Platelet-rich plasma (PRP) therapy is a treatment that uses a concentrated portion of a patient's own blood, injected into an area of injury or degeneration, with the goal of supporting the body's natural healing response. PRP is being studied for a range of musculoskeletal conditions, including certain tendon injuries and joint-related pain, though the strength of the evidence varies by condition and the treatment is considered investigational for most orthopedic uses. PRP is not appropriate for every patient or every diagnosis, and whether it may be a reasonable option depends on an individual evaluation. The physicians at Center for Spine & Pain Medicine (CSPM) discuss the current evidence, regulatory status, and realistic expectations with each patient considering PRP.
Platelet-Rich Plasma (PRP) Therapy
What Is Platelet-Rich Plasma Therapy?
Platelet-rich plasma therapy is a procedure in which a small sample of a patient's own blood is drawn, processed to concentrate the platelets, and then injected into a targeted area, such as a tendon or joint. It is a therapeutic procedure, not a diagnostic test, and is generally considered minimally invasive since it uses the patient's own blood rather than a synthetic drug or donor tissue.
Platelets contain growth factors and proteins that are involved in the body's normal healing and repair processes. The theory behind PRP is that delivering a concentrated dose of these factors directly to an injured or degenerated area may help support tissue repair or reduce inflammation, though the actual biological effect can vary depending on how the PRP is prepared and the condition being treated.
How Does Platelet-Rich Plasma Therapy Work?
PRP therapy works by drawing a sample of the patient's blood, spinning it in a centrifuge to separate and concentrate the platelet-rich portion of the plasma, and then injecting that concentrate into the target area, often using imaging guidance for accuracy. The exact biological mechanism of benefit is still being studied and may differ by tissue type and preparation method.
Different PRP preparation systems produce different concentrations of platelets and may or may not include white blood cells, which can affect the composition of the final injectate. This variability is one reason research results on PRP are inconsistent across studies, since a "leukocyte-rich" preparation and a "leukocyte-poor" preparation are not biologically identical products, even though both are called PRP.
What Conditions May Platelet-Rich Plasma Therapy Help Treat?
PRP has been studied for a range of musculoskeletal conditions, including certain tendon injuries such as tennis elbow, some cases of knee osteoarthritis, and other soft-tissue or joint-related pain. The quality and consistency of supporting evidence varies significantly by condition, and PRP is not established as a first-line or guaranteed treatment for any of these.
Research interest has been strongest in areas such as chronic tendon conditions and knee osteoarthritis, though results across studies are mixed, and some rigorous trials have not shown a clear benefit over placebo. PRP is not a treatment for every type of joint or spine pain discussed on CSPM's conditions page, and a physician evaluation is required to determine whether a specific diagnosis is a reasonable candidate for this approach.
Who May Be a Candidate for Platelet-Rich Plasma Therapy?
A potential candidate for PRP therapy is typically someone with a musculoskeletal condition for which PRP has been studied, who understands that evidence of benefit is mixed and who has realistic expectations about outcomes. Candidacy also depends on general health, prior treatments tried, and the specific diagnosis involved.
Physicians generally consider a patient's diagnosis, symptom duration, imaging findings where relevant, and prior conservative treatments such as physical therapy or medication. Certain blood or bleeding-related conditions, active infection, and some medications may affect eligibility, since PRP involves drawing and re-injecting blood components. Because PRP is not FDA approved as a therapeutic product for most orthopedic conditions, physicians typically discuss it as an elective, out-of-pocket option rather than a standard, insurance-covered treatment. Ultimately, the treating physician determines whether an individual patient's diagnosis and goals make PRP a reasonable option to consider.
Who May Not Be a Candidate for Platelet-Rich Plasma Therapy?
Some patients are not appropriate candidates for PRP therapy, including those with certain active infections, specific blood disorders or platelet dysfunction, certain cancers, or an inability to safely undergo a blood draw and injection procedure. A full list of exclusions is determined individually by the treating physician and cannot be generalized to every patient.
What Happens Before the Procedure?
Before PRP is considered, a patient typically undergoes a consultation, a review of the relevant diagnosis and prior treatment history, and a discussion of the current evidence, costs, and realistic expectations, since PRP is generally not covered by insurance. Certain medications, such as anti-inflammatory drugs, may need to be adjusted beforehand, since they can affect platelet function.
What Happens During the Procedure?
During the procedure, a small sample of blood is drawn from the patient, typically from the arm, and processed in a centrifuge to separate and concentrate the platelet-rich plasma. The concentrated PRP is then injected into the target area, sometimes using ultrasound or fluoroscopic imaging guidance to help confirm accurate placement.
The blood draw and injection are generally performed in the same visit. Local anesthetic may be used at the injection site, and sedation is not typically required for most PRP injections, though this can vary by procedure location and patient.
Does Platelet-Rich Plasma Therapy Hurt?
Patients commonly feel a pinch during the blood draw and pressure or discomfort during the injection, and some soreness at the injection site afterward is common, sometimes with a temporary increase in symptoms for a few days as part of the body's inflammatory response. Pain tolerance varies between individuals, and any unusual or worsening pain should be reported to the treating physician.
How Long Does the Procedure Take?
Procedure length varies depending on the blood draw, processing time in the centrifuge, and the injection itself, and by the number of areas being treated. Preparation and observation time can add to the total time spent at the facility.
How Long Is Recovery After Platelet-Rich Plasma Therapy?
Recovery after PRP is generally brief, and many patients resume normal, non-strenuous activity within a day or two, though some soreness or a temporary flare in symptoms can occur in the days following the injection. Specific instructions for activity, exercise, and follow-up vary by patient and treated area and should come from the treating physician rather than general guidance.
When Might a Patient Notice Results?
Because PRP is intended to support a biological healing process rather than provide immediate anesthetic relief, any improvement, if it occurs, typically develops gradually over several weeks rather than immediately after the injection. Some patients notice a temporary increase in symptoms in the first few days as part of the expected inflammatory response before any improvement begins. Relief is not guaranteed and does not occur for every patient.
How Long Might the Results Last?
The duration of any benefit from PRP varies widely across studies and patients, and there is no established, universal timeline for how long improvement, if it occurs, might last. In a large, rigorously designed randomized trial of PRP for knee osteoarthritis, researchers found that treatment with PRP vs saline injection did not significantly improve knee pain or slow disease progression, based on 12-month changes in pain scores and cartilage volume measured by MRI in adults with mild to moderate knee osteoarthritis. Other smaller systematic reviews and meta-analyses of PRP for knee osteoarthritis have reported pain and function improvements compared with placebo, hyaluronic acid, or corticosteroid injections, but these reviews also describe substantial differences in PRP preparation methods, patient populations, and follow-up periods across the included trials, which limits how directly the results can be compared or generalized.
How Much Does Platelet-Rich Plasma Therapy Cost?
PRP therapy is generally an out-of-pocket expense, since it is not typically covered by insurance, and CSPM cannot publish a fixed price without confirmed, current pricing. Costs may be affected by the number of injections recommended, the specific PRP preparation system used, imaging guidance, and the area being treated.
Because PRP is usually billed as a self-pay procedure rather than submitted through insurance, patients should ask about total expected cost, including any recommended series of injections, before proceeding.
Does Insurance Cover Platelet-Rich Plasma Therapy?
Insurance coverage for PRP therapy is limited and, for most musculoskeletal uses, is generally not available. Medicare's coverage policy classifies PRP injections for musculoskeletal injuries and joint conditions as non-covered, citing insufficient high-quality evidence, and many commercial insurers classify orthopedic PRP as investigational or experimental as well.
Some payers cover PRP only in narrow circumstances, such as certain chronic non-healing wounds under specific research-based conditions, which is different from the joint and tendon uses discussed on this page. Because coverage policies vary and can change, patients are encouraged to verify their specific plan's position directly with their insurer and to review CSPM's financial policy page for general guidance on out-of-pocket procedures.
What Is the Success Rate of Platelet-Rich Plasma Therapy?
There is no single, reliable success rate for PRP therapy that applies across conditions, since results differ by diagnosis, preparation method, and study design, and some of the most rigorous available trials have not shown a significant benefit over placebo. In the trial described above, a rigorously designed, placebo-controlled study involving adults aged 50 years or older with mild to moderate knee osteoarthritis found that PRP did not produce a statistically significant improvement in pain or a slowing of cartilage loss compared with saline injection over 12 months. At the same time, other systematic reviews combining multiple smaller randomized trials have reported statistically significant improvements in pain and function scores with PRP compared to some alternatives, though these reviews note significant variability in platelet concentration, preparation protocol, and patient selection across the studies. Because findings conflict depending on study design and PRP preparation method, no single statistic can predict an individual patient's outcome, and patients should understand that current evidence does not consistently support PRP's effectiveness for every condition it is used to treat.
What Are the Risks and Side Effects?
As an injection procedure using the patient's own blood, PRP is generally considered to carry a lower risk of allergic reaction or disease transmission than treatments using donor tissue or synthetic drugs, but it is not risk-free. Common temporary effects can include pain, swelling, or bruising at the injection site, along with a temporary flare in symptoms in the days following treatment. Less common risks can include infection at the injection site or lack of any noticeable improvement. Rare but serious complications can include significant infection or nerve or tissue injury related to the injection itself. Patients should promptly report fever, worsening pain, or signs of infection at the injection site to their physician.
What Are the Alternatives to Platelet-Rich Plasma Therapy?
Alternatives that may be considered instead of, or before, PRP therapy include physical therapy, activity modification, medication management, corticosteroid injections, epidural steroid injection, facet joint injections, hyaluronic acid injections for certain joint conditions, other injection-based treatments, and, in some cases, surgical consultation. The appropriateness of any alternative depends on the specific diagnosis and prior treatment history, and no single option is right for every patient.
How Does Platelet-Rich Plasma Therapy Compare With Corticosteroid Injection?
| Option | Common purpose | Typical candidate | Procedure type | Recovery considerations | Potential duration | Insurance considerations |
|---|---|---|---|---|---|---|
| PRP therapy | Deliver concentrated platelets from the patient's own blood to support a healing or anti-inflammatory response | Certain tendon injuries or joint conditions where conservative care has not resolved symptoms | Blood draw, processing, and injection in the same visit | Possible temporary symptom flare over a few days; brief overall downtime | Evidence on duration is inconsistent and varies by condition and study | Generally not covered; typically an out-of-pocket procedure |
| Corticosteroid injection | Reduce inflammation at the injection site | Joint or soft-tissue inflammation causing pain | Outpatient injection, no blood processing required | Little to no downtime for most patients | Relief often temporary and may prompt repeat injections over time | More commonly covered by insurance than PRP, though this varies by plan |
This table provides general information only and does not indicate that one option is superior for a given patient. A physician determines which treatment, if any, may be appropriate based on individual diagnosis.
When Should Someone Discuss Platelet-Rich Plasma Therapy With a Pain Specialist?
Someone with a musculoskeletal condition that has not responded to conservative treatment, and who is interested in a treatment option with variable but ongoing research support, may want to discuss PRP therapy with a pain specialist as part of a broader conversation about treatment options. A consultation allows a physician to review diagnosis, prior treatment history, and realistic expectations, including cost and evidence limitations, to help determine whether PRP, another treatment, or continued conservative care is appropriate. To schedule a consultation, visit CSPM's appointment page.
Frequently Asked Questions
Is PRP therapy FDA approved?
No. The equipment used to prepare PRP, such as certain centrifuge systems, has received FDA clearance for the technical process of separating blood components, but PRP itself has not been FDA approved as a drug or biologic for treating specific orthopedic conditions. Physicians who use PRP for musculoskeletal conditions are generally doing so under their clinical judgment and the practice of medicine, not under an FDA-approved indication. Patients should discuss this distinction with their physician before proceeding.
Does PRP regrow cartilage or reverse arthritis?
No reliable evidence currently supports the claim that PRP regrows cartilage or reverses the underlying degenerative changes of arthritis. In fact, one of the most rigorously designed trials to study this question found no statistically significant difference between PRP and placebo in slowing cartilage loss over 12 months in patients with knee osteoarthritis. Claims that PRP regrows tissue or reverses degeneration are not supported by current high-quality evidence and should be treated with caution.
Why isn't PRP covered by insurance?
Most insurers, including Medicare, classify PRP for musculoskeletal and joint conditions as investigational or experimental, citing a lack of high-quality, consistent evidence and the absence of a specific FDA-approved therapeutic indication. This is different from decisions about the safety of PRP, and coverage policies can vary and change over time. Patients should verify their specific plan's current position before proceeding.
How many PRP injections might someone need?
Some treatment approaches use a single injection while others use a series of injections spaced over several weeks, depending on the condition being treated and the protocol used. There is no universally established number of injections proven to be most effective, and this should be discussed individually with the treating physician. The number of recommended injections can also affect total out-of-pocket cost.
Is PRP the same as stem cell therapy?
No. PRP concentrates platelets and growth factors from a patient's own blood, while stem cell therapy involves a different category of cells intended to differentiate into other cell types. The two treatments use different biological materials, have different regulatory considerations, and are not interchangeable. For more information, learn about regenerative medicine and stem cell injections. A physician can explain how each is regulated and studied if a patient is considering either option.
Can PRP be combined with other treatments?
Some patients use PRP alongside other treatments such as physical therapy, though combining PRP with certain injections, like corticosteroids, at the same time or in close succession is generally avoided based on physician judgment. Any decision to combine treatments should be made by the treating physician based on the specific diagnosis and treatment history. This is not a standardized protocol that applies to every patient.
Medical Review
Reviewed by Dr Sadiq Sohani, MD.
Sources
- Effect of Intra-articular Platelet-Rich Plasma vs Placebo Injection on Pain and Medial Tibial Cartilage Volume in Patients With Knee Osteoarthritis: The RESTORE Randomized Clinical Trial – JAMA, 2021.
- Efficacy and safety of platelet-rich plasma injections for the treatment of osteoarthritis: a systematic review and meta-analysis of randomized controlled trials – Frontiers in Medicine, 2023.
- LCD - Platelet Rich Plasma Injections for Non-Wound Injections (L39058) – Centers for Medicare & Medicaid Services (CMS), 2025.