Platelet Rich Plasma Injection Therapy

PRP therapy is a completely safe treatment that every person, young and old can take. And, since doctors create the PRP serum from the patient’s own blood, there is a very rare chance of an allergic reaction or the body rejecting the serum. However, like with all other healing modalities, there are certain PRP injection contraindications that you need to be aware of.

At the time of signing up for the treatment, your medical practitioner will conduct a detailed examination of your medical history to make sure that you’re a good candidate for the treatment. That’s because, under certain conditions, some patients cannot receive PRP therapy. Here are some of the factors that doctors keep under careful consideration.

History of Metastatic Conditions like Cancer or Disease

A medical history of metastatic conditions like cancer or disease is one of the most important PRP injection contraindications. Patients with these conditions might have blood that is infected with cancer cells. This factor is especially true for patients that have hematopoietic cancer or cancer of the bone marrow. For this reason, doctors cannot use their blood for therapy.

Possibility of Infections in the Areas Targeted for PRP therapy

In case patients have any skin infections, blood infections, or infections in the targeted area, they must wait until they have healed completely before getting the treatment. PRP has white blood cells and can act as an antimicrobial agent. But, it can heal certain kinds of infections only. The treatment may not work on areas that have any form of chronic or acute infections.

You doctor might also check with you for the possibility of systemic disease. Systemic disease is an infection that affects the entire body. Patients must allow such infections to heal completely before they come in for the treatment.

Pregnancy or Breastfeeding

Pregnancy and breastfeeding are yet other important PRP injection contraindications. Although the possibility of infections from PRP therapy is extremely remote, doctors may not risk the treatment causing any adverse effects on the unborn or newborn baby.

Anticoagulant Prescription Medications or Antiplatelet Therapy

If patients have been taking anticoagulants or medications that stop blood from clotting, doctors may ask them to avoid the drugs for a few weeks before and after PRP therapy. But, if the patients cannot stop the medicines, they could be advised to wait until after they have completed the prescribed courses. These medications include:

  • Tranexamic acid (Cyclokapron®)
  • Clopidogrel (Plavix®), (Persantin® / Pytazen SR®)
  • Warfarin
  • Aspirin
  • Dipyridamole
  • Heparin
  • Dabigatran

Incidence of a Recent Fever or Illness

In case patients have just had a fever or serious illness, doctors may recommend that they wait for at least 60 days and recover completely before coming in for PRP therapy.

Incidence of Smoking or Drinking

The possibility of patients smoking and drinking excessively is one of the PRP injection contraindications that doctors keep in mind. Cigarettes contain tar that can hamper the production of growth factors. In addition, smoking can raise blood pressure and sometimes, lower the platelet count in the blood. Consuming too much alcohol can lower the body’s ability to create stem cells. Accordingly, doctors advise patients to avoid smoking and drinking for at least 4 weeks before and after taking PRP therapy.

Corticosteroid Injections and NSAIDS

Medical practitioners recommend that patients avoid taking NSAIDS like Mobic, Voltaren, and Nurofen for at least 7 to 10 days before and after their PRP session. As for corticosteroid injections, patients must not take them for up to one month before scheduling PRP therapy. Taking these agents may prevent inflammation which is essential for the PRP serum to work and is one of the most vital PRP injection contraindications.

History of Severe Liver Disease

Liver disease can hamper the functioning of the liver that takes care of all the major functions of the body. The PRP serum contains platelet-fibrin which forms the basic mesh for the healing of tissues. This platelet-fibrin is produced in the liver. And, if the blood has insufficient fibrin, PRP therapy may not be as effective.

Allergies to Bupivacaine HCL, Lidocaine, or Bovine Thrombin

Doctors need to add certain compounds like Bupivacaine HCL, Lidocaine, or bovine thrombin during the PRP preparation process. These compounds that may help with any pain or discomfort by working as topical or local numbing agents. Medical practitioners may also add anticlotting agents to make sure that the serum does not clot before it is injected. Accordingly, they must make sure that the patient is not allergic to any of these additives before using them to formulate the PRP serum. The possibility of such allergies is another of the PRP injection contraindications that doctors consider carefully.

Other PRP Injection Contraindications to Consider

Having made a careful note of your responses to the questions listed above, your PRP practitioner may also conduct a blood test to check for certain factors and eliminate the possibility of PRP injection contraindications. They are:

  • Low Platelet count: The blood must have a platelet count of at least 105
  • Insufficient Hemoglobin or Low HGB count: The patient must not be anemic, and the blood must have at least 10 g/dl of hemoglobin.
  • Low Fibrinogen count: Fibrinogen is a part of the platelets in the blood and acts as the key component of the PRP serum. Patient must have a normal count of 200–400 mg/deciliter of fibrinogen in the plasma. If the levels are lower than this minimum range, the blood cannot clot normally.

Evaluating You for PRP Therapy

Your PRP practitioners are committed to making sure that you avoid the possibility of PRP injection side effects and get the best possible results from the treatment. When checking for PRP injection contraindications, they may screen you and your medical history carefully before advising that you go in for PRP therapy. They may also have certain recommendations and dos and don’ts for you to follow in the few weeks before and after taking the treatment. Follow them carefully, and you’ll be able to avail all the benefits of this amazing new procedure – Platelet Rich Plasma therapy.

Platelet Rich Plasma Post Treatment Instructions

  1. You will be very sore about 45 minutes after treatment. Very sore as in “something is definitely wrong” level of soreness.
  2. You may use ice packs to calm soreness and reduce inflammation.
  3. Please call or text 415 987-1510 if there are follow up questions or concerns.
  4. DO NOT USE NON-STEROIDAL ANTI-INFLAMATORY DRUGS (NSAIDs) (like ibuprofen or naproxyn), or ASPIRIN, or TYLENOL for at least the next week. This is very important and will negate the effects of the therapy by inhibiting inflammation. (If you have a prescription for aspirin for a medical condition talk to me about it as your aspirin may be too important to stop.) We want the inflammation to start the healing process. Do not smoke.
  5. After the first 2-3 days, the pain should calm down. You will start having “good days and bad days” where you have more and less soreness. This is a good response.
    • For the first 2 days, no activity, rest only.
    • On day 3 move the limb / joint through its full range of motion without resistance. Move it around.
    • On day 4 – 14 start doing negative eccentric exercise with the limb. This means apply resistance while the muscle is lengthening, with no resistance while the muscle is shortening. 2 sets of 30 gentle repetitions twice a day. Gradually increase resistance. It is vital to move the limb to stimulate proper healing. Cross train for your cardio workout as you are able. (Swim, deep water running, upper body bike, recumbent bike, elliptical, walk etc.)
    • If your Achilles tendon was injected, if you want you can start jogging at 2 weeks if you feel up to it.
    • Formal Physical Therapy should start at 2 weeks. Keep track of your symptoms.
  7. Come in to be re-evaluated at two weeks. If you have had the condition for a long time, it will most-likely take several PRP treatments to reverse it and get back to pain-free full activity. If more injections are needed, they are usually done about every four to eight weeks. Do not use NSAIDs for the week before your next injection. Three to six injections is usual to resolve many chronic conditions.