Better Health: Smart Health Commentary Better Health (TM): smart health commentary

Article Comments (1)

Platelet-Rich Plasma Injections: Much Ado about Nothing?

Runningshoes 300x254 Platelet Rich Plasma Therapy: Much Ado about Nothing?

Platelet-rich plasma (PRP) therapy became a hot topic among professional and recreational athletes after some studies suggested it could hasten wound healing and several high-profile athletes reported using it as they rehabbed from various injuries.  But recently, the news hasn’t been quite so good. For those not in the know, let’s do a quick review of the subject.

PRP therapy involves extracting and centrifuging a person’s blood to create a concentrated broth of growth factors and white cells, and then then injecting the stew directly into injured tissue. The growth factors supposedly promote healing.

PRP therapy has been used for numerous conditions including tennis elbow and pulls, sprains and strains of dozens of different muscles, tendons and whatnot.

The treatment became buzzworthy after animal studies showed that it fostered collagen and new blood vessel formation in the tendons of animals that had been surgically injured by scientists.

The buzz grew after reports surfaced that Tiger Woods used PRP therapy to treat a sore knee, NFL player Chris Canty used it for a hamstring injury, and itinerant MLB pitcher Cliff Lee used it for an abdominal strain. After these high-profile athletes claimed to be satisfied with the results, recreational athletes began demanding PRP therapy for themselves, even though it cost $1,000 per shot and isn’t covered by most insurance plans.

Alas, recent scientific studies of PRP therapy should dampen that enthusiasm, at least a bit. It just doesn’t seem to work in humans with overuse injuries and strains, according to these studies.

This month for example, S. de Jonge and colleagues at Erasmus University (Rotterdam) published one-year follow-up data on their placebo-controlled trial of PRP therapy for Achilles tendinopathy. Their original report showed no benefits at 6 months, and the extended follow-up showed the same thing (no benefit). de Jonge’s group concluded there is “no evidence for the use of platelet-rich plasma” therapy in this particular condition.

A second paper by Leon Creaney and colleagues, which is in the publication queue at the British Journal of Sports Medicine, reportedly found that PRP therapy was not more effective (indeed, it was quite possibly less effective) than injections of un-centrifuged blood for the treatment of tennis elbow.

How do we reconcile the outcomes of the favorable animal studies with those from the human trials, which were negative? One theory is that the animal studies involved acute injuries, which provoke a vigorous inflammatory response that may well be enhanced by PRP therapy. By contrast, overuse injuries, strains, sprains and pulled muscles provoke a less robust response. PRP therapy seems unable to enhance the healing process in such instances. Of course, it may also be the case that animals just respond differently to PRP therapy than humans.

In any case, it’s clear that scientists don’t yet understand the mechanisms by which PRP therapy works, if and when it does. This uncertainty has prompted the International Olympic Committee to issue the following note of caution regarding PRP therapy: “We believe more work on the basic science needs to be undertaken,” and until such work is complete, athletes should “proceed with caution in the use of” PRP therapy for the treatment of sports-related injuries.

Your doctor or trainer knows best, but perhaps good old-fashioned physical therapy and RICE (rest, ice, compression, elevation) is the best way to go.

*This blog post was originally published at Pizaazz*


You may also like these posts

Read comments »


One Response to “Platelet-Rich Plasma Injections: Much Ado about Nothing?”

  1. Health Blog says:

    Good post. One thing I would like to mention here is, in the field of medicine one should use a drug or medical treatment only after it is proved to be safe and effective. There is no place for speculation and unsupported and unscientific things in medical field.

Return to article »

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

Read more »

How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

Read more »

See all interviews »

Latest Cartoon

See all cartoons »

Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

Read more »

The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

Read more »

Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

Read more »

See all book reviews »