For more than a decade now, platelet rich plasma (PRP) therapy has been used for treating the many problems which can afflict the shoulder — torn and injured ligaments and tendons, tendonitis at the rotator cuff, impingements, and more.
Among the conditions which it may help is shoulder impingement — a painful condition which produces shoulder pain as a result of bursitis or tendonitis in the acromiclavicular joint, or due to rotator cuff tendonitis.
This condition is frequently over-diagnosed, and many doctors are very fast to recommend surgery, yet surgery often leaves patients with residual pain even after the procedure.
PRP therapy therefore represents a welcome alternative for many patients.
What Is A Shoulder Impingement?
Shoulder impingements begin with bursitis or tendonitis in the acromioclavicular joint, or with a tendonitis in the rotator cuff.
The acromioclavicular joint is the joint which allows the clavicle to articulate with the frontal part of the scapula.
In theory, excessive impingement which is associated with the rotator cuff tendons rubbing over the scapula and under the clavicle results in shoulder pain. Nevertheless, many doctors are too quick to diagnose this as the cause of a particular patient’s pain — and too quick to offer surgery as the best method of treatment for shoulder pain in these patients.
As with back pain, most of these cases can be treated successfully with conservative therapy. On the other hand, an MRI scan can help assess the amount of rotator cuff or shoulder joint tissue injury.
A careful approach to recommending surgery is worthwhile as many patients who have arthroscopic surgery for this condition end up still suffering from pain even after the procedure. They also must undergo weeks or months worth of rehabilitative therapy.
How Platelet Rich Plasma Therapy May Be An Effective Treatment For Shoulder Pain
Platelet rich plasma, or PRP, may offer patients a non-surgical treatment for rotator cuff injuries and shoulder pain. PRP therapy works by enhancing the body’s natural process of healing, rather than cutting away tissue or injecting steroids.
The therapy begins when the patient’s blood is drawn and then processed using a sterile technique. The PRP is isolated and then drawn off, producing a platelet concentration which may be as much as 700% of the baseline.
These platelets contain growth factors, cytokines, and proteins which, once injected, will trigger a cascade of tissue regeneration and healing.
Then, the PRP is injected into the region of “impingement” or damaged tissue. White blood cells (macrophages) come into the region where the PRP was injected to clean away the damaged tissue.
A protein matrix forms to which the new tissue attaches. Fibroblasts come in to form new and strong collagen fibers, rebuilding the damaged tendons, ligaments, or cartilage. Stem cells are also recruited into the region — they differentiate into whichever tissue cells are needed to produce healing.
This whole process happens over 6-8 weeks.
Compared with surgery, PRP therapy takes just an hour or so and can be done in the office, without a hospital stay. Patients do not need rehab and don’t have any “down time.”
For many patients with shoulder pain, PRP may be able to help them avoid the many disadvantages of invasive therapies.