Orthobiologics and PRP Injections After a Car Crash or Work Injury

Orthobiologics and PRP injections use your own blood, bone marrow or fat to help an injured tendon, ligament or joint restart its repair. In St. Louis, after a car crash or a work injury, they fill the gap between rehab that stalled and a surgery you may not need.

Here is how the claim system treats an injured person. It pays for the scan, a few weeks of therapy and a cortisone shot. Then it waits. If you still hurt at month four, the next offer is an operation or a label: chronic. Nobody gets paid to treat the middle. Most crash and work injuries live in that middle, and that is where we work.

What are orthobiologics?

Orthobiologics are treatments made from your own tissue. We collect it, concentrate the parts that drive healing, and put them back exactly where the damage is. Nothing is grown in a lab. Nothing comes from a donor. You go home the same day.

Picture a torn tendon as a job site where the crew went home. The lumber is still on the lot. The foreman just stopped calling. Platelets, and the cells in marrow and fat, carry the signals that call the crew back. Your tissue still does the building. Our job is to deliver that signal to the right spot, in a big enough dose, and then load the tissue so it rebuilds in the right direction.

Which three orthobiologics do we use?

• Platelet-rich plasma (PRP). We draw blood from your arm, spin it and keep the layer packed with platelets. It is our first choice for most tendon tears, ligament strains and early joint wear.
• Bone marrow concentrate (BMAC). We take a small marrow sample from the back of the hip bone under local numbing. Marrow carries repair cells along with the signals they send. We save it for larger tears, worn joints and bone under damaged cartilage.
• Microfragmented fat. We take a small amount of fat, usually from the belly or flank, and break it into tiny clusters without chemicals. It cushions a worn joint and releases repair signals slowly. It fits joints with more wear, where one more round of PRP is not enough.

Which one you get depends on the size of the injury, your age, your lab work and what has already failed. It is never picked from a package.

Where do the injections go?

Where the needle lands decides the result more than what is in the syringe. We work at three targets:

• Into the joint. For the knee, hip, shoulder or a spine joint, where the lining is inflamed and the cartilage is thinning.
• Into the tendon or ligament. For a rotator cuff tear, a tennis elbow, a hamstring strain or a sprained ligament. The dose has to sit inside the damaged fibers, not beside them.
• Under the cartilage (subchondral). Into the bone just below a worn joint surface. In a crash knee, that bone often takes the bruise first. Bone that stays swollen keeps a joint aching long after the cartilage looks quiet on a scan.

Every one of these is done under ultrasound or live X-ray. A blind shot is a guess. A guess that misses gets written in your chart as a failed treatment, and an adjuster will read that line. Our page on why guidance matters for an injection explains the difference.

Conditions we treat with orthobiologics

These are the pages on this site where orthobiologics are part of the plan. Start with the body part that hurts.

Shoulder, elbow and tendons

• Rotator cuff tear after a car accident: the shoulder that took the seat belt or the door.
• Repetitive strain injury: a tendon worn down by the same motion, shift after shift.
• Ultrasound-guided tendon injections: why the needle has to land inside the damaged fibers.

Knee and other joints

• Knee injury at work: meniscus and ligament damage from a fall, a twist or a kneeling job.
• PRP for a knee hurt in a crash: the dashboard knee and how its damage gets graded.
• Arthritis after an injury: when an old accident comes back to the joint years later.

Neck and back

• Whiplash injury care: neck sprain, facet joint pain and where orthobiologics fit after a crash.
• Neck pain before a fusion: the tests to ask for before agreeing to fuse a neck.
• Injured discs and low back pain: what a pain society says about PRP and bone marrow for the spine.

Work injuries in Illinois

• Work injury and accident care for Belleville, IL: care for Metro East workers and drivers.
• Work injury and accident care for Glen Carbon, IL: the same care for Glen Carbon and Edwardsville area patients.

Every body area: healing, coverage and records

• What the orthobiologic guidelines say after an injury: the gap between the research and the denial letter.
• Not covered is not the same as not proven: how coverage decisions get mistaken for science.
• Documenting orthobiologic care for a claim: what the medical record has to show.
• The metabolic terrain before an orthobiologic: why your blood sugar shapes the repair.
• Why pain will not heal after you did everything right: what a stalled recovery is telling you.
• Specialized pain care after an accident: how a full injury plan is put together.
• Comprehensive pain management after an injury: how the whole team works on one case.
• The expert witness after Daubert: why evidence, not opinion, carries a medical claim.
• Dr. Gurpreet Singh Padda: the physician who reviews every treatment plan here.

Who is a good candidate after a crash or work injury?

You are likely a fit if most of these are true:

• Pain has lasted six weeks or more despite rest, rehab or a cortisone shot.
• An exam and an image show a partial tear, a strained tendon, a ligament injury or early to moderate joint wear.
• You want to avoid an operation, or you were told to wait until you are bad enough for one.
• You will do the rehab that follows the injection.

You are a poor fit if a tendon is torn all the way through and pulled back, if the joint is unstable, or if there is an infection. We also look hard at your blood sugar and inflammation. A tendon rebuilds from whatever blood you bring to it. Blood that runs high in sugar builds a slower, weaker repair, which is why we check the metabolic terrain before an orthobiologic. If you need a surgeon, we say so early and refer you. Holding someone back from a repair they need is as wrong as rushing them into one they do not.

What are the visit and the recovery like?

All of our regenerative care happens at 4477 Woodson Rd in St. Louis. Check in at the front desk and our team guides you from the lobby.

We use local anesthetic. There is no sedation. You stay awake, and most people drive themselves home. A PRP visit takes about an hour. Marrow or fat adds a short collection step at the start.

Expect soreness for about 48 hours after PRP, and a few days longer after marrow or fat. We ask you to skip anti-inflammatory pills for a short window, because they blunt the same signal we just delivered. Gentle movement starts within days. Loaded rehab follows on a schedule built for the tissue we treated.

The number of injections follows how you respond. Some people need one. Others need a second round. Nobody is sold a series up front.

Why do dose and rehab matter so much?

Not all PRP is the same product. A review of 18 placebo-controlled trials in people with knee arthritis found that PRP with a high platelet count gave pain relief patients could feel at three, six and twelve months. Low-platelet PRP did not clear that bar. A lot of “PRP did not work for me” stories trace back to a thin product, a missed target or no rehab afterward.

Rehab is the second half of the treatment. The injection starts a repair. Load tells the new tissue which way to line up. Without load, new fibers pile up like loose straw. With the right load, they line up like rope.

Timing matters too. For tennis elbow, a review of 11 trials with 730 patients found that cortisone worked faster in the first two months. PRP did better on pain and function at six months and beyond. That is the trade we explain to every patient: quick quiet now, or a repair that holds.

How is orthobiologic care handled in an injury claim?

Health plans usually do not cover PRP. That is a budget decision, not a ruling on the science, as we explain in not covered is not the same as not proven. HSA and FSA funds can generally be used. After a crash, care is often billed to the injury claim or under a lien. After a work injury, it runs through the workers’ comp process. Either way, the record has to show why the treatment was chosen, where it went and how you did after. Our page on documenting orthobiologic care for a claim lists what that record needs.

Pick your guide

Each guide arrives by email. Choose the one that matches your injury.

• Hurt in a car crash: get “Told You Need Surgery After an Injury? 10 Questions Before You Sign”.
• Hurt at work: get “Hurt at Work and Told You Need Surgery?”, the Missouri and Illinois second-opinion checklist.
• Low back or disc injury: get “Your MRI Report, Translated”.
• Neck injury: get the neck guide.
• Shoulder, elbow or other tendon injury: get the shoulder, elbow and tendon guide.
• Knee or joint wear after an injury: get “Is It Really Bone-on-Bone?”.

Frequently asked questions

Are orthobiologics the same as stem cell shots?

No. PRP carries growth signals but no cells that build tissue. Bone marrow concentrate holds a small number of repair cells along with those signals. Fat has its own mix. We describe each one for what it is and nothing more.

How soon after a car accident can I get PRP?

Most fresh injuries need a few weeks of standard care first, so the swelling settles and we can see what is truly damaged. If pain and function stall at about six weeks, that is the usual time to talk about it.

Does a PRP injection hurt?

The numbing medicine stings for a few seconds. After that, most people feel pressure rather than pain. The area stays sore for about two days.

Can I go back to work after an injection?

Desk work often resumes the next day. Heavy, overhead or kneeling work waits until the tissue has started to repair, and we write the work note to match your actual job.

Will my auto claim or workers’ comp pay for it?

That depends on the claim, the state and the insurer. We document the medical reason, and our staff walks you through the billing path before anything is done.

Do I need a referral?

No. You can request an evaluation through the form on this page or call (314) 887-5866. Bring any scans you have and your claim number if there is one.

Medically reviewed by Dr. Gurpreet Singh Padda, MD, MBA, MHP. Board Certified in Anesthesiology, Pain Medicine, Interventional Pain Management, Addiction Medicine, and Obesity Medicine. Last reviewed October 4, 2026.