Platelet-rich plasma (PRP) for chronic pain

How does platelet-rich plasma therapy work?

The body has a limited period during which it is dedicated to healing an injury — often called the “inflammation stage” of injury. After three to six months the body “gives up” on the injured tissue and moves on to other areas that need help. This is called the “chronic injury stage” as healing cells stop accumulating in the area and healing slows or stops.

The healing process of soft tissue problems such as chronic plantar heel pain and Achilles tendonitis or non-healing bone and cartilage injuries can be expedited by injecting cells that promote inflammation. This inflammation raises a red flag to alert the body to the injured tissue and kickstart the healing process.

These essential healing cells are already contained in your blood. The podiatrists at University Foot & Ankle Institute create PRP injections by isolating these healing components of your blood. We begin with a simple blood draw. The blood is then placed in a centrifuge to separate the components of your blood (platelets, plasma, red and white blood cells) and combine the platelets, growth factors, and cytokines into a concentrated healing injection. 

Cytokines are proteins that control inflammation and growth factors are proteins that (as their name suggests) promote the growth of new cells. The concentrated PRP is injected into the injured area to stimulate your body’s natural healing processes.

After the injection, you may experience minor pain for a week or two while the injected cells get to work. Several weeks later, however, the healing benefits begin to reduce inflammation and pain to a noticeable degree.

The benefits of PRP therapy 

Here at University Foot & Ankle Institute, we were one of the first to adopt PRP for treating foot and ankle conditions. Our physicians have also worked directly with scientists and manufacturers to develop new medical technologies.

We use PRP therapy due to its many benefits, such as:

• Accelerated healing: The growth factors released by PRP injection stimulate the recovery of the injured tissue, promoting faster healing and reducing downtime.
• Pain relief: Platelet-rich plasma injections effectively decrease pain by targeting inflammation and aiding the natural repair processes of the affected tissues.
• Minimally invasive: Unlike surgical options, PRP therapy requires no incisions. PRP is collected and administered using sterile syringes.
• Reduced reliance on medication: By addressing the root cause of the condition, PRP therapy can reduce the need for pain medication and anti-inflammatory drugs, minimizing potential side effects.
• Improved functionality: Patients often experience restoration of foot function and mobility, enabling a return to daily activities and improved quality of life.

PRP therapy for bone healing and cartilage repair

PRP treatment also shows promise in treating bone fractures and cartilage damage, conditions that traditionally have limited treatment options. The growth factors in PRP can accelerate bone healing, making it a valuable adjunct to surgical treatment for fractures. 

Similarly, in cases of osteoarthritis or cartilage injuries, PRP injections can help alleviate pain, improve joint function, and potentially delay the need for more invasive procedures like joint replacement.

PRP application in ligament and tendon injuries 

Ligaments and tendons, critical for joint stability and movement, are prone to injuries that can be debilitating. Traditional treatments often involve lengthy recovery periods, but PRP therapy offers an effective alternative. By injecting PRP directly into the injured site, we can significantly enhance the healing process. 

This process is particularly beneficial as part of the treatment of plantar fasciitis, Achilles tendonitis, and other chronic tendinopathies. PRP can reduce pain and improve function more quickly than conventional methods of treating these problems.

Enhancing surgical recovery with PRP 

Incorporating PRP modalities into surgical procedures has revolutionized post-operative recovery. Applying PRP during surgery can significantly reduce inflammation and promote faster healing of surgical sites. 

This is especially beneficial in complex foot and ankle surgeries, where recovery times can be extensive. Patients treated with PRP during surgery often experience reduced pain, quicker return to function, and improved overall outcomes.

What are the side effects of PRP? 

Following a PRP injection, it is common for patients to experience some discomfort at the site of the injection for up to three days. To manage this discomfort, ice and over-the-counter pain medications such as acetaminophen (Tylenol) are typically recommended. In some cases, the treating physician might prescribe stronger analgesics if necessary. It is important to avoid non-steroidal anti-inflammatory drugs (NSAIDs), as they can diminish the efficacy of the PRP treatment.

Since PRP therapy involves the use of the patient's own blood, adverse reactions are generally minimal. Bruising around the injection area is a common side effect, but like most other side effects related to PRP injections, it is usually temporary and tends to resolve on its own within a few days following the procedure. While complications are rare, there is a slight risk of infection at the injection site and bleeding, particularly for patients on anticoagulant therapy or those with bleeding disorders.

University Foot & Ankle Institute: rich in knowledge

We realize that our patients have busy lives and rely on our expertise to reduce pain and enable activity. We take this mission seriously.

Despite being highly skilled orthopaedic surgeons, University Foot & Ankle Institute’s doctors only turn to surgery as a last resort. At UFAI we firmly believe foot and ankle conditions should be treated as conservatively as possible, turning to more invasive methods only when necessary. Our “conservative treatments” deliver excellent results over 80% of the time. As a bonus, a conservative care approach is often considered the most cost-effective for the patient.

When conservative treatments such as splints, ice, rest, and painkillers are insufficient, we can move onto more advanced minimally-invasive treatment options. At University Foot & Ankle Institute those options may include the use of PRP, stem cell therapy, or extracorporeal shockwave therapy.

Our physicians have decades of combined experience using regenerative medicine and are internationally recognized experts using it to treat ankle and foot pain.

For a consultation, please call (877) 736-6001 or make an appointment online now.

University Foot and Ankle Institute is conveniently located throughout Southern California and the Los Angeles area. Our foot and ankle surgeons are available at locations in or near Santa Monica, Beverly Hills, West Los Angeles, Sherman Oaks, the San Fernando Valley, El Segundo, the South Bay, LAX, Calabasas, Agoura Hills, Westlake Village, Valencia, Santa Clarita, and Santa Barbara.

 

PRP FAQs

 

Platelet-rich plasma vs corticosteroid injections, what’s the difference? 

Autologous PRP (PRP developed from your own blood) provides long-term healing and is less likely to cause allergic reactions, making it a beneficial option for chronic conditions and for patients seeking a regenerative approach. Randomized controlled trials have shown slightly better efficacy of PRP over steroid injections over the long term.

 

However, PRP's effects can be slow to manifest, and multiple sessions may be required. 

 

On the other hand, cortisone injections offer quick relief from pain and inflammation by delivering potent anti-inflammatory medication directly to the affected area. Yet, the relief provided by steroid injections is usually short-term, and there are risks of tissue damage and weakening with repeated use.

 

Is PRP therapy painful?

The injection itself can cause a sensation similar to a standard shot, but because it's often administered to sensitive or injured areas, it might feel more painful to some people.

 

During the procedure, a local anesthetic may be used to minimize pain, although the area might still feel pressure or a stinging sensation.

 

Sources

Digiovanni BF, Nawoczenski DA, Malay DP, Graci PA, Williams TT, Wilding GE, Baumhauer JF. Plantar fascia-specific stretching exercise improves outcomes in patients with chronic plantar fasciitis. A prospective clinical trial with two-year follow-up. J Bone Joint Surg Am. 2006;88(8):1775-81.

Patel S, Dhillon MS, Aggarwal S, et al. Treatment with platelet-rich plasma is more effective than placebo for knee osteoarthritis: a prospective, double-blind, randomized trial. Am J Sports Med 2013;41:356–64.

Sathyendra KG, Dnyandeo Solankey R, Singh M, et al. Comparative study of local injections of autologous platelet rich plasma versus corticosteroid in management of chronic plantar fasciitis. Journal of Clinical Orthopaedics and Trauma. 2023 Aug;43:102225. DOI: 10.1016/j.jcot.2023.102225. PMID: 37520269.

Singh P, Madanipour S, Bhamra JS, Gill I. A systematic review and meta-analysis of platelet-rich plasma versus corticosteroid injections for plantar fasciopathy. Int Orthop. 2017;41(6):1169–81.