Platelet Rich Plasma (PRP) Therapy

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The Spine & Pain Center of California offers minimally invasive options to treat your condition and relieve your pain without surgery, dangerous high dose steroids, or harmful medication. You can restore the quality of your life using your body’s natural ability to heal orthopedic injuries through platelet rich plasma (PRP) therapy.

WHAT IS PRP THERAPY?

Platelet Rich Plasma (PRP) is a super-physiologic concentration of platelets that stimulate healing and regeneration of injured tissues such as; muscles, tendons, cartilage, or ligaments. Platelets contain hundreds of growth factors that aid in tissue repair.

When an injury occurs, platelets are attracted to the area to start the healing process. When PRP is injected into an injured area such as a strained tendon, sprained ligament, or arthritic joint, a cascade of events is initiated to heal the damaged tissue.

 

  • The PRP will recruit new blood vessel growth which is instrumental to providing oxygen and nutrients to area, as well as removing toxic tissue.
  • The PRP will also signal and stimulate local stem cells to the area, which may regenerate the same type of tissue that was damaged.

PRP injections are an increasingly popular alternative to traditional treatment because of the potential to heal minor to moderate orthopedic injuries without the need for surgery or harmful steroid injections.  The practice has been made popular by the reports of athletes using PRP to treat sports injuries

WHAT CAN I EXPECT DURING A PRP INJECTION?

To harvest PRP, a small sample of your blood is drawn into a specialized collecting system. This blood is centrifuged at high speeds to isolate the growth factors and platelets. Once the PRP has been isolated, it is ready to be injected into your injured site.  The entire process can last anywhere from 30 – 90 minutes, depending on how many sites are being injected and the complexity of the injection.  It is not uncommon to have discomfort for up to 24 hours post injection.  Although recovery times can vary, patients generally begin to see improvement in pain and function within 4 to 6 weeks.   

WHAT IS THE COST OF A PRP INJECTION?

Private commercial insurance, Medicare, and most workers comp insurance do not cover PRP therapy.  The full cost of the procedure is the responsibility of the patient. The cost of a PRP treatment varies based on your specific treatment needs.  Some patients may only need one injection to a small body part, while others may need a series of injections to a larger, more damaged, or more complex area such as the spine. The starting price for our basic PRP treatments is $950, while more complex, multi treatment options may cost up to $4000.     

WHAT PRP IS NOT.

Many physicians are touting PRP and regenerative medicine as a cure all for any condition. Simply get a couple of injections of PRP or stem cells and your rotator cuff tear or bone-on-bone arthritic knee pain will be cured and you will be back to running marathons .  The fact is, that while PRP shows great promise in treating orthopedic injuries, it is best suited for CERTAIN conditions that only a highly trained and conscientious physician can determine.  If for instance, you have a full thickness retracted rotator cuff tear or a true lumbar disc herniation with neurologic compromise, PRP is just not going to help with that.   

There are several pitfalls to avoid when considering getting PRP treatment such as;

WHO IS INJECTING YOU?  

Determine who is performing the injection and what the doctor’s background is.  Your treating physician should have a background in musculoskeletal evaluation and interventional injection therapy.  Your local family doctor, orthopedic surgeon, or chiropractor cannot perform these procedures, at least not safely or accurately.  Just feel the shoulder and inject the solution, doesn’t work.  Blindly inject PRP into the lumbar spine for back pain, that’s dangerous.  An  interventional physician will use ultrasound or fluoroscopic (live, low dose x-ray) guidance for all PRP injections to confirm the accurate delivery of PRP and avoid damaging any surrounding structures.  Is the doctor also performing PRP for cosmetic reasons, rejuvenation facials, hair loss, erectile dysfunction?  If so they are not serious about treating orthopedic injuries and they will inject PRP into anyone that walks in the door.  A regenerative interventionalist will strictly treat orthopedic injuries.  Why?  Because we want to help patients that are suffering in pain, losing function, and missing out on life, not treat elective cosmetic issues. It takes rigorous training, and huge investments in the proper equipment to perform regenerative orthopedics safely and accurately, which is why less than 1% of doctors are qualified to do so.  Dr. Mallavaram has personally performed over 10,000 image guided injections in the last 10 years that he has been treating musculoskeletal injuries.  You cannot learn safe needle based techniques and how to manage risk by taking a weekend course or watching online videos.  It takes years of practice.  My rule of thumb is “you have to see your needle tip at all times”. The only way to do this is with ultrasound or fluoroscopy, in experienced hands.

WHAT IS BEING INJECTED?

Not all PRP is made the same. When PRP is processed properly, it should have a nice yellow amber color. If you see red PRP, guess what, that’s not pure PRP.  Physicians have to utilize the proper equipment and take the time to process the samples correctly to inject PRP that has up to 7x the concentration of platelets as regular blood. The PRP equipment that we use has been independently tested and shown to produce PRP in the  5-7x range.  Published studies have shown that higher concentrations than that can actually slow down and impede healing, so more concentrated PRP is not necessarily better.  While some offices may process their PRP in a back office room, or break room, all of our processing occurs inside a separate processing room.    

WHERE IS THE INJECTION TAKING PLACE?

I’ve seen videos of PRP injections done in the back room of some dingy office.  It doesn’t even look like proper sterile techniques are being used. In some cases the doctor is not even wearing gloves, or just blindly stabbing the patient in the shoulder, back or knee.  All of my PRP injections are performed in a state-of-art, AAAHC (Accreditation Association for Ambulatory Health Care) accredited facility. You can rest assured that your procedure is being performed in a facility that meets the highest standards for patient comfort and safety.

WHY CHOOSE THE SPINE & PAIN CENTER OF CALIFORNIA FOR YOUR PRP TREATMENT?

Our mission is to be the premier center for successful outcomes in minimally invasive regenerative orthopedics.

Dr. Mallavaram is a double board-certified specialist treating all types of acute and chronic orthopedic conditions utilizing sophisticated image guided procedures.  He has personally trained with pioneers in the field of regenerative medicine and has incorporated some of their teaching into his current treatment protocols.  He continues to fine tune his protocols as new and exciting data come to light. He is also proud member of the Interventional Orthopedic Foundation which seeks to advance the field of regenerative orthopedics.

All injections are done under real time ultrasound or fluoroscopic guidance in an AAAHC accredited facility.  While some offices may perform PRP under local anesthesia, we will provide intravenous sedation administered by an anesthesiologist if requested by the patient. Your comfort, safety, and best clinical outcome is our number one priority.   

We feel patients deserve personalized, unbiased, information about their orthopedic injury and advice about what is the best course of action to undertake.  Other PRP or stem cell providers who belong to national chains or provider networks may not have the flexibility to treat your individual conditions as they see fit.  It’s like being part of a fast food franchise, corporate headquarters is going to dictate which special sauce to use.   In addition the franchise doctor is going to have to pay royalty fees to the network, and this will undoubtedly place financial pressure on the doctor to perform as many injections as possible. Here, you will never be sold on an injection. Dr. Mallavaram maintains a busy interventional pain management practice treating patients with highly coveted PPO insurance, Medicare beneficiaries, and injured workers through the workers compensation system.  He does not need to up-sell PRP injections. His aim is to provide an unbiased opinion on your orthopedic condition and provide non-surgical options in the field of regenerative orthopedics.     

To find out if PRP is right for you, call the office and schedule a consultation.