DOES PLATELET-RICH PLASMA (PRP) THERAPY WORK?
The human body does wonders when it comes to healing itself. It has the ability to adjust and adapt using intrinsic mechanisms and functions whenever it faces a certain disease or malfunction.
During recent years, medicine has advanced tremendously, and doctors have found ways to control and amplify those abilities, thus accelerating the process of healing oneself. One of the major medical advances that promote tissue healing is called “platelet-rich plasma (PRP) therapy”.
Platelet-rich plasma is a biological product made from your plasma and a concentration of your platelets. The idea of PRP therapy goes back to the 1970s when doctors used it to transfuse patients who had low platelet counts. Bit by bit, PRP treatment became more widely available, and it was developed to treat more complex conditions. Today, PRP is used to treat musculoskeletal injuries in sports medicine, as well as in the field of dermatology.
What Is Platelet-Rich Plasma (PRP) therapy?
To better understand PRP therapy, you must first know what Platelet-rich plasma is made of. There are two main components in PRP
- Plasma: The liquid fraction of your blood, mostly formed of water and proteins. It is the means through which your cells (i.e., red blood cells, white blood cells, and platelets) circulate within your vessels to reach all your organs.
- Platelets: a type of blood cells that serve the main function of forming blood clots. Platelets are also essential for your body’s healing functions.
To produce platelet-rich plasma, your blood will be first withdrawn and collected into a few plastic tubes. Next, the tubes will be put through a blood centrifuge machine to concentrate the platelets and remove unwanted cells and blood components. The resultant substance is the platelet-rich plasma.
Depending on the condition you’re being treated for, the PRP will be directly injected into the site of injury or disease. The body reacts by producing growth factors that further enhance your natural repair and healing processes. In many instances, your doctor might use ultrasound imaging to guide their injections, especially when PRP therapy is being given for musculoskeletal disorders.
PRP therapy is used to promote tissue healing and treat disorders affecting muscles, ligaments, and tendinous structures. Lately, platelet-rich plasma is also being increasingly used in dermatology, particularly for tissue restoration, wound healing, getting rid of scars, revitalizing skin, and treating hair loss.
What conditions are treated by PRP injections?
As we previously discussed, the use of PRP therapy is becoming increasingly popular and is not limited anymore to one medical field. Here are some conditions that can be treated using platelet-rich plasma:
- Thrombocytopenia: It is defined as an abnormally low platelet count, and it can result from many diseases. Given the high concentration of platelets in PRP injections, doctors first appreciated their value in the field of hematology, wherein they transfused thrombocytopenic patients with this platelet-rich product.
- Surgeries: PRP therapy is being progressively utilized in cardiac, pediatric, urologic, and plastic surgeries. The rationale behind this is the excellent homeostatic and anti-inflammatory effects of platelet-rich plasma.
- Musculoskeletal diseases and injuries: One of the major uses of PRP treatment is decreasing the pain associated with different musculoskeletal diseases, mainly chronic tendinosis (the degeneration of tendons from chronic overuse). This includes conditions like tennis or golfer’s elbow, chronic patellar tendinosis, and Achilles tendinosis. Another condition that can be treated with PRP therapy is osteoarthritis, which is a disease that destroys your joints. Platelet-rich plasma therapy was also shown to augment the healing process after musculoskeletal injuries such as tendon rupture, rotator cuff tears, and joint injuries.
- Dermatological conditions: The application of PRP therapy in cosmetics has caught the attention of many dermatologists. In fact, PRP injections were found to induce the proliferation and activation of fibroblasts, which are cells that play a key role in wound healing and tissue regeneration. Platelet-rich plasma also promotes the synthesis and deposition of collagen, in addition to the formation of blood vessels and adipose (fat) tissue, all of which are principal factors in cosmetics. This has allowed PRP therapy to play a role in reducing scars (e.g. post-surgical scars, burns, acne scars, etc.) and improving overall skin health.
- Hair loss: The latest use of PRP therapy is in the form of hair injections to stop hair loss and restore hair growth. As of 2006, PRP therapy has been considered a revolutionary curative treatment for conditions that cause hair loss, namely androgenetic alopecia and alopecia areata.
How is the PRP procedure done?
Platelet-rich plasma therapy is performed in three simple steps:
- Blood is withdrawn from one of your veins and stored in anticoagulated tubes to avoid blood clotting. The procedure requires only a small amount of your blood (60-100 ml)
- The tubes are put into a centrifugation machine which separates different blood components and concentrates the platelets to obtain the platelet-rich plasma.
- The obtained PRP is injected into the site of disease or injury, such as joints, tendons, or the scalp (for hair loss).
The procedure does not require any anesthesia, as it is neither invasive nor painful. It is similar to the process of blood donation and is not at all uncomfortable to the extent that you might require any sort of sedation. Nevertheless, local anesthesia might be sometimes applied to manage any mild discomfort in patients who don’t tolerate needle injections well.
The whole procedure from blood collection to PRP injection takes around two hours and is done on an outpatient basis (i.e., in the clinic). You can go back to your normal life routine right after the platelet-rich therapy treatment, although, you might want to avoid any strenuous activities in the immediate 24 hours following your procedure.
How to prepare for PRP therapy?
Your doctor will clearly explain to you how you can prepare for your platelet-rich plasma therapy during your first office visit. You might be asked to do the following:
- 1 month before PRP injections, you need to stop steroid injections if you’re on them
- 2-3 weeks before PRP injections, do not donate blood or plasma in order to have a sufficient amount for your procedure
- 1-2 weeks before PRP injections, stop blood-thinning agents and systemic steroids
- 3-4 days before PRP injections, stop anti-inflammatory drugs
- On the day of PRP therapy, drink lots of water and have a nutritious breakfast
What to expect during recovery after PRP injections?
After a PRP injection, doctors advise that patients limit their activity and rest for the remaining part of the day. In the couple of days following your procedure, avoid any extensive use of the injected site, particularly when it comes to joints. Nevertheless, movement is highly encouraged as it promotes joint recovery by allowing further absorption of the platelet-rich plasma into the surrounding tissues.
- During the first 3 days after your PRP injections, you might feel some pain at the site of injection. No need to worry, this means that your body is healing.
- It is important to stay hydrated early after the procedure to help with the healing process.
- Do not take any drugs after your treatment, unless clearly advised by your doctor. Many medications can impair healing and bring about several adverse effects, so always ask your physician before taking anything.
- Avoid using ice or heat pads at the site of injection for the first 3 days after your PRP injection. Similarly, taking hot baths, going to a sauna, using tanning beds are all forbidden early after the procedure. You shouldn’t shower in the immediate 24 hours after your PRP therapy.
- After the third day, you can progressively step up your activities and go back to your exercise routine. At this point, if you felt any discomfort, you can apply ice to the treated area for around 20 minutes up to four times a day. You can also use anti-inflammatory agents in case of pain or discomfort.
- During the first two weeks after your procedure, it is recommended that you keep away from alcohol, caffeine, and smoking
- One month after your procedure, schedule a follow-up session with your doctor to ensure that things are going as they should and recovery is achieved.
When can you start seeing results after PRP therapy?
For musculoskeletal disorders, like joint injuries and tendinosis, PRP treatment might need a few weeks to start taking effect. As for hair loss treatment, you should start seeing results one month after your PRP injection. Still, it might take up to 3-4 months to see the full results you are expecting. You might need up to 3 sessions (one month apart) to obtain the best results. This is largely due to your natural hair growth cycle
What are the possible side effects of PRP therapy?
PRP therapy comes in the form of injections and thus carries a small risk of side effects. Since the injected product is autologous (i.e., obtained from your own body), the risk of having an allergic reaction is extremely low. The adverse effects of this treatment are particularly due to the injection itself, rather than to the PRP product. These can include:
- Local Infection
- Nerve injury
- Tissue injury
- Pain at the injection site
Your doctor will discuss the probable side effects with you and will guide you through the steps taken to avoid them.
How much does PRP therapy cost?
The price of PRP therapy can vary a lot and it mostly depends on the condition being treated. PRP treatment for hair loss is a bit more expensive than those used for musculoskeletal pain. However, all in all, PRP therapy is affordable when considering how beneficial it is. Costs are mainly paid out of one’s own pocket, as only a few insurance companies cover the costs of PRP injections at the moment.
What does the future of PRP therapy hold?
The use of PRP injections is being broadly researched as it has shown strong healing potential in many musculoskeletal problems as well as dermatological conditions. Platelet-rich plasma currently offers encouraging results and is expected to ultimately guide the development of exceptional therapies.
Meanwhile, healthy amounts of caution should be taken until dyed-in-the-wool clinical evidence is ascertained. Ongoing research is being conducted to investigate the most ideal techniques of preparation and use to ensure faster and more efficient healing.
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