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Platelet Rich Plasma Injections for Plantar Fasciitis
Platelet rich plasma therapy (abbreviated as PRP) is a regenerative treatment for Plantar Fasciitis that consists on the injection of your own platelets to trigger the body’s natural repair and regeneration processes. PRP is effective in the treatment of several musculoskeletal conditions, including injury of tendons, ligaments, muscles and joints. PRP injections have been replacing traditional surgery for many orthopedic conditions ranging from soft tissue injuries (tendonitis, ligament injuries, muscle tears) to joint disorders, such as a meniscus tear or mild to moderate joint arthritis.
PRP therapy takes advantage of the fact that platelets have an important role in the process of wound and soft tissue healing, particularly when inflammation has developed. PRP therapy requires only a small amount of your own blood. This sample is centrifuged to obtain a fraction that has a high concentration of activated platelets—the platelet rich plasma fraction. The PRP is then injected into the injured tissue to promote its healing.
The administration of these activated platelets causes a local response that promotes healing and regeneration. This treatment exerts beneficial effects through several mechanisms. These include:
- Stimulation of the tissue’s natural regeneration processes via the activation and release of natural growth factors in the injured tissue.
- Local inflammatory reaction that promotes the increase of blood flow to the injured tissue.
- Restriction of scar tissue formation.
We perform this procedure using ultrasound imaging to guide the injection. Ultrasound guidance increases the accuracy of the PRP administration, which may decrease pain following the procedure. We also use light activation to increase the efficacy of our platelets, which may also reduce any discomfort you may feel after the procedure. In general, PRP therapy requires only one session, but depending on the clinical characteristics of your Plantar Fasciitis, additional injections may be needed.
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Step 1: Collect Blood
Step 2: Centrifuge Blood
Step 3: Light Activation
Step 4: Inject Under Ultrasound Guidance
Your body’s growth factors that are present in Platelet Rich Plasma include:
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:
- 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.
- 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?
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.
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:
- 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.
- Abate, M. (2013). Hyaluronic Acid and Platelet Rich Plasma in Hip Osteoarthritis: Work in Progress. Surgery Curr Res, 3, e110.
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600 Worcester Rd, Suite 301,
Framingham, MA 01702
600 Worcester Rd, Suite 301,
Framingham, MA 01702
This information is for educational purposes only and is NOT intended to replace the care or advice given by your physician. Always seek the advice of your physician or other qualified health provider before starting any new treatment or with any questions you may have regarding a medical condition. For more information see our Medical Disclaimer.
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