Wednesday, September 30, 2009

Plasma replacement therapy/platelet rich plasma injections

Almost 2 years ago, I tore tendons in my groin. Like a jackass, I played through it and made it much worse. By the time someone looked (using an ultrasound), the tear was 4mm long and had no interest in healing. Basically it was a scarred mess that my body had given up on fixing. It always hurt some...especially the day after activity but even when standing or stretching.

As an active guy, this was pure hell. I sought every witch doctor and treatment in the land and eventually, a real doctor recommended one of two options: dry needling or platelet rich plasma treatments.

Dry needling had the advantage of being totally covered by my insurance. Using dry needling, a doctor pulls up the injury on an ultrasound and then directs the needle to the tear using the ultrasound. The doctor tears up the scar tissue with the needle (re-injuring the body) in order to restart the healing process.

Platelet rich plasma (PRP) injections are somewhat similar. First, the doctor draws your blood. Then he spins it in a centrifuge to get a concentration of platelets. That's important because platelets are critical in the healing process--they are the heavy lifters in the healing cascade. Again, the doctor locates the tear using the ultrasound, and directs a needle to the location of the tear. In PRP, the doctor uses a smaller needle than dry needling, but also pokes the injured area from a few directions--reinjuring the area but at the same time, injecting some of the platelets into the injured area to kick the healing up a notch. Unfortunately, PRP is currently not covered by most insurance (I have a kick ass plan) and can cost $250-$750 per treatment. For tendon tears, 2-3 visits are required.

Given the choice between dry needling and PRP, I chose the later. To me, it made sense.

The blood draw is nothing. The needle to the tendon (in my case, groin) is painful but some novacaine takes the edge off and it wasn't bad. Post-needle, tylenol (you can't take motrin or other anti-infalmmatories because you want the blood to flow to the area) takes the edge off and was fine for me. My doc was willing tot give me more for the pain but I didn't need it. I was back to swimming and light gym work in a couple days.

2 treatments and 3 months after the initial treatment, my 2-year old tendon tear is 100% healed. If you're in the Philadelphia area, drop me an email and I'll be happy to recommend my doctor. Otherwise, make sure that you get a doctor who knows how to use the ultrasound (the critical component) and has done this before.