Chiropractor Chandler AZ

Platelet-Rich Plasma Prolotherapy for Headaches

Different methods are used to treat musculoskeletal injuries and relieve the pain. These methods include the use of:

  1. Narcotics, Anti-Inflammatory Drugs and Corticosteroid Injections
  2. Surgery
  3. Ice
  4. Heat
  5. Rests
  6. Wraps And Braces
  7. Physical Therapy

But these methods are expensive and sometimes they failed to relieve the pain. Therefore, alternative methods are being proposed to treat chronic musculoskeletal pains. One of the most effective and less invasive methods is the platelet-rich plasma Prolotherapy.

platlet rich plasma az
What is Platelet-Rich Plasma Prolotherapy?

In platelet-rich plasma Prolotherapy, the patient's own platelets are used to accelerate the healing process by activating the body's healing mechanism. In this method, the reversed composition of the blood is used. In platelet-rich plasma Prolotherapy, the red blood cells are decreased to 5% and platelets are increased to 94%.

How does Platelet-Rich Plasma Prolotherapy work?

When the platelet-rich plasma is injected at the site of injury, it releases alpha granules that cause the release of one's own growth factors. Growth factors are the proteins that initiate the tissue repair by cell growth and proliferation. Platelets cause the growth factors to stimulate the epithelial growth factors (EGF) which induce the cell migration and replication at the site of damage, causing the damaged tissues to heal quickly.

The platelet-rich plasma injection is followed by three stages of healing:

  1. Inflammation phase that lasts for 2-3 days. In this phase, growth factors are released.
  2. Proliferation phase that lasts for 2-4 weeks. It is vital for musculoskeletal regeneration.
  3. Remodeling which lasts over a year. In this phase, collagen is matured and strengthened.

The platelet-rich plasma Prolotherapy specialist makes sure that these three phases are completed to ensure the complete recovery from the injury.

Platelet-Rich Plasma Preparation

For platelet-rich plasma preparation, 30-60 ml of venous blood is drawn under sterile conditions. It is advised to use 18 or 19g butterfly needle to avoid trauma or irritation to the platelets. The blood is then centrifuged for 15 minutes at 3,200 rpm.

Platelet-rich plasma is separated and there is approximately 3-6 cc of platelet-rich plasma available depending on the initial blood drawn from the patient.

Injection procedure

To increase the accuracy of location of injection, a dynamic musculoskeletal ultrasound with a transducer of 6–13 Hz is used. The patient receives the injection directly into the site of injury under sterile conditions. The patient is observed for 10 -15 minutes and if there is no pain or any side effect, the patient is discharged.

The patient is re-checked after 2-6 weeks of the injection to follow infection, injection site, pain or any other side effect.

Safety Issues

Platelet-rich plasma Prolotherapy uses the blood of the patient thus there are no chances of immunogenic reaction or blood-related disease transfer. No studies have documented that platelet-rich plasma Prolotherapy causes tumor growth or cancer.

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Platelet-Rich Plasma Prolotherapy for Headaches

A headache is a pain or a discomfort in the head region. A headache can occur on one or both sides of the head or can be confined to a specific region of the head. Around 4% of the adult population experience headaches every day. Almost 45 million Americans suffer from long-term headaches and 28 million of them suffer from a migraine. A headache is among the top 10 reasons for medical visits. It has a huge economic impact on the society, not only with the treatment cost, but also by the loss of productivity.

Causes of a headache

The tissues present in the brain do not have pain receptors and they do not feel pain. But the other parts of the head can feel pain and be the reason for a headache. These parts include:

  1. Nerve bundles in the head that extends over the scalp
  2. Facial or oral nerves
  3. Muscles of the head, neck, and shoulders
  4. Blood vessels in the brain
  5. Loose ligaments and tendons in head region
Classification of headaches

Based on the cause of a headache, it is divided into two types:

  1. A primary headache in which a headache is the main medical problem and it is not caused by another disease or medical condition.
  2. A secondary headache which is caused by other medical conditions and it is not the main medical problem, but caused by an underlying disease condition.
Types of headaches

There are around 150 types of headaches. The main types of a headache are:

  1. Tension headache: it is the most common type of a headache among adults and teens. Approximately 78% of adults feel a tension headache at some point in their life. Women experience this type of a headache more than men. It is a non-specific pain and can be caused by a chemical imbalance in the brain or due to neck or back muscles tightening. A tension headache can be an episodic, frequent, or long-term pain.
  2. Migraine: In a migraine, the pain occurs in some parts of the head. A migraine affects 13% of the US population, that is, 29.5 million people. A migraine is also accompanied by other symptoms such as nausea and vomiting, loss of appetite, light and sound sensitivity, and light-headedness. A migraine attack can last from 4 hours to 72 hours. It is more common in women as compared to men and can be due to genetics or hormonal changes.
  3. Cluster Headache: In a cluster headache, the headaches occur in series and last for a long period of time. Around 1 million people suffer from a cluster headache and it affects men more than women. A cluster headache is caused by inflammation due to the interaction between brain nerves and blood vessels in the sheets that cover the brain. It can last for weeks and months and then disappears for months and years. Most people have 1-4 headaches per day. In a cluster headache, the pain is one sided and remains on the one side during the whole pain episode.
Symptoms of a headache

The symptoms of a headache vary which depend on the type of a headache. Some common symptoms of headache include:

  1. Pain sensations in the head region
  2. Muscle tightness in the head, neck and shoulders
  3. Sensitivity to sound and light
  4. Nausea and vomiting
  5. Loss of sensations in some parts of the body
  6. Even fainting spells
Diagnosis of a headache

To determine the cause of a headache, doctors ask a series of questions to know the location of pain, pain intensity and pain features along with conducting a blood test, sinus X-rays, an MRI and a CAT scan.

Treatments for a headache

Medicines used to treat headaches include:

  1. Non-steroidal anti-inflammatory drugs
  2. Triptans
  3. Muscle relaxants

Only 50% of patients with a migraine get relief from pain after 3 months of treatment.

People with a headache find relief by lifestyle changes. It includes changing eating habits such as avoiding alcohol, chocolates and cheese, managing stress, rest and reducing the noise at the workstation.

The drawback of conventional treatment method is that the patient becomes dependent on the medications and sometimes the medicines can trigger a headache. If a headache is left untreated, the duration and intensity of a headache increases with time.

Due to the limitation of conventional treatment methods, patients suffering from a long-term headache are exploring new treatment methods such as platelet-rich plasma Prolotherapy. The conventional treatment method relieves the pain by reducing inflammation while the Prolotherapy technique uses the inflammation process to heal the damage and offer long-term pain relief.

The research has shown a decrease in headache duration, intensity and associated symptoms after Prolotherapy. In a pilot study, the patients showed improvement even after 22 months of receiving the injection.

In platelet-rich plasma Prolotherapy, the platelet-rich plasma injection is administered at the pain trigger site to start or accelerate the healing process.

During the treatment of a headache caused by ligament and tendon weakness, Prolotherapy injections cause inflammation at the site of administration which starts the healing process and increases the ligament tightness which leads to ligament thickness and strength and thus reduces the pain caused by weak ligaments.

The stiffness of muscles in the head and neck region leads to a tension headache. To treat this headache, the injection is administered to the posterior attachments of the neck muscles at the base of the skull which decreases the muscle tension and relieves the symptoms of a headache.

According to Dr. Allan Mishra, "Prolotherapy is a better option for the problems that do not have great solutions." Platelet-rich plasma therapy is a hope for the patients with chronic headaches, but there is still a need to find better modifications in the process for long term stability.


DeChellis, D. M., & Cortazzo, M. H. (2011). Regenerative medicine in the fieLd of pain medicine:Prolotherapy, platelet-rich plasma therapy, and stem cell therapy-Theory and evidence. Techniques in Regional Anesthesia and Pain Management, 74-80.

Gordin, K. (2011). Comprehensive Scientific Overview on the Use of Platelet Rich Plasma Prolotherapy (PRPP). Journal of Prolotherapy, 813-825.

Sampson, S., Gerhardt, M., & Mandelbaum, B. (2008). Platelet rich plasma injection grafts for musculoskeletal injuries: a review. Current Reviews in Musculoskeletal Medicine, 165–174.

Jensen R et al. Epidemiology and comorbidity of headache. Lancet Neurol. 2008 Apr;7(4):354-61.

Headache Classification Committee of the International Headache Society (IHS. The International Classification of Headache Disorders, 3rd edition. Cephalalgia. 2013 Jul;33(9):629-808