NATURAL RELIEF FROM JOINT PAIN
WE ARE NOW OFFERING PLATELET RICH PLASMA (PRP) THERAPY
We are thrilled to offer those who are suffering from osteoarthritis (aka degenerative joint disease, or ‘wear and tear’ arthritis) a new holistic option for treatment. It is one that uses your own natural healing factors to reduce pain. This therapy is called Platelet Rich Plasma, or PRP.
PRP FREQUENTLY ASKED QUESTIONS:
What are Platelets?
Platelets are cell fragments that float around our bloodstream. They repair cell damage whenever they come across it. When a person gets a cut, it is the platelets that go to the area of injury, activate, form a temporary clot, and promote the healing process.
What is Platelet Rich Plasma (PRP) Therapy?
PRP is not a new concept with early publications dating to almost 20 years ago. You may have also heard of many professional athletes successfully using PRP to accelerate the healing of their injuries. In one study, a 2108 meta-analysis looked at seven published studies of 908 patients for knee osteoarthritis. All showed that PRP was an effective option for the patients with knee arthritis. PRP is an autologous procedure which means we use your own blood from your own body, and then back to you, which greatly reduces risk or side effects.
How is PRP Therapy Done?
Platelet Rich Plasma (PRP) therapy involves drawing 1 or 2 ounces of your own blood, spinning it in a centrifuge, and harvesting the platelets and other healing factors . By placing these concentrated healing factors into a specific area, a variety of signaling chemicals and growth factors may help to accelerate tissue healing. It can be used in patients with muscle, tendon, ligament and joint injuries to stimulate healing and tissue regeneration.
Is PRP Like a Steroid (Cortisone) Injection?
PRP is different from steroid injections. Usually, when a patient gets a steroid injection, the steroid (often referred to as cortisone) which can temporarily reduce inflammation, is mixed with an anesthetic numbing medicine (ie. Lidocaine, Novocaine, etc.) and injected into the joint. It can certainly help, but there are side effects and limitations. The steroid can weaken the ligaments and tendons, especially if the physician doing the injection mistakenly injects directly into them. Also, too much of the numbing medicine can do damage to the cartilage lining the joint. It is generally not a good idea to do repeated steroid injections because they can be counterproductive in the long run.
Platelet Rich Plasma has the advantage of avoiding these potential problems. It has the potential to reduce inflammation more naturally and promote the healing of the cartilage, ligaments, and tendons, not their weakening. Injecting PRP into a tendon or ligament is not a problem. In fact, in some cases, it done intentionally to help heal a partial tear or tendonitis. The other advantage of PRP therapy is that it comes from your own body, so you cannot have an allergic reaction to it. (The only thing added to it is a small amount of anticoagulant so the blood does not clot in the harvesting process.)
Is PRP the Same as Stem Cell Therapy?
Platelet Rich Plasma therapy is not the same as Stem Cell therapy. While both are considered to be under the umbrella of Natural Regenerative Medicine, they are different. Stem Cell therapy involves taking special cells from your own fat cells or bone marrow (adult stem cells) or cells from an aborted baby (fetal stem cells). Also, sometimes this therapy is derived from the umbilical cords of live born babies. While Stem Cell therapy may show great promise for many people, it is extremely expensive and can be invasive. Platelet Rich Plasma therapy is much more accessible and affordable.
Which Joints Do You Inject?
Currently, we are focusing on knee and shoulder injections. It can also be done to treat plantar fasciitis, tennis elbow, etc. We are not able to do injections of the neck, back, ankle, wrist, or hip.
When Would You Not Do PRP Injections?
If you have had a joint replacement, you should not have a PRP injection of that joint, but you could have it done in other joints.
If you have severe (aka ‘bone on bone’) arthritis, while it is safe to get a PRP injection, we caution patients that there may not be enough cartilage in the joint to be healed to see benefit.
It has been suggested that a PRP injection of a joint immediately after arthroscopic surgery may promote more rapid healing of the joint, but this is something that you should discuss with your orthopedic surgeon.
How Should I Prepare for the PRP Injection?
You should discontinue anti-inflammatory medications, such as ibuprofen, naproxen, meloxicam or aspirin (you may continue the 81 MG dose), for 7-10 days prior to this procedure. The medications should not be used for 10 days after the injection, as they may interfere with the benefits of the procedure. Tylenol is appropriate for pain relief, if necessary. Lidocaine patches applied to the affected area also will not interfere with the PRP.
If you are taking anticoagulant medications, such as Coumadin (warfarin), Eliquis, Plavix, Xarelto, or Pradaxa, or take heparin injections, please contact the physician prescribing them to see if you can stop them a day or two prior to the injection.
What Happens on the Day of the Injection?
We ask that you arrive 15 minutes prior to your appointment to complete paperwork and for a member of our staff to prepare you for the injection. It is also recommended before any injection and blood draw that you are well hydrated and in good health. Any recent fevers or sickness should be told to one of our medical assistants.
If we are treating your knee, please wear clothes that will allow us easy access to it.
On the day of your appointment, a sample of your blood will be obtained. The blood will then be processed on site to create the PRP. A small needle will be introduced to the affected area and your PRP will then be injected. The overall purpose of this procedure is to stimulate tissue healing and regeneration. The entire injection process will take approximately an hour.
What Happens After the Injection?
After your PRP injection, it is common to experience some pain in that area. If this occurs, you can ice the area for 20 minutes every hour, as needed, in order to reduce the pain. You may also take one to two acetaminophen 500 mg tablets up to four times per day, as needed, but do not take NSAIDS (ibuprofen, naproxen, meloxicam or aspirin) for 6 weeks.
It is not uncommon to have increased pain in the region of injection for the first 7-14 days, as the injection stimulates an inflammatory reaction, which is a necessary component of the healing cascade. You may resume routine activities of daily living immediately. Any activity restrictions can be discussed on the day of your appointment. Please understand that PRP requires time and rest in order to work. Most patients will notice early benefits after 4-8 weeks that may continue to further improve over time.
If you develop signs or symptoms of infection, such as drainage from your injection site, swelling, redness, or fever, call your physician immediately.
What Should I Do After My Treatment?
● First 2 days - Relative rest, no heavy lifting; normal daily activities. Tylenol and ice.
● 2 days – 2 weeks: Daily stretching; daily activities as tolerated; no sports; no heavy lifting.
● 2 weeks - 6 weeks: resume strength training on your own or with your Physical Therapist (if preferred). Increase recreational activity as tolerated. Discuss sports-specific reintroduction with your physician.
● 6 - 8 weeks - Follow up appointment if any concerns 6 weeks – 3 months: Activity as tolerated. Use of tissue is encouraged to promote healing.
● 3 month - Follow up if any questions/concerns
● 3 - 6 months - Advance activity to goals; if not already achieved. Continue strength training.
● 6 months: Activity as tolerated.
Can PRP Injections Be Repeated?
We certainly hope that injecting a joint once is enough to help it heal sufficiently, they can be repeated if the effects wear off. We encourage patients to allow 6 months for the PRP to work before considering another injection.
What is the Cost of PRP Therapy?
For patients who have been members of our practice for at least a year, the cost is $500 for one joint, and $100 each for up to three additional joints.
For patients who are not members, or who have not been in the practice for a year, the cost is $1000 for one joint, and $200 each for up to three additional joints.
PRP must be used within 4 hours of preparing it, so it cannot be stored or frozen for future use.
What Else Can I Do to Improve My Arthritis Naturally?
It is always our goal to improve and maintain our patients’ health using as little prescription medication as possible. We recommend an anti-inflammatory diet, which is one that is as low as possible in highly processed foods, especially white sugar and white flour. We also encourage our patients to get as close as they can to an ideal body weight, which puts less stress on their spine and other joints, which makes arthritis worse.
We also suggest trying supplements, such as Glucosamine (with or without Chondroitin) 1500 mg daily, and/or Fish Oil 1000-2000 mg daily for a trial of 8 weeks to see if it helps. If it does, continue taking it. If not, discontinue. Turmeric is also a supplement that people feel can help reduce inflammation.
Topical treatments, such as Arnica or Menthol (Biofreeze) are always worth a try.
Please Let Us Know If You Have Any Questions, or Would Like to Schedule an Appointment to Discuss PRP Therapy.
