For joint and tendon injections, PRP has a good safety record. A 2026 meta-analysis of randomised trials found mild, transient pain and swelling as the main side effects, more with leukocyte-rich preparations, and no severe adverse events. NICE found no major safety concerns. The real risks sit in who prepares it, who injects it, and who was not told no. At The London PRP Clinic by The Wellness, every treatment is doctor-led, and telling patients no is part of the job.
Key points
A 2026 systematic review and meta-analysis in PM&R of randomised trials published since 2015 foundintra-articular PRP for knee osteoarthritis associated with mild, transient knee pain and swelling,particularly with leukocyte-rich formulations, resolving without intervention, with leukocyte-poor PRP showing a safety profile similar to hyaluronic acid and no severe adverse events observed.
NICE interventional procedures guidance IPG637 states that current evidence on PRP injections for knee osteoarthritis raises no major safety concerns, while describing the efficacy evidence as limited in quality.
A systematic review of 5 randomised hip osteoarthritis trials of 43 to 111 patients each reported no major adverse events, and a 2025 double-blind trial of 86 patients receiving intraosseous PRP into bonerecorded no serious adverse events.
Serious complications are rare but real. Septic arthritis after intra-articular leukocyte-rich PRP has been reported in the case literature, which is why sterile technique, a medical setting and a same-day pathway for a hot, red joint matter more than the product itself.
If you are weighing the risks for your own situation, message us on WhatsApp or email team@thewellnesslondon.com and a doctor will go through your history before saying whether PRP is appropriate.
Why PRP is safer than most injections, and where that ends
PRP is made from your own blood. There is nothing foreign to reject and no drug to react to, which removesthe allergic and systemic risks that come with steroids and with some hyaluronic acid products. The 2026meta-analysis in PM&R compared adverse events in randomised trials of intra-articular PRP against corticosteroid, hyaluronic acid and saline and found the PRP side effect profile was mild pain and swelling that settled on its own, with no severe events. The hip trials and the intraosseous trial report the same. Across the tendon trials, including the 240-patient Achilles trial and the 79-patient hip trial in the UK, serious harm was not reported.
Where that reassurance ends is the procedure around the product. Any injection into a joint can introduceinfection, damage a structure the needle passes through, or provoke a reaction to the process rather than the plasma. Those risks are not PRP risks. They are needle risks, and they scale with who is holding the needle,whether it is guided, and how the blood was hand led between the vein and the joint. A perfectly safesubstance injected by the wrong person into the wrong place is not a safe treatment.
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The side effects you should expect
The commonest experience is a flare. The treated joint or tendon is more painful for 2 to 4 days, sometimes with swelling and stiffness, because platelets release their growth factors by triggering a controlled inflammatory response. The 2026 meta-analysis found this more often with leukocyte-rich preparations, and the 2026 network meta-analysis of 21 knee trials and 2,254 patients advised leukocyte-poor PRP as the moreprudent choice on tolerability. Bruising at the blood draw site and at the injection site is common. Light-headedness during the blood draw affects some people and is over within minutes.
Less common are a longer flare of a week or more, which is more likely in the tendon than the joint, and ashort-lived increase in stiffness. Rare, and worth naming because they are the ones that matter, are infection in the joint, bleeding into the joint in someone on anticoagulants, nerve irritation from a needle passed nearone, and tendon damage from an injection placed into rather than around a tendon that was already close totearing. Each of those is a technique or a selection failure rather than a property of the plasma.
Ask us about the risks for your joint on WhatsApp and a doctor will tell you which of these apply to you and which do not.
Who should not have PRP
Some people should be told no, and a clinic that never says it is not screening. The clearest exclusions are medical. Platelet disorders or a low platelet count, since the treatment depends on functioning platelets.Active infection anywhere in the body or at the injection site. Active cancer, particularly blood cancers,because injecting growth factors is not something to do without an oncologist’s view. Severe anaemia or anunstable medical condition. Pregnancy, where there is no safety data and no reason to take the risk.Anticoagulant treatment is a relative rather than absolute exclusion, needing a doctor’s judgement on bleedingrisk and never a patient stopping their own medication.
The second group is people for whom PRP is safe but point less, which is its own kind of harm. A full-thicknesstendon tear needs a surgeon. A bone on bone joint needs a surgical opinion. Ankle osteoarthritis, thumb base arthritis, refractory greater trochanteric pain and Achilles tendinopathy all have placebo-controlled trials showing no benefit, and taking money for an injection the evidence says will not work is not made safe by the injection being harmless. The third group is timing. A steroid injection into the same site within recent weeks,anti-inflammatory use in the fortnight before, or a joint in an acute inflammatory flare are reasons to wait rather than to inject.
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How PRP is regulated in the UK, and why that matters to you
PRP prepared for a medical purpose is treated by the MHRA as an unlicensed medicine. Doctors are permittedto prepare it for their own named patients under an exemption, which is why a doctor-led clinic can offer it and why the doctor’s name should be on your treatment. The same product prepared by someone without thatstanding sits outside the framework, whatever the marketing says. The government’s proposed licensingscheme for non-surgical procedures places PRP in its amber tier, meaning it should be performed by or under the oversight of a qualified healthcare professional, and NICE’s guidance for the knee requires clinicalgovernance, consent and audit arrangements.
For a patient this translates into 3 questions. Is the person injecting a GMC-registered doctor. Is the blood drawn, spun and injected in one place under one clinician’s control, with the preparation system named. And is there a clinical governance structure, meaning someone answerable if it goes wrong. A clinic that injects PRP into joints on the same menu as facial treatments, staffed by injectors without medical registration, may belegal in the narrow sense and is still the setting in which the rare complications above are most likely to happenand least likely to be recognised.
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A 10 point safety checklist for any PRP clinic
Take this to whichever clinic you see, including ours.
Who will inject, and are they a GMC-registered doctor whose name I can check.
Has anyone asked about my platelet count, anticoagulants, infections, cancer history, pregnancy andcurrent medication.
Has a diagnosis been made, with imaging where needed, before PRP was recommended.
Is the injection ultrasound guided, and will I see the needle in the target on screen.
Is the blood drawn, prepared and injected in the same room by the same team, with a closed system.
Which preparation system is used, and is it leukocyte-rich or leukocyte-poor.
Have I been told to stop anti-inflammatories for 2 weeks before and after.
What is the plan if the joint becomes hot, red or increasingly painful after day 3, and who do I call.
Has anyone told me the conditions for which PRP has failed against placebo, and confirmed mine is not one.
Has the clinic ever told anyone no.
Our doctors put it this way. PRP is one of the safer things you can inject into a joint. The unsafe part is the clinic that has never declined a patient, never scanned one, and never had to manage a hot knee at 9 inthe evening.
Message us on WhatsApp with your joint or tendon, your medical history in brief, and any imaging, and adoctor will give you a straight answer.
What a good safety record does not mean
A good safety record does not mean PRP works. The two are separate questions, and NICE answered them separately, finding no major safety concerns and limited evidence of efficacy in the same paragraph. It does not mean the injection can be done anywhere by anyone, since almost every serious complication in the literature is a procedure failure rather than a product one. It does not mean there are no exclusions, and it does not mean a clinic is safe because it has never reported a problem, since a clinic without governance hasnowhere to report one. PRP is not routinely commissioned by the NHS and private medical insurance rarely covers it, so the safeguards that come with NHS or insured care are the ones you have to check for yourself.
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What safe PRP costs, and what unsafe PRP costs
Specialist central London clinics commonly charge from around £780 to £900 or more per image guided PRP injection including assessment, with a course of 2 to 3 taking a plan past £2,000. Outside central London PRPis advertised from around £250 to £500, and the cheaper the injection the more likely one of the safeguardsabove has been removed, most often the doctor, the scan or the ultrasound.
The reframing is the one every patient understands after the fact. The cost of an infected joint is a hospitaladmission, a washout, weeks of antibiotics and a joint that may never be the same. The cost of an unguidedneedle into the wrong structure is a second problem on top of the first. Against those, the difference betweena £300 injection and an £800 one is not the number that matters.
Care at The London PRP Clinic by The Wellness is doctor-led and priced below flagship central London rates,with your exact figure confirmed at the free suitability review, which is also where the screening above happens.
Ask about the cost for your joint on WhatsApp and we will explain what the review covers.
The free suitability review
Every enquiry here starts with a free, doctor-led suitability review rather than a booking. A GMC-registereddoctor goes through your medical history, medication, the joint or tendon, and any imaging, and gives one oftwo answers. Either you are approved for treatment, with the risks specific to you explained and a plan for what to do if anything goes wrong, or you are not approved, with an honest explanation of why, whether that isa medical exclusion, a condition the evidence does not support, or a reason to wait.
We decline a meaningful share of the people who enquire. That is deliberate. A clinic that approves everyone isoptimising for bookings, not outcomes.
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Why people choose The London PRP Clinic by The Wellness
An 87 percent patient success rate across treatments.
More than 187 five star reviews.
Every treatment performed by a GMC-registered doctor.
100 supervised treatments completed by every clinician before they treat a patient here unsupervised.
A 32 percent average density increase reported in our hair restoration programme.
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Frequently asked questions
Is PRP safe for joints
Yes, with the usual caveats for any injection. A 2026 meta-analysis of randomised trials found mild, transientpain and swelling as the main side effects and no severe adverse events, and NICE found no major safety concerns. The risks that remain are infection, bleeding and needle injury, which depend on technique and setting rather than the plasma.
What are the side effects of PRP injections
A flare of pain and swelling for 2 to 4 days is the commonest, more so with leukocyte-rich preparations.Bruising at the blood draw and injection sites is common. Longer flares, stiffness and, rarely, infection orbleeding into the joint are the less common ones, and infection needs same-day attention.
Who should not have PRP
People with platelet disorders or low platelet counts, active infection, active cancer, severe anaemia, unstablemedical conditions, or who are pregnant. Anticoagulant use needs a doctor’s judgement. PRP is also not appropriate for full tendon tears, bone on bone joints, or conditions where placebo-controlled trials show no benefit.
Can PRP cause infection
Rarely. Septic arthritis after intra-articular PRP has been reported in case reports, and it is a procedure risk rather than a property of the plasma. Sterile technique, a closed preparation system, a medical setting and asame-day pathway for a hot, red joint are what keep the risk low.
Is PRP regulated in the UK
PRP prepared for a medical purpose is treated by the MHRA as an unlicensed medicine that doctors may prepare for their own named patients. The proposed licensing scheme for non-surgical procedures places it inthe amber tier, requiring a qualified healthcare professional, and NICE requires governance and auditarrangements for knee use.
Can I have PRP if I take blood thinners
Sometimes, with a doctor’s assessment of bleeding risk and a decision on whether and how to proceed. Neverstop a prescribed anticoagulant or anti platelet drug on your own before an injection. A clinic that does not ask about blood thinners has not screened you.
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References
PM&R, 2026. Nakagawa et al. Assessment of adverse events and safety associated with intra-articularplatelet-rich plasma injections compared to other injectates for knee osteoarthritis, a systematic review and meta-analysis. https://pubmed.ncbi.nlm.nih.gov/42101047/
NICE, 2019. Platelet-rich plasma injections for knee osteoarthritis, interventional procedures guidance IPG637. https://www.nice.org.uk/guidance/ipg637/chapter/1-Recommendations
Cureus, 2024. Almutairi and Alazzeh. Efficacy and safety of PRP intra-articular injections in hip osteoarthritis, a systematic review of randomised clinical trials.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11578636/
Journal of Clinical Medicine, 2025. Sánchez Santiuste et al. Plasma rich in growth factors versus saline intraosseous infiltrations combined with intra-articular PRGF in severe knee osteoarthritis, a prospectivedouble-blind multicentric randomised controlled trial with 1-year follow-up.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12653810/
Adverse events related to platelet-rich plasma therapy and future issues to be resolved, including acase of septic arthritis after leukocyte-rich PRP.https://www.researchgate.net/publication/382426495_Adverse_events_related_to_platelet-rich_plasma_therapy_and_future_issues_to_be_resolved
Journal of Orthopaedic Surgery and Research, 2026. Leukocyte-rich versus leukocyte-poor platelet-richplasma and hyaluronic acid for knee osteoarthritis, a systematic review and network meta-analysis of 21randomised trials. https://link.springer.com/article/10.1186/s13018-026-06689-4
JAMA, 2021. Kearney et al. Effect of platelet-rich plasma injection vs sham injection on tendon dysfunction in patients with chronic midportion Achilles tendinopathy, the ATM randomised clinical trial.https://pmc.ncbi.nlm.nih.gov/articles/PMC8278266
Journal of Bone and Joint Surgery, 2025. Atchia et al. Efficacy of platelet-rich plasma versus placebo for the treatment of greater trochanteric pain syndrome, a double-blinded randomised controlled trial, the HIPPO trial. https://pubmed.ncbi.nlm.nih.gov/39804899/
Central London clinic price lists for image guided PRP and steroid injections, accessed September 2026.
This article is for general information and does not replace a medical assessment. Speak to one of our doctors,and your own GP or specialist if you have a medical condition, before deciding whether PRP is safe for you.