ObjectiveThis pilot study aimed to inform future research evaluating the effectiveness of Platelet Rich Plasma (PRP) injection for tendinopathy.DesignRandomized control trial (RCT) and synchronous observational cohort studies. For the RCT, consecutive consenting patients treated at an academic sports medicine clinic were randomly assigned to either a PRP or placebo control group.SettingThe Glen Sather Sport Medicine Clinic, Edmonton, Canada.PatientsThe RCT included 9 participants with rotator cuff tendinopathy. The cohort study included 178 participants with a variety of tendinopathies.InterventionsPatients receiving PRP were injected with 4 ml of platelets into the supraspinatus and/or infraspinatus, while patients in the placebo group were injected with 4ml of saline. All participants undertook a 3-month standardized, home-based, daily exercise program.Main Outcome MeasuresParticipants in the RCT were re-evaluated 3, and 6 months post-injection. Change scores before and after injection on pain, disability and MRI-documented pathology outcomes were compared. In the cohort study, pain and disability were measured at 1, 2 and 3 months post-injection.ResultsFor the RCT, 7 participants received PRP and 2 received placebo injections. Patients receiving PRP reported clinically important improvements in pain (>1.5/10 on VAS), disability (>15 point DASH change), and tendon pathology while those receiving placebo injections did not. In the observational cohort, statistically and clinically significant improvements in pain and disability were observed.ConclusionThis pilot study provides information for planning future studies of PRP effectiveness. Preliminary results indicate intratendinous, ultrasound-guided PRP injection may lead to improvements in pain, function, and MRI-documented tendon pathology.Trial RegistrationControlled-Trials.com ISRCTN68341698

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Functional social support as a prognostic factor for depression and possible target of LBP management warrants further investigation. Implications for Rehabilitation Depression is a common condition in adults with low back pain (LBP), and is associated with poorer patient outcomes. This study provides evidence for social support as a prognostic factor for depressive symptoms and recovery from depression in patients with LBP problems. Management of pain conditions may be enhanced by a better understanding of modifiable risk factors for depression, such as social support.

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