and go over strategies
- 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.
- 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.
- 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. Walking is nature’s balm
- Motion is lotion. Move the joint through full range of motion without resistance. This is different from stretching! Move it around.
- After the first week (or when you feel comfortable) begin doing eccentric exercises. 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 injection in a month. We won’t really know how you actually responded until around 3 months after the injection.
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)
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?
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
How many PRP treatments will I need?
Hopefully one! Maybe two. At the end of the day it depends. Everyone is different, has a different history, and ability to heal. The biggest predictor of improvement comes down to your ability to 1) Stop hurting it and 2) Do things that help and strengthen it.
Does PRP hurt?
Getting poked with a needle can always bring discomfort… We will offset that by using ice to numb the prick. It is very common to feel soreness that fades within 24 hours.
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.
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.
Why is the cost so much different?
PRP mandates a higher cost due to the increased preparation time, the equipment necessary to prepare it, training to prepare and administer, and the overall complexity of the process.