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Platelet-Rich Plasma (PRP) and Injection Therapies PDF

What the evidence shows for platelet-rich plasma and related injection therapies in tendinopathy, osteoarthritis and rotator cuff disease — where they help and where the data is weak.

What you're feeling

You may notice a deep ache in your knee or elbow that lingers after you have been active. This pain often feels worse at night, making it hard to find a comfortable sleeping position. You might also feel stiffness when you first wake up in the morning. For some, the discomfort flares up after you have been on your feet for a while.

In your elbow, the pain is usually on the outside of the joint. You might feel tenderness when you grip objects or lift things. Simple tasks like turning a doorknob or tucking in a shirt can become difficult. If you have knee issues, you may find it harder to climb stairs or stand up from a chair. The pain can limit your ability to reach behind your back to fasten a bra or button a shirt.

You might also experience swelling or a feeling of fullness in the joint. This is often due to inflammation. In acute knee injuries, this swelling can be significant. You may notice that rest helps reduce the pain, while activity brings it back. Your doctor will look at these symptoms to decide if injection therapy is right for you.

For knee osteoarthritis, effects from treatment typically last for at least 24 weeks. You might need at least two injections to get the best result. If you have lateral epicondylitis (tennis elbow), high-dose PRP shows significant efficacy. However, evidence does not support PRP as a recommended treatment for this condition compared with placebo. Routine use is also not supported for greater trochanteric pain syndrome (hip pain).

If you are a competition sports practitioner, PRP therapy is recommended for large joint osteoarthritis. It can effectively improve pain and functional impairment in tendinopathy. In the early follow-up period, PRP injections are considered a safe and effective conservative treatment for reducing pain symptoms. You may find that your daily tasks become easier as the inflammation subsides.

What's actually happening

Your body uses special fluids to heal itself. Platelet-rich plasma (PRP) is a concentrated version of your own blood. It contains platelets, which are cells that help repair tissue. When you have wear-and-tear arthritis or a strained tendon, your body’s natural healing is not enough. The tissue becomes inflamed or damaged.

For knee osteoarthritis, the smooth coating on your bone ends wears down. This causes pain and stiffness. Your doctor may recommend at least two PRP injections for this condition. The goal is to reduce inflammation and support repair. The effects of these injections last for at least 24 weeks. You can receive leukocyte-rich or leukocyte-poor PRP. Both options work well for knee osteoarthritis. The choice depends on how advanced the wear-and-tear is. Early stages often need less inflammation control. Advanced stages may need more support for tissue repair.

For conditions like lateral epicondylitis (tennis elbow), the tendon fibers are strained. PRP can help calm this irritation. Higher doses of PRP often provide more symptom relief. You may feel less pain over time compared to using corticosteroids. However, PRP is not a cure-all. It does not work for every condition. For example, it is not recommended for Achilles tendinopathy or greater trochanteric pain syndrome. Routine use is not supported for these issues.

In sports injuries, PRP can help acute muscle strains. It may also reduce the risk of retear after rotator cuff repair. This is a surgery to fix shoulder tendons. Using leukocyte-poor PRP during this repair can help the tendon heal stronger. The concentration of platelets matters. A higher concentration often leads to better results for elbow pain. But for some conditions, the evidence is not strong enough to recommend PRP yet. Your doctor will decide if it is right for you based on your specific injury and stage of healing.

What we can do about it

Start with self-care and physical therapy. Gentle exercises help keep your joints moving and strengthen the muscles around them. This support reduces stress on the damaged areas. Your physiotherapist will guide you through safe movements. Give this approach time to work. Consistency is key to seeing real improvement in your daily comfort.

If simple measures are not enough, your doctor may suggest medical management. For knee osteoarthritis, platelet-rich plasma (PRP) injections are a strong option. PRP uses your own blood to help heal tissue. At least two PRP injections are recommended for treating knee osteoarthritis, with effects lasting for at least 24 weeks. You can choose between leukocyte-rich PRP or leukocyte-poor PRP. Both are effective treatment options for knee osteoarthritis with comparable efficacy. For early arthritis, low platelet and high leukocyte PRP reduces inflammation. For advanced arthritis, high platelet and low leukocyte PRP promotes repair. Combining PRP with hyaluronic acid is safe and yields better outcomes in pain relief and functional improvement compared to PRP monotherapy.

For other conditions, results vary. PRP injections are a safe and effective conservative treatment for reducing pain symptoms and increasing functionality in patients with lateral epicondylitis in the early follow-up period. However, evidence does not support PRP as a recommended treatment for lateral epicondylitis when compared with placebo. It is also no more effective than placebo for treating Achilles tendinopathy and should not be used for this indication until new, large, high-quality RCTs upend current knowledge. Routine use of PRP is not supported for the treatment of greater trochanteric pain syndrome. If symptoms are severe and persist despite the above, a doctor may refer you for specialist assessment. For some specific conditions, a procedure may occasionally be considered to restore function and relieve pain.

When to see someone

Ask for a specialist review if your knee pain persists despite rest. You may need at least two PRP injections for wear-and-tear arthritis, with effects lasting at least 24 weeks. See your GP if you have elbow pain from tennis elbow. High-dose PRP can help, though results vary by concentration. Seek care if symptoms interfere with sleep or work. PRP is also recommended for competition sports practitioners with joint issues. However, routine use is not supported for hip pain or certain elbow conditions. Your doctor will tailor the plan to your specific stage of arthritis or injury.

Reviewed by Kieran Hirpara · 2026-06-13 00:36:31.165653+00:00.

Want the clinical detail? Read the clinician version.

Talk to your treating clinician for advice specific to you.

For an appointment with the CQ Hand + Upper Limb team, ask your GP about a referral or visit www.cqupperlimb.com.

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