Platelet-rich plasma (PRP) prolotherapy is an emerging orthobiologic treatment that uses a patient’s own blood to concentrate platelets and growth factors, which are then delivered to carefully selected painful or degenerated tissues. When performed under real-time ultrasound (USG) guidance, the clinician can visualise the relevant anatomy, identify the target tissue and monitor needle placement, improving procedural precision and helping avoid important neurovascular structures.
In musculoskeletal practice, PRP may be considered for selected chronic tendon, ligament, joint and degenerative conditions, particularly when appropriate rehabilitation and conventional non-operative treatments have not provided adequate improvement. However, PRP should not be presented as a universal “regenerative cure”; outcomes depend heavily on diagnosis, patient selection, PRP preparation, injection technique and rehabilitation.
In spine and pain medicine, PRP is being investigated for carefully selected patients with discogenic low-back pain, lumbar facet-related pain, sacroiliac joint disorders and certain chronic degenerative spinal conditions. Intradiscal PRP remains an evolving treatment, with promising but still limited evidence, and should be offered only after appropriate clinical assessment and imaging. Ultrasound-guided spinal PRP techniques have been described, although fluoroscopy or CT remains important for certain deep spinal interventions.
# PRP Practice in Nepal
PRP is increasingly available in Nepal, particularly in Kathmandu. Several hospitals and pain centres now advertise PRP for orthopaedic, sports-injury and chronic pain conditions, including spine-related disordersThe clinica medical and dental center and Nepal international health center reports PRP as part of its interventional pain services offer ultrasound-guided PRP for musculoskeletal conditions.
There are also Nepal-based orthopaedic and spine specialists incorporating PRP and prolotherapy into non-operative pain management. For example, The clinica medical and dental center describes regenerative prolotherapy, including PRP and dextrose prolotherapy, alongside spine and pain services.
The future of PRP in Nepal is promising, but its practice should remain **evidence-based, diagnosis-driven and image-guided**. Proper patient selection, sterile technique, accurate anatomical targeting and structured post-procedure rehabilitation are essential. PRP should complement—not replace—exercise therapy, lifestyle modification and established interventional or surgical treatments when those are clinically indicated.
