Measured preparation
We record the blood draw volume and platelet count used, then tell you the exact platelet concentration measured after centrifugation.
Regenerative medicine
I use platelet-rich plasma for selected knee osteoarthritis, chronic tendon injuries, and spine conditions when the diagnosis, image-guided target, platelet dose, and rehabilitation plan fit together.
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Care built around the diagnosis
PRP is most coherent when the diagnosis is specific, the preparation is measurable, the injection is accurately placed, and the tissue is progressively loaded afterward.
We record the blood draw volume and platelet count used, then tell you the exact platelet concentration measured after centrifugation.
Knee osteoarthritis, tendon injuries, and selected spine conditions require different targets and recovery plans.
For knee osteoarthritis, I may discuss PRP alone or PRP combined with hyaluronic acid based on your presentation and the evidence.
From question to plan
I identify the joint, tendon, or spinal structure and decide whether PRP fits.
We draw and process your blood, document the preparation, and inject under image guidance.
We coordinate relative rest, follow-up, and progressive rehabilitation.
Platelets are the part of your blood that helps you clot, and they also carry growth factors and other signaling proteins that participate in tissue repair. A PRP injection starts with a blood draw from your arm. That sample is processed so the plasma portion contains a much higher concentration of platelets than whole blood. The concentrate is then placed, usually under ultrasound or, for certain spine targets, under fluoroscopy, into the joint, tendon, or spinal structure we have already identified as the problem.
The material is autologous, which means it comes from you. Platelets carry growth factors that participate in tissue repair, which is why we use PRP as a regenerative option inside a diagnosis and a rehabilitation plan. It sits on the practice’s regenerative medicine list alongside prolotherapy and other regenerative treatments.
After the blood is drawn, it is placed in a centrifuge and separated into layers. The platelet-containing plasma is collected and, depending on the protocol, may be processed a second time. One reason some people do not get as good a result from PRP is the quantity of blood drawn and the amount of platelets actually used. That dose is something we pay attention to at Westport Longevity, Pain & Performance.7 After we draw your blood and spin it down, we will tell you the exact platelet concentration we are using that day. The rest of the plan, including physical therapy, still has to be in place.
Knee osteoarthritis is the setting in which PRP has been studied most thoroughly. A 2025 systematic review and meta-analysis of 28 randomized trials, covering 3,246 people with knee osteoarthritis, found that intra-articular PRP improved function more than hyaluronic acid, with meaningful pain relief as well, and that earlier-stage disease responded particularly well.1 People with symptomatic osteoarthritis who want to stay active are the group in whom we most often use it. Sometimes we combine PRP with hyaluronic acid for knee injections, which has some great emerging data. A meta-analysis of dual PRP and hyaluronic acid versus PRP alone found better pain and function scores with the combination, including at 12 months.8
PRP for the knee is typically a self-pay service. We discuss the fee in the visit. This page does not list a number, and it does not claim that insurance will cover the procedure. Coverage, when it exists at all, has to be verified.
Tendons are a different biological problem from a worn knee joint, and PRP is one of the tools we use when a chronic tendon injury has already had appropriate loading, time, and rehabilitation, and the ultrasound or MRI appearance matches the examination.
Lateral elbow tendinopathy, the problem most people call tennis elbow even when tennis is not involved, is one of the best-studied tendon uses of PRP. In a double-blind randomized trial of 100 people with chronic lateral epicondylitis, 73% of those treated with PRP met the success criteria at one year, compared with 49% of those treated with corticosteroid, and the PRP group continued to improve while the corticosteroid group declined after an early bump.2 A two-year follow-up of the same trial showed that the PRP advantage was still there.3 We still pair the injection with a graded loading program, because the tendon has to be able to take load after the pain eases.
Painful rotator cuff tendinopathy and partial-thickness tears are the cuff scenarios in which we use PRP. In a double-blind randomized trial of 99 people with ultrasound- or MRI-proven partial-thickness rotator cuff tears or tendinopathy, ultrasound-guided PRP produced greater improvement in pain and function at three months than corticosteroid.4 A complete tear that has retracted, or a tendon that is no longer attached in a way that can be loaded, is a different conversation, and we will say so. PRP is not a method for reattaching a tendon that needs a surgical discussion.
Greater trochanteric pain is often gluteal tendinopathy, and chronic plantar fascia pain that has lasted well beyond an ordinary flare is another site where we use PRP after stretching, load adjustment, and time have already been tried. Ultrasound lets us confirm that we are in the tendon that is tender. Hip joint osteoarthritis is thought about more like the knee conversation above than like a tendon. Across these sites, PRP is an adjunct for a tendon that is still structurally in the game, in a person who will continue loading it correctly, which is why we coordinate the weeks after the injection with concierge physical therapy.
Dr. Nessim also uses PRP for selected spine injuries, which is a different imaging world from a knee or a tendon. Spine targets are typically reached under fluoroscopy, the same live x-ray used for epidural steroid injections and medial branch blocks.
For disc-related low back pain, a double-blind randomized trial of intradiscal PRP showed significant improvements in pain, function, and patient satisfaction over eight weeks compared with control, and the functional improvement was still present at one year.5 For radicular pain from a prolapsed lumbar disc, a meta-analysis of randomized trials found that epidural PRP provided sustained improvement in pain and disability over months of follow-up, with better six-month pain and Oswestry scores than epidural steroid.6 We still start with a diagnosis. Spine-generated radicular pain and facet-mediated axial pain are not the same problem, and the target has to match the question we are trying to answer.
The visit starts with the diagnosis, not with the centrifuge. We confirm, with history, examination, and the imaging we already have or still need, that the joint, tendon, or spinal structure in question is the generator. Ultrasound is used in the room for most joint and tendon injections. Spine PRP is usually a fluoroscopy procedure.
A standard blood draw is taken from the arm. Processing takes a short interval in the same visit. The skin is cleaned. Local anesthetic may be used at the skin; we are thoughtful about placing large volumes of anesthetic into a tendon because the goal is to treat the tendon, not to soak it in numbing medicine. The concentrate is then placed under image guidance. Most people are awake and go home the same day. A driver is needed if we have used sedation, which is uncommon for joint and tendon injections and more often discussed for spine procedures. Because PRP is typically self-pay, we settle the practical questions about the visit before the blood is drawn, still without posting a fee on this page.
The injected joint, tendon, or spinal target is often sore for several days. That flare can be more noticeable than the needle itself. We ask for relative rest of the target, which means walking and ordinary life with a pause on the aggravating load, not bed rest. Anti-inflammatory medication is a separate discussion, because some protocols ask people to pause those medicines around the injection; we will tell you what we want in your case.
Tendons, in particular, need a return to graded loading. For the knee, a calmer joint is an opportunity to restore quadriceps and hip strength. When PRP helps, the change is often judged over weeks, not hours. We set follow-up on that timeline. A second injection is sometimes considered; it is not an automatic series.
Because the injectate is your own blood, allergic reaction to the plasma itself is unlikely. Infection, bleeding, and bruising remain possible with any needle through the skin. A pain flare for several days is common enough that we describe it in advance. Nerve or vessel injury is uncommon under image guidance. Intradiscal injection carries a small additional discussion about disc-space infection, which was not observed in the randomized trial cited above and is still part of consent. This page is not a consent form. Consent happens in a visit, with your medications, your imaging, and your goals in front of us.
PRP is a poor match for a joint that is being asked to become a new joint, for a tendon that is no longer attached, for an undiagnosed pain that has not been localized, and for a person who cannot participate in the rehabilitation that makes biologic injections work. Active infection, some blood and platelet disorders, and certain cancers change the plan. Anticoagulation is manageable in many cases and still has to be reviewed.
Pain and sports medicine visits do not require membership. The Westport location is planned to open in July 2027. An inquiry now helps us understand whether the problem you are describing is a knee, a tendon, a spine, or something that still needs a name.
There is no universal series. Some protocols use a single injection and reassess. Some use more than one, spaced over weeks. We decide based on the severity of the osteoarthritis, the response, and whether continued injection still has a job to do. We do not sell a package on this page.
PRP is typically a self-pay service. A few plans make exceptions; those have to be verified and should not be assumed. We will discuss the fee in the visit. This page does not list a price and does not promise coverage.
Soreness in the first several days is common. When PRP helps, the more meaningful change is often judged over weeks. That timeline is one reason we schedule follow-up on a slower clock than we would after a local-anesthetic diagnostic block, and one reason rehabilitation has time to do its work in between.
Sometimes, and the sequence matters. Corticosteroid and PRP are different tools with different time courses and different effects on tissue. We will tell you if a recent steroid injection means we should wait, and we will tell you if steroid is the more coherent next step for the problem in front of us.
Yes, in selected cases. Dr. Nessim uses PRP for certain disc-related and radicular spine injuries, under fluoroscopy, after the diagnosis is clear. It is not a substitute for a medial branch block when the problem is facet arthritis, and it is not automatically the first injection for every sciatica presentation.
For tendons, graded loading is the treatment PRP is meant to assist. For the knee, restoring strength and walking capacity is how a calmer joint becomes a more useful joint. Our physical therapy page describes that work.
Dr. Adam Nessim is the interventional spine physician at Westport Longevity, Pain & Performance. Dr. Fernando Martinez is a pain medicine physician on the team. These pages do not diagnose and do not replace a visit. Pain and sports medicine visits do not require membership. The Westport location is planned to open in July 2027; an inquiry helps us plan the first conversation.
The next step
Tell us what you are experiencing and what care you have already tried. We will help you determine the appropriate next step.