Marc Darrow, MD, JD
PRP treatments involve collecting a small amount of your blood and spinning it in a centrifuge to separate the platelets from the red cells. The collected platelets are then injected into the thumb/wrist area to stimulate healing and regeneration. Blood is made up of four main components; plasma, red blood cells, white blood cells, and platelets. Each part plays a role in keeping your body functioning properly. Platelets act as wound and injury healers. They are first on the scene at an injury, clotting to stop any bleeding and immediately helping to regenerate new tissue in the wounded area.
A February 2025 study (1) examined the use of PRP for thumb pain. “Intra-articular platelet-rich plasma (PRP) injections have recently emerged as a promising alternative, with encouraging outcomes in knees and hips.” In this study, researchers looked to highlight the safety and efficacy of PRP injections in thumb joint osteoarthritis. A review of 115 patient histories (average age 62.6 years old and mostly women) from previously published research, found patients who received an average of 1.4 PRP injections per thumb joint, with an average follow-up of 14.1 months provided favorable outcomes.
In comparing with control groups who were administered corticosteroids, normal saline, and hyaluronic acid, all PRP-treated patients resumed their prior activities of daily living with a satisfaction rate at 73.7 % (76 out of the 115 patients). Statistically significant pain reduction in 98 patients and improvement in pinch strength were reported, while no statistically significant improvement in grip strength was observed (in 39 patients). No adverse events occurred. The researchers found Intra-articular PRP injections in thumb (joints) yields favorable outcomes for pain relief and hand function without major complications.”
Similar observations have been observed for years. A 2018 study in the journal Cartilage (2) offered this comparison between PRP injections and cortisone injections. Before I start with this study I would like to point out that many people reach out to me and tell me how painful the actual cortisone injection was for them. The problem is the size of the needle and the size of the joint space. When we inject into this area we typically use a freeze spray and very fine needles. This provides the patient with a lot of comfort during the procedure. Also we do not offer a single injection of PRP. We inject into various areas of the wrist and thumb area to maximize the healing effect of the PRP injection.
To the research – the summary learning points:
- Various systematic reviews have recently shown that intra-articular platelet-rich plasma can lead to symptomatic relief of knee osteoarthritis for up to 12 months. There exist limited data on its use in small joints, such as the trapeziometacarpal joint (TMJ) or carpometacarpal joint (CMCJ) of the thumb.
- A prospective, randomized, blind, controlled, clinical trial of 33 patients with clinical and radiographic osteoarthritis of the trapeziometacarpal joint (grades: I-III) was conducted.
- Group A patients (16 patients) received 2 ultrasound-guided IA-PRP injections, while group B patients (17 patients) received 2 ultrasound-guided intra-articular methylprednisolone and lidocaine injections at a 2-week interval.
- Patients were evaluated prior to and at 3 and 12 months after the second injection.
- After 12 months’ follow-up, the IA-PRP treatment has yielded significantly better results in comparison with the corticosteroids, in terms of pain relief, better function, and patients’ satisfaction.
Doctors presented this case study of a concert pianist helped by PRP
This case review (3) was published in October 2019:
“Thumb carpometacarpal osteoarthritis is a progressively disabling, debilitating condition presenting with thumb base pain and hand functional impairment. Platelet-rich plasma has been used widely for the management of musculoskeletal pathologies, osteoarthritis being among them.
- A 59-year-old male professional pianist presented with chronic, mild onset of right thumb base pain involving a progressive lack of pinch strength in his right hand, and severe difficulties with playing.
- Three PRP injections were administered to the Thumb carpometacarpal joint on a 1-week interval regime.
- Clinical outcomes were assessed by using standard scoring scales including those for pain, grip and pinch strength
- Functional outcome was excellent according to patient’s capability with daily living activities and specific playing demands.
- At 12 months follow-up, no recurrences or complications were identified, with the musician returning to his previous level of performance 2 weeks before the end of this period.
“Patient self-reported satisfaction was high and he reported to return to his routine piano activity with no limitations. This case-based review study documents the clinical efficacy of PRP treatment from both functional and perceived-pain perspectives in a professional pianist. Presenting this case, our aim is to draw attention of healthcare providers dealing with Thumb carpometacarpal osteoarthritis to PRP as a safe, beneficial therapy for this condition which needs further assessment in randomized controlled trials.”
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References
1 El Sewify O, Datta S, Legler J, Sylvain M, Cheah A, Efanov JI. Safety and Efficacy of Platelet-Rich Plasma Injections in Basal Thumb Osteoarthritis; Should We Offer It or Not?. Journal of Hand and Microsurgery. 2025 Feb 8:100223.
2 Malahias MA, Roumeliotis L, Nikolaou VS, Chronopoulos E, Sourlas I, Babis GC. Platelet-rich plasma versus corticosteroid intra-articular injections for the treatment of trapeziometacarpal arthritis: a prospective randomized controlled clinical trial. Cartilage. 2021 Jan;12(1):51-61.
3 Medina-Porqueres I, Martin-Garcia P, Sanz-De Diego S, Reyes-Eldblom M, Cantero-Tellez R. Platelet-rich plasma for thumb carpometacarpal joint osteoarthritis in a professional pianist: case-based review. Rheumatology International. 2019 Dec 1;39(12).