Recently, a client was thinking about PRP (platelet rich plasma) therapy for her shoulder and asked us at Back to Motion what we thought. It was then that we realized that we were not sure what to think.
Anecdotally, we each have heard stories of success and of failure with the treatment and I have even had a family member ask me if I had heard about the “new treatment” that heals injuries with products from your own blood. We decided to research the therapy since we had not seen any facts regarding the procedure or the typical outcomes. We learned that PRP is a serum derived from blood drawn from the client that has been separated to contain just the parts used for healing like platelets and growth factor. This is then injected into the injured joint, tendon or ligament to facilitate healing and regrowth of tissue.
While the research is sparse and inconclusive, we have been able to gain some insight into how PRP can be successful. There are several factors that may influence one’s response to PRP and should be included in the discussion with your physician when deciding how your treatment should proceed. The first is the serum itself. There is no standardization of what is in the serum or how it is prepared, so you just want to feel your physician has given consideration to what is required to provide the most benefit possible. The second factor is how the injection is given. Studies have shown that using ultrasound or fluoroscopy to guide the injection yields a more positive outcome by delivering the serum to the appropriate area. Finally, you want to have a good understanding of what to do after the injection. This usually consists of a few days rest, followed by gentle stretching, then transition to a program that facilitates strength and function of the healing tissue.
There are two other aspects of PRP to consider when deciding if it is right for you. PRP is not intended to be a quick fix as is a cortisone shot. The studies that demonstrated favorable outcomes saw a difference in benefit from the traditional treatment six months to a year after the treatment. In addition, PRP has not been in use long enough to know if there are any long term effects that may be detrimental. All in all, the decision to pursue PRP as a treatment is a personal one. The risks and benefits should be carefully discussed with a physician and you should feel confident in his or her procedures before making a decision. A discussion with your physical therapist regarding your condition will help you decide if conservative treatment will be effective or if a more aggressive approach, such as PRP, is warranted.
By Lorienne Fisher PT DPT