PRP (platelet-rich plasma) and RFA (radiofrequency ablation) are both non-surgical, day-care pain procedures, but they do different jobs. PRP uses concentrated platelets from your own blood to support healing in a worn joint or damaged tendon, and usually needs one to three sittings a few weeks apart. RFA uses controlled heat to quieten the nerve that carries pain from a joint, and is usually done in a single sitting, with relief that often lasts six months or more. Some patients need both because PRP works on the tissue while RFA works on the pain signal, so together they can tackle two parts of the same problem.
If your doctor mentioned both and you’re unsure what the difference is, or why one patient gets PRP while another gets RFA, this guide explains it in plain language.
What Is PRP Therapy?
PRP stands for platelet-rich plasma. Platelets are the cells in your blood that help wounds heal, and they carry growth factors that signal repair. In PRP therapy, a machine spins a small amount of your blood to concentrate platelets, then injects the concentrate into the painful joint, tendon, or ligament.
Because it comes from your own body, PRP has a low risk of allergic reaction. It’s considered a regenerative treatment: the aim is to calm inflammation and support healing in the tissue, rather than just numbing the pain.
What Is Radiofrequency Ablation (RFA)?
RFA is a procedure that uses heat, produced by a mild radiofrequency current through a thin needle, to switch off the small sensory nerves that carry pain signals from a joint to the brain. It doesn’t repair the joint itself. Instead, it interrupts the pain message.
Before RFA, most patients have a diagnostic nerve block: a numbing injection near the target nerve. If it gives good short-term relief, that nerve is very likely the source of the pain, and RFA can give longer-lasting relief.
PRP vs RFA: What’s the Difference?
| PRP therapy | Radiofrequency ablation (RFA) | |
| What it works on | The damaged tissue: cartilage, tendon or ligament | The nerve carrying the pain signal |
| How it works | Growth factors from your own platelets support healing and calm inflammation | Controlled heat interrupts the pain nerve |
| Test needed first? | Clinical exam and imaging | Usually a diagnostic nerve block |
| Typical sittings | One to three, a few weeks apart | Usually one; repeated only if pain returns |
| When relief starts | Gradually, over weeks | Builds over one to three weeks |
| How long relief may last | Several months, sometimes a year or more | Often six months to two years |
| Best suited to | Early to moderate joint wear, tendon and ligament problems | Joint pain from a confirmed nerve source, including moderate to advanced arthritis |
Who Is PRP Right For?
PRP tends to work best when there’s still healthy tissue to support. It may suit you if you have:
- Early to moderate knee osteoarthritis, where the cartilage is thinning but not completely worn away
- Tendon problems, such as supraspinatus tendinopathy, patellar tendinopathy, tennis elbow or plantar fasciitis
- A partial rotator cuff tear or long-standing ligament strain
- Pain that hasn’t settled with medicines and physiotherapy, and a wish to avoid repeated steroid injections
PRP is usually less useful for severe, bone-on-bone arthritis. It isn’t recommended if you have an active infection, a blood or platelet disorder, active cancer, or are on certain blood thinners. Your doctor will check this before treatment.
Explore PRP for the knee, shoulder and neck.
Who Is RFA Right For?
RFA suits people whose pain comes from a joint with a clearly identified nerve supply. It’s commonly used for:
- Knee osteoarthritis pain, through genicular nerve RFA, including in people who aren’t ready for or can’t have knee replacement
- Facet joint pain in the lower back, often linked to spondylosis
- Sacroiliac (SI) joint pain
- Cervical facet joint pain in the neck, including some long-standing pain after whiplash
RFA is a good fit when a diagnostic block has clearly reduced your pain. It’s usually not the right choice if the pain is mainly from a pressed nerve root, such as sciatica from a herniated disc, which is often better treated with a nerve root block or epidural injection.
How Is PRP Done, Step by Step?
- Assessment: your pain specialist examines the joint and reviews X-rays, MRI or ultrasound.
- Preparation: you may be asked to stop anti-inflammatory painkillers (NSAIDs) for a short time before and after the injection, only on medical advice, because they can blunt the platelet response.
- Blood draw: a small amount of blood is taken from your arm.
- Processing: the blood is spun in a centrifuge for about 15 to 20 minutes to concentrate the platelets.
- Injection: the area is cleaned and numbed, and the PRP is injected under ultrasound or X-ray guidance so it reaches the exact spot.
- Going home: you leave the same day. Soreness for one to three days is common.
How Is RFA Done, Step by Step?
- Diagnostic block: a test injection confirms which nerve carries the pain.
- Preparation: you’ll be told whether to pause blood thinners (only on medical advice) and to arrange someone to take you home.
- Positioning and numbing: the skin is numbed with local anaesthetic.
- Guiding the needle: a thin needle electrode is guided to the nerve using X-ray or ultrasound.
- Testing: a small electrical test confirms the needle is next to the right nerve and away from nerves that control movement.
- Ablation: the nerve is heated for about 60 to 90 seconds per spot. The whole procedure usually takes 20 to 45 minutes.
- Recovery: you rest briefly and go home the same day. Most people return to light activity within a day or two.
How Many Sittings of PRP and RFA Will You Need?
This is one of the most common questions patients ask, and the answer differs for each.
PRP: most people need one to three sittings, usually spaced four to six weeks apart, depending on the joint, how much damage there is and how you respond. Improvement builds gradually, with the clearest benefit often seen around three to six months. If pain returns after a year or more, a repeat sitting may be considered. Be cautious of packages that offer many more sessions than this without a clear reason.
RFA: usually one sitting treats the target nerves. Because nerves slowly regrow, pain can return, typically somewhere between six months and two years later. If it does, RFA can be repeated.
| PRP | RFA | |
| Initial course | One to three sittings | Usually one sitting |
| Gap between sittings | About four to six weeks | Not applicable |
| Time in clinic | One to two hours, including blood processing | A few hours, including preparation and rest |
| When to consider repeating | If pain returns, often after a year or more | If pain returns, often after six months to two years |
Why Do Some Patients Need Both PRP and RFA?
Combining the two makes sense when pain has more than one part to it. Here’s why your doctor might suggest both:
They work on different parts of the problem
RFA turns down the pain signal, while PRP works on the tissue itself. In moderate knee arthritis, for example, RFA can quieten the nerves around the knee while PRP aims to improve the environment inside the joint.
Pain relief makes rehabilitation possible
Many people can’t do the strengthening exercises they need because the pain is too strong. RFA can bring the pain down quickly enough to start physiotherapy for chronic pain, while PRP’s slower, healing effect builds in the background.
There may be two pain sources
Some patients have arthritis in a joint as well as a damaged tendon or ligament nearby. RFA might treat the joint pain while PRP targets the tendon.
When one alone isn’t enough
If PRP gave partial relief but pain still limits walking, or RFA reduced pain but the joint keeps flaring up, adding the other can fill the gap.
Early studies, mostly small trials and case series in knee osteoarthritis, suggest that combining radiofrequency treatment with PRP may give better pain relief than radiofrequency alone. Larger studies are still needed, so the decision should be made case by case with your pain specialist.
What Results Can You Expect From PRP and RFA?
Both procedures aim to reduce pain and improve movement, not to give you a new joint. Realistic goals include walking further, climbing stairs more easily, sleeping better and relying less on painkillers. Results vary from person to person, depending on age, weight, how advanced the condition is and how well you follow your rehabilitation plan.
To get the most out of either procedure:
- Start the exercise plan your physiotherapist gives you, such as these strengthening exercises that help avoid knee surgery
- Manage your weight, since every extra kilogram adds load to the knees and back
- Eat well: an anti-inflammatory diet supports joint health
- Track your progress with a pain diary, so your doctor can see what’s working
Are PRP and RFA Safe?
Both are considered low-risk when done by a trained pain specialist under image guidance.
- PRP: soreness, swelling or bruising at the injection site for a few days. Infection is rare.
- RFA: soreness at the needle site, temporary numbness or a short flare of pain for a week or two. Infection and bleeding are rare.
Tell your doctor if you take blood thinners, have diabetes, have a pacemaker or have any allergies before either procedure.
PRP, RFA or Something Else?
PRP and RFA are two options among several. Depending on your diagnosis, your doctor may also discuss hyaluronic acid injections, GFC therapy, prolotherapy or nerve blocks. For advanced arthritis where these no longer help, it’s worth reading 5 questions to ask before a knee replacement.
How Nivaan Decides Between PRP and RFA
At Nivaan, the choice between PRP and RFA, or both, starts with finding the root cause of your pain. Our pain specialists combine a detailed examination, imaging and, where needed, diagnostic blocks, then build a plan with physiotherapy, pain counselling and nutrition support alongside any procedure.
Not sure whether PRP, RFA, or both is right for you? Book a consultation with a Nivaan pain specialist.