Platelet Rich Plasma (PRP) Injection

Natural Injections to Heal Damage and Reduce Inflammation

Table of Contents
View All
Table of Contents

Platelet-rich plasma (PRP) is a treatment used for a variety of common orthopedic conditions. PRP is a concentration of platelet cells taken from your blood, and these platelets have growth factors that may help in the healing process of chronic (long-term) injuries.

Growth factors are chemicals that signal the body to initiate a healing response. By injecting PRP into areas of an injury, the hope is to stimulate and optimize your body's ability to heal chronic conditions. PRP contains a high concentration of platelets, other blood cells important in healing, and growth factors.

This article provides an overview of what PRP injections are, what they’re used for, how they work, and what to expect when receiving them.

Insulin separated from blood in container
 

What Are PRP Injections Used For?

PRP has been used in operating rooms for several decades to help with wound healing, and to stimulate bone formation in spinal fusion surgery. Recently, PRP has been used in outpatient settings for the treatment of common overuse conditions including:

  • Achilles tendonitis
  • Rotator cuff tendonitis
  • Tennis elbow
  • Patellar tendonitis

Some doctors seem to use PRP for just about any condition, while others are more selective.

There is limited data about many conditions for which PRP may be helpful, and only a few conditions for which it has been shown to provide some benefit.

How to Prepare for a PRP Injection

Your healthcare provider will give you specific instructions on how to prepare for your PRP injection. As part of the instructions, you may be told to:

  • Stop taking any non-steroidal anti-inflammatory medications (NSAIDs) seven days before the procedure (you may also be told not to take them for seven days after).
  • Bring someone with you to drive you home (for lower extremity injections).
  • Prepare to use crutches for one to two days after a lower extremity injection.
  • Eat a full, healthy breakfast on the day of the procedure and drink lots of water.

If you have a medical condition that requires you to take chronic steroids or blood-thinning medications, you may need to work with your healthcare provider to gradually discontinue them in the weeks before the PRP injection.

How Well Do PRP Injections Work?

Studies show that PRP can help increase certain growth factors that are important in the healing process. However, it is unclear if this makes any difference in healing when PRP is injected into an injured part of the body.

Clinical studies that have been done so far do not clearly demonstrate if PRP is more effective than other treatments.

While there are reports of cases of success, it is not known if these successes are better or worse than other standard treatments. Currently, investigations are underway to determine if PRP is more helpful than other treatments for chronic tendonitis.

PRP has been shown to have some beneficial effects for tennis elbow, Achilles injuries, and even knee arthritis. Unfortunately, these are relatively small studies that follow the patients for a relatively short duration. Because of this, most doctors, and definitely most insurance companies, consider PRP to be experimental.

It is important to remember that even though there are some success stories and small studies that show benefits, more scientific evidence is needed to clarify if PRP lives up to the claims.

How Long do PRP Injections Last?

A single dose of PRP can last up to one year or longer. This sustained efficacy has been seen in studies of PRP injections for knee osteoarthritis and chronic low back pain. How long PRP treatment lasts may also depend on the area being treated, and the number of doses that are given.

PRP Injection Procedure Process

PRP injections can be done in a physician's office. The procedure takes about 30 minutes in order to withdraw the blood, spin the blood in the centrifuge, and inject the PRP into the injured area.

Finding a physician who provides PRP injections can be a challenge, but most commonly these are offered by orthopedic physicians who specialize in the care of chronic sports injuries. 

How PRP Is Obtained

PRP is obtained from the patient who is being treated. Blood is withdrawn from a vein in the patient's arm and the blood is placed in a centrifuge, a machine that spins at a high speed to separate the different types of blood cells.

The physician extracts the platelet-rich portion of the blood and injects this into the area of injury. There is not just platelets in the concentrated layer of the "spun" blood, but also other important growth factors, plasma, and some red blood cells.

How PRP Is Injected

PRP injections are given as soon as the blood has been spun and the platelets separated. Some physicians may choose to add an "activating agent," usually either thrombin or calcium chloride, while some inject just the platelets. Studies have shown that the tendons being injected can also activate the PRP, so the activating agent may not be necessary.

There is no clear science to justify a particular quantity of PRP and the number of injections needed. Most physicians perform one injection, although sometimes PRP injections are given as a series of injections over a span of several weeks.

Are the Injections Painful?

There is some discomfort associated with both acquiring the blood to inject, and for the actual injection itself. Both parts of the procedure involve placing a needle through the skin. There are anesthetics that can be given to help alleviate some of the discomfort associated with placing a needle into the skin. The relief found from a PRP injection is not immediate, often like what people experience with a cortisone injection.

Side Effects

Side effects are uncommon, but they are possible. Whenever a needle is inserted through the skin, an infection can occur. The other more common side effect of PRP injections is an increase in inflammation and pain after the injection.

PRP injections are not recommended in individuals with bleeding disorders, those taking anti-coagulation medications (e.g. warfarin), or those who have cancer, active infections, or are pregnant.

How Much Do PRP Injections Cost?

PRP injections are not covered by most insurance plans, so there is usually a fee for providing this service. If your insurance does not cover these injections, you can try to appeal to the insurance provider. But, because there is little scientific evidence to support PRP use, the likelihood of coverage may be low.

The cost of a PRP injection varies from a few hundred to a few thousand dollars, depending on the area being treated. In 2019, the average cost of a single PRP injection for ankles was $712, while a single injection for hips was $1,712. The average cost of a PRP treatment for any body area was $1,000.

This can be quite pricey, particularly considering that many providers recommend multiple PRP injections over time. While there is no guarantee, you may be able to negotiate a reduced price, or work out a payment plan with your PRP provider.

Summary

Platelet-rich plasma (PRP) is a therapy used to treat chronic injuries, like tendonitis and tennis elbow. The therapy involves withdrawing a patient's blood, withdrawing platelets from the blood in a lab, then injecting the platelet-rich plasma into the site of the injury. It's not entirely clear how effective PRP is for chronic injuries, if at all. Not to mention, the treatment is not typically covered by insurance. Since there is a low risk of side effects, it may be worth trying PRP for a chronic injury if other treatment options haven't helped.

14 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Patil P, Jadhav M, Suvvari T, Thomas V. Therapeutic uses of platelet-rich plasma (PRP) in sport injuries - a narrative review. J Orthopaed Rep. 2024 Jun;3(2):100287. doi:10.1016/j.jorep.2023.100287

  2. Manini D, Shega F, Guo CF, Wang YX. Role of platelet-rich plasma in spinal fusion surgery: Systematic review and meta-analysis. Adv Orthop. 2020 May;2020(1):8361798. doi:10.1155/2020/8361798

  3. Padilla S, Orive G, Sanchez M, Anitua E, Hsu WK. Platelet-rich plasma in orthopedic applications: evidence-based recommendations for treatment. J Am Acad Orthop Surg. 2014;22(8):469-70. doi:10.5435/JAAOS-22-08-469

  4. Stanford School of Medicine. Platelet rich plasma (PRP) injections - Information and instructions for patients.

  5. Northeast Knee and Joint Institute. Before and after PRP procedure guidelines.

  6. Hussain N, Johal H, Bhandari M. An evidence-based evaluation on the use of platelet-rich plasma in orthopedics - a review of the literature. SICOT J. 2017 Oct;3(1):57. doi:10.1051/sicotj/2017036

  7. Mohammed S, Yu J. Platelet-rich plasma injections: An emerging therapy for chronic discogenic low back pain. JSS. 2018 Mar;4(1):1-8.

  8. Bansal H, Leon J, Pont J, Wilson D, Bansal A, Agarwal D, Preoteasa I. Platelet-rich plasma (PRP) in osteoarthritis (OA) knee: correct dose critical for long term clinical efficacy. Sci Rep. 2021 Feb;11(1):3971. doi:10.1038/s41598-021-83025-2

  9. Yale Medicine. Platelet-rich plasma (PRP) injections in sports.

  10. Dhurat R, Sukesh M. Principles and Methods of Preparation of Platelet-Rich Plasma: A Review and Author's Perspective. J Cutan Aesthet Surg. 2014;7(4):189-97. doi:10.4103/0974-2077.150734

  11. Vilchez-Cavazos F, Millán-Alanís JM, Blázquez-Saldaña J, et al. Comparison of the clinical effectiveness of single versus multiple injections of platelet-rich plasma in the treatment of knee osteoarthritis: A systematic review and meta-analysis. Orthop J Sports Med. 2019 Dec;7(12):1-9. doi:10.1177/2325967119887116

  12. Raeissadat SA, Rayegani SM, Hassanabadi H, et al. Knee osteoarthritis injection choices: Platelet-rich plasma (PRP) versus hyaluronic acid (A one-year randomized clinical trial). Clin Med Insights Arthritis Musculoskelet Disord. 2015;8:1-8. doi:10.4137/CMAMD.S17894

  13. Magruder M, Caughey S, Gordon A, Capotosto S, Rodeo S. Trends in utilization, demographics, and costs of platelet-rich plasma injections: A ten-year national investigation. Phys Sportsmed. 2024 Feb;52(1):89-97. doi:10.1080/00913847.2023.2178816

  14. Harvard Health Publishing. Can platelet-rich plasma injections heal your joints?.

By Jonathan Cluett, MD
Jonathan Cluett, MD, is board-certified in orthopedic surgery. He served as assistant team physician to Chivas USA (Major League Soccer) and the United States men's and women's national soccer teams.