Overuse injuries to the upper and lower extremity tendons remains a common source of pain and lost activity for patients at our Boulder Physical Therapy practice. Tendon injuries can be challenging to treat, but these injuries have been shown to respond to exercise interventions designed to appropriately load and promote healing (remodeling) of the injured tissue. Often patients ask about additional interventions to accelerate the healing of injured tendons including platelet rich plasma (PRP).
PRP remains the most common biological injection provided by physicians to treat the injured tendon. In short, blood is taken and spun (centrifuged) to concentrate the blood's platelets which are subsequently injected into the injured tendon in an effort to heal the injured tissue. The effectiveness of this treatment is still being researched. Authors have reported improvements in tissue structure, mainly in animal models, after PRP injections but improvements in clinical outcomes are less clear. Improvements in tissue healing and remodeling may or may not correlate to improvements in patient's pain and function. Further, multiple trials have not shown an additional clinical benefit of pain or improved function over a placebo injection.
In short, more research is needed to compare PRP to placebo as well as comparing PRP to proven treatments for tendon injury including strengthening exercise. The injections remain an expensive treatment option for patients and require more scientific inquiry before being used on a widespread basis.