Platelet-Rich Plasma (PRP)
What is PRP ?
How does PRP work ?
PRP promotes healing of the damaged area, which means the pain will subside when the healing process is complete, (about 6 weeks after the injection). PRP injection at first may feel like re-spraining or re-bruising the joint or tendon.
WHO MAY BENEFIT?
All patients: from age 10-99 and at all levels of health. Some patients may require two or three PRP injections before they experience the maximum decrease in pain. About 80 % of the patients feel at least 60 % better after one – two treatments. About 10 % need a third or fourth injection. After each injection, schedule a six-week follow-up and determines whether additional injections are needed.
Sports: PRP is now accepted by most sports organizations.
The World Anti-Doping Agency has taken PRP off the list of prohibited substances. Professional and college athletic organizations (eg NFL and NCAA) allow their players to receive PRP treatment. PRP is used to return injured athletes back to the game quicker; it does not enhance their performance. Rather, PRP speeds-up the healing process and get patient back to baseline.
Work and Accidents: Stop working and living with Pain !
PRP is used to return injured back to the work / life quicker. PRP speeds-up the healing process and get patient back to their usual healthy condition.
Billing considerations: Insurance companies might not cover it. Few PPO or Work Comp third-party carriers are currently reimbursing for PRP injections. At present, PRP injections should be considered a direct cost to the patient. If the Surgical Center is used, there may be two fees, a Doctors Professional Charge and the Outpatient Facility Fee. When the insurance company doesn’t pay for the injection, the patients must pay the procedure fee directly to the practice and/or the outpatient facility. Some procedures can be done in the office, others at the ASC. Medicare / HMO: At this time, there is no HMO or assigned Medicare value and is a cash-pay procedure.
Equipment: The Single-Use Kits and Centrifuges are included in the charge. Fluoroscopy or Musculoskeletal Ultrasound may be used to guide needle placement and Anesthesia Sedation. These are extra charges.
Contraindications: for PRP injection are: Anemia; Hematologic Blood Diseases, Platelet Dysfunction; Blood Infections or Fever; Skin Infections; Malignancy; Allergy to Bovine Products if Bovine Thrombus is to be used.
Pre-injection guidelines: Be aware of and compliant with the following guidelines: (Discuss with the physician) No corticosteroids for 2 to 3 weeks before the procedure; Discontinue (NSAIDs) non-steroidal anti-inflammatory drugs at least week before PRP; No anticoagulation (eg Coumadin or Plavix) use 5 days before the procedure; Increase fluid intake in the 24 hours preceding PRP; Anti-anxiety medication may be required for certain patients.
Procedure: The procedure is very simple. The Pain Doctor is an Expert and a uses standard sterile technique, a small amount of venous blood is obtained from your arm vein and is transferred into the centrifuge machine, processed, and the PRP is extracted from the centrifuge. The skin is cleansed around the painful injection site.
With real-time image guidance (fluoroscopy, or ultrasound) and sterile technique, the PRP is injected into the appropriate painful area. PRP injections go right onto the joints / ligaments / tendons for healing and support. Physicians must find the source of the pain and inject the PRP into the appropriate pain location.
Complications: There is 0% chance of catching a blood disease, as this is 100% the patient’s own blood platelets and plasma.
Ankle and Foot Pain