Scientists are still exploring which patients should be eligible for PRP injections. While no definitive conclusions can be made, experts recommend that patients have already tried appropriate traditional non-surgical treatments such as rest and physical therapy.

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Suggested Indications for Treating Tendons with PRP

Experts have not developed definitive criteria for deciding when and to whom to recommend PRP injections, but some suggestions are below:

  • Tendon pain affects daily activities
  • Physical therapy has not adequately improved function and reduced pain
  • Other non-surgical treatments have failed or been eliminated
  • The patient is sensitive to anti-inflammatory medications (NSAIDs) such as ibuprofen; finds medications do not provide adequate pain relief; or wants to avoid long-term use of medications.
  • Surgical treatment is not optional or not desired.

Platelet-rich plasma injections may not be recommended for the most severe cases of tendinosis or tendinopathy. In these cases a doctor may advise the patient to consider surgery to repair the damaged tendon.

Contraindications for PRP Therapy

Platelet-rich plasma injections may not be appropriate for a patient who:

  • Has a medical condition that could worsen or spread with injections, such as an active infection, a metastatic disease, or certain skin diseases
  • Has certain blood and bleeding disorders
  • Is undergoing anticoagulation therapy (and cannot temporarily suspend treatment)
  • Is anemic
  • Is pregnant

Additionally, patients who have an allergy to cow products should tell their doctor. These patients could experience an allergic reaction if the platelet-rich plasma is combined with an additive called bovine thrombin, which is derived from cows.

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