PRP Injections: What the Research Actually Says

The ordinary lives of us weekend warriors don’t look too much different than that of uber-rich pro athletes.

Other than the extravagant vacations, private chefs, dating supermodels, and a team of workers to take care of the mansion and kids, we all wake up each morning to take on the grind of making our bodies better.

However, elite athletes do seem to have special rehab and recovery tools at their disposal.

One of them is called platelet-rich plasma, better known as PRP.

If you follow pro sports, you've likely heard of it as the treatment Tiger Woods and Aaron Rodgers used to help rehabilitate from their injuries, which is then picked up by the media as the key to their elite supernatural healing.

I'm here to tell you it's not just for elite athletes. If you've got an injury, these injections are an option if you're willing to spend the time and money.

But what are these platelet remedies? How do they work to promote healing? And are they worth it? Let's explore.

What Is PRP—and What Is It Trying to Do?

Platelets are small cell fragments in your blood that support clotting and healing.

When you get injured, platelets rush to the site of the injury, where they help form clots to stop bleeding and release growth factors that kickstart the healing process.

Platelet-rich plasma, or PRP, is a concentration of platelets taken from your blood and injected into the injury site.

Here's how it works:

• Blood Draw: Blood is drawn from your arm, just like during a regular blood test.

• Centrifuge: The blood is then placed in a machine called a centrifuge, which spins it at high speed. This process separates the blood into its different components—red blood cells, white blood cells, plasma, and platelets.

• Concentration: The plasma, now rich in platelets, is collected. This is the PRP.

PRP contains a high concentration of growth factors and other proteins that stimulate healing.

Therefore the goal of PRP is to give the body an extra dose of repair factors to support faster and more effective healing, especially for tissues with poor blood flow (i.e., ligaments and tendons).

PRP vs Corticosteroid Injections

Unlike corticosteroid injections, which we covered in a previous newsletter, PRP aims to boost the body's natural healing ability rather than trying to quiet the signals as steroids do.

An Aside: Platelet-Poor Plasma (PPP)

Another injection associated with PRP is called platelet-poor plasma, or PPP. After the platelets are removed to create PRP, what's left behind is the Platelet-Poor Plasma.

While PPP doesn't have the high concentration of growth factors found in PRP, it still contains proteins and nutrients that are shown to support healing.

I mention PPP because it can be used in conjunction with PRP to provide a comprehensive treatment approach, offering both the concentrated healing factors from PRP and the supportive elements of PPP.

Or, it might be used on its own. The gist is,

• PRP: Contains a high concentration of platelets, making it potent in promoting tissue repair and regeneration. It's used primarily in cases where accelerated healing is desired.

• PPP: Has fewer platelets but still contains useful proteins and nutrients. It can be used for more general support in healing or as a complementary treatment to PRP.

Why Use PRP?

The appeal of PRP lies in its ability to use your body's own resources to heal itself. Since the treatments come from your blood, they are considered quite safe and have minimal risk of side effects.

This "natural approach" is particularly attractive to those looking to avoid more invasive procedures or medications.

Now, unfortunately, we must dial back our hopes on the idea of PRP therapy as a guaranteed cure-all.

Despite the hype and it’s advertised use among elite athletes, more research is still needed to fully understand the best applications and long-term outcomes of these therapies.

Currently, it's hard to say how effective PRP can be, and the best answer is that it most likely varies based on the type and severity of the problem, along with a plethora of other individual factors.

What Does the Research Actually Say?

Here's a summary of the latest research around PRP for common joint disorders:

Rotator Cuff Tears

A 2024 review published in the Journal of Joint Disorders and Orthopedic Sports Medicine acknowledged that symptoms related to rotator cuff tears did appear to improve with PRP in the 3–6 month range, but didn’t do much looking beyond that.

The authors concluded that:

“Compelling evidence for symptom improvement in [partial rotator cuff tear] patients following PRP treatment remains elusive.”

Another review in the Journal of Arthroscopy delivered a similar conclusion when comparing PRP to steroid injections.

The good news is that it showed similar results for pain management with less risks compared to corticosteroids, but over the long term they did not find magical healing properties for your rotator cuff tear.

Elbows

For those with an especially nasty case of tennis elbow that’s failed the conservative approach, it appears that PRP is at least as good as surgery.

According to the Journal of Shoulder and Elbow Surgery, platelet-rich plasma injections and surgical treatment produced equivalent pain scores and functional outcomes in patients with lateral elbow tendinosis.

Osteoarthritis

Arthritis is another common condition treated with PRP, but the research regarding its effectiveness is lacking.

In a review of the research on treating knee arthritis with PRP, patients felt that their pain, stiffness, and physical function all improved, but it was attributed to the placebo effect rather than actually improving the condition.

Similar research on hip and ankle osteoarthritis, similarly found that PRP did do much to actually correct the issue and may be more of a placebo effect than anything else.

Meniscus

The knee meniscus is another injury site that often has complications with healing due to it’s woeful blood supply and, therefore fewer healing factors.

In theory, PRP should help overcome these factors, but the research is inconclusive.

According to an article in Orthopedic Reviews:

“Patients experienced enhanced outcomes in terms of pain reduction and increased sports activity… but [beyond 1yr] did not find significant differences between groups treated with PRP and groups not treated with PRP.”

So… Is PRP Worth It?

Overall the research on PRP is far from conclusive, but it does represent the exciting advancements happening in sports medicine around a class of treatments called regenerative medicine.

The plus side is that PRP is relatively safe and carries few side effects other than what I hear is an awfully painful injection. To prove that point, in all my reading, I did not find a single adverse reaction to PRP treatment in any of the reviews.

The primary downside is the cost, which has a slim chance of being covered by insurance. The total cost is practitioner dependent, but expect to pay $500 to $1500 dollars out of pocket for each treatment.

Overall, based on the mixed bag of evidence, with some studies showing promise and others finding a lot of nothing, at this time, it's hard to say that it's definitely worth digging into your bank account for some PRP injections.

Although that would certainly depend on the problem and level of need. For many issues, it presents as a viable alternative to corticosteroids with less risk.

If I were a pro athlete making millions to perform, there’s enough potential upside with little risk that I would almost certainly give it a shot.

Or, even if you’re not a pro athlete but you don't mind spending the dough, sometimes an investment in your health is the catalyst to prioritizing all the other parts of the rehab plan that aren’t as sexy as processing and injecting your blood products back into your joints.

Despite inconclusive evidence, this type of VIP treatment, for many conditions, does seem to help with symptoms in the shorter term, but keep in mind that it’s still just a part of the bigger treatment plan.