What Is PRP Therapy for Foot and Ankle Pain?

If you've been dealing with a tendon or ligament injury in your foot or ankle that just won't heal — despite rest, physical therapy, and maybe a cortisone injection or two — your doctor may have mentioned PRP therapy. It's become one of the most discussed treatments in sports medicine and orthopedics, but there's a lot of confusion about what it actually is and whether it works.

What Is PRP?

Platelet-rich plasma (PRP) is a concentrated preparation made from your own blood. A small blood sample is drawn (similar to a lab draw), then spun in a centrifuge to separate the components. The resulting concentrate contains a high concentration of platelets — the cells responsible for initiating healing — along with growth factors that stimulate tissue repair.

This concentrated plasma is then injected directly into the injured tissue under ultrasound guidance for precision. The goal is to deliver a concentrated dose of your body's own healing signals directly to the area that needs it most.

What Conditions Does It Treat?

PRP is primarily used for chronic soft tissue injuries — conditions where the body's natural healing process has stalled or is insufficient. In the foot and ankle, the most common applications include chronic plantar fasciitis that hasn't responded to standard treatments, Achilles tendinopathy (chronic degeneration of the Achilles tendon), chronic ankle ligament injuries and instability, and other tendon injuries (peroneal tendinopathy, posterior tibial tendinopathy).

PRP tends to be most effective in conditions involving tendons and ligaments — tissues with naturally poor blood supply that heal slowly on their own. It's less applicable for bone problems, joint arthritis, or acute injuries.

What the Procedure Looks Like

The entire process takes about 30–45 minutes in the office. A small amount of blood is drawn from your arm, processed in a centrifuge for about 10 minutes, and then injected into the targeted area. The injection itself is brief — similar to a cortisone shot. Most patients describe it as a pressure sensation with mild discomfort.

Unlike cortisone, PRP works by stimulating an inflammatory healing response rather than suppressing inflammation. This means there may be some increased soreness in the injection area for a few days after the procedure — this is expected and actually indicates the treatment is working as intended.

How It Compares to Cortisone

Cortisone injections are anti-inflammatory — they reduce swelling and pain quickly, often within days. But they don't heal the tissue. In fact, repeated cortisone injections can weaken tendons and ligaments over time, which is why most physicians limit the number of injections to a given area.

PRP takes the opposite approach. It may take 4–6 weeks to notice improvement because the treatment is stimulating actual tissue repair, not just masking symptoms. But when it works, the results tend to be more durable because the underlying tissue has been strengthened rather than just quieted down.

For acute flare-ups, cortisone may be more appropriate. For chronic conditions where the goal is long-term healing, PRP is often the better choice.

What the Evidence Says

The research on PRP is promising but still evolving. The strongest evidence supports its use in chronic plantar fasciitis and Achilles tendinopathy, where multiple studies show improvement over placebo and comparable or superior outcomes to cortisone injections — with the advantage of not weakening the tissue.

Results vary based on the specific PRP preparation technique, the severity and duration of the injury, and patient factors. It's not a guaranteed fix, and not every patient responds. But for the right candidate with the right condition, it can be a meaningful step forward when other treatments have plateaued.

What to Expect After

The injection site may be sore for 3–7 days. Anti-inflammatory medications (ibuprofen, naproxen) should be avoided for the first two weeks, as they can counteract the healing response PRP is trying to trigger. Acetaminophen is fine for pain management. Most patients can return to normal activities within a few days, with a gradual return to exercise over 2–4 weeks.

Some patients feel significant improvement after a single injection. Others benefit from a series of 2–3 injections spaced several weeks apart, depending on the severity of the condition.

The Bottom Line

PRP therapy uses your body's own biology to promote healing in tissues that have been slow to recover. It's not magic and it's not right for every condition, but for chronic plantar fasciitis, Achilles tendinopathy, and certain ligament injuries, it's a well-supported option worth discussing. Call (760) 728-4800 to find out if PRP might be appropriate for your situation.