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July 19, 2024
PRP Therapy Gets Injured Workers Back on Their Feet and Should be Covered By Insurers
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Platelet-Rich Plasma (PRP) therapy is an innovative, though well-established, approach to healing common injuries. It was first used in the 1970s by doctors specializing in blood disorders to treat patients with low platelet counts. Today, with over fifty years of evidence behind it, doctors are using PRP to help a growing number of patients heal from their various conditions, including acute and chronic soft tissue injuries, such as rotator cuff tears of the shoulder and mild meniscal tears. PRP has been increasingly used to treat osteoarthritic conditions, as well as ligamentous sprain and strains.
Historically speaking, athletes were some of the first “consumers” to recognize value in PRP therapy and seek it out. The long list of top-tier athletes who have received PRP therapy includes NBA legends and current stars like Kobe Bryant, Joel Embiid, and Stephen Curry, NFL Hall of Famers Ray Lewis and Troy Polamalu, and the Philadelphia Phillies’ two aces, Zack Wheeler and Aaron Nola. As a group frequently suffering from repetitive motion strains and related injuries, athletes have been using PRP for decades to heal quickly from their injuries. Aside from the quick recovery time, PRP therapy is a minimally invasive out-patient procedure, making it a safer option than some forms of surgery, and with more efficacy—and less risk—than steroid injections.
PRP therapy is no longer a therapy limited to athletes. Doctors are increasingly recommending it to the public. PRP therapy has been recognized as particularly helpful for treating workplace injuries. These injuries are similar to the kinds that athletes have been using PRP therapy to recover from, such as injuries from overexertion, falls, repetitive strains, and bodily contact. This one-time exotic technique for helping professional athletes heal is now helping society’s hardest workers do the same.
How PRP therapy works
PRP therapy is a relatively simple procedure. Once a doctor has determined that this treatment is appropriate for a patient, they will take a blood draw from them, usually from the arm. Once they have extracted enough blood, they will run it through a centrifuge to separate out the different elements. The goal of this step is to isolate platelets in a patient’s blood from their white and red blood cells.
Once the components are sufficiently separated, a doctor will extract the platelets and inject them into the site of the patient’s injury. Platelets are full of healing proteins and other molecules that help the body recover from damage caused by an injury. When injected into an injury site, the platelets act as reinforcements for the body’s natural healing process already occurring at the site.
Approximately two weeks before the injection is to be received, patients are asked to stop taking any kind of anti-inflammatory medications like Advil and Ibuprofen. Typically, a patient will receive three injections, approximately four to six weeks apart. Each treatment takes less than an hour to complete.
Doctors are finding more uses for PRP therapy
PRP therapy can treat several categories of injuries, with doctors now recognizing its use in healing musculoskeletal injuries and even degenerative conditions like osteoarthritis. PRP therapy is even used in cosmetic procedures, such as for treating male pattern baldness and in providing skin rejuvenation.
Doctors are confident in PRP therapy because in addition to being effective, it is also safe. The most frequent issue experienced by patients receiving it is minor bruising and soreness at the site of the injection. However, this relatively minor complication does not occur every time. Because PRP therapy uses a patient’s own blood, there is a much smaller chance of their body rejecting the injection or having an allergic reaction compared to other injectable treatments like corticosteroids.
As we noted, athletes at the peak of their health were at the forefront of PRP therapy. Today, it has now gained widespread recognition for its value in treating the general population. Doctors are now recommending PRP therapy to people of all types with orthopedic injuries, even adolescents.
Perhaps the most promising application of PRP therapy is to workers who suffered workplace injuries on the job, such as acute injuries caused by repetitive strain and stress from manual labor. Because the treatment provides fast-acting healing in a minimally invasive way, it has the potential to change how injured workers recover from workplace injuries. One of the most common types of workplace injuries is repetitive strain injuries, or RSIs. By performing the same rote movements over and over, many workers develop recurring problems in their joints and tendons associated with these movements. Over years at the same job, this can lead to recurring pain and stiffness.
By introducing platelets full of healing proteins and compounds into the injury site, PRP therapy offers a uniquely safe and effective treatment option for these workers that other treatment options do not. With just a few injections, workers can be back on the job sooner rather than later, feeling rejuvenated and able to carry out their normal duties.
PRP therapy is beneficial to workers for more than RSIs, however. Many of the conditions commonly associated with blue collar work, such as strains, joint and tendon fatigue, contact injuries, and overexertion can all be healed with PRP therapy.
An effective therapy that is rarely covered by insurance—but should be
Despite PRP therapy’s long history and established benefits, many insurers generally refuse to cover the treatment because they consider it to be speculative and experimental. In some more progressive states, however, there are carriers that have added PRP to treatments they will reimburse healthcare providers for.
It is clear PRP therapy offers a host of benefits to the public, especially injured workers, on a shorter timeline and is a less invasive option compared to traditional treatments. It also may prevent surgeries, thus saving patients from potential complications and perhaps saving insurance carriers money in the long run. Thus, insurers should cover this treatment. They would benefit as much from doing so as their insureds.
Not only does PRP therapy offer patients access to an effective, minimally invasive treatment option, it also offers insurers a relatively low-cost and effective treatment option. PRP therapy eliminates the need for hospital stays and costly surgeries. Equally important, it is an effective way for patients to get their chronic and recurring health problems under control. This is particularly true with injured workers who sustain injuries in the course of their jobs and are likely to aggravate previous injuries that were not treated effectively.
Insurers who continue to refuse to cover PRP therapy may find that the market and judicial decisions compel them to do so. Employers, particularly those in industries that rely heavily on manual labor, could look for insurers that do offer coverage for PRP therapy when they are shopping for employee benefit providers. These employers know that any increase in costs for offering a plan to their employees that covers PRP therapy could be offset by productivity gains when their injured workers get back on their feet and back at work sooner. If insurers feel market pressure, they may have no choice but to offer coverage for this treatment. Pressure from judicial decisions to offer that coverage will be equally, if not more, persuasive.
It’s time more injured workers had affordable access to PRP therapy
Decades ago, it might have made sense for insurers to view PRP therapy as a speculative treatment. We’re not suggesting that insurers should be encouraged to pay for ineffective unproven or unscientific treatments and pass their costs for funding these treatments onto their insureds as higher premiums. But once a treatment has withstood the test of time and is overwhelmingly recognized within the medical community as a safer, more effective, and cheaper alternative to costly surgeries, insurers must adjust their attitudes and begin covering that treatment just as they would any other proven method.
PRP therapy is unquestionably at that point today. The treatment has been around for more than half a century and has found widespread approval in the medical community for a diverse array of uses. PRP therapy offers several benefits to patients, especially injured workers, suffering from both chronic and acute conditions without serious side effects or risks.
It is time for insurers to recognize that this treatment is no longer experimental. They should cover the cost of PRP therapy in most cases. When they do, injured workers, their employers, and insurers themselves will all benefit.
Dr. Uplekh S. Purewal is a practicing Board Certified Interventional Pain Management Specialist and Board Certified Anesthesiologist. Keld R. Wenge is a partner at Pond Lehocky Giordano LLP, the largest workers’ compensation and social security disability law firm in Pennsylvania, and one of the largest in the U.S. They can be reached at uplekh@hotmail.com and kwenge@pondlehocky.com, respectively.
Reprinted with permission from the July 19, 2024 edition of The Legal Intelligencer © 2024 ALM Media Properties, LLC. All rights reserved. Further duplication without permission is prohibited, contact 877-257-3382 or reprints@alm.com.
