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Platelet Rich Plasma injections for Morton’s neuroma

Platelet Rich Plasma Injections – a brief overview:

activated plateletsPlatelet rich plasma therapy (abbreviated as PRP) is the re-administration of the your own platelets to activate the body’s natural healing cascade for repair and regeneration(1). PRP has been successfully used for the management of several musculoskeletal conditions such as ligamentous tear, joint inflammatory disorders, torn tendons and muscular ailments(2).  In fact, Platelet rich plasma injections are replacing traditional orthopedic surgery in many instances for conditions ranging from soft tissue injuries (tendonitis, muscle tears, ligamentous injuries) to various joint afflictions, such as a torn meniscus or mild to moderate arthritis of the joint.

PRP is prepared by centrifuging a small amount of patient’s blood to obtain a platelet-rich sample. The platelets are activated and then injected under ultrasound guidance. In most cases, the treatment can be completed in one session.  Rarely, more than one course of PRP may be required and can be safely performed depending upon the response to the therapy and clinical indications.

The treatment exert positive effects via multiple mechanisms including:

  • Activation and release of the body’s natural growth factors in the abnormal tissue. This response has been proven to stimulate the tissue regeneration processes.
  • Localized inflammatory response that increases the blood flow to the abnormal tissue.
  • Limitation of scar tissue formation.
 
Plasma Rich Platelet infusion : Stage 1 Plasma Rich Platelet infusion : Stage 2 Plasma Rich Platelet infusion : Stage 3

Your body’s growth factors that are present in Platelet Rich Plasma include:

Indications for a Platelet Rich Plasma injection in Morton’s neuroma management:

  • Morton’s neuroma refractory to conservative treatments: Most cases of Morton’s neuroma responds to conservative care or ultrasound guided ablation procedures. However, if symptoms does not improve, PRP can be used as a final step before resorting to surgery.
  • Morton’s neuroma with co-existing musculoskeletal lesions: Morton’s neuroma often co-exists with other lesions of muscles and joints such as bursitis, plantar fasciitis and arthritis. In all these cases, platelet rich plasma injections are not only safe but a preferred therapy to alleviate these other conditions as well as Morton’s neuroma.
  • Routinely after Morton’s neuroma surgery: Surgical intervention is sometimes necessary to treat refractory cases of Mortons neuroma. Platelet rich plasma injections can be used to hasten the pace of recovery after Mortons neuroma surgery.
  • To treat pain or complications after Morton’s neuroma surgery:  Even with best practices and aseptic care, the risk of complications of Mortons neuroma surgery is fairly high. For example, tendon exposure, fibrosis, scarring and wound dehiscence are some complications that are often reported in patients after surgical repair.

Platelet Rich Plasma injections can be very helpful in post Morton’s Neuroma surgery pain. In fact, we often recommend Platelet Rich Plasma injections in post Morton’s neuroma surgery pain cases. Your body’s natural growth factors can be very helpful in fighting some of the complications that can occur with Morton’s Neuroma surgery. In fact, we’ve had some great results with PRP in patients with post Morton’s neuroma surgery pain.

Complications from PRP injections

Platelet rich plasma injection therapy is usually well-tolerated by patients. In a small percentage of individuals, mild complications/ adverse effects are observed such as: irritation or redness at the injection site; localized pain and discomfort; or, bruising of surrounding skin

Most of these side effects are temporary and resolve spontaneously within a couple of days after the initial procedure. You can also use non-steroidal anti-inflammatory drugs or over-the-counter analgesics to resolve these temporary symptoms.

Improving the quality of results with PRP Injections

The results of platelet rich plasma therapy can be further improved by using ultrasound guidance to increase the precision of the injection. Additionally, ultrasound guided PRP injections are associated with minimizing the risk of post-procedure pain and discomfort.

Any contraindications to Platelet Rich Plasma Injections?

Platelet-Rich-PlasmaAlthough the treatment is generally well-tolerated by individuals of all age groups, there are certain contraindications to PRP Injections. For example:

  • Recent history of anti-coagulant therapy/ course
  • Bleeding disorders
  • Pregnant or breastfeeding mothers
  • Active malignancy, severe infection or thrombocytopenia

What to Expect After the PRP Injections

The aftercare for most PRP injections is relatively simple. Patients will resume activity at their own pace. The pain from the process typically will last a few days, occasionally longer, and some patients have more severe or sporadic pain than others. Because your own blood is used, there is no risk of a transmittable infection and a very low risk of allergic reaction to the treatment.

Who should give Platelet Rich Plasma Injections?

We recommend going to a clinician with experience in giving Platelet Rich Plasma injections. We give Platelet Rich Plasma injections under ultrasound guidance.

 

Mortons neuroma ultrasound

 

 

 

 

 

 

 

 

 

References:

  1. Murawski, C. D., Smyth, N. A., Newman, H., & Kennedy, J. G. (2014). A Single Platelet-Rich Plasma Injection for Chronic Midsubstance Achilles Tendinopathy A Retrospective Preliminary Analysis. Foot & ankle specialist, 1938640014532129.
  2. Abate, M. (2013). Hyaluronic Acid and Platelet Rich Plasma in Hip Osteoarthritis: Work in Progress. Surgery Curr Res, 3, e110.
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