In the past I have discussed PRP or plasma rich protein injections. Studies are very few that show that these injections actually help long term. The only studies reveal that PRP does help with tendonitis, specifically around the elbow. A lot of patients of mine think that PRP injections are new. They are not. PRP has been around since the late 1980’s. I used to work with a spine surgeon who utilized it on every spine surgery in the 1990’s and then stopped because he couldn’t find that it did anything. In my opinion, I do believe it will help with tendon related injuries but that is all. I have seen local doctors inject this stuff everywhere and they even inject it for wrinkles. There is little proof that it actually works but it makes the doctors a lot of money since it is a cash based treatment. At our office, we offer PRP injections at a reasonable price that is currently $400 plus the cost of the injection. While that may sound like a lot, the cost of the disposables involved is over $300. The disposables are a kit that you have to purchase from the maker of the centrifuge and thus they charge $300 for $30 dollars worth of stuff. Other places charge over a thousand dollars an injection. Personally, if you have shoulder or other tendon related pain then this might benefit you but if you get no relief with the first injection than don’t waste your money on repeating it. The real reason PRP has become popular is that it is a cash related business and as you are seeing more and more of, doctor are trying to get away from insurance, if possible. That is why you see these primary care doctors becoming concierge doctors and charging annual fees to see you as a patient. If I were a patient, this would annoy me since I already pay for health insurance and it is a known fact that if you call the doctor too often, he won’t renew your membership the next year. So again, PRP may help for tendon related issues but the literature is weak. As for stem cells, tis is another cash based business and everyone is jumping on the stem cell bandwagon. People think that stems cells cure or rejuvenate and that is the hope but the reality is that there are few studies that truly reveal that stem cells do much at all. This is why insurance companies will not pay for them. I personally did a stem cell study for the treatment of disc issues in around 2005 and the results were poor. The reality is that stem cells already exist in your body and the injection of premade stem cells may not survive. This is another injection that you might consider once but if you do not get improvement with one than don’t waste your money on any others. If your doctors says insurance doesn’t cover a procedure than be cautious about proceeding with them and ask questions.
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