WHAT IS PRP?

Platelet Rich Plasma, or PRP is used to treat muscle bone and joint pain. Whether it's your hips, knees, hand/wrist, elbow, shoulder, foot/ankle or spine, PRP could be an option for you. 

 

 Platelets are pieces from cells called megakaryocytes which are produced in the bone marrow. Blood consists primarily of plasma (liquid), red blood cells, white blood cells and platelets. Platelets are best known for their importance in clotting blood, but they are also what triggers healing when an injury occurs. Platelets contains hundreds of different growth factors and cytokines essential to healing.

 

PRP can facilitate healing and decrease inflammation of tissue when the PRP mixture is introduced into the right location under precise guidance. Different locations and conditions in the body require different concentrations of platelets and leukocytes (white blood cells).

 

To make PRP, blood is drawn from the patient and mixed with a small amount of anticoagulant (so the blood does not clot). The blood is then placed in a centrifuge that separates the red blood cells, and the remaining platelets and plasma are then concentrated. The red blood cells are discarded. Depending on the location and condition, we will vary the concentration of platelets and leukocytes. This process, along with the injections, usually takes 30-40 minutes.

 

At the CAPRI clinic, we have done extensive research on the optimal PRP preparations for different conditions. We have a lab with a hematology analyzer so that we can measure the concentrations of the different components of our PRP.

 

A thorough assessment is perhaps the most important factor in PRP success so we can ensure we are treating the right area. Very often we will find that multiple areas need to be treated. Using the right concentration of PRP is also important, as this can vary for different areas and conditions. We also believe that image guidance by a skilled physician is important, in particular with tendon, ligaments and spine injections

FAQ

Pre PRP Instructions


Do not have a corticosteroid injection within 3 months before or after treatment. These injections will inhibit treatment success and we will not treat a patient who has had a cortisone injection within 3 months of their scheduled procedure. In the case that you have had a corticosteroid injection within the 3 months of your scheduled treatment please let us know as soon as possible so we can reschedule your procedure. Discontinue taking anti-inflammatories one-week prior to and 4 weeks following your treatment. These medications have shown to adversely affect the healing cells used in our cell therapies and may inhibit your treatment. Anti-inflammatories include orally and topically administered medications such as Aspirin, Advil, Motrin, Aleve, and Voltaren. Please avoid taking natural anti-inflammatories such as turmeric or using ice as well. Other medications that treat pain, like Tylenol, Tramadol and other narcotics are permissible. Baby aspirin for heart health is OK. Statins like Crestor, Lipitor, Pravachol, and Zocor should be avoided. Please only discontinue taking your statin medications if your doctor feels it is safe to do so. Please coordinate having someone else drive you home following the procedure. There may be some increased soreness following an injection that could inhibit your ability to drive safely. On the day of your procedure, please shower and wear clean clothes. This will reduce the risk of infection. You will be changed into our shorts, t-shirt, booties and a hair covering for the procedure to help prevent this as well. Please do NOT wear any perfume, cologne, scented lotions, or scented hair products. On the day of the procedure, we will proceed with your treatment only if it is safe to do so. If you show signs of infection (fever, chills, nausea) or if your blood pressure is too high we may need to reschedule your treatment. If you have high blood pressure, please take your regularly scheduled medication before your procedure. Please eat a light meal before your procedure. Have realistic expectations and be patient. A small percentage of our patients do not experience any relief from these treatments, however, the majority get a 50% reduction in pain or better. Our cell therapies encourage a natural healing process to take place. This takes time. Be patient. Although some experience relief within days, most won’t notice a difference until 8-12 weeks following treatment.




Post PRP Instructions


EXPECT POST-INJECTION SORENESS. You may experience added stiffness, soreness, pain and discomfort in the area(s) you had treated for a few days or weeks following treatment. Although some patients report no increase in pain, you may experience some increase in pain, or “flare-up,” especially during the first 24 hours after treatment. Our therapies stimulate healing by causing local inflammation, so soreness is a normal response, please do not panic. PLEASE COORDINATE HAVING SOMEONE ELSE DRIVE YOU HOME FOLLOWING YOUR PROCEDURE. There may be some increased soreness following an injection that could inhibit your ability to drive safely. DO NOT USE ANTI-INFLAMMATORY OR CHOLESTEROL-LOWERING (STATINS) MEDICATIONS OR ICE ON THE INJECTION SITE(S) FOR AT LEAST FOUR WEEKS AFTER TREATMENT. Medicines such as aspirin*, ibuprofen, Naproxen, or Aleve (either oral or topical) including natural anti-inflammatories, like turmeric, and/or ice may limit the benefits of treatment. Statins (Crestor, Lipitor, Pravachol, and Zocor) should be avoided as they have been shown to be harmful to the healing cells used in our cell therapies. Topical creams should also be avoided for 4 weeks after treatment. Corticosteroid injections should be avoided for 3 months after treatment. You may use heat for 15 minutes at a time along with gentle stretching to relieve discomfort. Using acetaminophen, narcotic pain medicines, or muscle relaxants may also relieve pain without interfering with the effect of the treatment. *Baby aspirin (81mg) for heart health is OK to use. IT IS CRITICAL TO REST TO ALLOW YOUR TISSUE TO HEAL. We recommend that you rest for a minimum of three days after treatment, which means minimal weight-bearing activity (minimize activities such as standing, walking, stair climbing etc.), this includes operating motor vehicles. After this time, we would like you to ease yourself back into normal activity of daily living as tolerated. Avoid heavy exercise or impact sports for the first 4-6 weeks after treatment. Physical activities such as walking, cycling, swimming and gentle stretches such as yoga are encouraged as tolerated after two weeks. The rehabilitative stretches and exercises you received should be started gradually, after two weeks, or as soon thereafter as you are comfortably able. A common setback is that people will feel better soon after the treatment then overdo it by deciding to catch up on all the manual work they need to do, such as yard work or housework. BE PATIENT WITH THE HEALING PROCESS AND CURB UNREALISTIC EXPECTATIONS. Although some patients notice a reduction in pain within a few days after treatment, most start to notice pain relief between 3-6 months. Most often, maximal pain relief is not experienced until 6 months after treatment. Repeating the treatment may be necessary to optimize benefits, especially for old chronic injuries or advanced, “bone-on-bone” arthritis.




Medications to avoid


Here is a list of the most common anti-inflammatories (NSAID) that you will need to discontinue for ONE WEEK prior to and ONE MONTH following your procedure. If you take any medications for any other purpose, please continue to take them like normal. For example, if you take medication for high blood pressure, please continue to take those like normal. If applicable, we would like you to continue taking baby aspirin for heart health as well.

Any Tylenol (Acetaminophen) product can be used as a substitute pain killer if necessary.

Common Anti-inflammatory Medications:

  • Ibuprofen (Advil, Motrin, Robaxasal)
  • Naproxen (Aleve)
  • Celecoxib (Celebrex)
  • Indomethacin
  • Ketoprofen or Ketorolac (Toradol)
  • Anaprox
  • Piroxicam
  • Sulindac
  • Topical NSAIDs (ie. Voltaren, diclofenac, Rub A535, etc.)

Common Natural Anti-inflammatories:

  • Turmeric
  • Boswellia
  • White Willow Bark Extract
  • Ginger Root Extract
  • Bromelain
  • Quercetin
  • Devil's Claw





 

PRE & POST PRP

Pre PRP Instructions


Do not have a corticosteroid injection within 3 months before or after treatment. These injections will inhibit treatment success and we will not treat a patient who has had a cortisone injection within 3 months of their scheduled procedure. In the case that you have had a corticosteroid injection within the 3 months of your scheduled treatment please let us know as soon as possible so we can reschedule your procedure. Discontinue taking anti-inflammatories one-week prior to and 4 weeks following your treatment. These medications have shown to adversely affect the healing cells used in our cell therapies and may inhibit your treatment. Anti-inflammatories include orally and topically administered medications such as Aspirin, Advil, Motrin, Aleve, and Voltaren. Please avoid taking natural anti-inflammatories such as turmeric or using ice as well. Other medications that treat pain, like Tylenol, Tramadol and other narcotics are permissible. Baby aspirin for heart health is OK. Statins like Crestor, Lipitor, Pravachol, and Zocor should be avoided. Please only discontinue taking your statin medications if your doctor feels it is safe to do so. Please coordinate having someone else drive you home following the procedure. There may be some increased soreness following an injection that could inhibit your ability to drive safely. On the day of your procedure, please shower and wear clean clothes. This will reduce the risk of infection. You will be changed into our shorts, t-shirt, booties and a hair covering for the procedure to help prevent this as well. Please do NOT wear any perfume, cologne, scented lotions, or scented hair products. On the day of the procedure, we will proceed with your treatment only if it is safe to do so. If you show signs of infection (fever, chills, nausea) or if your blood pressure is too high we may need to reschedule your treatment. If you have high blood pressure, please take your regularly scheduled medication before your procedure. Please eat a light meal before your procedure. Have realistic expectations and be patient. A small percentage of our patients do not experience any relief from these treatments, however, the majority get a 50% reduction in pain or better. Our cell therapies encourage a natural healing process to take place. This takes time. Be patient. Although some experience relief within days, most won’t notice a difference until 8-12 weeks following treatment.




Post PRP Instructions


EXPECT POST-INJECTION SORENESS. You may experience added stiffness, soreness, pain and discomfort in the area(s) you had treated for a few days or weeks following treatment. Although some patients report no increase in pain, you may experience some increase in pain, or “flare-up,” especially during the first 24 hours after treatment. Our therapies stimulate healing by causing local inflammation, so soreness is a normal response, please do not panic. PLEASE COORDINATE HAVING SOMEONE ELSE DRIVE YOU HOME FOLLOWING YOUR PROCEDURE. There may be some increased soreness following an injection that could inhibit your ability to drive safely. DO NOT USE ANTI-INFLAMMATORY OR CHOLESTEROL-LOWERING (STATINS) MEDICATIONS OR ICE ON THE INJECTION SITE(S) FOR AT LEAST FOUR WEEKS AFTER TREATMENT. Medicines such as aspirin*, ibuprofen, Naproxen, or Aleve (either oral or topical) including natural anti-inflammatories, like turmeric, and/or ice may limit the benefits of treatment. Statins (Crestor, Lipitor, Pravachol, and Zocor) should be avoided as they have been shown to be harmful to the healing cells used in our cell therapies. Topical creams should also be avoided for 4 weeks after treatment. Corticosteroid injections should be avoided for 3 months after treatment. You may use heat for 15 minutes at a time along with gentle stretching to relieve discomfort. Using acetaminophen, narcotic pain medicines, or muscle relaxants may also relieve pain without interfering with the effect of the treatment. *Baby aspirin (81mg) for heart health is OK to use. IT IS CRITICAL TO REST TO ALLOW YOUR TISSUE TO HEAL. We recommend that you rest for a minimum of three days after treatment, which means minimal weight-bearing activity (minimize activities such as standing, walking, stair climbing etc.), this includes operating motor vehicles. After this time, we would like you to ease yourself back into normal activity of daily living as tolerated. Avoid heavy exercise or impact sports for the first 4-6 weeks after treatment. Physical activities such as walking, cycling, swimming and gentle stretches such as yoga are encouraged as tolerated after two weeks. The rehabilitative stretches and exercises you received should be started gradually, after two weeks, or as soon thereafter as you are comfortably able. A common setback is that people will feel better soon after the treatment then overdo it by deciding to catch up on all the manual work they need to do, such as yard work or housework. BE PATIENT WITH THE HEALING PROCESS AND CURB UNREALISTIC EXPECTATIONS. Although some patients notice a reduction in pain within a few days after treatment, most start to notice pain relief between 3-6 months. Most often, maximal pain relief is not experienced until 6 months after treatment. Repeating the treatment may be necessary to optimize benefits, especially for old chronic injuries or advanced, “bone-on-bone” arthritis.




Medications to avoid


Here is a list of the most common anti-inflammatories (NSAID) that you will need to discontinue for ONE WEEK prior to and ONE MONTH following your procedure. If you take any medications for any other purpose, please continue to take them like normal. For example, if you take medication for high blood pressure, please continue to take those like normal. If applicable, we would like you to continue taking baby aspirin for heart health as well.

Any Tylenol (Acetaminophen) product can be used as a substitute pain killer if necessary.

Common Anti-inflammatory Medications:

  • Ibuprofen (Advil, Motrin, Robaxasal)
  • Naproxen (Aleve)
  • Celecoxib (Celebrex)
  • Indomethacin
  • Ketoprofen or Ketorolac (Toradol)
  • Anaprox
  • Piroxicam
  • Sulindac
  • Topical NSAIDs (ie. Voltaren, diclofenac, Rub A535, etc.)

Common Natural Anti-inflammatories:

  • Turmeric
  • Boswellia
  • White Willow Bark Extract
  • Ginger Root Extract
  • Bromelain
  • Quercetin
  • Devil's Claw





PRP APPOINTMENT OVERVIEW

CONSULTATION: At an assessment appointment the doctor will review your medical information and perform an orthopaedic exam on the areas you would like considered for treatment. You will have a chance to ask the doctor any questions you may have. This is when the doctors will collaborate with you to finalize the areas to be treated, so any joint you would like considered should be brought up at this  appointment. Please keep in mind that assessing certain areas may take more time:

  • Tendons, Joints & Ligaments Assessment - 30 minutes

  • Spine or Neck Assessment- 60 minutes

TREATMENT: Once in the procedure room, we will extract a sample of blood, typically from your arm. The blood will then be processed in a centrifuge to concentrate the platelets, and this concentrated solution will be injected directly into the areas discussed at the assessment. This is all completed under ultrasound guidance. After the procedure you may be provided with a prescription for a pain killer(Tramadol or Tramacet). You can try Tylenol extra strength and fill the prescription only as a last resort. We will contact you within a week after the procedure to check on your recovery and answer any questions you may have.es) 

  • Tendons, Joints & Ligaments PRP: 30-45 minutes

  • Spine or Neck PRP: 60-90 minutes