Orthobiologic Myth #2: “PRP Works Instantly." It’s Biology, not Botox.
- cassis101
- Oct 10
- 3 min read
Updated: Oct 10
By Deborah Westergaard, MD | Pain Experts | Dallas–Plano
“PRP Works Instantly " Is Expecting Instant Gratification From Biology
In a world of quick fixes and instant results, it’s easy to think that regenerative injections like PRP works instantly or Bone Marrow Concentrate should “work right away.”
After all, we’ve been conditioned by cortisone shots that calm inflammation in days—or cosmetic procedures that show results overnight. or in a few days.
But orthobiologic treatments aren’t chemistry tricks—they’re living signals.
PRP and Bone Marrow Concentrate activate your body’s repair systems, not just by suppressing inflammation, but by recruiting and rebuilding. That takes time.
If you expect a cosmetic timeline from a biologic process, you’ll miss the very thing that makes it powerful.
The Truth: Biologic Repair Unfolds in Phases—Not Overnight
Both PRP (platelet-rich plasma) and BMC (bone marrow concentrate) trigger cascades of biological signaling that unfold over weeks to months.
They work through growth factors, cytokines, and progenitor cells that progressively rebuild structure, integrity, and function.
Phase 1: Inflammation (Days 0–7)
Platelets and marrow cells release powerful signals like PDGF, VEGF, TGF-β, and IGF-1.
These call in immune and stromal cells and set the stage for repair.
It’s normal to feel soreness or mild swelling here—it means the process has begun.
Phase 2: Proliferation (Weeks 1–4)
Fibroblasts, mesenchymal stem cells, and endothelial cells multiply.
Early collagen (Type III) and micro-vessels form.
This is when pain begins to ease and stiffness improves—but strength is still building.
Phase 3: Remodeling (Weeks 4–12+)
Collagen transitions to Type I. New tissue organizes, aligns, and strengthens.
MRI and ultrasound often show improved tissue quality months after treatment, even when early pain relief was modest.
Phase 4: Structural Integration (Months 3–12)
Ongoing cellular turnover, matrix crosslinking, and neuromuscular adaptation stabilize the repair.
This is where Bone Marrow Concentrate shines. Its stem and progenitor cells support long-term repair beyond what PRP alone can achieve.
What the Research Shows
Regeneration is slow by design. Multiple RCTs confirm that biologic repair builds durability, not speed.
Gluteal Tendinopathy (Fitzpatrick et al., Am J Sports Med, 2019):
In a double-blind RCT, PRP improved pain and function over 24 months, whereas corticosteroid peaked at 6 weeks then declined.
Biology wins in the long run.
Achilles Tendinopathy (de Vos et al., JAMA, 2010):
No early difference at 6 weeks—but gradual improvement over 24 weeks.
Healing followed the timeline, not the injection.
Osteoarthritis (Shapiro et al., Am J Sports Med, 2017):
BMC outperformed saline at 6 and 12 months in pain and function.
MRI sub-analysis showed cartilage signal improvement—again, delayed but durable.
Subchondral Bone Augmentation (Hernigou et al., Int Orthop, 2018):
Bone Marrow Concentrate injected into the femoral condyle and tibial plateau reduced need for knee replacement at 10 years.
The biology keeps working long after the injection.
These studies echo the same message:
Orthobiologic treatments don’t give instant gratification—they create lasting repair.
Patience Is the Protocol
You’re not waiting for the treatment to “kick in.”
You’re giving biology the time it needs to build new tissue.
That’s the cost of authenticity in medicine—true repair, not temporary relief.
Plan Your Timeline and Support the Process
If you’re investing in PRP or Bone Marrow Concentrate:
1. Expect progress, not miracles. Early inflammation is part of the blueprint.
2. Follow the regenerative rhythm. Weeks 4–12 are when structure catches up to sensation.
3. Support your biology. Creatine, clean protein, light exercise, and no alcohol all enhance remodeling.
4. Stay engaged. Periodic ultrasound or motion analysis tracks your gains in real time.
Understand Your Regenerative Timeline
Don’t judge biology by cosmetic standards.
At Pain Experts Dallas | Plano, we combine precision imaging with advanced PRP and Bone Marrow Concentrate protocols to repair what surgery can’t replace.
Schedule your regenerative consultation today.
Let’s build a plan aligned with your biology—because patience isn’t passive. It’s powerful.
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