What is PRP and how does it work?

Platelet-rich plasma (PRP) is made from your own blood. A small sample is drawn and processed in a centrifuge to concentrate the platelets and growth factors they carry. That concentrated solution is then injected precisely into the affected joint, tendon, or ligament using ultrasound guidance. PRP works with your body's own healing mechanisms to reduce inflammation and support tissue repair over time.

Is PRP covered by insurance?

PRP is not typically covered by insurance. It is considered investigational by most insurance carriers in the United States, including Medicare and most commercial plans in California. Our practice is cash-pay, with no insurance billing or referral required.

How many PRP injections will I need?

For knee osteoarthritis, the evidence supports a three-injection protocol spaced two to four weeks apart, followed by reassessment. Some patients do well with a single injection. Treatment is individualized based on severity, imaging, and your response to the first treatment.

How long does PRP last compared to a cortisone shot?

Cortisone relief typically peaks at four to six weeks and fades by three months in most patients. PRP relief tends to build gradually and, in good responders, lasts 12 to 24 months. A five-year follow-up study found that PRP patients had a significantly lower rate of needing re-treatment at 24 months compared to hyaluronic acid.

Am I a good candidate for PRP?

The best candidates are people with mild to moderate osteoarthritis or soft tissue injuries such as tendons and ligaments who have not responded adequately to conservative care and are not yet at the point of needing surgery. Advanced arthritis (bone-on-bone) is less likely to respond well to PRP. A thorough evaluation including review of your imaging is necessary before recommending treatment.

What is BMAC therapy?

Bone Marrow Aspirate Concentrate (BMAC) is an orthobiologic treatment where bone marrow is drawn from your pelvis, concentrated, and injected into a damaged joint or tissue. BMAC contains stem cells, growth factors, and anti-inflammatory proteins. It is typically used for moderate to advanced joint degeneration where PRP alone may not be sufficient.

Alpha-2-Macroglobulin (A2M) is a naturally occurring protein in your blood that inhibits the enzymes responsible for cartilage breakdown in arthritic joints. A2M therapy concentrates this protein from your own blood and injects it into the affected joint to help protect remaining cartilage and slow further deterioration.

Do you accept insurance?

No. This is a cash-pay practice. There is no insurance billing, no referral required, and no wait for prior authorization. Regenerative medicine treatments including PRP, BMAC, and A2M are not covered by most insurance plans and are offered on a self-pay basis.

Where Science Meets Healing | Dr. Mikiko Murakami

Separating Signal from Noise

Why I’m Launching This Series

Starting a new chapter is never easy — whether it’s moving to a new place, shifting a relationship, or starting a new exercise routine. I love teaching my patients and medical students, and this feels like the right moment in my career to connect more broadly with those who, like me, want to understand health through both science and real-life experiences.

Why this, why now

I’m Dr. Mikiko Murakami, a dual board-certified physician in Pain Medicine and Physical Medicine & Rehabilitation. Over the years, I’ve worked with patients who want to recover from injuries, move more freely, and avoid unnecessary surgery.

I’ve also been a patient — navigating conventional and integrative therapies, multiple surgeries, and moments of hopelessness. Those experiences reshaped how I think about medicine. I realized that modern science often separates the dots instead of connecting them.

My passion for integrative and regenerative medicine grew from wanting to bridge that gap — blending ancient wisdom with modern evidence to understand how our biology, environment, and lifestyle intertwine.

Where science meets the human story

Science has made incredible strides — in diagnostics, therapeutics, and our understanding of what drives health and disease. We’re learning how inflammation, hormones, the gut microbiome, environmental toxins, and stress resilience all shape how we heal. We are learning how different types of medicines, traditional and non-traditional, can work together.

This newsletter is where I’ll unpack that science — while cutting through the noise of misinformation, and translating it into insights you can actually use.

The community I hope to build

This will be a space for thoughtful, open-minded people who want to take ownership of their health.

If you’ve ever wondered:

Is the term inflammation just a buzzword?
How does my gut health relate to my pain and mood?
How do hormones, stress, and environment shape pain and recovery?
Does regenerative medicine (PRP or stem cells) really work?

If those questions resonate, you’re in the right place. You can expect conversations that are both evidence-based and experience-informed — exploring what science tells us today, and where it’s heading tomorrow.

What to expect

I’ll publish about twice a month, focusing on the most common questions I hear from patients.

Each post will include:

Clear, evidence-based explanations
Practical tips you can use right away
Reflections that link science back to everyday life

My hope is that this becomes a trusted corner of the internet — where science meets curiosity, and curiosity inspires change.

? A note from the hive

Outside of medicine, I spend time with our bees on our small urban farm. I’m fascinated by their collective intelligence — how they work for the good of the whole and resist disease together.

Watching a colony thrive when balance is maintained reminds me that health — whether in humans or bees — depends on knowledge, community, resources and the ability to restore what’s been disrupted.

That spirit of connection and renewal is what I hope to cultivate here.

Thank you for joining me at the beginning.

Where science meets healing — and curiosity sparks renewal. ?

Dr. Mikiko Murakami

Physician-Founder at Bay Area Pain Rehab, PC | Website | + posts

Dr. Mikiko Murakami is a dual board-certified physician in Physical Medicine & Rehabilitation (PM&R) and Pain Medicine, practicing in Walnut Creek, California. She is the founder of Bay Area Pain Rehab, PC and sees patients for regenerative medicine and orthobiologics at Evolved Medical, 1270 Springbrook Road Suite E, Walnut Creek, CA 94597.

Dr. Murakami completed her Pain Medicine fellowship at UC San Diego and her PM&R residency at Mount Sinai Medical Center. She is a Qualified Medical Examiner (QME) for the California Division of Workers' Compensation, and also serves as an Expert Witness on federal cases. She also serves as adjunct clinical faculty for Touro University College of Osteopathic Medicine, and has published in peer-reviewed pain medicine literature.

Her clinical focus is combining various therapies, which includes regenerative medicine — including platelet-rich plasma (PRP), bone marrow aspirate concentrate (BMAC), and alpha-2-macroglobulin (A2M) injections — for patients with joint pain, osteoarthritis, tendinopathy, and spine conditions who are seeking alternatives to surgery or long-term medication. She writes on spine and joint longevity, musculoskeletal health, and regenerative medicine for an informed general audience.