Imagine a typical situation: you’re out for a run, take a wrong step, twist your ankle, and end up with a sprain. In many cases, all that’s required is rest, cold compression, elevation, and perhaps some anti-inflammatory medication. This is a great example of the body’s remarkable ability to heal itself.
While the human body is incredibly skilled at self-repair, there are times when injuries or conditions overwhelm its natural healing capacity. This is where regenerative medicine comes into play. This cutting-edge field of medicine is designed to enhance the body’s innate healing processes, using various techniques to speed up recovery, restore function, and reduce pain.
Platelet-Rich Plasma (PRP)
Regenerative medicine can be compared to gardening. Just like a garden requires three essential components—soil (the scaffold), seeds (the regenerative cells), and fertilizer (growth factors)—the body needs these same elements to heal tissues. For many minor injuries, the body already has the necessary scaffold (existing tissue structures) and seeds (repair cells). The goal of regenerative medicine is to act as the gardener, adding fertilizer to accelerate the healing process.
In this analogy, Platelet-Rich Plasma (PRP) serves as the fertilizer. PRP is rich in growth factors, such as platelet-derived growth factors and transforming growth factors, which help stimulate the body’s healing processes. PRP is obtained by drawing blood, centrifuging it to concentrate the platelets, and then injecting it directly into the damaged tissue.
PRP is harvested by first withdrawing blood from a patient. The blood is then centrifuged and PRP is obtained by withdrawing the PRP layer of the centrifuged plasma. This growth factor rich PRP is then injected into the injured tissue
This picture demonstrates how the red blood cells and plasma has separated from each other after centrifugation. The bottom layer of the plasma is rich in platelets.
PRP for Pain Management
Elbow Pain
Tennis Elbow: This condition causes pain and tenderness on the outside of the elbow, often from overuse or degeneration of the tendons that connect the forearm muscles to the bone.
Golfer's Elbow: Similar to tennis elbow but on the inner side of the elbow, this condition also results from tendon inflammation, typically from repetitive motions or stress.
Shoulder Pain
Rotator Cuff Tendinopathy: This involves degeneration or inflammation of the tendons and muscles stabilizing the shoulder. It’s commonly aggravated by overhead activities.
Shoulder Arthritis: The breakdown of cartilage in the shoulder joint, often due to osteoarthritis, causes pain and may lead to stiffness, creaking sounds, or limited movement in the joint.
Knee Pain
Knee Osteoarthritis: Just like shoulder arthritis, this condition involves the breakdown of cartilage in the knee joint, leading to pain and difficulty moving. It’s common in older adults or individuals with extra weight.
Ligament Injuries: The knee relies on ligaments for stability, and injuries to structures like the cruciate ligaments, meniscus, or collateral ligaments can cause significant pain and mobility issues.
Does PRP Always Work?
Think of PRP as a tool that supports tissue recovery—it helps, but it doesn’t guarantee results for everyone. While PRP has shown success in treating conditions like tennis elbow and golfer’s elbow, its effectiveness for other conditions, such as knee osteoarthritis or rotator cuff tears, can vary.
Several factors influence the success of PRP therapy:
Patient Factors: The severity and location of the injury, as well as the presence of repair cells at the injection site, can impact how well PRP works.
Injectate Factors: Different centrifuge machines and techniques produce varying concentrations of PRP, leading to differences in the quality of the treatment. This is a major reason why assessing PRP’s overall effectiveness can be challenging.
Technical Factors: The accuracy of the injection, the number of injections, and the timing between them all play a role in the treatment's success.
Is PRP Covered by Insurance?
PRP injections are often not covered by insurance, as they are considered experimental in many places. However, PRP therapy has been in use for over two decades, especially for musculoskeletal issues like tennis elbow, golfer’s elbow, and knee osteoarthritis. Despite its proven benefits, it’s important to be aware that out-of-pocket costs may apply.
Before proceeding with PRP therapy, it’s advisable to consult a healthcare professional with experience in regenerative medicine. They can provide tailored advice on whether PRP is the right treatment option for your specific condition.
Dr Christopher Liu is a renowned Pain Specialist in Singapore. He treats patients with Frozen Shoulder and pioneered an Ultrasound MSK Injection at Singapore General Hospital. Dr. Liu also treats patients with Musculoskeletal Pain, including hip and shoulder pain.