Platelet-rich plasma (PRP) injection

An injection of a concentrate made from a sample of your own blood into or around a painful tendon, sometimes offered for stubborn tendon problems — an adjunct with mixed evidence, not a proven cure.

✓ Medically reviewed by a GMC-registered consultant · last reviewed September 2026 · next review September 2027 · how we review

In short

PRP is an injection of a concentrate from your own blood into or around a painful tendon, sometimes offered for stubborn cases.
The evidence is mixed and NICE highlights uncertainty about how well it works, especially long term — it is not a proven cure.
It is an adjunct to a progressive loading and rehabilitation programme, which remains the mainstay.
Be wary of clinics that guarantee results, call it 'regenerative' as a certainty, or sell repeated paid injection courses.

A plain-English summary. The detail — including risks and recovery — is below.

At a glance

TypeMinor injection procedure

AnaestheticLocal anaesthetic sometimes used; the injection itself can be uncomfortable

How long it takesUsually around 20–40 minutes including preparing the blood

Hospital stayOutpatient

Time off workUsually none, though you may need to ease off the area for a few days

When you'll see resultsSlow and uncertain; any benefit usually builds over weeks to months

On the NHS?Not routinely funded for tendinopathy; NICE advises special arrangements. Often private

A general guide. Your specialist will give you advice for your situation.

Best fit

Uses your own blood, so there is no donor material involved

Pause if

You have an active infection at or near the site, or are generally unwell.

Main recovery point

Expect soreness and possibly a flare of pain at the injected tendon. Use simple pain relief as advised and ease off heavy or aggravating activity.

Good aftercare

A clear plan combining PRP with a loading and rehabilitation programme.

First 24–72 hours

Expect soreness and possibly a flare of pain at the injected tendon. Use simple pain relief as advised and ease...

First week

The puncture site and any bruising settle. Many clinicians advise gentle activity and starting or continuing a...

Weeks 2–6

You build your rehabilitation back up. Any benefit from PRP, if it comes, usually develops gradually rather than...

6 weeks to a few months

A reasonable point to review honestly whether it has helped, alongside your loading programme. Results are...

Medical line illustration of the shoulder joint and upper limb for Platelet-rich plasma (PRP) injection. — Illustration only - not a diagnosis, medical advice or a promise of result. Your anatomy and treatment plan may differ. Vuemedics does not publish before-and-after photos.

What is a platelet-rich plasma (PRP) injection?

A platelet-rich plasma (PRP) injection uses a small sample of your own blood, which is spun in a machine to concentrate the platelets and the growth factors they contain. This concentrate is then injected into or around a painful tendon, sometimes using ultrasound to guide the needle. It is a type of autologous (your own) blood injection.

The idea is that the growth factors might encourage the tendon to heal. However, this is not proven. NICE has reviewed autologous blood injection (including PRP) for tendinopathy and found the evidence mixed, with uncertainty about how well it works — especially in the longer term.

PRP is best understood as an adjunct — an extra option sometimes considered for a tendon that has not settled with a proper loading and rehabilitation programme — not a first-line treatment, and not a guaranteed cure. Results vary a great deal between people.

NICE advises that, because of the uncertain evidence, PRP for tendinopathy should be used with special arrangements for clinical governance, consent and audit or research, that patients should be told clearly about the uncertainty, made aware of alternatives, and given written information.

Types, options & approaches

There may be different ways to do this. The right approach depends on the clinical question and your circumstances.

Leukocyte-poor PRP

A preparation with fewer white blood cells. Different systems produce different concentrations of platelets and cells, and there is no single agreed 'best' formula, which makes results hard to compare.

Leukocyte-rich PRP

A preparation containing more white blood cells. Some studies use this for tendons, but evidence does not clearly establish which type is better.

Whole autologous blood injection

An older approach injecting a small amount of unspun whole blood rather than a concentrate. NICE considers this together with PRP, with similar uncertainty about benefit.

Ultrasound-guided injection

Many clinicians use ultrasound to place the needle accurately into or around the target. Guidance improves needle placement but does not overcome the underlying uncertainty about whether PRP works.

PRP versus other options for stubborn tendon pain

Feature	Loading rehab	Steroid injection	PRP injection
Role	Mainstay	Short-term relief	Adjunct, uncertain
Evidence	Strongest	Short-term only	Mixed / limited
Speed	Slow, durable	Often fast, fades	Slow, variable
Cost	Sessions	Lower	Higher, often repeated

PRP is not a proven upgrade on rehabilitation. Steroid can help short term but may be no better, or worse, than exercise longer term and is generally avoided near the Achilles.

Preparing for your procedure

Tell the clinician about your full medical history, including any bleeding problems, blood-thinning medicines, anaemia, infection or skin problems over the area.
Discuss what rehabilitation you have already tried and for how long, as PRP is meant to follow a proper loading programme.
Ask which tendon is being targeted, whether ultrasound will be used, and how many injections are proposed.
Ask honestly about the evidence for PRP for your specific problem and what the plan is if it does not help.
Check whether you should pause any anti-inflammatory medicines beforehand, as some clinicians advise this.
Plan for the area to be sore for a few days and arrange to ease off heavy activity.

What happens

A small sample of your blood is taken from your arm, much like a routine blood test. It is then placed in a machine (centrifuge) that spins it to separate and concentrate the platelets, which takes a short time.

The skin over the target is cleaned. Local anaesthetic may be used, though the injection itself can still be uncomfortable. The clinician injects the concentrate into or around the tendon, sometimes guiding the needle with ultrasound.

The whole appointment usually takes around 20–40 minutes. You can normally go home straight away. There is no surgical wound — only a needle puncture site, which may be a little sore or bruised. Your clinician will advise how to ease back into activity and continue rehabilitation.

Is this procedure right for me?

A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.

May not be suitable if…

You have an active infection at or near the site, or are generally unwell.
You have a significant bleeding disorder, or anaemia or a blood condition that makes taking and concentrating blood unwise.
You take blood-thinning medicines that cannot be safely managed.
Your pain is from a different cause that has not been properly diagnosed.
You have not yet tried a proper loading and rehabilitation programme, which should normally come first.

Delay or rearrange if…

You have an active infection anywhere, particularly over the injection site.
You are pregnant or breastfeeding and this has not been discussed.
Your diagnosis is uncertain or has red-flag features that have not been assessed.
You have recently started a blood thinner or had a change in bleeding risk.
You are in a severe acute flare where settling it first is more sensible.

Alternatives to discuss

A progressive loading and rehabilitation programme, which is the mainstay for tendinopathy.
A corticosteroid injection for short-term relief in selected cases (with caution, and generally avoided near the Achilles).
Other adjuncts such as shockwave therapy or high-volume injection, each with its own mixed or limited evidence.
Watchful waiting, as many tendinopathies improve with time and rehabilitation.
Specialist or surgical opinion if a sustained programme has not worked.

Before you decide

Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.

What matters most to me?

Think about symptoms, daily life, work, caring responsibilities, sport, fertility, travel, appearance and anxiety — the right choice depends on your priorities, not just the medical facts.

What are all my options?

Ask about waiting, monitoring, medicines, rehabilitation, a smaller or larger procedure, a different test, NHS referral, or a second opinion where that would help.

What would make me pause?

Active infection, pregnancy, unstable medical problems, smoking, medicines that increase bleeding, poor support at home, or feeling pressured are all reasons to slow down and get tailored advice.

What happens if I do nothing today?

For some problems, waiting is safe; for others, delay can make treatment harder. A good consultation should explain the trade-off in plain English.

Comfort, sedation or contrast choices

If local anaesthetic, sedation, contrast or pain relief is used, ask what is planned, why, and what it means afterwards.

No anaesthetic

Some clinicians inject without local anaesthetic; the injection can be uncomfortable.

Local anaesthetic

Local anaesthetic to the skin or around the area is sometimes used to reduce discomfort during the injection.

Benefits

Uses your own blood, so there is no donor material involved
Avoids the risks of surgery for those wanting to try an injection first
Does not carry the longer-term tendon-weakening concerns associated with repeated steroid
May reduce pain and improve function in some people, though benefit is uncertain and variable
Can be combined with a loading programme rather than replacing it
Only a minor procedure, usually done as an outpatient

Risks & complications

More common

Pain or soreness at and around the injection site, often for a few days
A post-injection flare — a temporary worsening of pain after the injection
Bruising at the puncture site or where blood was taken
No clear benefit, given the mixed evidence

Less common

Stiffness or swelling around the treated tendon for a time
Feeling faint at the time of the blood draw or injection
Needing further treatment or a repeat injection without guaranteed benefit

Rare but serious

Infection at the injection site, which can be serious and needs urgent treatment
Damage to nearby nerves or blood vessels from the needle
Tendon damage, particularly with repeated injections into a tendon

PRP is usually low-risk in terms of serious harm, but its main limitation is uncertain benefit: NICE found the evidence mixed and the long-term efficacy unclear. The most common issue is a post-injection flare of pain. Choose a clinician who uses sterile technique, ideally ultrasound guidance, and who is honest that this is an adjunct, not a cure. Ask what happens if it does not work.

Published figures to discuss

Reported benefit from PRP varies widely between studies, tendons and preparation methods, and there is no agreed 'best' formula, which makes results hard to compare. NICE found the evidence mixed and the long-term efficacy uncertain. Serious complications such as infection are uncommon, but a post-injection flare of pain is a common, expected effect rather than a rare one. Precise success or complication rates cannot be quoted reliably.

Figure	Reported range	How to interpret it	Source / confidence
Post-injection pain flare	Common	Pain often worsens for a few days because PRP is intended to provoke a healing response.	Guide sourcesClinical context
Benefit uncertain or delayed	Condition- and preparation-dependent	Evidence varies by tendon/joint, PRP preparation and study design; improvement, if it occurs, is not immediate.	Guide sourcesClinical context
Infection, bleeding or nerve injury	Rare	Sterile technique, ultrasound guidance when appropriate and medication review reduce risk.	NICE — Autologous blood injection (incl. PRP) for tendinopathy (IPG438)nice.org.ukSource-linked context
Marketing overclaim	Important consent issue	Be wary of guaranteed regeneration, stem-cell language or high-pressure packages unsupported by NICE-level evidence.	NICE — Autologous blood injection (incl. PRP) for tendinopathy (IPG438)nice.org.ukSource-linked context

These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.

What happens afterwards

There is no surgical recovery — only a needle puncture site. 'Afterwards' is mainly about managing a possible flare of soreness for a few days and continuing your rehabilitation while you wait to see whether any benefit builds.

First 24–72 hours

Expect soreness and possibly a flare of pain at the injected tendon. Use simple pain relief as advised and ease off heavy or aggravating activity.

First week

The puncture site and any bruising settle. Many clinicians advise gentle activity and starting or continuing a graded loading programme as guided.

Weeks 2–6

You build your rehabilitation back up. Any benefit from PRP, if it comes, usually develops gradually rather than immediately.

6 weeks to a few months

A reasonable point to review honestly whether it has helped, alongside your loading programme. Results are variable and not guaranteed.

What's normal — and not a worry

Soreness and a possible flare of pain for a few days after the injection
Bruising at the puncture and blood-draw sites
No immediate improvement — any benefit usually builds over weeks
Being able to do gentle daily activities and, soon, your exercises
Needing patience while you wait to judge the result

Aftercare

Continue or start your loading and rehabilitation programme as advised — PRP is an adjunct to this.
Use simple pain relief for the post-injection flare; some clinicians prefer you avoid anti-inflammatory tablets for a short time, so follow their advice.
Ease off heavy or aggravating activity for the first few days.
Keep the puncture site clean and watch for signs of infection.
Attend the review appointment to judge, honestly, whether it has helped.
Do not assume more injections are the answer if the first did not help — discuss this with your clinician.

Before your procedure

Simple pain relief to hand for a possible flare
Clear advice on whether to avoid anti-inflammatory tablets briefly
Your loading exercise programme to continue alongside
A note of activities to ease off for a few days
A review date to judge benefit
Awareness of infection warning signs
An agreed plan if it does not help

Scars and how they heal

There is no surgical scar. PRP is given through a needle, leaving small puncture sites where the blood is taken and where the injection is given. These may be a little sore or bruised for a few days and then settle.

⚠ Get urgent help if…

Spreading redness, heat, swelling, fever or feeling unwell — possible infection, seek urgent help
Severe or rapidly worsening pain that is out of proportion to a minor injection
New numbness, tingling or weakness beyond the injected area
A sudden snap, severe pain or weakness in the tendon — seek urgent assessment for possible rupture
A large or expanding bruise or swelling at the site
Feeling very unwell, hot and shivery in the days after the injection

Who to contact: your clinician, clinic or test provider first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.

General guidance — it doesn't replace the specific advice your specialist gives you.

Results & realistic expectations

A good result is reduced pain and improved function, building over the weeks after the injection and alongside a loading programme. Because the evidence is mixed, some people improve and some notice little or no benefit, and PRP cannot be promised to cure a tendon problem.

In one randomised trial in tennis elbow, fewer people needed further intervention after PRP than after steroid, but other trials — for example in Achilles tendinopathy — found no significant benefit over placebo. This is why honest care treats PRP as an option to try, not a certainty, and reviews whether it actually helped.

How long it lasts

Where PRP appears to help, the durability of any benefit is uncertain and varies between people, and symptoms can return — particularly if the underlying overload is not addressed. Keeping up a loading programme and sensible activity gives the best chance of a lasting result. Repeating injections does not guarantee longer-lasting benefit.

Related tests, treatments or support

PRP is meant to be combined with a progressive loading and rehabilitation programme, which remains the mainstay. It is sometimes discussed alongside or instead of other injections such as steroid; your clinician should explain the trade-offs honestly. It should not be sold as a stand-alone fix.

Follow-up & long-term care

You should have a planned review, often around 6 weeks to a few months, to judge honestly whether it has helped alongside your rehabilitation. If it has not, the sensible step is to revisit the diagnosis and overall plan rather than simply repeat the injection. NICE recommends that PRP for tendinopathy is done with arrangements for audit or research and clear consent.

Keep up your loading and strengthening exercises after the injection.
Increase activity gradually rather than in sudden jumps.
Address contributing factors such as training load, technique or footwear.
Return for review rather than assuming repeated injections are the answer if symptoms persist.

Repeat, follow-on and what comes next

If a single injection does not help, repeating it does not guarantee benefit and the diagnosis and plan should be reviewed.
Some clinics offer a course of injections; this should follow an honest review, not be sold upfront as a certainty.
Persistent symptoms despite PRP and rehabilitation may prompt specialist or surgical referral.
Open-ended paid courses without clear benefit are a red flag, not normal care.

Ask what happens if the result is unclear or needs repeating, and what is included if further tests or follow-up are needed.

What good aftercare looks like

A clear plan combining PRP with a loading and rehabilitation programme.
Written information about the procedure and its uncertainty, as NICE recommends.
A named contact and a planned, honest review of benefit.
Clear infection and rupture warning signs and how to seek urgent help.
A sensible threshold to stop, reconsider the diagnosis, or refer on if it is not helping.

What affects the cost

Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:

Whether you are charged per injection or for a course
The number of injections recommended
Whether ultrasound guidance is used
The PRP preparation system and laboratory processing involved
Whether an assessment, imaging and follow-up are included or separate
Whether rehabilitation/physiotherapy is bundled or extra

Make sure your written quote includes

The cost per injection and the total cost if more than one is planned
Whether ultrasound guidance is included
Whether the assessment and any imaging are included
Whether rehabilitation/physiotherapy is part of the package
What follow-up or review is included
The cancellation policy
What happens, and what it costs, if it does not help or a complication occurs

On the NHS? PRP for tendinopathy is not routinely funded by the NHS and NICE advises special arrangements for governance, consent and audit or research; most people who have it pay privately.

You're entitled to your total cost in writing — including reports, follow-up and what happens if the result is inconclusive — before you decide.

Choosing a specialist safely

Check the specialist is on the GMC Specialist Register for this area.
Make sure they work at a CQC-registered service, and look for membership of the relevant Royal College or professional body.
You're entitled to time to consider and to have your questions answered before you agree — the specialist who looks after you should explain it, not a salesperson.
Be wary of pressure: time-limited offers or deposits taken before you've had time to think are red flags, not bargains.
You're entitled to your total cost in writing — including any follow-up — before you decide.

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Questions to ask your medical professional

Take this to your consultation. A good specialist will welcome every one of these.

What is the evidence for PRP for my specific tendon problem?
Have I had a proper loading and rehabilitation programme first?
Will you use ultrasound to guide the injection, and how do you keep it sterile?
How many injections are you proposing, and why?
How and when will we judge whether it has worked?
What is the plan if it does not help — and will you avoid simply repeating it?
How does PRP compare with a steroid injection or no injection for me?
Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
Will you be the specialist who carries out my procedure, and who looks after me afterwards?
What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
What does a realistic result look like — and what can this procedure not achieve?
What are my options, including waiting, doing nothing for now, or choosing a different approach?
Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
What is the total cost in writing, including any follow-ups, and how much time do I have to decide?

Frequently asked questions

Does PRP actually heal tendons?

This is not proven. The marketing word 'regenerative' overstates what is known. NICE found the evidence for PRP in tendinopathy mixed and the long-term efficacy uncertain. Some people improve, some do not. It is best seen as an adjunct to rehabilitation, not a cure.

Is it better than a steroid injection?

It depends on the tendon and the outcome you care about. In tennis elbow, one trial found fewer people needed further treatment after PRP than after steroid, but evidence is not consistent. Steroid can relieve pain short term but may be no better, or worse, than exercise longer term, and is generally avoided near the Achilles.

Does it hurt, and is there much recovery?

There is a needle into the tendon, which can be uncomfortable, and a flare of soreness for a few days afterwards is common. There is no surgical wound, only puncture sites, and most people return to gentle activity quickly while continuing rehabilitation.

Can I get PRP on the NHS?

It is not routinely funded for tendinopathy. NICE advises it be used with special arrangements for governance, consent and audit or research, so most people who have it do so privately.

How many injections will I need?

There is no agreed number. Be cautious of clinics that sell a fixed course of repeated injections upfront, especially before a rehabilitation programme has been tried or without reviewing whether earlier injections helped.

Do I still need to do my exercises?

Yes. Progressive loading remains the mainstay of treatment, and PRP is an adjunct to it. Skipping the exercise programme undermines the most reliable part of your treatment.

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How we made this page

Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →

Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.

Sources & standards: NICE — Autologous blood injection (incl. PRP) for tendinopathy (IPG438) NICE IPG438 — patient information leaflet Versus Arthritis — Achilles tendinopathy NHS — Tennis elbow Faculty of Sport and Exercise Medicine UK

Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.

Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.