PRP Therapy for Joint Pain: What the Research Actually Shows
Platelet rich plasma (PRP) therapy has become one of the most talked-about treatments in pain medicine over the past decade. But with growing popularity comes growing confusion — and plenty of overpromising. As a physician who uses PRP regularly in my practice, I want to give you an honest, evidence-based picture of what PRP can and cannot do.
What Is PRP?
PRP is made from your own blood. A blood draw is taken, spun in a centrifuge to concentrate the platelets, and the resulting plasma — rich in growth factors including PDGF, TGF-β, VEGF, and IGF-1 — is injected into the affected joint or tissue.
These growth factors promote healing by attracting stem cells, stimulating tissue regeneration, and modulating the inflammatory environment in the joint.
The Evidence for Knee Osteoarthritis
Knee osteoarthritis is where PRP has the strongest evidence base. Multiple systematic reviews and randomized controlled trials show that PRP:
- Provides significantly greater pain relief than corticosteroid injections at 6 and 12 months
- Improves function scores compared to hyaluronic acid at 12 months
- Has a durable effect that builds over weeks to months post-injection
The results are most impressive in patients with mild to moderate knee osteoarthritis. Severe, bone-on-bone arthritis responds less robustly — though even these patients often benefit.
Hip and Shoulder Arthritis
Evidence for hip and shoulder OA is less extensive than for the knee, but growing. Clinical studies and my own practice experience support meaningful improvement in many patients with hip and shoulder arthritis who have not responded well to steroid injections.
What PRP Is NOT Good For
PRP is not a cure for arthritis. It doesn't reverse structural damage that's already occurred. And it doesn't work equally well for everyone. Patients with the following characteristics tend to respond less well:
- Very advanced (Grade 4) osteoarthritis with severe joint space narrowing
- Active inflammatory arthritis (rheumatoid arthritis, psoriatic arthritis) not controlled by disease-modifying drugs
- Obesity — higher BMI is associated with poorer PRP outcomes in some studies
How Many Injections?
Most of my patients start with a series of 1–3 injections spaced 4–6 weeks apart. The decision depends on the severity of the condition and initial response. Many patients maintain benefit for 12–18 months before considering repeat treatment.
Self-Pay Only — And Worth Discussing
PRP for musculoskeletal conditions is not covered by Medicare or most commercial insurance — it is a self-pay treatment. The cost is real, but for patients who have repeatedly gotten only 6–8 weeks of relief from steroid injections, PRP often provides significantly longer-lasting results and is worth the investment.
If you're interested in PRP therapy for joint pain, call our office at 516-492-3100 to discuss whether you're a good candidate.