Platelet Rich Plasma
A little about platelets and repair
Our blood has three types of cells, Red blood cells, white blood cells and platelets. The rbcs carry oxygen, wbcs work for immunity and platelets do the blood clotting and repair
Whenever there is any injury which leads to bleeding, its the platelets at the site of injury that get activated. They do two things, they start blood clotting immediately and release chemicals that stimulate the repair cells.
This repair process is nothing short of nature's magic. There are tens of growth factors, stimulants and repair cells involved, which work in harmony. But at the top of this cascade are the platelets. They initiate and regulate the whole process. They stop the bleeding within minutes, but keep working for days to manage the tissue repair.
What is Platelet rich plasma?
The patient's own Blood is drawn from a vein, kept in specially sterilized tubes with a chemical to prevent clotting, and then rotated at a high speed in a centrifuge machine. After this, the heavy rbcs and wbcs settle at the bottom of the tube, the plasma floats at the top, and the platelets make a layer in the middle. That middle layer is carefully taken in a syringe.
This platelet layer, along with a small amount of plasma is called Platelet rich plasma. It has 3-4 times more concentration of platelets than normal blood and its power to start repair is also much more.
In which conditions is prp a good treatment?
Wherever repair is not happening naturally. Prp started and gained popularity for treating hairfall and reparing skin problems. Its power of regeneration was then recognised by pain physicians, surgeons and dentists. It was seen that injecting prp at any site of surgery or injury led to accelerated repair.
Sports injuries get benefitted especially well by prp. These injuries are generally in tendons and ligaments. These structures are made very strong by nature but to make them strong nature had to reduce their blood supply. That's why they look white. Because of this poor blood supply, there is no bleeding when these get injured, and no bleeding means no platelets for repair. Injection of PRP leads to repair and strengthening of these structures. Pain and instability that refuses to go away for years, get relieved in a matter of days to weeks.
Cervical and lumbar pains are also caused by structures that have poor blood supply, like the discs, ligaments and tendons. Platelets are able to kick start repair, relieving years old pains in a matter of days.
Arthritis, the age related degradation of joints, is another condition where bleeding does not occur. These are slow wear and tears which don't get repaired because of no platelets. PRP injections repair the joint surfaces and strengthen the supporting ligaments of the joints. Knee, shoulder, hip pains respond very well to PRP.
What are the possible side effects?
Slight needle pain at the site of injection, temporary swelling for a few hours are the common side effects. Because it is made from your own blood, any reaction to it is not possible.
What would be my real experience of PRP?
Once you decide to take PRP, a local anaesthetic cream would be applied to the site of blood drawing to minimize the pain. The site of injection for pain would also get the local anaesthetic cream. After that, around 30-50ml blood would be drawn from the vein. This would take about a minute. Then you can sit comfortably in the waiting area as making of PRP would take about 30 minutes. Once the PRP is collected, you need to come to the procedure room again. The PRP injection would be given with a very thin needle to the site of pain, for example, the knee or back. This would take a minute.
That's it, you are good to go home.
In which cases should PRP not be given?
It is just like taking your own blood and injecting it in your body. There is no harm possible. It can be tried in all cases where repair is needed. Only in cases where there is an active infection in the blood that PRP should not be made from it.
Who should I take PRP injection from?
Prp for skin and hair is easy to inject, because these are very superficial sites. The injections are done at a depth of only a few millimetres and the volume of blood drawn is also much less. But PRP for pain is done to joints and spine. Here the volume of blood drawn is also much more and the needle has to be placed very accurately. These should be done only by a trained pain physician.
Dr Nitish adds a special step to PRP injections. He activates the platelets before injection, this is a crucial step but is overlooked by even many pain physicians.