What to Expect from an Ultrasound-Guided Injection Made from Your Own Blood
Platelet-rich plasma (PRP) is made from a small sample of your own blood. Your blood is spun in a centrifuge to concentrate the platelets, which carry growth factors involved in tissue repair, and the concentrate is injected into the injured tendon, joint, or muscle under ultrasound guidance. The whole process takes place in our office in a single visit. PRP is not a quick fix: its effect builds gradually over about eight weeks, and how well it works depends a great deal on the condition being treated.
Who May Be a Candidate
PRP tends to work best when there is a clear, specific source of pain that can be seen on exam and imaging:
Tendon problems such as tennis elbow, rotator cuff tendinopathy, plantar fasciitis, and gluteal tendinopathy.
Joint arthritis, especially mild to moderate knee osteoarthritis (not bone-on-bone disease).
Select spine conditions, such as facet or sacroiliac joint pain, using x-ray guidance.
People who have already tried physical therapy, activity changes, and other first-line treatments without enough relief.
PRP is less likely to help widespread pain, pain driven mainly by the nervous system, or a complete tendon or ligament tear that needs surgical repair.
How Strong Is the Evidence?
The evidence varies widely by condition. The list below summarizes the 2024 American Society of Pain and Neuroscience (ASPN) multispecialty consensus guideline and newer studies through 2026. Grade A/B means favorable, consistent evidence; Grade C means mixed results; Grade D means current evidence does not support routine use; Grade I means there isn't enough evidence to judge.
Knee osteoarthritis: Level I · B
Tennis elbow (lateral epicondylitis): Level I · B
Rotator cuff tendinopathy: Level I · B
Shoulder (glenohumeral) arthritis: Level I · B
Plantar fasciitis: Level I · B
Lumbar facet and sacroiliac joint pain: Level I · B (x-ray guided)
Hip osteoarthritis: Level I · C
Gluteal and hamstring tendinopathy: Level I · C
Achilles tendinopathy: Level I · C
De Quervain's tenosynovitis: Level I · C
Disc pain and sciatica: Level I · C (x-ray guided)
Golfer's elbow: Level II-2 · C
Myofascial (muscle) pain: Level II-2 · C
Patellar tendinopathy: Level II-3 · D
Hand and foot arthritis: Level I · D
Evidence levels are summarized from the ASPN 2024 consensus guideline (D'Souza et al., J Pain Res 2024) and a 2025–2026 literature review for general reference. Guidelines are periodically updated; please verify current recommendations before relying on this summary for clinical decision-making.
Before Your Procedure
Anti-inflammatory medications: NSAIDs such as ibuprofen and naproxen can blunt platelet activity. They are usually stopped before the injection (about one day for ibuprofen, about seven days for aspirin) and avoided for 4 to 8 weeks afterward. If you take aspirin or a blood thinner for your heart or circulation, we coordinate with your prescribing doctor first. Never stop a prescribed blood thinner on your own.
Supplements: Fish oil, turmeric, high-dose vitamin E, and similar supplements are usually paused for at least one week before.
Steroid injections: We generally wait 4 to 6 weeks after a steroid injection at the same site.
Tobacco and alcohol: Both can reduce platelet function, so avoiding them around the procedure is encouraged.
Hydration: Drink normally the day before and the morning of your blood draw.
The Day of the Procedure
We review your consent and medication instructions.
A small amount of blood is drawn from your arm, much like a routine blood test.
Your blood is processed in a sterile, closed system in the office while you wait.
The skin is cleaned, and the PRP is injected using ultrasound to guide the needle precisely to the target.
Most visits take about an hour. Nothing is added to the PRP; it contains only your own blood components.
After Your Procedure
Soreness: A flare of pain lasting 24 to 72 hours is common and expected. Acetaminophen, ice, and rest can help. Please avoid NSAIDs during this time.
Activity: Expect to limit stress on the treated area for 2 to 7 days. A brace, boot, or crutches may be used for some leg and foot conditions.
Rehabilitation: Gentle stretching and range of motion usually begin within the first week, followed by progressive strengthening around weeks 2 to 3.
Return to activity: Most people return to full activity or sport in 4 to 6 weeks, guided by how rehab is progressing.
Follow-up: Many studies used a short series of 1 to 3 injections spaced 2 to 6 weeks apart. We decide together at follow-up whether a repeat injection makes sense.
Risks and Safety
PRP has a favorable safety record because it comes from your own blood.
Common: soreness, a temporary pain flare, bruising, or mild swelling.
Uncommon: infection, or feeling lightheaded during the blood draw.
PRP should not be used if you have an active infection, a cancer at or near the injection site, or certain platelet disorders. Pregnancy is usually a reason to wait.
Regulation and Cost
PRP prepared from your own blood in the office is regulated by the FDA as a minimally manipulated human tissue product. It is not an FDA-approved treatment for any specific musculoskeletal condition, so its use for these conditions is considered off-label. Medicare and most commercial insurers do not cover PRP for joint, tendon, or spine pain, so it is almost always a self-pay service. We provide the fee and a written financial agreement before your blood draw.
Alternatives
Other options include continued physical therapy and home exercise, corticosteroid or hyaluronic acid injections, nerve-targeted procedures such as radiofrequency ablation, and surgical evaluation. Each has its own benefits and trade-offs, which we review together.
Conditions This May Help
Talk With Us About Your Options
Call 650-507-4113 or send us a message to schedule a consultation at our Daly City, Los Altos, or Stockton office. We will review what may be causing your pain and walk through the risks, benefits, and alternatives of each option with you.
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This information is provided for general patient education and does not replace individualized medical advice. Please discuss your specific symptoms, diagnosis, and treatment options with your pain management physician.
