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Platelet Rich Plasma Injections for Plantar Fasciitis
Platelet rich plasma therapy (abbreviated as PRP) is the re-administration of your own platelets to activate the body’s natural healing cascade for repair and regeneration to treat Plantar Fasciitis.

activated platelets

Platelet Rich Plasma Injections for Plantar Fasciitis

Platelet rich plasma therapy (abbreviated as PRP) is the re-administration of your own platelets to activate the body’s natural healing cascade for repair and regeneration to treat Plantar Fasciitis. It is successfully used for various musculoskeletal problems, such as of injured tendons, ligaments, muscles and joints.  In fact, Platelet rich plasma injections are replacing traditional orthopedic surgery in many instances for conditions ranging from soft tissue injuries (tendonitis, muscle tears, ligamentous injuries) to various joint afflictions, such as a torn meniscus or mild to moderate arthritis of the joint.

Platelet activation plays a key role in the process of wound and soft tissue healing, especially when inflammation is present. Platelet rich plasma injections involves the use of a portion of your own blood, which has a high platelet concentration.  PRP injections are prepared by using a small amount of your own blood which is centrifuged and then a portion of concentrated blood containing activated platelets is injected into the abnormal tissue.

The injection of your own platelets causes a local inflammatory reaction, releasing growth factors that stimulate healing and muscle regeneration, and limiting the amount of scar tissue. The treatment exert positive effects via multiple mechanisms including:

  • Activation and release of the body’s natural growth factors in the abnormal tissue. This response has been proven to stimulate the tissue regeneration processes.
  • Localized inflammatory response that increases the blood flow to the abnormal tissue.
  • Limitation of scar tissue formation.

We use ultrasound imaging to guide the injection and this increases the accuracy of the PRP procedure, and potentially reduces post-procedural pain. We also use light activation of our platelets, which increases the effectiveness of the platelets and also decreases the post procedure discomfort. PRP injection therapy is generally completed in just one session, but may require additional injections depending upon the clinical circumstances.

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Step 1: Collect Blood

collect blood for PRP

Step 2: Centrifuge Blood

centrifuge blood for PRP

Step 3: Light Activation

light activation for PRP

Step 4: Inject Under Ultrasound Guidance

PRP injection

Indications for a Platelet Rich Plasma injection in Plantar Fasciitis management:

  • Routinely in chronic or long term Plantar Fasciitis:  When Plantar Fasciitis is chronic and lasts over 4 months or after other treatment such as Shock Wave Therapy have been tried, PRP can be extremely effective in treating stubborn cases of Plantar Fasciitis.
  • Plantar Fasciitis refractory to conservative treatments: Most cases of Plantar Fasciitis respond to conservative care or Shock Wave Therapy . However, if symptoms does not improve, PRP is an excellent next step.
  • Plantar Fasciitis with co-existing bursitis, capsulitis, synovitis, or arthritis: Plantar Fasciitis often co-exists with other lesions of muscles and joints such as bursitis, capsulitis, synovitis and arthritis. In all these cases, platelet rich plasma injections are not only safe but a preferred therapy to alleviate these other conditions as well as Plantar Fasciitis.
  • Routinely after Plantar Fasciitis surgery: Surgical intervention is very rarely but sometimes necessary to treat refractory cases of Plantar fasciitis. Platelet rich plasma injections can be used to hasten the pace of recovery after Plantar Fasciitis surgery.

Platelet Rich Plasma injections can be very helpful in chronic Plantar Fasciitis pain. Your body’s natural growth factors can be very helpful in fighting some of the complications that can occur with chronic Plantar Fasciitis.

How Do We Use PRP Injections in Plantar Fasciitis?

We use PRP injections in certain patients with chronic Plantar Fasciitis:

  • Patients who have indications of a co-exisiting bursitis, capsulitis, synovitis  or arthritis;
  • Patients who have had Plantar Fasciitis for a long time (chronic plantar fasciitis) and have continued pain and discomfort where PRP can be very effective; and,
  • Patients with complex Plantar Fasciitis.

A PRP injection can be uncomfortable and cause post-procedural pain that lasts a few days. When used to treat Plantar Fasciitis, PRP injections scan be combined with other treatments such as Shock Wave Therapy.

Improving the Quality of Results with PRP Injections

The results of platelet rich plasma therapy can be further improved by:

  1. Using light activation. We activate the platelets using light activation which stimulates the platelets before they are injected back into you. This decreases post-procedure pain and discomfort as well as increasing the effectiveness of the platelets.
  2. Using ultrasound guidance to increase the precision of the injection. This increases the accuracy of the procedure and deceases the likelihood of complications.

Any contraindications to Platelet Rich Plasma Injections?

Platelet-Rich-Plasma

Although the treatment is generally well-tolerated by individuals of all age groups, there are certain contraindications to PRP Injections. For example:

  • Recent history of anti-coagulant therapy/ course
  • Bleeding disorders
  • Pregnant or breastfeeding mothers
  • Active malignancy, severe infection or thrombocytopenia

What to Expect After the PRP Injections

The aftercare for most PRP injections is relatively simple. Patients will resume activity at their own pace. The pain from the process typically will last a few days, occasionally longer, and some patients have more severe or sporadic pain than others. Because your own blood is used, there is no risk of a transmittable infection and a very low risk of allergic reaction to the treatment.

Who should give Platelet Rich Plasma Injections?

We recommend going to a clinician with experience in giving Platelet Rich Plasma injections. We activate PRP using light activation to increase their effectiveness and give Platelet Rich Plasma injections under ultrasound guidance to increase the accuracy of the procedure.

Platelet Rich Plasma Injections for Plantar Fasciitis

Side Effects of PRP injections

Most patients will experience some post-procedural pain at the injection site for up to 3 days and in some cases longer. This is typically managed with ice and over-the-counter pain relievers like Acetaminophen (Tylenol); however the physician may prescribe stronger pain relievers. Non-steroidal anti-inflammatory agents (NSAIDS) should be avoided since they interfere with the effectiveness of the PRP treatment.

Other side effects of PRP injections are very limited as the patient is utilizing their own blood, which they should have no reaction to. Sometimes the color around the skin of a PRP injection will appear bruised. Most of these side effects are temporary and resolve spontaneously within a couple of days after the initial procedure. Rare complications includes infection at the injection site and bleeding especially with anticoagulant therapy or bleeding disorders.

References:

  1. Murawski, C. D., Smyth, N. A., Newman, H., & Kennedy, J. G. (2014). A Single Platelet-Rich Plasma Injection for Chronic Midsubstance Achilles Tendinopathy A Retrospective Preliminary Analysis. Foot & ankle specialist, 1938640014532129.
  2. Abate, M. (2013). Hyaluronic Acid and Platelet Rich Plasma in Hip Osteoarthritis: Work in Progress. Surgery Curr Res, 3, e110.

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Janet Pearl MD

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