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PRP Injection for Tennis Elbow

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Top Six Reasons Why Platelet-Rich Plasma Injections Fail

The other day we received an email from a person who had Platelet-Rich Plasma (PRP) Injection that failed to produce any results. “Not impressed, did not work for me. Had it done for my back,” she said. Comments like these are charged with emotions as almost all of these patients have paid for PRP injections out of their own pockets. That’s why the same patient also added later “…but did empty my wallet.” For us, her comment was one of the kinder ones. Others, who were really mad at seeing their money wasted, called it a sham, quackery, and “ways for doctors to make money.” We understand this sentiment. And we can’t argue with the fact that these treatments may have been failures.

But the thing is very few people, including some expert physicians understand why these PRP injections fail.

What The Tremendous Popularity Of PRP Means

In the 1990s, there were about 150 new research articles on Platelet-Rich Plasma every year. At least in the Pubmed database. Back then, only a select group of physicians who really understood the treatment actually offered it to their patients. Now, just this year alone, there were more than 600 new articles. The trend line has gone from a gradual climb to a “U curve” or exploding popularity.

Platelet-Rich Plasma PRP Injections Search Results Pubmed Database

And so did the number of physicians offering this treatment.

Certainly, money wasn’t the objective for those physicians – for if it were, the best ways to do it would’ve been to prescribe a battery of tests, drugs and surgeries approved by insurance companies. Instead, the physicians started offering it once they knew well the inherent benefits of an interventional autologous medicine like Platelet-Rich Plasma.

The problem is, not all physicians were that passionate about it.

Some did it because patients asked for it. Some did it because everyone else was doing it. Still others just wanted to experiment with it casually.

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And so not all Platelet-Rich Plasma injections worked. That’s why, as the treatment exploded in popularity, we saw a small portion of those treatments end up being a waste of the patient’s money – and that gets talked about a lot because, as I mentioned above, the patient usually has huge emotional response to the outcome.

But on the other hand, majority of the patients are happy about their results.

“I had it done on my injury and MAN, IT REALLY WORKS!!!”

That’s another response we got on the SAME DAY that this women told us it didn’t work for her. Another physician also told us the very same day, “PRP works great. We have had fantastic results on patients in the office.”

So what’s making the difference?

Why do some PRP treatments work spectacularly while some others turn out to be a dud?

That’s what we’ll explain in the rest of this post here. There are six main reasons why it can fail. Plus a seventh no-so-common reason. Let’s look at them one by one.

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1. Improper Selection of Patients

As much as the Platelet-Rich Plasma injection enthusiasts would like beat the drum of its universality of application, there are certain instances where a PRP injection may be unnecessary. The classic case is demonstrated in the 2015 Double-Blind Randomized, Placebo-controlled Study that showed that PRP injections are NOT beneficial at all.

According to expert researchers we subscribe to, it is clear that this study had selected the WRONG PATIENTS!!!

Here’s what that means. This study, conducted by researchers at Cooper Medical School of Rowan University, New Jersey, was done in the emergency care department where patients who’d just had a ankle sprain were given a Platelet-Rich Plasma Injection.

First of all, ankle sprains are relatively acute medical condition, commonly occurring due to over-stretching and tearing of the muscle or tendon. And they’re usually healed on their own. The thing that emergency care physicians usually do for this condition is to put ice packs or local anesthetic to numb the pain so the patient can rest. For patients who’re very active, their body is able to heal itself from most of these types of ankle sprains very rapidly. For them, a PRP injection might not accelerate healing. On the other hand, because injections break up the tissue and poke holes, it can actually cause unnecessary complications.

That’s why successful studies on Platelet-Rich Plasma Injections are almost always done on chronic wounds and injuries that wouldn’t heal on its own. If you’re out to test PRP’s efficacy, the untreated-by-PRP “control group” should be non-healable so we can determine clearly the effects of PRP.

So definitely, Platelet-Rich Plasma injections are not ideal for emergency care.

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The same is true for patients on the other end of the spectrum. That is the category of patients who’d been on steroids and drugs for a long time and are in the very advanced stages of the disease. Although there might be hope, Platelet-Rich Plasma might not be enough to reverse course here.

The ideal candidate for Platelet-Rich Plasma injection is a patient who has a relatively new, chronic musculoskeletal condition and whose only other option is surgery or heavy steroid/drug use.

2. Use of certain drugs

One of the other reasons why Platelet-Rich Plasma may not be ideal for emergency care patients is that when patients come in with intense pain, it’s a common practice for the ER physician to administer powerful local anesthetics and/or steroids in high dose. The problem with both of them is that they are are known to be toxic to stem cells and growth factors as shown here here, here and here. So if you’re using these steroids, anesthetics or drugs, it is recommended to wait till the patient can get off of them before applying Platelet-Rich Plasma. Otherwise, the toxicity of the chemicals may limit Platelet-Rich Plasma’s ability to recruit stem cells to the area.

For example, the local anesthetic Marcaine is found to be extremely harmful to stem cells even in small quantities. So as a general practice, the patient has to avoid harmful steroids, anesthetics and drugs at the time or up to 48 hours prior to PRP injections.

3. Lack of Rehab

It’s been reported that PRP injection works well when combined with the physical therapy for sports injuries. However, some physicians mistakenly see PRP injections as an alternative to physical therapy. Hence the comparisons like these where PRP is pitted as a rival to physical therapy. The fact is Platelet-Rich Plasma can only supplement the effects of a proper rehabilitation program as illustrated in this study which demonstrated that PRP + physiotherapy is more effective than Dry Needling + Physiotherapy for patellar tendonisis.

There is one thing we need to add to that though. Most PRP injections are done in a way that breaks up scar tissue and triggers new healing response to which the platelets can respond. So the best post-Platelet-Rich Plasma treatment rehab program is one which treats the patients as if they just had an acute injury. Meaning, the physiotherapy regimen following a PRP injection has to aim at square one – stimulation of blood flow to the injured area to provoke the inflammatory response. This is a different approach than the usual where the PT tries to attenuate the inflammatory response.

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4. Under dosing

Under-dosing is a serious problem in this field. If you’re using PRP with below 3X platelet concentration, you’re under-dosing your patients. An example is the PT vs PRP study we highlighted earlier. Not only did they mistakenly conclude that Platelet-Rich Plasma could be an alternative to Physiotherapy, they were severely under dosing the patients by using PRP with 2.1-2.5X concentration of platelets.

Studies have shown that a concentration of at least 1,000,000 platelets/µl is needed for optimal therapeutic benefits. That is 5X the concentration of platelets in normal whole blood. Here is one such study.

That is the very reason why we advocate not using Gel-based PRP Kit for PRP separation. The problem with gel-based kit is that most of the platelets will get trapped in the gel. Instead a kit like DrPRP kit gives you 5X-9X platelets because it uses a mechanical separation process while giving the same 1-step convenience of gel separators.

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5. Using PRP as just another injectate

There is a fundamental difference between Platelet-Rich Plasma based orthopedic intervention and typical modern surgical and drug-based treatment. And that is surgery and the drugs are designed to eliminate symptoms of diseases. For example, pain is one of many symptoms that occur when a certain part of the body is out of balance. By taking a drug, steroid, NSAID or even undergoing surgical correction, the physician hopes that the pain goes away. This approach has led to all the problems that we face in modern orthopedic medicine. Because when we treat symptoms, the underlying problems usually don’t go away.

But scores of physicians look at Platelet-Rich Plasma with that same attitude. They inject Platelet-Rich Plasma expecting the symptoms to go away.

That’s NOT what Platelet-Rich Plasma is for.

Platelet-Rich Plasma is a HEALING AGENT. It’s different. It’s not designed to eliminate symptoms like a drug. The only thing that PRP can do is use the body to heal itself.

So the first task, if you’re an orthopedic surgeon or someone treating a musculoskeletal issue, is to IDENTIFY precisely what’s producing the symptoms. This means looking at the connection between various muscles, tendons and ligaments. Understanding how they work in unison and finding out what’s causing stress in the system. All the muscles and ligaments and tendons are like different pieces of the puzzle – pulling weights in sync with their functions. So if there’s a anomaly in the whole picture, chances are one of the pieces of the puzzle is not able to carry out its job.

For an easy example, a tightness in the hamstring might be a result of a twisted ligament or bone in the back caused by a bad sitting posture. So in addition to injecting PRP to the hamstring, you might also need to inject to the ligament or bone on the back. And advise the patient to change posture.

This is the definition of Interventional Orthopedics.

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And it requires extensive experience on the anatomy – AND delivering precise injections into the weaker links in the musculoskeletal system to improve overall function of the body. This means using image guidance technologies like fluoroscopy (Ultrasound guidance isn’t enough) to accurately place Platelet-Rich Plasma on areas which require healing. These type of injections enable efficient tissue regeneration and healing, and is usually not taught in medical school, residency, or fellowship.

That’s why we encourage physicians who’re offering PRP injections to get certified by taking one of the courses at the non-profit Interventional Orthopedics foundation.

Getting certified in Advanced Injection practices will make your Platelet-Rich Plasma results more consistent. There is a must-have for all physicians offering PRP Injections. It will also educate you on all the different ways regenerative medicine is being used right now.

6. Thinking only about relieving pain

We touched on it a little on the section above, but this is a broad topic that deserves an explanation on its own. Platelet-Rich Plasma as a healing tool is not something that you should make use of when your patients are in pain. Instead, PRP is used for a wide variety of issues that doesn’t involve pain including wound healing, skin aging reversal, wrinkle correction, dry eye syndrome, nerve regeneration, bone union, hair regeneration and even women’s fertility restoration and strengthening the uterus.

The bottom line is… Platelet-Rich Plasma isn’t just a tool for containing pain due to sports injuries. That days are far behind us now. Today, every physician, from the family physicians to neurologists and cardiologists, to fertility specialists and optometrists, to dermatologists and hair restoration experts… everyone uses Platelet-Rich Plasma.

Plus, more and more applications are discovered every day.

Platelet-Rich Plasma, on its own without funding by Big Pharma or the government, has become an integral part of modern medicine.

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BONUS: The 7th Reason Why PRP Injections Fail

7. Super-concentration of Platelets

We know all analogies are imperfect but we like to use the expresso shot analogy when it comes to platelets. Platelets are like expresso shots for healing. But like expresso shots, your body can’t function using expresso shots alone. It needs food. That’s why studies like this one by Giusti has shown that super concentrating the Platelets may not only be useless, it can actually be harmful. What they did was completely isolate Platelets and platelets alone – and applied it in different concentrations on tendon cells to see if higher concentrations hurt or helped. That’s not Platelet-Rich Plasma. That’s just platelets.

And Platelets alone can’t do the job. In fact, it has nothing to support the survival of cells.

Instead, Platelet-Rich Plasma, is rich in Platelets while also including a small portion of RBC, WBC and the plasma serum which contains the nutrients the cells needed to survive.

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That’s why research shows that taking the concentration above 1,000,000 platelets/µl doesn’t necessarily increase therapeutic benefits and as the Giusti study pointed out, it can actually have a detrimental effect.

This may not be an issue for the average physician, but it is possible to make this mistake thinking that higher concentration is better. That’s why we believe choosing the right Platelet-Rich Plasma kit plays an important role.

Because the kit has to produce Platelet-Rich Plasma in the ideal concentration – not just Platelets – so it can work every single time you administer it on patients.

Patent Application By Allan K Mishra

Speaking of the composition of Platelet-Rich Plasma, the famed Stanford researcher and Platelet-Rich Plasma pioneer Allan K. Mishra has recently filed a patent application titled “PLATELET RICH PLASMA FORMULATIONS” which can be found here. In it, Mishra claims he’s identified specific concentration of platelets, red blood cells, and white blood cells for treating treating connective tissue and/or cardiac tissue damage. It’s worth a look if you’re curious.

Add Regenerative Medicine to Your Practice

If you need help in getting started with Platelet-Rich Plasma, don’t hesitate to give us a call at (844) 377-7787 for a quick consultation. We can support you not only in supplying all the necessary equipment, but also provide you with the information you need to be a confident pioneer in this field. We’re looking forward to having you as part of our family.

You can also email us via hello@drprpusa.com or visit our shop to order directly.

Thank you for reading our blog. We love you.:)

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Why Doctors Are Now Ditching Steroid Injections For PRP

The use of immunosuppressive biologics, non-steroidal drugs (NSAIDs) and corticosteroids, collectively known as Anti-Inflammatory Therapeutics (AIT), has been rebuked by many, including well-known MDs. But there are, still, a good majority of family doctors, pain-management specialists, and orthopedic surgeons who routinely prescribe them for arthritis, tendonitis, and bursitis because apparently, there’s no other better alternative. This is evident in the ballooning anti-inflammatory therapeutics market which is projected to reach a valuation of $100 Billion by 2020. But according to researchers, there already exists a better alternative and that is Platelet-Rich Plasma and scores of physicians are now prescribing it as a first line treatment instead of AITs.

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Why Anti-Inflammatory Therapeutics?

One of the reasons why AITs are popular is the belief that most musculoskeletal diseases are due to inflammation. It is believed that inflammation is the cause of injuries and pain. But over the years, numerous studies have shown, rather persuasively, that inflammation is a signaling process used by the body to recruit growth factors and cytokines to the tissue microenvironment. While suppressing the inflammation with drugs interrupts this natural process and provides short term relief to the symptoms, in the long run, it prevents structural healing.

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But the argument among pro-AIT physicians is that they provide the best short term relief. They claim that a short or two of AITs keeps the situation under control and is not a big deal in the larger scheme of things.

Not true. They have pain-relieving properties but not as dramatic as we may think.

First, corticosteroids are not as the ultimate pain-killers and there are other methods far superior.

Second, neither can NSAIDs be considered the most effective pain-killers and that’s a fact.

Third, the immunosuppressive biologics like DMARDS, cytokine-blockers and TNF-blockers are not effective pain-killers anyway.

But they all have one thing in common. And that is, a long-list of side effects.

The Debilitating Effects of AITs

It would have been acceptable if we could just temporarily harness the whatever little pain-relief that AITs offered while we’re looking for a favorable course of action. But that isn’t the case. Studies show that even a single dose of these AITs can lead to unwanted complications. Let’s take a deeper look.

1. Steroids
Steroids are evidently the most destructive ones. Physicians know that they must prescribe steroids very cautiously. But the problem is once they work, patients may prefer them again and again. Especially athletes who just want to get back in the arena for that final game. After all, who wants to sit on the sidelines when life passes by? Just one more time, they’ll say.

But the long term effects are disastrous. Not only are they hard to get off of, the steroids have the ability to kill mesenchymal stem cells, lead to cartilage loss, and are one of the most common causes of secondary osteoporosis. Scores of athletes and weekend warriors have used steroids to temporarily push away pain only to end up in the surgery table a few years later.

2. NSAIDS

NSAIDs are a totally different beast. Medscape reports that more than 70 million of them are prescribed to patients each year in the United States alone. This is in spite of the warning issued by the Arthritis, Rheumatism, and Aging Medical Information System (ARAMIS) against NSAID use.

To the patient, it sounds like a decent proposal – use non-steroidal drug to temporarily alleviate pain. However, the consequences are enormous. In this comprehensively researched article on the Journal of Prolotherapy, the writer calls for a total ban on the use of NSAIDs for joints owing to its potential for degenerating cartilage. This is alarming considering that majority of the NSAIDs are prescribed for joint conditions like arthritis. In another study, use of NSAIDs was shown to have tripled the progression of Knee Osteoarthritis.

Furthermore, even in the 1980s researchers have found that NSAIDs can disrupt intestinal integrity.

3. Biologics

Anti-inflammatory biologics include drugs that block pro-inflammatory cytokines like tumor necrosis factor alpha (TNF) and interlukin-6 (IL-6) as well as conventional disease-modifying antirheumatic drugs (DMARDs). The problem with these drugs is that they suppress the biologic entities responsible for the natural immunity of the body. Applying them to a joint for example, doesn’t limit its effect to that area. Instead, it suppresses these biologic entities THROUGHOUT the body including liver, colon, small intestine, bones, skin and even neurons.

That’s why they have been linked to neurological diseases, and other diseases.

Blocking pro-inflammatory cytokines are definitely a bad idea. For example, the cytokine IL-6, one of the main cytokines targeted by the new generation of Arthritis drugs is a major component of the central nervous system. So is anti-TNF drugs. Blocking these can only lead to adverse events in the long term elsewhere in the body.

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Can PRP Disrupt The Anti-Inflammatory Therapeutics Market?

Although not immediately evident, the trend for these Anti-inflammatory Therapeutics are actually going down. As researchers discover more serious side effects, the market will start shifting to more natural solutions like Platelet-Rich Plasma. In fact, it’s already happening as we speak. Even without the support of insurance companies, more and more people are opting for PRP instead of AITs. That means people are willing to pay out-of-pocket for PRP instead of accepting free drugs. In other words, the downward trend for AITs has begun.

Patients and physicians are learning the hard way that SUPPRESSION OF INFLAMMATION DOES NOT EQUAL TO HEALING.

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On the other hand, the trend for Platelet-Rich Plasma is climbing organically.

Here’s Allen Mishra’s tweet about PRP’s Google trends. Alan is the founder of the Biologic Orthopedic Society that has over 6,500 members in Linkedin.

Independent research is also catching up with Platelet-Rich Plasma. It has proved so far that PRP is far superior for:

1. Chronic low back pain

The study shows that sacroiliac joint (SIJ) injection of Platelet-Rich Plasma has a longer-lasting effect on pain than steroids. And the difference is HUGE. While efficacy of steroids was only 25% at 3 months, it was 90% for PRP.

2. Tennis Elbow

In this study, the steroids were only able to suppress symptoms for recalcitrant lateral epicondylitis, while PRP was able to biologically heal the lesion. Furthermore, the steroids caused further tendon degeneration. Another study proved that patients who had PRP shows better pain and functional improvements than patients who had corticosteroid injection.

3. Plantar fasciitis

This randomized, blinded study concluded that PRP delivered at least the same pain-relief results as steroids. Other researchers have concluded that PRP is actually more effective than steroid injection in terms of pain and functional results. Another study also proved that PRP was more effective and durable than cortisone for plantar fasciitis. Yet another British study also pointed out that PRP injections are superior to corticosteroid injections.

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4. Knee Osteoarthritis

The study above showed that intra-articular PRP injections are better than HA, ozone, and corticosteroids. Another study recently proved that PRP injections are better than Hyaluronic Acid for knee osteoarthritis.

5. Rotator Cuff Tears

This study proved that Platelet-Rich Plasma injections show benefit earlier than cortisone injections for rotator cuff tears. Another similar study also found that a single dose of PRP is better than steroid for Shoulder impingement syndrome.

Why PRP Is Actually Good For Both Patient And Physician

As you can see, the reason why more and more physicians and patients favor Platelet-Rich Plasma over Anti-inflammatory Therapeutics is that PRP not only eliminates the symptoms (pain and function) but it actually heals biologically. Yes, of course, the manufacturers of the conventional drugs would love you to believe that their billion-dollar-research-backed miracle drug is VASTLY superior to the autologous Platelet-Rich Plasma that can be produced within 10-20 minutes in a small clinic. But what we’ve seen is quite the opposite.

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One of the early pioneers of Platelet-Rich Plasma, an orthopedic surgeon Dr. Allan Mishra, M.D., says, that soon this biologic tool would be “safe, simple to use, inexpensive, and available immediately at the point of care.”

And that requires a tipping point in its adoption by physicians. It’s already accelerating at a good pace.

Dr. Mishra goes on to say that, “chronic tendinopathy is the most common indication for applying PRP in my practice. I have used the treatment for tennis elbow, patellar tendinosis, partial Achilles tendon tears and occasionally partial rotator cuff tears as a stand-alone treatment. I also now routinely augment all of my Achilles and patellar tendon repairs with PRP. And I am considering augmenting my arthroscopic rotator cuff repairs as well with PRP. For nonunions or difficult fractures, I combine PRP with bone grafting.”

For the patients, Platelet-Rich Plasma has been helping them avoid surgery for years now. See the videos below for actual testimonials from real patients.

Here’s another patient’s story of how PRP helped avoid surgery.

“When I tore my rotator cuff in 2008, I had conventional laparoscopic surgery to repair it. The outcome was excellent, but the recovery was long and horrible. The orthopedist wouldn’t let me drive for six weeks, or run, swim or lift weights for three months. I suffered through weeks of torturous physical therapy. It was nearly six months before I felt normal again.”

And the patient vowed to never go through that ever again.

Unfortunately, the patient suffered another injury in 2014.

But this time decided to try Platelet-Rich Plasma instead.

The patient said, “I had the first PRP injection on Oct. 23. It was painful, and the aching persisted for about 36 hours. I had one bad night, followed by an uncomfortable day. After that, the pain stopped. Still, my doctor advised me to baby the shoulder — to use my other arm when holding a dog leash and to skip swimming and weights for two weeks. Running was fine. He also recommended physical therapy after two weeks.”

The patient reported that by February 2015, the shoulder was 80% healed. The doctor advised the patient to have a second PRP injection to heal the remaining 20%.

Here’s what the patient said:

“I had [the second injection] on March 4. When I returned to see [the doctor] on April 12, I was feeling pretty good. No pain, no problems. He rolled in the ultrasound machine, and I was not surprised by the results.”

Watch this second video for another excellent patient story.

Get Started On Platelet-Rich Plasma Now

The best way to start making a big difference in your patients, especially if you’re an orthopedic surgeon, rheumatologist or any kind of pain management specialist, is to get going with Platelet-Rich Plasma. Don’t just have it as a back up treatment that you can try when things don’t go well. Instead, it can be used as a standard first-line treatment for musculoskeletal issues.

Give it a serious consideration.

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We can guarantee that once you start offering Platelet-Rich Plasma, you’ll end up prescribing less and less Anti-Inflammatory Therapeutics and more and more Platelet-Rich Plasma. And it will have a tremendous impact on the lives of your patients. We want to see a world where the “replacement surgeries” are a thing of the past.

And Platelet-Rich Plasma can make it happen.

Give us a call if you need more information. We can be reached at (844) 377-7787 or email via hello@drprpusa.com. Or you can order a Platelet-Rich Plasma kit online and try it in your practice.

Together, let’s welcome the Anabolic Era of Medicine.

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Six Ways Platelet-Rich Plasma Saves Your Patient’s Money

In 2011, Stanford University researcher Jason L. Dragoo, reported that there are over 86,000 PRP Injections performed in the US each year. Market analysis by exerts put the growth rate of the Platelet-Rich Plasma market at almost 12% compounded rate which means that the number is probably 170,000 this year. Yes, well over 170,000 PRP injections are performed annually in the US. A recent scientific research by Russian researchers claim that patients save about US$876.84 on average when choosing Platelet-Rich Plasma over conventional treatments. This researchers included only data for PRP applied for wound healing. But we believe the savings for sports injuries and arthritis patients to be much higher. That’s a WHOPPING $149 million in COSTS SAVED BY PRP INJECTIONS in the US alone.

And we’re just scratching the surface here.

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Skyrocketed During The Past 5 Years

Stephen Clark, PT, DPT, MBA, OCS, president and founder of Athletic Physical Therapy in Los Angeles, notes that “the number of physicians performing PRP procedures has skyrocketed during the past 5 years.” This correlates to the aggressive demand we’re seeing for this safe and autologous treatment. The patients can’t find enough physicians performing the procedure. We receive inquiries from patients wanting to do the treatments and some are even willing to go out of state if there’s none in their area.

Watch this response from this patient about her PRP injections.

And patients like Ken below come back for more after their initial injection.

The science, however, is just catching up with this trend. Recent FDA-Sanctioned, Randomized, Double-blind, Placebo-controlled study and Meta-analysis of Level 1 Randomized Controlled Trials continue validating Platelet-Rich Plasma’s role as a better therapeutic tool than conventional treatments.

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Six Ways Patients Save Money When You Offer Them PRP

The big stumbling block for PRP is insurance acceptance. Right now, the insurance companies gleefully ignore the 0232T code – the CPT code for Platelet-Rich Plasma injections, with or without image guidance including its harvesting and preparation. But as they’ll soon realize, not accepting PRP injections is actually costing them a lot of money down the road. That’s why many physicians we talk to believe that it’s only a matter of time before the insurance start accepting it.

But even if it remains that patients have pay out of the pocket for these injections, it still is a very cost-efficient way for them to deal chronic injuries and degeneration.

Here are six ways we know.

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1. Symptom management vs true healing

Typical drug-based approach to healthcare is more symptom management than true healing. This is because the drugs typically do nothing to promote the reversal of the root cause. Instead, they’re good at masking the symptoms. The implications of this are vast when it comes to cost. Since the root cause is not addressed, the patient becomes dependent on the drugs as the disease progresses and symptoms recur. Each time they’re given a stronger dose or a different drug until it no longer works.

Now, compare that to Platelet-Rich Plasma’s approach to actually correct the root cause by promoting healing of the broken or degenerated tissues. Often patients are healed by just one or two injections. And they’re happy for years.

In the long run, the patient who’d had Platelet-Rich Plasma Injections are less likely to develop complications leading to surgery.

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2. Eliminate surgeries

This is huge. Analysts estimate that there are over 600 thousand knee-replacement surgeries performed every year. When people think of the cost of these surgeries, even minimally invasive ones, they only look at the hospital bill that may be covered by the insurance provider. But there are numerous other costs like loss productivity due to patient’s downtime, psychological costs, and even miscellaneous costs during the patient’s stay in the hospital.

Moreover, stuff like arthroscopic surgery, the most common orthopedic surgical procedure, has a history of leading to further deterioration and arthritis.

So the patient’s actual costs are high.

All of these are eliminated when you suggest your patients choose Platelet-Rich Plasma at an earlier stage.

3. Complications, scars or downtime

According to this paper, post-surgical complications can exceed $10,000 for each patient. That is just for surgeries. What about complications due to side effects of drugs? Research indicate that it’s about $1300 per adverse drug reactions.

In fact, medical complications and side effects are some of the biggest cost burdens associated with modern western medicine.

Then there are scars associated with surgeries. Not to talk about downtime.

Platelet-Rich Plasma on the other hand would have none of that troubles. This risk of injection is extremely low since it’s all autologous. And the procedure is done on an outpatient basis after which the patient can return to normal activities the following morning.

All of these translates to increased savings every time you recommend Platelet-Rich Plasma for your patients.

4. Multi-potential therapeutic effects

One of the problems with FDA-approved drugs is that they can only be prescribed for the stated purpose of use. A drug for arthritis patients can only be prescribed for arthritis patients even if it might help a patient with tendonitis. Thus if the patient has more than one orthopedic conditions, chances are each one will need different drugs specifically approved for that condition. Take arthritis and osteoporosis – they are treated completely different when using FDA-approved injections.

On the other hand, Platelet-Rich Plasma is multi-potential. It can be injected on…

  • Knees to heal meniscus, ACL, MCL and arthritis
  • Shoulder to heal rotator cuff tears and tendonitis
  • Hip to heal labrum and bursitis
  • Low Back to heal spinal degeneration and sciatica
  • Foot to heal Plantar Fasciitis, Achilles heel and ligament sprains
  • Elbows to heal lateral epicondylitis and medial epicondylitis
  • Bone to aid the union of fractured bones

You get the point. The possibilities are endless.

This means that the patient do not have to get an assortment of drugs if they need relief for multiple symptoms and thus there is no cost of acquiring new drugs (or potentially leaving drugs unused) each time they have a symptom.

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5. No research and marketing costs are added

This is one of the main advantage of Platelet-Rich Plasma injections. Unlike FDA-regulated drugs, for which the companies spend millions of dollars for research, several times more on marketing and mass production, there’s little capital costs involved with Platelet-Rich Plasma.

To produce it, all you will need to invest in is a good PRP Kit and a centrifuge and the patients can come and get the PRP injections unlimited number of times.

All the research on Platelet-Rich Plasma is done by independent researchers around the world and there’s one no single entity who’s licensing it. So customers aren’t paying for bloated research funding and marketing costs.

This means you can afford to charge your patients less.

6. Outpatient treatment, benefits small and independent clinics

The process of getting admitted to a hospital is mentally taxing. And most of the surgical procedures, however minimal require hospitalization. And that means you need big equipments and all sort of things. So only big hospitals can do those. There is an endless list of charges that the hospital needs to include as a standard and depending on the co-pay agreement with their insurance, the patients may end up paying anywhere from 10% to 50% of these extra unnecessary charges.

With Platelet-Rich Plasma, though, it is an outpatient treatment done in small, independent clinics as a 45-minute procedure. And these clinics are very cost-efficient in their operations because they do not need to employ a lot of staff.

The takeaway? Patients pay significantly less compared to surgeries. And the small, independent clinics have a big advantage over large hospitals.

As a last resort I had two injections of PRP

Platelet-Rich Plasma is here to stay. The skyrocketing demand is proof. And there is no reason why you shouldn’t be offering it. Thousands of cases prove that it works. We’ve shown you how it saves your patients money.

If you’re an orthopedic surgeon, rheumatologist, and/or run a pain management clinic, you’re doing a tremendous disservice to your patients if you’re not suggesting Platelet-Rich Plasma to your patients. Because Platelet-Rich Plasma has the highest adoption rate in this field – and for a reason. It has become indispensable.

The second group of people who uses PRP is aesthetic professionals followed by ophthalmic surgeons.

We’ll let some of the stories from Physicians themselves convince you about offering Platelet-Rich Plasma.

Here’s one physician who saw the value in Platelet-Rich Plasma ONLY when he himself was forced to seek the treatment.

“I am a physician who suffered with high hamstring tendinopathy which prevented me from playing competitive soccer and sprinting. I tried all conventional treatments for two years without any improvement. These included physiotherapy from a nationally recognized sports physio. I also used NSAIDs, fish oil/omega 3, glucosamine and chondroitin. I was looking at retiring from competitive sport. As a last resort I had two injections of PRP by a specialist sports physician. After three months I can now run without pain. This was a last ditch treatment that worked for me. (Although it was a trial of n=1).”

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Another dentist reports that he’s been using it for more than 8 years for grafting procedures.

PRP is very effective in bone grafting procedures with a huge amount of research supporting it’s effect in speeding healing. It’s use in tendonitis seems to be questionable. I am an oral & maxillofacial surgeon and have used it for greater than eight years with great success in my grafting procedures in the jaws.

The point is, we could go on and on and on about the reasons why a lot of physicians are excited about this treatment. It is simple and practical enough to quickly adopt it into your practice. And the risks are absolutely minimal.

Consider Getting Trained For Advanced Precision PRP Injections

That being said, you might want to undergo training for advanced prp injections at the Interventional Orthopedics foundation. Because, the ability to accurately localize the Platelet-Rich Plasma is one of the biggest needle movers when it comes to extracting the maximum therapeutic benefits. According to the foundation, only 1% of the physicians are able to do these precise injections without training. And so, chances are you may not have had the training. The Interventional Orthopedics Foundation also offer home study videos if you’re not able to attend in-person.

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And if you need help setting up your Platelet-Rich Plasma workbench, we’re here to help. Give us a call at (844) 377-7787 or drop us an email via hello@drprpusa.com. We handle everything from PRP kits to centrifuges to workspace for PRP and marketing brochures.

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5 Ways Platelet-Rich Plasma Is Relieving Pain in America

Few things are as life-shrinking as chronic pain. Health economists report that chronic pain costs our nation more than $635 billion each year in medical treatment and lost productivity – more than cancer, heart disease and diabetes. Painkillers have been the only relief medication in modern history. That’s changing with Platelet-Rich Plasma. It has been emerging as one of the key players in pain management.

In any life that’s exclusively ruled by pain, Platelet-Rich Plasma has the power to bring back pleasure and normalcy. It’s certainly a better option for those who’re getting by on four or five Advils a day and wondering what the long term consequences would be.

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First of all, Platelet-Rich Plasma injections are completely safe. The PRP, prepared by centrifuging the patient’s blood in a special blood tube, works in a two step way. First the injections, often guided by ultrasound, breaks up the tissues and second, the growth factors in the PRP helps rebuild the entire tissue. This produces a healing effect and reduces pain.

Here are five common types of pain that can be healed with Platelet-Rich Plasma.

1. Arthritis pain

It’s been well-proven that a few shots of Platelet-Rich Plasma can produce a huge effect for Arthritis patients. It has the potential to…

  • Inhibit inflammation and thus slowing down degeneration
  • Stimulate cartilage formation
  • Kickstart the production of lubricating fluid

These activities in the affected site ends up reducing the pain sensation.

As a long term effect, Platelet-Rich Plasma injections tend to preserve the joints in more than 70% of the cases – as reported by a landmark study in 2013. Recent studies have shown similar results too. They discovered that a two or three injection treatment over a period of 4-6 weeks with Platelet-Rich Plasma does more benefit that similar injection treatments with either Corticosteroids or Hyaluronic Acid. Moreover, the cartilage degeneration was significantly slowed even for patients in advanced stages of Osteoarthritis.

The researchers also conclude that repeating the injections after 6 months ensured better results.

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2. Neurological pain

Platelet-Rich Plasma is one heck of a wonder treatment whose healing potential seems to be expanding everyday and seems like it’s only limited by the physician’s imagination. The latest of those new discoveries is in the field of nerve regeneration and the resulting neuropathic pain. Nerve fibers consisting of neurons are very delicate structures and not much has been discovered about its operating mechanism. But recently, platelet rich plasma have been shown to promote the restoration of nerve fibers.

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In a study performed at Hasanuddin University in Indonesia, Platelet-Rich Plasma was successful in nerve regeneration for patients with leprosy peripheral neuropathy – a situation where all traditional treatments have failed. Which means PRP injections are effective in restoring sensations when it has been lost. This is remarkable news.

Then there is another study conducted in Greece the shows very encouraging mid-term results regarding PRP for treatment of Carpal tunnel syndrome.

All of this is proof that Neuropathic pain can be alleviated by Platelet-Rich Plasma. This paper by a researcher at the University of Puerto Rico analyses how Platelet-Rich Plasma has been able to eliminate neuropathic pain. He reports that PRP’s ability to promote axon regeneration is the key.

Here’s a video from a Rejuv Medical where a patient explains how she had PRP Injections for Nerve treatments and how it changed her life remarkably.

3. Chronic back pain

Chronic back pain and sciatica are mysterious conditions and physicians generally have a hard time figuring out what’s causing them. They first thing they do is to scan the lower back area for defects. When they find one, they’ll recommend surgery to correct that defect even though they have no idea if that defect is indeed the culprit of the pain. When they can’t find any defects, they end up being puzzled and sent the patient away with a bunch of Advils.

In a spine health forum, a patient explains his situation which was similar. His physician suspected the tears in L4-L5 spine segment to be the causing the pain. But there were minor tears and bulges everywhere, so the physician was confused. The patient ended up having to take 8 Advils a day. Unable to continue with that, the patient skeptically tried Platelet-Rich Plasma injections. He went from not being able to sit back in office or drive in a car (even with those medications) to stopping the medications altogether and going on a family trip overseas. Talk about a dramatic shift in life experience!

Another patient on the same forum describes how she had PRP injection for chronic pain in the cervical spine, and it’s been pain-free for two years.

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These kind of stories are supplemented by occasional clinical studies like this where the patients not only had experienced near complete pain relief but also were able to sustain those results for 2 years. This is remarkable for a degenerative disease, aka, a condition that worsens as time goes by. Here are another study conducted in China and another one by Japanese researchers.

4. Joint Pain

In addition to back and knees, almost all other joints are being treated by Platelet-Rich Plasma now. As the science of PRP evolves, the treatment is vigorously gaining popularity with more and more patients demanding it from their physicians. After all, the procedure is incredibly straightforward and is easily understood by most. The physicians hardly need to talk before the patient accepts eagerly.

Hence the doctors are now quick to prescribe Platelet-Rich Plasma for any case of chronic bursitis – in areas like fingers, elbow, toes, hip, shoulders, neck, wrist, ankle, and hip – and the results are almost always positive.

In fact, Platelet-Rich Plasma can be – and must be – prescribed for more than 50% of the musculoskeletal issues that are usually treated with surgery or steroid injections.

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5. Post surgical pain

Surgical pain relief is one of the newer areas where Platelet-Rich Plasma is gaining ground. This is primarily to take advantage of the wound-healing and bone regeneration aspects of PRP, but pain-relief is a very evident beneficial side-effect. Some medical perfusionists advice Platelet-Rich Plasma after almost all surgeries including Neurosurgery, Tumor removal surgery, Oral and Maxillofacial Surgery, Head and Neck Surgeries, Reconstructions and Cosmetic Surgery, Orthopedic/Spinal Surgery, Hand and Foot Surgery, Bone Graft Surgery, Cardiothoracic Surgery and Bariatric Surgery.

By cutting short the time it takes to heal from the wounds of surgery, Platelet-Rich Plasma plays a pivotal role in assisting patients get productive as early as possible. And when done in conjunction with surgery, Platelet-Rich Plasma injections are almost always paid for by the insurance provider covering the surgery.

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The beginning of the end of orthopedic surgery?

At a time when big hospitals are racing towards a possible automation of orthopedic surgeries, there are some physicians who believe that the rise of Platelet-Rich Plasma together with the rise of stem cell technology marks the beginning of the end for 80% of the orthopedic surgeries. They say science is finally waking up to the fact that human intervention is not the most efficient way of dealing with musculoskeletal issues. Rather, it’s best to provide the necessarily biologics in the form of PRP and stem cells so that the body can invoke it’s own healing.

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I hope you agree – because today’s regenerative medical trends are certainly pushing the medical industry in that direction.

If you haven’t started offering Platelet-Rich Plasma – or would like to know some general protocols, we would love to share them with you. Just call us at (844) 377-7787 or email via hello@drprpusa.com.

Rheumatologits' Guide To Platelet-Rich Plasma2a
The Rheumatologist’s Guide To Platelet-Rich Plasma

Shelly (not the real name) had been suffering from Achilles Tendonitis for a while now. She has rheumatoid arthritis and celiac disease. Plus she had a minor surgery on one of her toes and it had gone a tad bit bad. She was determined to find a solution and started with all the usual treatments. When it became obvious that the solution she’s looking for is not so straightforward, she began flirting with alternate treatments. Someone suggested Platelet-Rich Plasma. And so began a love-affair.

I got my first PRP for my Achilles Tendonitis and the doctor told me to get a shot each for 8 straight weeks,” Shelly said. A bit doubtful, she stopped after the second treatment. By the third week, the Tendonitis showed more progress than all of the previous months trying so many conventional treatments. She says, ” just three simple shots and my foot was probably 75% better.”

This is what Rheumatologists can expect when they introduce Platelet-Rich Plasma to their patients.

Rheumatology Had Found A Winner

Rheumatology is one of the fields of medicine that has immensely benefited from the advances of Platelet-Rich Plasma. Because it turns out that Platelet-Rich Plasma Injection is one of the most simplest treatments for musculoskeletal diseases – those that affect the joints, muscles, and bones, swelling, and deformity.

However, they have not been pushing the limits of this novel treatment, as well as the dermatologists.

Rheumatologits' Guide To Platelet-Rich Plasma

Are you a rheumatologist?

If you are, I’m pretty sure you have tried Platelet-Rich Plasma for your patients.

And if you did, you may have saved a few of your patients from going under the knife. But not every Rheumatologist have bought into the idea of Platelet-Rich Plasma. This is unfortunate since just in the osteoarthritis segment alone there are over 27 million U.S. adults who’d be much happier if their rheumatologist had suggested Platelet-Rich Plasma Injections.

Like Kenneth (not the real name), who was part of an experimental group at a local university and got PRP Injection for his torn hip ligament. Prior to this, he was told that he’d need surgery. But three (!) years later, the pain has never really returned and he’s had no surgery.

Another patient, Desiree (not real name), said she and her husband are firm believers of the treatment. It shoved her plantar fasciitis into oblivion and gave her husband’s shoulder joints and knees a big boost.

Cases like these are not rare.

Not All Treatments Of Platelet-Rich Plasma Are Successful

We’d be the first to admit that we’ve seen quite a number of cases where Platelet-Rich Plasma failed to show improvements. Sometimes, we’ve seen cases where the same patient can have mixed results. Like Lynda (not real name) whose PRP treatment for her severely sprained right ankle worked like a charm whereas the one for her similarly compromised left big toe turned out to be a dud.

Rheumatologits' Guide To Platelet-Rich Plasma

But we can improve the chances of success dramatically by adhering to a standard for the following.

1. Concentration

By definition, PRP must contain a higher concentration of platelets than baseline. This can vary as the baseline, which is the platelet concentration in the patient’s blood, varies. But the use of a good PRP kit like this can result in a concentration that’s 5X-8X times the baseline concentration. This kit can also be used to get a downgraded sample with 2.5X – 3X times the baseline concentration, which may sometimes be required based on the treatment performed. Therefore, getting a PRP kit that only produces lower grade PRP is not advised.

2. White Blood Cells (Leucocytes)

PRP containing white blood cells have a different biologic effects than the ones without. The most popular form of PRP is L-PRP which contains Leucocytes. The DrPRP Kit which provides higher concentration of platelets delivers an end product that’s classified into three fractions: the Red Blood Cells (RBC) without platelets, the Platelet Serum in which the platelets are suspended and the Buffy Coat which contains both the platelets and white blood cells (WBCs). This makes it possible to adjust the end product to include some White Blood Cells. Because, the macrophages (circulating monocytes) present in WBC can remove debris and ingest harmful foreign particles, bacteria, and dead or dying cells to speed up the healing process.

3. The Use Of ACD

The standard protocol for Platelet-Rich Plasma requires the addition of an Anti-Coagulant (ACD) to prevent the blood clotting. The addition of ACD makes the blood more acidic than normal. This can have a negative effect on the half-life of growth factors. So in certain cases, we recommend buffering the PRP back to a physiologic range prior to injection.

Rheumatologits' Guide To Platelet-Rich Plasma

The Growth Factors In Platelet-Rich Plasma

The Platelet-Rich Plasma owes it’s healing prowess to the growth factors found in platelets. They are made accessible to the tissues and ligaments when the platelets are activated. The exact roles of these growth factors remain a bit vague at this time but from what researchers have been telling us it is evident that they support a wide range of processes in all three of the healing stages – inflammation, proliferation and remodeling.

Here’s a nice little infographic that lists out the functions of the primary growth factors in Platelet-Rich Plasma.

GROWTH FACTORS IN Platelet-rich Plasma

Clinical Evidence

1. Platelet Rich Plasma and Subacromial Tendonitis

In recent years, Platelet-Rich Plasma has proven to be effective for Subacromal tendonitis. In a study conducted by Dr. Turlough O’Donnell, MD, and Aamir H. Shaikh, MSc, MRCSEd, MCh, of UPMC Beacon Hospital in Dublin, Ireland, 102 patients were treated with PRP injections administered directly into the suprasimatos tendon (shoulder) and 102 patients were treated with treated with 20 mL solution of 0.05 percent bupivacaine and 80 mgs of methylprednisolone.

“At 12-month follow-up, patients who received a series of PRP injections were 16 times less likely to have undergone surgical intervention than patients who received corticosteroid injections,” the authors reported.

Another study by Michael Carpone DO et al, which concluded that “a single ultrasound-guided, intralesional injection of PRP resulted in safe, significant, sustained improvement of pain, function, and MRI outcomes in participants with refractory Rotator Cuff Tendonitis.”

2. Platelet Rich Plasma and Epicondylitis

Epicondylitis is often a chronic case of tendinopathy and a healing response is usually hard to obtain. Platelet-Rich Plasma’s role in this started in 2006, when in a Pilot study by Allan Mishra, 19 patients with refractory epicondylitis who were prescribed surgery, was given a single Platelet-Rich Plasma injection. After 8 weeks, patients reported 60% improvement which rose to 93% and after just two years.

In another controlled clinical study, the effect of PRP was compared with corticosteroids, in a randomized, double-blind manner with 100 patients who had chronic epicondylitis. After one year, the authors concluded that PRP significantly exceeded the clinical benefit obtained by corticosteroids.

3. Platelet Rich Plasma and Plantar Fasciitis

Plantar fasciitis is one of the bigger fields in rheumatology – and the standard procedure for rheumatologists has been to mask the symptoms using corticosteroid injections. However, in this study, platelet-rich plasma injection was found to better than corticosteroid injections at the three-month follow up.

4. Platelet Rich Plasma and Knee Osteoarthritis

There are multiple studies in the past 3 years, both controlled and open, which highlight the efficacy of Platelet-Rich Plasma for Knee Osteoarthritis. In the largest of these studies, researchers in Taiwan, conducted 8 single-arm studies, 3 quasi-experimental studies, and 5 randomized controlled trials with 1543 participants to validate that Platelet-Rich Plasma does improves outcomes for patients with knee joint cartilage degenerative pathology. And does that better than Hyaluronic Acid.

However, recent research suggests that a combination of HA+PRP may be even more effective.

Platelet-Rich Plasma Knowledge Mandatory For Rheumatologists?

There is no doubt that Platelet-Rich Plasma is here to stay. And it can be the biggest item in the rheumatologist’s therapeutic rolodex. The safety, efficacy and simplicity is something that no other treatments can rival. However, as I mentioned before rheumatologists have not been taking advantage of it as much as others. Perhaps they are waiting for more conclusive evidence or insurance acceptance of the procedure, but considering that this procedure carries virtually no risk, it’s the somewhat of duty of every rheumatologist to give it a try. And come to new discoveries of their own.

You can try this at a relatively inexpensive way – with this kit and a standard lab centrifuge like this.

The medical community need more rheumatologists’ acceptance of Platelet-Rich Plasma to formalize the frequency, volume and etiquette for this life-saving procedure. After all, there are 27 million Americans at stake here.

Plus, the Platelet-Rich Plasma industry is undergoing rapid changes. New innovations are added every month. Getting in the game in these early stages will make you one of the pioneers in the field.

Here’s a recent interview with Dr. Lance Johansen who says we might see Platelet-Rich Plasma being combined with genetics like Bone morphogenetic proteins (BMPs) and DNAs to help grow new cartilage.

DR ALAIN ELBAZ DOES PRP FOR TENNIS ELBOW & MORE
Dr. Alain Elbaz Does PRP Injection For Tennis Elbow, Knee Patellar Tendon And More

Dr. Alain Elbaz, a well-known orthopedic surgeon in the Houston area, regularly does PRP Injection treatments for his patients. We had posted video of him performing the treatments before. This time he’s back again with even more treatments. This is just a tiny testament to the growing popularity of PRP.

Here’s the link to his latest video.

One of the patients in this video is having PRP for Tennis Elbow. And it’s one of the most challenging injuries suffered not only by pro athletes. But even regular active adults go through it, as you’ll see in the video. It’s also of a highly repetitive nature which means when you have it once, chances are, you may have the same injury again.

And frankly, it’s hard to heal a Tennis Elbow Injury. There isn’t enough blood supply to lateral epicondyle (the tendon that’s affected by Tennis Elbow.) That’s what makes it a perfect candidate for PRP Injection. That together with the simplicity of the procedure is what makes it appealing. As you might already know, the procedure is simple. Draw blood from the patient, spin the blood to isolate the growth-factor-rich platelets and re-inject the platelet into the affected area.

PRP gets you more results the more you do, so patients typically go for three shots in a span of six weeks.

Dr. Elbaz does all injections with the help of Ultrasound imaging. In the video, you’ll also see a patient with a shoulder injury and another with a knee patellar tendon injury.

Dr PRP Kit For Quality PRP Every Single Time

Dr. Elbaz also talks about why he chose Dr. PRP Kit for all his PRP procedures. Basically he says it gives him the quality PRP that he’s looking for. And according to him, the system is relatively fool-proof. Anyone using the system who follows a simple protocol will end up very good quality PRP. “There’s not a whole lot of things that can go wrong,” says Dr. Elbaz.

Again, here’s the link to the video.

If you want more information about the Dr. PRP Kit and would love to try it, you can get samples here. Or if you’d like to be our distributor, click here to talk to us.

PRP INJECTION FOR TENNIS ELBOW
PRP Injection For Tennis Elbow: 5 Quick Tips [INFOGRAPHIC]

Contrary to the popular belief, Tennis Elbow is not something only tennis players suffer. In fact, only 5% of patients suffering from the condition are tennis players. Others affected are painters, plumbers, butchers, and carpenters. It happens when the tendon in the elbow area called the Extensor Carpi Radialis Brevis (ECRB), which is quite susceptible to overuse, gets overused.

To understand what happens when it gets overused, let’s see how movements happen in our body. A tendon is tough, but flexible, band of fibrous tissue that forms a very strong connection between a muscle and a bone. When the muscle contracts, it pulls the tendon causing the bone to move as well. But to make sure the movement is precise, the tendons are stretched very tightly, precisely. And for this reason, they are prone to injuries.

Common Treatments For Tennis Elbow

First tier treatments include rest, non-steroidal anti-inflammatory medicines like ibuprofen and physical therapy. In most cases, a combination of the three can calm down the tendon.

The second tier of treatments, performed only if the first tier fails to show results, are the following.

1. Braces. Using a brace to severely restricting the movement of your elbow.
2. Steroid injections — these are rapid-action anti-inflammatory medicines. More and more research nowadays the use of these injections as they tend to contain the injury by shutting down healing (which is not beneficial in the long term.)
3. Ultrasound shock wave therapy. Sound waves shake up the tendon area triggering fresh new inflow of blood causing healing to happen.

PRP Injection For Tennis Elbow

PRP Injections may be considered third tier but it could very well be a first tier treatment. And since the substance for the injection is taken directly from the patient’s blood, there are no side effects to it. Hence theoretically, there’s no limit to the number of injections you can have.

The process is simple:

1. Draw approximately 20cc blood from the patient’s arm.
2. Putting the blood in a specially designed tube like the Dr.PRP tube, follow the protocol to spin it in a centrifuge.
3. Once the spinning is complete, you’ll have your Platelet-Rich Plasma which you can inject into the affected area.

The only downside of PRP right now is the lack of coverage by the insurance.

The other alternative in the third tier is surgery. It’s covered by insurance. But the results are not always promising. Plenty of things could go wrong during and after the surgery leaving you with more pain and the need for further surgeries.

Here’s a handy little infographic to remind you of all the options:
PRP INJECTION FOR TENNIS ELBOW

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