The Platelet-Rich Plasma (PRP) Procedure
When you are in pain or injured, it is only natural you want to seek the best treatment possible. Now, there is a minimally invasive and natural way to help your body heal itself: platelet-rich plasma (PRP) therapy. PRP therapy is a therapeutic process with real results for pain management and soft tissue injuries.
The PRP technique incorporates your body’s innate ability to heal itself by isolating healing components of your blood and applying them to the site of injury.
When you are injured, platelets (and growth factors inside them) naturally travel through the body to the damaged site to heal the tissue. The PRP method uses this idea and maximizes it. PRP therapy concentrates these growth factor-containing platelets and injects them into the site of injury to expedite repair and recovery.
Here’s how the PRP process works, what you should do before the PRP procedure, and what to expect after it.
How It Works
The PRP method is usually customized to your specific injury or needs. The treatment is preferred not only because of its results but because it helps patients avoid more invasive forms of treatment. There are three basic steps to the procedure: (1) extraction of the blood; (2) concentration of the platelet-rich plasma; and (3) injection of the PRP.
PRP therapy is completed in the office and takes about 30-40 minutes from the moment you sit in the chair for the blood draw. Before the PRP procedure takes place, the site to withdraw the blood from your arm will be cleaned.
Step 1: Extraction
Here, you are placed in a chair as you would be for any type of blood sample. The doctor or technician draws a blood sample from your arm into a syringe, which has already been prepared with an anticoagulant to prevent the blood from clotting. The drawn amount is typically 60mL, or about 1/5 of a can of soda. In some cases, more blood may need to be drawn.
Once the blood is taken, the site of the blood draw will be cleaned and bandaged.
Step 2: Concentration
After the blood samples are taken, the technician or doctor will dispense the contents into the appropriate chamber of a disposable container used for blood processing.
The disposable container is loaded into the centrifuge where it spins for about 15 minutes at 3200 RPM. The centrifuge spins to separate the the blood into 3 distinct layers - red blood cells, the serum or platelet-poor plasma (PPP), and the platelet-rich plasma (PRP).
The PRP is then removed from the disposable, and the doctor or technician will prepare the PRP for injection immediately.
Step 3: Activation
After preparation of the PRP, the injection site is cleansed with alcohol or iodine. Lidocaine or another local anesthetic may be applied to numb the area to relieve discomfort, though the process itself is associated with minimal discomfort even without anesthetic.
An ultrasound or x-ray may be used to accurately guide the injection. When used, a special gel may be applied to the same area of the skin near the injection site. A probe will be placed on the skin to give a live image of the injury site.
Once the site is completely prepared, the patient is asked to relax to enable ease of injection. A syringe and needle are used to inject PRP into the affected area.
Once the injection is completed, which takes only a minute, the injection site is again cleaned and bandaged.
And then you are ready to leave the office. The injection site may be sore, even swollen, for the remainder of the day or up to five days later, but the pain is mild and tender mostly only to the touch.
What You Should Know Before a PRP Procedure
Preparation for PRP therapy is minimal but does require some attention. First, you want to make sure you are drinking plenty of fluids, especially the day before the PRP procedure. You also must refrain from taking certain medications weeks before the procedure, including:
anticoagulation medication (blood thinners), which you must stop taking at least five days prior to the PRP procedure unless you are under doctor supervision to do so;
anti-inflammatory medication -- like aspirin or ibuprofen (although a low dose of 81 mg may be permissible if your doctor approves it), which you must stop taking two weeks prior to the PRP procedure;
arthritis medication -- like Celebrex -- one week prior to the PRP procedure; and
corticosteroid medication for two - three weeks prior to the PRP procedure.
Taking the precaution of refraining from the above medicines will make sure that the medicines do not interfere with the effectiveness of the PRP therapy.
Note: Do not stop taking any of your regular medications, even the ones mentioned above, without first discussing it with your physician.
What You Should Know After a PRP Procedure
Post PRP therapy, the main considerations include what you can (or can’t) do, what risks or complications to be aware of, and how long you can expect recovery to take.
After treatment you want to refrain from the following:
exercising or doing too much for a few days directly after the injection because the PRP injection can cause some temporary and mild inflammation, pain, and swelling;
placing your full bodyweight on the affected area (joint, tendon, or another part) to minimize or prevent straining it; and
consuming any anti-inflammatory medication -- like aspirin -- for two weeks after the PRP procedure -- your doctor, however, may prescribe another medication for any pain.
To address any pain or swelling, you can apply a cold compress a few times throughout the day. Leave the compress on for between 10 and 20 minutes for sufficient effect and to decrease the pain and swelling at the injection site.
Further, depending on where the injection site is located and the injury treated, you may need to ensure the area remains immobilized for a certain amount of time to facilitate recovery, and this could mean:
wearing a brace, or
wearing a sling.
With regard to recovery, every patient has a different rate of healing. Some may see positive effects right away while others will notice changes over weeks as the growth factors go to work.