Cortisone Or Platelet Rich Plasma Therapy, What Is the Difference?

I get this question a lot in my practice. Many people come in desperate need of pain relief and believe cortisone injections are the best and only treatment for what ails them. So, I'm going to lay out all the facts here, tell you what I do in my own practice, The Darrow Sports and Wellness Institute, and let you decide.

Cortisone Injections:

It is true that corticosteroids, like cortisone, are powerful anti-inflammatory substances. They are not used to relieve pain, but rather reduce inflammation, which in turn can lessen a patient's level of discomfort.

Cortisone is often injected into the area of injury or pain like joints or tendons. Examples of conditions for which local cortisone injections are used include inflammation of a bursa (bursitis), a tendon (tendonitis), and a joint (arthritis). Knee arthritis, hip bursitis, painful foot conditions such as plantar fasciitis, rotator cuff tendinitis and many other conditions may be treated with cortisone injections.

Although cortisone packs a powerful anti-inflammatory punch, it can only reduce inflammation and pain. It cannot repair the injury or the wear and tear abuse caused to a tendon or joint from years and years of use. Cortisone also masks the pain, which gives people a sense of false security. "No Pain, No Problem!" This mentality can result in further damage down the road from overdoing it when a tendon hasn't healed fully or properly.

What is more, some studies have shown that the long-term use of cortisone (i.e., repeated injections over a period of months or years) can cause degeneration of tendon tissue or cartilage if injected into the tendon itself.

With that said, although we don't like to do repeat injections of steroids or cortisone, sometimes doing it once is a very good diagnostic tool to see where the problem is occurring. By using cortisone, we can isolate an area by figuring out where cortisone is working the best. That area is where we focus our other tissue-building techniques, which naturally lead me to....

PRP Injections:

PRP (Platelet Rich Plasma) Therapy works on a totally different platform than cortisone. While cortisone inhibits inflammation, PRP initiates a collection of harmonious healing actions. The platelets stimulate proteins which encourage cellular growth and tissue regeneration. By concentrating the number of platelets normally found in an injured area, you're basically boosting this healing mechanism at the same time. It attracts stem cells which eventually grow into healthy joints, tendons, or ligaments.

Simply put, PRP injection allows a quick and focused action to the area of injury, which allows it to heal more effectively and rapidly.

Requiring only a small amount of blood from the patient, a trained professional can, with the help of a centrifuge, create a highly concentrated platelet rich plasma, which is then injected into the patient's injured tissue. This injection "jump-starts" the healing process.

A recent study presented at the International Meeting on the use of Autologous Growth Factors in Orthopedics and Sports Medicine found patients receiving cortisone showed a 40% improvement compared to PRP, which demonstrated a 75% improvement at 12 months. The study concluded that PRP injections reduced pain and increased function significantly, exceeding the effect of corticosteroid injection.

Sources: Nichols AW. Complications associated with the use of corticosteroids in the treatment of athletic injuries. Clin J Sport Med. 2005;15:E370.

Suffering from chronic joint and tendon pain and want to learn more about Prolotherapy and PRP Injections?