PRP Injections (Platelet Rich Plasma)

PRP Injections (Platelet Rich Plasma)

Patient Information

Upper Limb Department

• Author ID: BH 
• Leaflet ref: UL 018
• Version: 7
• Leaflet title: PRP Injections (Platelet Rich Plasma)
• Last review: June 2025
• Expiry Date: June 2027

Tendinopathy (Tendon Disorder)

Tendinopathy occurs as a result of altered tissue structure leading to pain in the tendon, usually in response to a change in load on the tendon. A change in load can be an increase in load, e.g., during a period of home improvement activities, or from repetition of load, e.g., gym activities.

PRP Injections

PRP stands for platelet rich plasma. Plasma and platelets, along with red and white blood cells, make up our blood. Platelets contain our own growth factors which have an ability to aid healing and repair. Injecting these into the tendon aims to promote repair of the damaged and painful tendon.

Are the Injections Effective?

Tendinopathy settles by itself in time. However, this can take many months and for most people causes a negative impact on their usual activities. Treatment and advice, including a graduated loading exercise programme, can help the problem resolve. For some patients, this is not sufficient. Injecting PRP into elbow tendons is a relatively new procedure and is still undergoing research. It is a safe procedure. The current evidence does not show any significant effect of PRP compared to placebo for the outcomes of pain and function in those with a tendinopathy diagnosis.

What are the Side Effects or Risks?

The risks of having a PRP injection are low. Your elbow may be sore after the injection. This should be temporary and should resolve within 1 week. It may cause a flare-up of your symptoms, again this should be temporary. You may need to take painkillers but must avoid using anti-inflammatories such as Ibuprofen, Aspirin, Diclofenac, or Naproxen. The risk of infection is very low. There is a theoretic risk of tendon injury, but this has not been reported.

What are the Alternatives to PRP?

A comprehensive graduated loading exercise programme should improve your symptoms and strength. This takes time. We know that for patients who have had symptoms for over 6 months, it will take 6 months of an exercise programme to resolve your symptoms. There are alternative injections; these include cortico-steroid injections or a hyaluron injection. Traditionally, steroid injections have been used but recent evidence has raised concerns regarding recurrence of symptoms. Hyalurons have yet to be proven to be effective.

During the Procedure

The injection will be carried out in theatre. You will come to the ward as a day case. In theatre, you will remain fully awake throughout and be able to talk to the surgeon and nurses.

A blood sample will be taken from you. This is the same as having a routine blood test. Your blood will then be spun very fast in a machine; this separates the components of the blood. Whilst this is happening, the surgeon will inject small amounts of local anaesthetic around the painful part of your elbow. This will numb the area prior to the main injection. Once your blood has been separated, the platelets are removed from the sample. A small amount is then injected into the painful tendon.

After the Injection

When back on the ward, a Physiotherapist will see you. You will be shown some exercises that will help the tendon repair. You may be sore following the injection; therefore, the Physiotherapist will demonstrate the exercises, and you can start them in 48 hours when the pain has settled. It is normal to feel sore for a few days following the PRP injection. Whilst your elbow is sore, you may take paracetamol to help the pain. It is important that you do not take anti-inflammatory drugs such as Ibuprofen, Aspirin, Naproxen, or Diclofenac as these can affect the result of the PRP injection.

Following Discharge Home

It is important that you do the specific exercises daily, and that you try to rest or avoid aggravating the tendon as much as possible.

Activity Modification

Modifying activities that aggravate your elbow may help ease your symptoms.

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Phone: 01257 488272
Email: wwl-tr.therapyadmin@nhs.net
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