Platelet Rich Plasma (PRP)
Platelet-Rich Plasma (aka PRP) is blood plasma that has been enriched with platelets. As a concentrated source of a patient’s own platelets, PRP contains (and releases to the environment where it is placed) several different growth factors and other cytokines that stimulate healing of bone and soft tissues.
This concept of assisting a patient’s own healing process dates back to the ancient Roman days. People with chronic unrelenting painful musculoskeletal conditions (like gladiator shoulders!) were treated by stabbing the painful areas with a hot poker from the fire pit. Low and behold, when the burn healed, frequently the chronic painful condition improved. Most of our present-day patients wouldn’t be much in favor of such a brutal procedure!
This concept, however, evolved in the 1930’s, and then gained ground in the 1950’s scientific community, intoprolotherapy (aka proliferation therapy). Here irritants (such as a concentrated sugar solution) would be injected in and around these painful musculoskeletal conditions resulting in in inflammatory response. Similarly to the “Roman experience,” when the inflammatory response resolved, often the painful condition did as well, but it often required several treatments.
It appeared that when the body received the appropriate signal (burns or caustic substances in the above examples) it sends the repair mechanisms we all have within our incredible bodies to restore the painful area back to health. Many of these exact signals have since been identified such as growth factors and cytokines (as well as a host of others) – all found in our plasma. This has led to the concept of PRP (which technically makes it a form of prolotherapy as is cellular therapy such as Stem cells which will be covered in another section).
When PRP is performed, it generally takes less than an hour. The patients blood is first drawn – generally 30 – 60 milliliters. The PRP is then prepared in the lab using a variety of centrifugation techniques. The final product is then injected in and around the painful site (often with a small amount of lidocaine( a numbing medication). While light activity is advised the day of the procedure, within 24 – 48 hours normal activities of daily living including athletic training can be resumed. There is generally minimal discomfort and many report little to none. The healing process begins within days and continues for weeks.
Many professional athletes, including Tiger Woods and Pittsburgh Stealers’ Hines Ward have undergone PRP therapy with great success (not to mention a legal alternative to the many questionable substances used by my competitive athletes). Isn’t it time you took advantage of these treatments for painful musculoskeletal conditions previously only available to the “rich and famous?”