Can Platelet Rich Plasma (PRP) Speed up the Healing Process?

Introduction 

Although its use remains somewhat controversial, the selection of platelet-rich plasma (PRP) as a means by which to help injuries heal faster and more effectively has gained much popularity.  Instead of (or in addition to) treating physical injuries with physical therapy, medications and surgery, some people have opted to use PRP. 

Most notably in relation to its usage by famous athletes (e.g., Tiger Woods), PRP has been credited with helping athletes return more quickly to their sports, after suffering impromptu cases of chronic tendon injuries, torn muscles, sprained knees, etc.  

Despite the many accolades, and the scientific support and testimonials it has received, PRP is still burdened in the eyes of some people with too many unanswered questions, studies that have yet to be conducted on its behalf, and a public that is mostly uninformed about this rather unusual treatment option.  

Platelet Rich Plasma--What Exactly Is It?

Blood is not only made up of a liquid part called “plasma,” it also contains solid parts:  white cells, red cells, platelets, etc.  One of the most important roles of platelets is the ability to help blood clot, a natural mechanism that prevents bleeding to death when a cut or an injury takes place. 

Yet another role of platelets is their capacity to contain/distribute something called “growth factors,” special types of proteins that can greatly assist in the healing process of injuries.  

Platelet-rich plasma, as the name suggests, is natural plasma that has been greatly enriched with extra platelets.  In fact, the growth factors (and the platelets that contain them) in these plasma concentrations may be as much as 5 to 10 times their normal count.  

In order to prepare a batch of platelet-rich plasma, a patient must provide a fresh sample of blood.  Platelets are then picked or sorted out of blood cells; their concentration is subsequently enhanced by using centrifugation.  The additional platelets gathered or culled this way are then mixed with the original sample of blood.  

How Does Platelet-Rich Plasma Work?

As of this time, no one is quite sure how platelet-rich plasma works in regard to its use as a “healing process” enhancer or speeder-upper.  The most obvious physiological explanation is that the growth factors involved should be given most (if not all) of the credit, but that has yet to be confirmed through formal clinical studies and reproducible experiments. 

If a wound or injury exists, platelet rich plasma is introduced into the area using one of two preferred approaches.  The first option involves carefully injecting PRP directly into the injured tissue.  

An Achilles tendonitis situation (something tennis players & joggers often succumb to), for example, might receive such a treatment, hopefully helping the patient more-quickly-than-usual overcome the inflamed, painful and swollen heel cord that this type of injury entails. 

The patient might receive an anesthetic as well as PRP for such a procedure.  The anesthetic is provided because this treatment can lead, at least at first, to increased pain at the site; another slight drawback is the fact that the benefits expected may take several weeks to come to fruition.        

Platelet-rich plasma can also be a useful tool to speed up/enhance the healing process after undergoing surgery.  A torn tendon, for example, might benefit not only from surgical manipulation/restoration but also by being subjected to PRP during the surgical procedure.  Platelet-rich plasma may then be applied in a special form that involves stitching it directly into or around the torn tissue.   

Conditions That May be Helped by Platelet-Rich Plasma

Overview of Treatment

Because much is not yet known about platelet-rich plasma as a viable treatment option for injuries, studies are being conducted to more scientifically confirm the medical efficacy of PRP.  Unfortunately, though, because of the variability of the results thus far, more studies will be needed.  

Like other relatively new treatment options, many things can affect results, including the health of the patient at the time he/she receives treatment, what area of the body is being treated, and whether the injury is chronic (developed over time) or acute (the result of a recent accident or fall).    

Chronic Tendon Tears & Sprains

Platelet-rich plasma appears to be useful for the treatment of chronic tendon ailments/injuries; this is especially true about tennis elbow.  Other tendon-related injuries—i.e., inflammation of patellar tendons at the knee (otherwise known as “jumper’s knee”) or chronic Achilles tendonitis—may also benefit from PRP treatments but it’s not yet known whether PRP provides definite advantages over other treatment modalities.     

Acute Ligament & Muscle Injuries

Much of the press that has been given to platelet-rich plasma therapy has revolved mostly around sports injuries, including muscle and ligament-involving mishaps. PRP has frequently been used on professional athletes suffering from things like pulled hamstrings in the thighs and/or knee sprains.

Scientific studies may be needed, though, to confirm that PRP is ideally suited for these injuries.  The consensus among many athletes, though, is that PRP is definitely a beneficial option.         

Surgery

Platelet-rich plasma is also being used with more and more frequency in surgery.  PRP was first tried on patients undergoing torn rotator cuff tendons and anterior cruciate ligaments surgery to see if the healing process was pushed along or enhanced.  

Although conclusive statistics aren’t yet available, many people affirm that PRP will eventually be recognized as a valuable asset in the arena of surgery. 

Conclusion  

There are other uses, including arthritis of the knee and fractures, for PRP therapy that have yet to fully backed by clinical studies and formal experimentation.  The problem with establishing formal scientific justification/proof for anything, though, is that conducting studies and tests is both time-consuming and expensive.  

Beyond that, flaws in the study design or even the way the study is conducted can throw a wrench into the plans.  The point is that something may be very promising and yet, still, not get the backing of the scientific community for much longer than you’d expect. 

For a long time, for example, some doctors suspected that scurvy (a nasty disease that led to many complications and, eventually, death) was caused by a nutritional deficiency but, in spite of this fact, it took decades before the scientific community finally admitted that vitamin C-rich citrus fruits were the simple cure for scurvy. 

Why should it be surprising that many people now question PRP, not because they have scientific evidence that it doesn’t work, but because they demand evidence that they want someone else to pay for and obtain?     

The fact is that PRP therapy is a natural, low-risk option for which logical scientific explanations already exist; the fact that formal studies have yet to prove its efficacy isn’t proof of anything other than the fact that more studies need to be conducted. 

Meanwhile, the fact that some experts vouch for it and the fact that many of the people who have already used it have given it their thumbs up is reason enough for you to at least give it a chance, if the opportunity presents itself, you can afford to pay for it, and your doctor doesn’t object too strenuously.     

Copyright, 2018.  Fred Fletcher.  All rights reserved.

References & Resources 

https://www.emoryhealthcare.org/orthopedics/prp-therapy.html

https://www.spinemd.com/treatments/platelet-rich-plasma

https://www.painscience.com/articles/platelet-rich-plasma-does-it-work.php