PRP Injections and Orthobiologics in St. Louis

PRP injections in St. Louis are for the pain that keeps coming back after the steroid shot wears off. We use your own platelets, bone marrow or fat to push a worn joint, a frayed tendon or a sore low back joint toward repair. It is a step between therapy that stalled and surgery you would rather skip.

What are orthobiologics, in plain words?

Orthobiologics are treatments made from your own body. We take blood, marrow or fat, prepare it in the room, and inject it where the tissue has stopped healing. Nothing is grown in a lab. Nothing comes from a donor.

Think of an old roof with one slow leak. A steroid shot is a bucket under the drip. It helps for a while, then the bucket fills and you need another one. An orthobiologic is closer to sending a roofer up to patch the spot. The work is slower, and it does not always hold, but it aims at the leak itself.

Want the whole picture first? The low back guide above walks you through the steps by email. It comes from our regenerative team and covers the questions people ask before their first visit.

The three treatments we use

• PRP (platelet-rich plasma). We draw your blood and spin it down. The platelets carry growth signals that call repair cells to the area. This is our most common choice for tendons, mild to moderate arthritis, and the small joints of the low back.
• Bone marrow concentrate. We take marrow from the back of the hip bone through a needle, with numbing medicine. It carries more repair cells than blood does. We reach for it in joints with more wear, or when PRP alone has not been enough.
• Microfragmented fat. A small amount of fat is drawn from the belly or flank, washed and broken into tiny pieces. It cushions the joint and keeps sending repair signals for weeks. It suits worn joints where padding matters as much as signaling.

Which one you get depends on the tissue, the stage of wear and how you live. A roofer in Florissant and a retired teacher in Kirkwood can have the same knee X-ray and need two different plans.

Where the injection goes

Placement decides results. A good product in the wrong spot does nothing. We guide every needle with ultrasound or live X-ray, and we aim at one of three targets.

• Into the joint. For arthritis in the knee, hip, shoulder, ankle or thumb, and for the facet and sacroiliac joints of the low back.
• Into the tendon or ligament. For a rotator cuff that frays, a hip tendon that aches at night, or a wrist tendon that burns with each lift.
• Into the bone under the joint. When the bone beneath worn cartilage is bruised and swollen, we can treat it from below. This is called a subchondral injection. It is often paired with an injection into the joint.

Conditions we treat with orthobiologics

Each page below explains one problem, how we confirm it, and where PRP or another orthobiologic fits. Start with the part of the body that hurts.

Low back and pelvis

• Facet joint pain: the small paired joints at the back of the spine.
• Facet joint injection: how we confirm and treat a facet joint.
• Sacroiliac joint pain: pain low in the back where the spine meets the pelvis.
• Sacroiliac joint injection: an image-guided shot into the SI joint.
• Sacroiliac joint radiofrequency ablation: quieting the nerves of a confirmed SI joint.
• Sacroiliac joint fusion: the last step, and what we try before it.

Shoulder and hip tendons

• Shoulder injury and pain: rotator cuff, bursa and labrum problems after a fall or crash.
• Bursa injection: for bursitis at the outer hip or the shoulder.

Knee, ankle and joint arthritis

• Knee pain: worn cartilage, meniscus wear and the tendons around the kneecap.
• Osteoarthritis: wear in any joint, and how we slow it down.
• Ankle arthritis: often the late bill for an old sprain or fracture.

Hand and wrist

• Thumb arthritis: pain at the base of the thumb when you pinch or grip.
• De Quervain’s tenosynovitis: thumb-side wrist pain from an irritated tendon sheath.

Pick your guide

Each guide is a short email series from our regenerative team about one part of the body. Pick the one that matches your pain.

• Low back and spine guide: facet and SI joint pain, and where PRP fits.
• Knee and joint arthritis guide: knee, hip and ankle wear.
• Shoulder, elbow and tendon guide: rotator cuff, bursitis and hand tendons.

Who is a good candidate?

The best candidates have a clear pain source and a body that can still heal. In practice, that usually means a few things are true.

• You tried therapy, bracing or a steroid shot, and the relief faded.
• Your exam and imaging point to one or two spots, not pain everywhere.
• You want to delay or avoid a joint replacement or a fusion.
• You are willing to do the rehab that follows the injection.

Some people are not ready yet. Very high blood sugar, smoking and heavy drinking all slow repair. So does belly fat, which pours inflammatory signals into the blood and reaches every joint. That is why we check sugar and inflammation at the first visit. Fixing the soil is part of the treatment, not a lecture. You may not love hearing it. You will like the result more.

Over 90% of our accepted case-study patients see significant improvement. These are practice-reported figures from our own population, not trial outcomes, and individual results vary.

What the visit and recovery are like

The first visit is an exam and a talk. We look at your scans, press on the sore spots, and tell you what we think is causing the pain. If an orthobiologic fits, the procedure is done at our regenerative clinic at 4477 Woodson Rd in St. Louis.

You stay awake. We use local numbing medicine, and there is no sedation, so most people drive themselves home. Marrow and fat visits take longer than a PRP visit because of the harvest step.

Expect soreness for about 48 hours. That ache is the repair response starting, so we ask you to skip anti-inflammatory pills like ibuprofen for a while. Light walking starts the same day. Heavy lifting waits until we clear it.

How many injections you need depends on what we find. Some people need one. Others need a second round weeks later. There is no preset package. PRP is not covered by insurance, but HSA and FSA funds can generally be used for it.

Why dose and rehab decide the result

Not all PRP is the same. Some clinics spin a small tube of blood and inject whatever comes out. The platelet count in that mix can be too low to do much. An international expert panel agreed in 2026 that preparation and dosing still vary widely, which explains many failed shots. We choose the product and the dose for your tissue and your stage.

Rehab is the other half. Repair cells lay down new tissue in whatever direction the load tells them to. Without the right exercise, that new tissue forms weak and loose. Our physical therapy team loads the area step by step, so the new fibers line up and get strong. A shot with no plan around it is a lottery ticket. A shot with the right dose, the right spot and the right rehab is a plan.

Frequently asked questions

Is PRP the same as a steroid shot?

No. A steroid shot calms swelling for a while but does not repair tissue, and repeated steroid can weaken cartilage and tendon. PRP uses your own platelets to start a repair response. It works more slowly, and the effect tends to last longer.

Does PRP help low back pain?

It can, when the pain comes from a facet joint or the sacroiliac joint. A 2026 review of ten trials found PRP beat steroid for pain at three and six months in those joints. We confirm the source with a diagnostic block first, so we treat the right joint.

Do I have to stop my medicines before PRP?

We ask most people to avoid anti-inflammatory pills around the injection, because they blunt the platelet response. We give you the exact timing at your visit. Blood thinners are handled case by case with the doctor who prescribed them. Never stop a blood thinner on your own.

Will I be put to sleep?

No. Every orthobiologic procedure here is done with local numbing medicine while you are awake. There is no sedation, and most patients drive home afterward.

Where do I go for the procedure?

Your first visit can be at our Natural Bridge Road office. Orthobiologic procedures are done at 4477 Woodson Rd in St. Louis, and our staff will direct you once you arrive.

Is it ever too late for an orthobiologic?

Sometimes. When a joint is bone on bone, PRP may still ease pain and buy time, but it will not rebuild the joint. We will tell you plainly where you stand and whether a referral for surgery makes more sense.

Sources

• Kunze KN et al. An International Expert Consensus Statement Defining the Best Practices and Areas of Uncertainty Concerning the Use of Orthobiologics. The Journal of bone and joint surgery. American volume, 2026. PubMed 42520131
• Alatefi D et al. Platelet-Rich Plasma versus Corticosteroid Injections for Facet and Sacroiliac Joint Pain: A Systematic Review and Meta-Analysis with Trial Sequential Analysis. Pain medicine, 2026. PubMed 42296329
• Manchikanti L et al. Comprehensive Evidence-Based Guidelines for Regenerative Therapies in the Management of Chronic Low Back Pain: 2025 Update from the American Society of Interventional Pain Physicians (ASIPP). Pain physician, 2025. PubMed 41481869
• Kon E et al. Platelet-rich plasma injections for the management of knee osteoarthritis: The ESSKA-ICRS consensus. Knee surgery, sports traumatology, arthroscopy, 2024. PubMed 38961773