PRP therapy explained in plain words
Many patients hear the term PRP therapy for the first time in my practice and want to know what actually happens. In this article I explain the method step by step: what is in the blood, how it is prepared, why I inject under ultrasound — and where the limits lie.
In short
For PRP therapy (platelet-rich plasma) I take blood from a vein in the arm and prepare it in a centrifuge. In doing so I obtain that fraction in which the platelets and their growth factors are concentrated. This I inject under ultrasound control exactly where the findings are — at an irritated tendon insertion, for example. What is introduced is not a foreign agent, but a prepared component of your own blood.
What platelets and growth factors are
Blood consists of a liquid part, the plasma, and of cells: the red blood cells for transporting oxygen, the white blood cells for defence and the platelets (thrombocytes). Most people know the platelets from a different context — they see to it that a wound seals and that a bleeding comes to a stop.
But platelets can do more. Inside them they store proteins that are called growth factors: messenger substances that the body releases in an injury and that take part in the natural repair processes. They attract cells, stimulate them to divide and steer the remodelling of tendon, cartilage and connective tissue.
This is exactly where PRP therapy comes in. The abbreviation PRP stands for platelet-rich plasma. The thought behind it is plain: if these messenger substances are needed at a damaged site, they are brought there in concentrated form. They deliver a signal to the tissue — new tissue does not arise from that by itself.
How the preparation works
At the beginning there is an ordinary blood sample from a vein in the arm, as you know it from a blood test. The tube then goes into a centrifuge. Through the rapid spinning the components separate according to their weight: the red blood cells at the bottom, the plasma at the top and, in between, that layer in which the platelets are concentrated.
From this separation I take the platelet-rich part. It is not mixed with a medicine. The blood stays in a closed system, does not leave the practice and is used again in the same session.
Why I inject under ultrasound control
An irritated tendon insertion, a partial tear or a narrow joint space are small targets; under the skin they cannot be seen and often cannot be felt reliably. On ultrasound I show the tissue and follow the tip of the needle in real time. In this way I place the preparation where the change is and avoid vessels and nerves.
An injection by feel may not reach the spot; then the treatment remains without effect. Ultrasound is available to me in the practice and works without radiation exposure.
Which complaints I use PRP therapy for
- Irritation of a tendon insertion — above all epicondylitis lateralis (tennis elbow) and epicondylitis medialis (golfer's elbow); more on this on the page about the treatment of tennis elbow and golfer's elbow.
- Partial tears of tendons — at the rotator cuff of the shoulder, for instance, when the tendon is torn but not completely severed; for the distinction see rotator cuff tear.
- Cartilage complaints — with beginning wear, for example in shoulder osteoarthritis or wrist osteoarthritis, when the pain under load is in the foreground.
What these pictures have in common is that the tissue is irritated or affected, but still intact in its structure. PRP therapy never stands on its own; it is one building block alongside physiotherapy, an adjusted load and — depending on the findings — shockwave therapy.
What the method cannot do
A completely torn part of a tendon does not grow back through an injection, and an unstable joint does not become stable through it. Worn cartilage is not formed anew. In such cases an injection is the wrong route, and I say so openly.
The scientific evidence carries different weight depending on the condition; some applications are better studied than others. The response is individual as well — a result cannot be assured.
Like every injection, this one too is a small procedure. A feeling of pressure or tension in the treated area is possible afterwards, as is a temporary increase in the complaints; a risk of infection exists with every puncture, small though it is.
How the decision is made together
Before every PRP therapy stands the assessment: first the detailed conversation, then the clinical examination. Ultrasound is available to me in the practice for this; where needed I arrange an X-ray or an MRI.
Only when the findings are clear do I put together a treatment plan: what contribution PRP therapy can make alongside the other measures and in which order the steps make sense. Whether it is an option for you depends on the findings; the decision we make together. All the details of the procedure can be found on the page about PRP therapy in Vienna.
Frequently asked
Frequently asked questions about PRP therapy
Cortisone is a medicine that dampens the inflammation and often relieves the complaints quickly, but changes nothing in the tissue itself. With PRP therapy I introduce a prepared component of your own blood, which contains growth factors and is aimed at the repair processes in the tissue. Both injections have their place. Which of them makes sense in an individual case I decide together with you on the basis of the findings.
Taking the blood is like an ordinary blood sample from the arm. You feel the puncture of the injection; how clearly depends on the tissue being treated — at an irritated tendon insertion it is more unpleasant than in a joint. Afterwards a feeling of pressure or tension can occur, which subsides again. Cooling helps. What you should pay attention to in the time afterwards I discuss with you.
You do not have to come fasting. Drink enough beforehand, that makes taking the blood easier. It is important that I know about blood-thinning medication and about anti-inflammatory painkillers that you take. Please also bring everything you have: doctors' letters, previous reports and X-ray, CT or MRI images. A referral is not necessary.
With a complete tendon tear, with an unstable joint and with far advanced wear of the joint I expect no useful contribution from an injection; here I discuss other routes with you. An acute infection, a known clotting disorder or a disease of the blood also speak against it. That is why the assessment always comes before the treatment.
Dr. med. Martin Eigenschink
Specialist in Orthopaedics and Traumatology · Specialist in elbow, shoulder and hand surgery
Surgical and conservative treatment of the elbow, shoulder and hand, preferably minimally invasive. In my practice at the Orthozentrum Döbling I use ultrasound, shockwave therapy, magnetic field therapy and PRP therapy where the findings allow. More about my background
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Medical notice: The contents of this page serve as general information. They do not replace a medical examination, diagnosis or individual advice. Medicine is a constantly evolving field — despite careful research, no guarantee can be given that the content is fully up to date.