PRP Injections or Platelet Rich Plasma, are a great alternative to Sterioid Injections. Here is why.
PRP Injections for joint pain
This post is for anyone interested in alternatives to steroid injections and not wanting or able to do surgery. PRP lasts longer, they use your own plasma, and there's no extra breakdown of your tissue like Steroids. Unfortunately, the medical establishiments in the US have yet to cover the expence. They can range from $600-$1500 depending on who you go to. But the fact they last so much longer and could potentially only need 1 -3 rounds depending on your joint, is well worth it.
Brief history of my hips
When I was in college as a ballet major I injured my Right hip. I had an MRI but it came back inconclusive. I was told it must be Psoas tendinitis. Your Psoas is a major hip flexor and my hip flexors were so in pain it hurt to walk some days. Other days, I could still do a ballet barre but found it difficult to do external rotation with abduction unsupported ( see picture below).
Fast forward 15 years later…
My hips hurt a lot and normal physical therapy wasn’t helping. I spoke with a sports medicine doctor who suggested that the only way to know for sure if I had a tear or injury in my hip, was to get CONTRAST DYE injection for the MRI results to show up on the images. I highlight that because a lot of doctors won’t do it unless you ask. I immediately got in for that procedure and low and behold I had a labral tear to the superior anterior surface of my hip. What they also found is mild cam deformity (the neck of my leg bone was malformed) along with mild hip dysplasia (hip acetabulum doesn’t fully cover the head of the femur bone) which allows for more range of motion of the femur.
After speaking with a surgeon, he was hesitant to do surgery because he wanted a second opinion from another surgeon who does PAO (peri acetabular osteotomies). This procedure is to fix the hip dysplasia. They basically go in and saw your hip, readjust it over the femur head, attach it with screws. The results from that are a year recovery, and often times patients need a 2nd surgery to get the screws out, with another year recovery.
Due to limitations in my insurance..
and there being only 3 doctors available, which none called me back... I was left with really not a lot of options. Until, I asked about other less invasive options. My sports Medicine doctor suggested steroid injections and PRP and Stem Cell. I have had two steroid injections into my hips. Both gave minimal results, maybe lasted a month and I became super angry and emotional during the second round. Steroids are covered by insurance, but they break down the tissue over time. Funny that something that makes you worse is covered by insurance....hmmm.
I then researched PRP doctors.
The procedure: Platelet Rich Plasma
They take vials of your own blood, put it in a centrifuge to separate the plasma. The platelets in your blood help with wound healing and the plasma provides cushioning. Results vary for how long they last but on average results are a year. I had this procedure in 2023. Almost a year to that date, I woke up with the deep arthritic ache I had forgotten about. Within a day it was so bad I was calling my doctor desperate for pain killers.
Seeing the PRP specialist they said it was unusual for my pain to come back so quickly. Usually, it comes back gradually. This type of dismissiveness really boils my blood. I know my body better than anybody, how dare they tell me it couldn’t possibly be the PRP running out. After asking a physical therapist I trusted who works with people in the hypermobility spectrum, she assured me everyone’s results are different and it didn’t surprise her it came back so fast.
2nd Procedure TIPS for the ladies.
I convinced the doctors to get me ASAP for the procedure. I was scheduled within a week and given muscle relaxers to cope until then. Some helpful tips for the ladies, when I got my first procedure my period came on very fast right after I sat down from the injection table. Word to the wise, bring tampons, they don’t always have them in the bathrooms. And, because they take so much blood ( for me 5 vials) I ate 2 days prior meals with steak and had enough for the next day or two after to continue eating red meat. I am borderline anemic and this helped me greatly.
They will prescribe drugs to pick up prior to the procedure. Mine was an opioid, a drug for anti nausea and one to help constipation. You want your pain meds with you on the day of surgery. You also will need a driver. I took my opioid immediately as I sat down. I got woozy after that much blood was taken and the stress of HUGE NEEDLES going deep into my body so it took me 15 minutes to feel okay enough to walk.
After the procedure
I was bedridden the day of the procedure and for 4 additional days in bed. My pain tolerance was 2-3 pills a day. I stuck to walking to the bathroom and kitchen. By the 5th- 7th day after I was feeling okay to stand and walk a little bit more and return to work only sitting.
By the 8th day I was able to wake up with NO PAIN!!!! This is huge. I had to take 500 mg Tylenol 2x a day. But that is a relief from having to rely on muscle relaxers which make you incredibly sleepy and unmotivated. By the weekend, the 9th day I didn’t need any pain killers and was able to walk on flat surfaces for 30 minutes.
They send you a packet of what not to do.
Stay hydrated (crazy hydrated) no alcohol or sugary foods. I tested both of these, and I instantly had increased pain. Sticking to a healthy diet with fresh fruit. I ate 3 pieces a day to be able to stay regular…trust me it helps b/c the pain meds block you.
Do activity to your tolerance.
No deep bending, twisting or squatting. You leave pretty stiff the same day but it gets better. The physical therapy exercises are sooooo light. For instance lying glute squeeze and holding for 10 seconds. My muscles were quivering just from this exercise. So prepare for the HARD fact your body is starting back at ZERO for activity and you have to give it time. Slow is the fastest way to recover. My nurse who drew my blood had PRP and her results didn’t last nearly as long as mine did because she returned to activity too hard and too quickly. So word to the wise, go slow.
Shockwave Treatment
This is an additional add on. Shockwave uses sound waves to penetrate deeply into your tissues to release tight tissue, helping even the ligaments, tendons and bone. It apparently tells your cells to reorganize to where they should be. It feels very weird but I had 6 sessions last year and it relieved nagging muscle tightness I had had for years of compensation. It is worth it, in my opinion. 2nd session, I am crossing fingers for 18 months of relief which is typical. To read more about shockwave click below.
I hope this was helpful, funny and insightful for anyone curious and needing help and relief. If Surgery isn't possible for you for whatever reason I recommend you look into PRP doctors in your area and get a few quotes and talk with the specialists to see if you jive well.
Best on your journey.
-Jessa
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