PRP Therapy for Musculoskeletal Conditions: What You Need to Know

Platelet-rich plasma (PRP) has moved from research labs into many orthopedic and sports-medicine clinics over the last decade. Promoted as a “regenerative” option that uses your own blood to stimulate healing, PRP is being used for joint pain, tendon injuries, and some soft-tissue problems. But what does the evidence actually say, who is a good candidate, and what should you expect if you’re considering PRP? This guide walks through the essentials in plain language so you can make a more informed decision.

What is PRP Therapy… in plain terms?

PRP is made by drawing a small amount of your blood, spinning it in a centrifuge to concentrate the platelets, and then injecting that platelet-rich fraction into the injured area. Platelets contain growth factors and signaling molecules that—at least in theory—help jump-start tissue repair and reduce inflammation. Because the material comes from your own blood, PRP avoids immune reactions that can follow foreign substances. 

Which musculoskeletal problems is PRP used for?

Clinics commonly offer PRP for a range of conditions, including:

• Knee osteoarthritis (mild–moderate).
• Tendinopathies such as tennis elbow (lateral epicondylitis), Achilles tendinopathy, and plantar fasciitis.
• Rotator cuff tendinopathy and other shoulder problems.
• Some focal ligament or meniscal issues, and as an adjunct in certain surgical repairs.

The strength of evidence varies by condition: knee osteoarthritis and several tendinopathies have the strongest and most consistent support, while results for other applications can be mixed. 

What does the research say about effectiveness?

Overall, systematic reviews and recent meta-analyses suggest PRP can reduce pain and improve function for many people—especially in knee osteoarthritis and specific tendon injuries. Several high-quality meta-analyses published recently report clinically relevant improvements in pain and functional scores at 3–12 months after PRP versus saline or hyaluronic acid in knee OA. Results for rotator cuff tendinopathy and lateral epicondylitis are promising for short- to mid-term relief, though long-term superiority is less consistent across studies. Importantly, study designs, PRP preparation methods, and outcome measures differ widely, which contributes to variability in results. 

Why do study results differ so much?

There are several reasons:

• PRP is not a single, standardized product. Different labs and clinics use different centrifugation speeds, volumes, and protocols; some concentrates leukocytes (white blood cells) while others intentionally reduce them. These differences can affect the mix of growth factors and inflammatory molecules.
• Activation methods vary. Some providers “activate” PRP with calcium or thrombin before injecting; others inject it unactivated and rely on the body to activate platelets. Activation can change how quickly growth factors are released.
• Patient selection and severity matter. PRP tends to perform better in early-to-moderate joint disease or focal tendon degeneration than in advanced arthritis or complete tendon ruptures.
• Differences in outcome measures and follow-up length. Some trials look at pain at 3 months; others look at function at 12 months—those are not directly comparable.

The procedure: what happens during a PRP visit?

1. Consultation and consent. Your clinician will review history, prior treatments, and imaging (if needed).
2. Blood draw. A small amount of blood (typically 30–60 mL) is taken from your arm.
3. Centrifugation. The clinic spins the blood to separate the platelet-rich layer.
4. Injection. Using sterile technique, the provider injects the PRP into the targeted area—often with ultrasound guidance to increase accuracy. The whole clinic visit usually takes 45–90 minutes.

How many injections and what’s the recovery like?

• Number of treatments: Common protocols range from a single injection to a series of 2–3 injections spaced 2–6 weeks apart, depending on the condition and provider.
• Immediate recovery: You may have soreness and mild swelling at the injection site for 48–72 hours; some patients describe a short-term increase in pain before improvement. Rest for 24–48 hours, avoid heavy exercise for about a week, and follow the clinic’s post-procedure instructions.

Risks and side effects

PRP is generally low risk because it uses autologous blood, but it is not risk-free. Possible issues include:

• Transient increase in pain or inflammation at the injection site.
• Infection (rare, as with any injection).
• Needle injury to adjacent structures (nerve or tendon), which is why image guidance is often recommended.
• Variable outcomes—some people get meaningful relief, others get little or no benefit.

Contraindications and precautions

PRP is usually avoided in patients with active infection, blood-borne illnesses, platelet disorders, or certain blood-clotting problems. If you take strong blood thinners or have a platelet dysfunction, your provider will evaluate risks and may coordinate with your prescribing clinician. Also, because PRP is considered an experimental or evolving therapy for many indications, insurance coverage is inconsistent. In some regions or for some indications Medicare and other insurers may not cover PRP because of variable evidence.

Cost and insurance

Costs vary widely depending on the clinic, number of injections, and geographic area. Because PRP is often classified as a regenerative or investigational treatment, many insurers consider it elective and don’t reimburse it—so expect out-of-pocket expense unless your plan explicitly covers it. Always check with your insurer and ask the clinic for a full price estimate and billing policy.

How to choose a provider

• Pick an experienced clinician who performs PRP regularly (orthopedic surgeons, sports-medicine physicians, physiatrists, or trained sports-medicine NPs/physician assistants).
• Ask about technique details: how they prepare PRP (leukocyte-rich vs. poor), whether they activate it, whether they use ultrasound guidance, and the number/timing of injections they recommend.
• Request outcome data or published protocols if available, and ask about complication rates.
• Beware of overpromising. Clinics that guarantee dramatic tissue “regeneration” or sell PRP alongside a long list of miracle cures should raise red flags.

Bottom line

PRP is a promising, low-risk option for many musculoskeletal complaints—especially certain tendinopathies and mild-to-moderate knee osteoarthritis—but it’s not a miracle cure. Evidence supports meaningful short- to mid-term improvements in many patients, but response varies, and protocols are not standardized. If you’re considering PRP, discuss realistic goals, possible alternatives (physical therapy, injections such as corticosteroid or hyaluronic acid, surgery when appropriate), expected costs, and the specific technique your pain management provider.