What is Platelet-Rich Plasma Therapy?

I’ve been going on and on and on about my recent treatment that I’ve barely had a moment to get down to the nitty-gritty. So if you’re sitting there, scratching your head, wondering if PRP is some sort of voodoo, read on. Today, I’m laying out the facts.

PRP is an easier-to-type acronym for platelet-rich plasma, a type of injection therapy that, in a nutshell, uses a person’s own blood platelets to heal an injury.

What the heck are platelets?
Your blood is full of platelets, particles that aid in clotting. Platelets are packed with growth factors, which are involved in wound healing and tissue regeneration.

How does PRP therapy work?
Before your body becomes a pin cushion, you’ll donate a small amount of your own blood for the treatment. Once the blood is drawn, it’s rapidly spun in a centrifuge so that it separates. Light particles like red blood cells float to the top, while heavier blood platelets fall to the bottom. Your doctor will fill a syringe with those separated platelets suspended in a teensy amount of blood plasma, and inject them into your injured area.

The idea is that the high concentration of platelets jump starts the body’s self-healing and spreads growth factors to areas otherwise untouched by blood (like ligaments, tendons, and joints). When the platelets are done doing their thing, the body will have repaired damaged muscle or tissue.

And because PRP uses your own blood, there’s no risk of rejection. In other words: The treatment is more or less risk-free. (OK, OK, there’s always a slight risk when it comes to injections. Even if you’re shooting cortisone in your body, there’s a chance of infection. Consider yourself warned.)

Which injuries does it treat?
The beauty of PRP is that its application is expansive. It’s commonly used for ligaments and tendon injuries, but also treats back pain, arthritis and cartilage injuries like patella femoral pain syndrome. Most famously, PRP was used to treat NFL player Hines Ward after a knee ligament sprain. Ward left mid-game, got injected the following day, and played in the Super Bowl two weeks later.

How long does the procedure take?
Not counting the time it takes to draw blood and spin it in a centrifuge, the whole procedure takes about 15 to 20 minutes. During each visit, your injury will get a number of injections. My doctor injected platelets into six different areas surrounding my knee injury.

What happens after that?
Well, if you got PRP injections in your knee, you practice deep breathing as your leg stiffens and the littlest toe wiggle sends searing pain up your leg. You pop a pain killer and suck it up as your knee throbs deep within. If you got PRP in something other than a joint, it can hurt a little less—but don’t expect to be pain-free. At the very least, you’ll be stiff for a bit.

You’ll feel stiff for a couple weeks post-treatment, and then you’ll feel pretty much the same as you did before. Feel free to work out and go about life as usual. Then, some time between weeks four and six (or, in my case, the end of week seven) you’ll start to notice a big change in pain. If your body takes longer to hit that Ahh! point, don’t worry. My doc says some patients can take eight, 10, or even 12 weeks.

Any dos or don’ts?
There are a few rules to PRP: You can’t use anti-inflammatories, which counteract everything the treatment is trying to do. Yep, you want to be inflamed, so put away the Advil, Motrin, Excederine, and Aleve. (Tylenol is OK, though.) Since the injected platelets keep working for up to a year after they’re injected, forget popping these pills for the near future.

Ice is also out of the question. Like anti-inflammatories, it curb’s the body’s natural reaction to the injected platelets. Instead, stick with heat. (You’ll be thankful for this rule come winter, trust me.)

How long does it take to heal?
Oh you’d like to know, wouldn’t you? Yeah, me too. But all humans are different, and we all heal at our own speed. Plus, all injuries are different. For the average injury, it can take one to three treatments, though more complex injuries—like my cartilage damage—can take even longer.

Most doctors will do a set of injections over the course of several months, then take a break to let the injury heal. That’s because platelets continue to work for up to a year after they’re injected. At the one-year mark, you and your doc will likely reassess your pain and mobility.

Is there a scar?
Nope. Nada. Well, if you look reeealy close you can make out a pinprick-size dark dot where the needle was inserted. But if that’ll bother you, you’re not in real pain.

So, what’s it cost?
Thanks to PRP’s rising popularity among the elite athlete crowd, insurance providers are becoming more open-minded about the treatment. While my plan turned down my request for reimbursement on prolotherapy (more on that in the near future), it willingly coughs up dough for PRP.

Since I don’t pay the bills, I’m not sure how much it costs me in total. But according to a New York Times article on the treatment, it will run you about $2,000—pennies, compared to surgery. I pay $215 a pop, which covers the cost of the blood-spinning kit.

Who performs it?
Mad scientists. Kidding. Though your typical orthopedic surgeon may tsk-tsk your choice in alternative medicine, many are gradually becoming open to the treatment. Mine didn’t offer PRP, so I visit a pain center that specializes in noninvasive therapy.

But before you let just any doctor shoot your knee full of platelets, make sure he or she is qualified. PRP therapy is a relatively new area, and even experienced orthopedic surgeons may be PRP newbies. It’s best to go to someone who knows what they’re doing and has treated hundreds of other patients with the therapy. Here’s why: The success of PRP is as much about the injections as it is the doctor’s skill. Platelets swimming around in the wrong area aren’t going to do your injury much good.

What’s science say?
Not much. That’s because PRP therapy is still in its infancy, so there aren’t too many clinical studies about its effectiveness out there. Much of the hubbub out there is from word-of-mouth counts—people raving about their quick recoveries. Most researchers say it’s too soon to count PRP’s merits and further research and evidence is needed.

What possessed you to get PRP?
I plead insanity.

Really? I tried everything else outside surgery. Rest, anti-inflammatory drugs, physical therapy, and cortisone injections failed. When my doc suggested exploratory surgery (doctor speak for We have no idea why you feel this way), I opted for prolotherapy, then moved on to PRP.