Own blood plasma injection may provide relief for tendinopathy, where traditional treatment fails

Mayo Clinic Health LetterMar 22 2010

When tendon trouble -- such as tennis elbow or Achilles tendon pain -- doesn’t respond to traditional treatment, an injection of the patient’s own blood plasma into the tendon may provide relief.

The March issue of Mayo Clinic Health Letter describes this new treatment approach, now being used for some patients at Mayo Clinic.

Tendinopathy, ongoing pain in frequently used tendons, can affect the elbow, knee, hamstring tendons, Achilles tendon and other tendons. Traditional treatments are physical therapy, medications, activity modification and the use of a brace. Even with treatment, the pain associated with tendinopathy can drag on for months.

In the past, doctors have believed that tendinopathy resulted from inflammation. Now, researchers are approaching treatment from a different perspective, one that doesn’t focus on reducing inflammation, but instead stimulates healing of the tendon.

Platelet-rich plasma (PRP) is injected directly into the ailing tendon. Plasma is the liquid portion of the blood that transports red and white blood cells and platelets through the blood vessels. It’s derived from the patient’s own blood, a process that involves spinning a blood sample at high speeds. One byproduct is plasma, which contains a high concentration of platelets -- thus the name platelet-rich plasma.

Doctors have found that about 70 percent of those receiving PRP therapy showed improvement. Early research suggests that PRP injections:

• Attract healing cells to tendon tissues that have deteriorated
• Stimulate new growth of tendon cells
• Stimulate production of tendon collagen -- the building blocks that give tendons their strength

PRP is still considered experimental and is not appropriate for all patients. At Mayo Clinic, the use of PRP is considered when tendon problems have persisted for three months and haven’t responded to nonsurgical treatments. Those with bleeding disorders, a platelet disorder or infection are not candidates for PRP therapy.