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PRP Injections

What is PRP? The blood is made up of two essential parts: the formed elements and the plasma. The formed elements comprises 45% of our blood composition and contains red and white blood cells. The plasma makes up the other 55% of our blood and consists of vital proteins and nutrients that are essential to cell growth.

PRP stands for “platelet-rich plasma” and can be administered as an effective treatment for tissue or joint damage, ultimately treating your pain.
What does the PRP procedure look like? PRP is administered as an injection of concentrated blood platelets that contain and release growth factors to stimulate the recovery in non-healing injuries. For your PRP procedure, the physician will collect a sample of your own blood which will then run through a centrifuge to concentrate the plasma, resulting in a solution enriched with vital nutrients that contain regenerative and healing properties. After the PRP solution is obtained, it will be injected to the site of pain/injury. As a result, the platelets will release growth factors to build new healthy tissue and alleviate pain.

Who is PRP for? PRP can be a beneficial option for patients suffering with chronic muscle and/or joint pain that have been unresponsive to other methods of treatment. If you are a patient who has already tried one or more of the conservative care treatment options (anti-inflammatory medications, painkillers, rest, physical therapy, or cortisone injections) and still continue to experience pain, you may be a good candidate for PRP and should consult this option with your physician.

Research studies on PRP: The following results were obtained from a study conducted by a group of doctors that was published in the American Journal of Sports Medicine1:

A randomized control study followed 80 patients experiencing gluteus medius/minimus muscle pain with a mean age of 60 years old (female to male ratio was 9:1). Patients complained of pain and function problems lasting for an average of 14 months.

Patients were randomized to receive either a glucocorticoid shot or PRP injection.

No significant difference was observed in pain and function after 2 or 6 weeks. However, by 12 weeks, a significant improvement was seen in patients who received the PRP injections compared with the corticosteroid group.

“Patients with chronic gluteal tendinopathy >4 months, diagnosed with both clinical and radiological examinations, achieved greater clinical improvement at 12 weeks when treated with a single PRP injection than those treated with a single corticosteroid injection”

The same group of doctors pursued a follow-up study to see if the improved outcomes observed with PRP injections could be sustained long-term in the following study2:

  • A follow-up study was conducted to determine whether the improved outcomes for a leukocyte-rich PRP could also be observed at a 2 year follow-up, as measured by the modified Harris Hip Score (mHHS).
  • 80 patients were randomized to receive either a LR-PRP or corticosteroid injection (CSI). Patients had an average of 60 years and 90% were female. The average length of symptoms was >15 months.
  • The mean mHHS improved significantly at 12 weeks in the PRP group as compared to the CSI group. At 24 weeks, the LR-PRP group improved further than the CSI group.
  • In conclusion, “among patients with chronic gluteal tendinopathy and a length of symptoms >15 months, a single intratendinous LR-PRP injection performed under ultrasound guidance results in greater improvement in pain and function than a single CSI”, and this improvement after LR-PRP injection was sustained at 2 years.

Low back pain often originates at the sacroiliac joint (SI joint). The following study implements PRP as an effective treatment method for SI joint-related pain and was published in the Journal of Back and Musculoskeletal Rehabilitation3.

  • A case series followed 4 patients with SI joint instability and severe chronic low back pain who were treated with PRP injections. Outcome measures were collected at 12 month and 48 month follow-up.
  • The study found a “marked improvement in joint stability, a statistically significant reduction in pain, and improvement in quality of life. The clinical benefits of PRP were still significant at 4-years post-treatment”.
  • Conclusion: “PRP exhibits clinical usefulness in both pain reduction and for functional improvement in patients with chronic SI joint pain. The improvement in joint stability and low back pain was maintained at 1- and 4-years post-treatment”.

**NOTE: Receiving an injection from a PRP system with clearance indicates a device is safe in that it does not create a preparation that’s hazardous or dangerous, although FDA approved devices does not equal FDA “clearance”.**

References:

Fitzpatrick, J., Bulsara, M. K., O’Donnell, J., Mccrory, P. R., & Zheng, M. H. (2018). The Effectiveness of

Platelet-Rich Plasma Injections in Gluteal Tendinopathy: A Randomized, Double-Blind Controlled Trial Comparing a Single Platelet-Rich Plasma

Injection With a Single Corticosteroid Injection. The American Journal of Sports Medicine, 46(4), 933–939. doi: 10.1177/0363546517745525 2. Fitzpatrick, J., Bulsara, M. K., O’Donnell, J., & Zheng, M. H. (2019). Leucocyte-Rich Platelet-Rich Plasma

Treatment of Gluteus Medius and Minimus Tendinopathy: A Double-Blind Randomized Controlled Trial With 2-Year Follow-up. The American Journal of Sports Medicine, 47(5), 1130–1137. doi: 10.1177/0363546519826969 3. Ko, G. D., Mindra, S., Lawson, G. E., Whitmore, S., & Arseneau, L. (2017). Case series of ultrasound-guided platelet-rich plasma injections for sacroiliac joint dysfunction. Journal of Back and Musculoskeletal Rehabilitation, 30(2), 363–370. doi: 10.3233/bmr-160734

Dr. DeCaria is a double-board certified physician in anesthesiology and pain management medicine with extensive training and experience in treating chronic pain with trigger point injections.

Schedule your appointment with Dr. DeCaria of Revitalize Medical Center in Glenview and Evanton, IL, to take the first step towards a long-term solution for your chronic pain!

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