PRP for Pain

What is PRP?

Platelet-rich plasma starts as a small sample of your own blood that we spin in a centrifuge. The sample then separates into layers including red blood cells and plasma. The platelet-rich layer of plasma is then withdrawn and injected directly into the joint, tendon, or muscle that’s causing pain. Platelets release growth factors that can improve local inflammation and support the tissue’s own repair process. For this reason, PRP is sometimes described as regenerative.

Because it’s made from your own blood, there’s no donor tissue and no medications other than local anesthetic used. One downside of PRP compared to cortisone is that its effect builds gradually as those growth factors activate.

PRP can be prepared as leukocyte-poor (fewer white blood cells, generally used for joints) or leukocyte-rich (more white blood cells, generally used for tendons), and given as a single injection or a short series. The right combination depends on the specific diagnosis, which is why every condition in our full evidence-graded patient guide is handled differently.

Appointment day

PRP is a same-day, in-office procedure. Most patients are in and out in under an hour: roughly 5–10 minutes for the blood draw, 5–10 minutes of centrifuge processing, and 15–20 minutes to prepare and inject — 45 to 60 minutes in total, including paperwork and talking to the doctor.

1 · Check-in

Consent, history, and physical exam. We confirm your signed consent and other paperwork, review your current medications and history, and answer any last questions you may have.

2 · Blood draw

A standard blood draw. Between 20 and 60mL of blood, depending on your specific diagnosis.

3 · Processing

Your blood is centrifuged and separated in-office. The centrifuge concentrates the platelet layer while you wait, and Dr. Vargas uses the ultrasound to scan the injection site.

4 · Injection

Sterile prep and an ultrasound-guided injection. Ultrasound lets us confirm the needle tip is exactly where it needs to be for the procedure.

5 · Walkout

Written aftercare instructions and your follow-up booked. You can typically drive yourself home. If your indication calls for a short series instead of a single injection, we will schedule the next one before you leave.

How to prepare

Eat a normal meal, stay well hydrated, bring your full medication and supplement list, wear loose clothing, and have your goals ready to discuss with Dr. Vargas.

Hold before your appointment

• NSAIDs (ibuprofen, naproxen). Hold about 3 days before. Aspirin needs a longer hold, about 7 days before.
• Natural supplements and naturopathic agents. Fish oil, turmeric and high-dose vitamin E: hold at least 1 week before.
• Tobacco and alcohol. Both show lab evidence of platelet toxicity; avoid through the whole window around your visit.

Talk to us first

• Blood thinners (anticoagulants). Never stop these on your own; we will coordinate any hold with the prescribing physician.
• A cortisone shot at the same site in the last 4–6 weeks. This can blunt PRP’s effect if the timing is too close.
• DMARDs or other immune-modulating medications. Usually continued as prescribed, but we flag them so we can coordinate if needed.

What to avoid afterward

NSAIDs can make the injection less effective, and rigorous exercise can exacerbate soreness.

Avoid

• NSAIDs (ibuprofen, naproxen, aspirin) for 4 weeks. Use acetaminophen instead if you need pain relief. Suzetrigine can help for severe flares.
• Heavy weight-bearing or stress on the treated area for 2 to 7 days. The exact restriction depends on the joint or tendon treated.

Expect and do

• A 24–72 hour flare is normal. Treat with acetaminophen and rest, not NSAIDs.
• Gentle stretching and range-of-motion, days 2–7. Progressive strengthening usually starts days 14–21.
• Return to full activity around 4–6 weeks. The timeline depends on your rehab progression.
• Keep your follow-up appointment. Some indications call for a short series, 2–6 weeks apart, decided based on your response.

PRP compared with cortisone

Neither is universally better; the choice depends on the side-effect profile and your medical history.

	PRP	Cortisone
Mechanism	Your own concentrated platelets, released to support tissue repair and modulate inflammation.	A potent anti-inflammatory medication that suppresses local inflammation directly.
Onset	Gradual: the growth-factor effect builds over roughly 8 weeks.	Fast: often noticeable within days.
Duration of relief	Tends to last longer once it takes hold; in several ASPN-graded conditions it outperforms cortisone from around 3 months onward.	Often the more effective option in the first few weeks, but relief can fade over subsequent months.
Typical side effects	Injection-site soreness, a common 24–72 hour flare, bruising; since it is autologous, systemic side effects are rare.	Generally well tolerated short-term; can cause a transient blood-sugar rise in diabetic patients and local skin or fat thinning with repeated use.
Repeat use	Often given as a short series (1–3 injections) without the same cumulative tissue concerns.	Usually limited to a small number of injections per site per year, due to cumulative tissue effects.

Guided by graded evidence, not habit

Every recommendation on this page and in our diagnosis-by-diagnosis guide is checked against the American Society of Pain and Neuroscience (ASPN) 2024 consensus guideline, a Delphi-derived, multispecialty review of the injectable-biologics literature (D’Souza et al., Journal of Pain Research, 2024). Where the evidence is strong, we say so; where it is thin or mixed, we say that too.

Level I–III study quality · Grade A/B favorable · Grade C mixed · Grade D not recommended · Grade I insufficient evidence

The medication holds and aftercare timeline on this page come from that same guideline’s peri-procedural evidence review, not informal practice habit.

Medical review

Andrew Vargas, MD
Board-Certified, Anesthesiology & Chronic Pain Management · Ivy en Rose, San Francisco
Medical College of Wisconsin, MD 2015 · UCSF Anesthesiology Residency · UCSF Pain Management Fellowship · ASPN · NANS · ASRA

This page is for general patient education and doesn’t replace an in-person evaluation. PRP is a regulated human cell/tissue product, not an FDA-approved drug or device — its use here is generally off-label and self-pay. Whether PRP is right for you, which preparation to use, and whether a series is appropriate should be decided with your treating provider based on your specific history, exam, and imaging.

Last reviewed September 2026.