When dealing with chronic joint pain, tendon injuries, or arthritis, many patients are presented with two popular options for relief: PRP (Platelet-Rich Plasma) therapy and cortisone (corticosteroid) injections. Both treatments are administered via injection and have shown efficacy in reducing inflammation and pain. However, they work through vastly different mechanisms, and their long-term outcomes vary significantly.
So, which one is better for long-term healing?
In this blog post, we’ll explore the key differences between PRP and cortisone injections, examine their benefits and limitations, and help you make a more informed decision based on your condition and goals.
Understanding the Basics
What Is PRP Therapy?
Platelet-Rich Plasma (PRP) therapy is a regenerative treatment that uses a patient’s own blood to promote healing. Here’s how it works:
- A small amount of the patient’s blood is drawn.
- It is spun in a centrifuge to concentrate the platelets and growth factors.
- This concentrated plasma is injected into the injured area.
PRP is rich in proteins and growth factors that support tissue regeneration, reduce inflammation, and accelerate healing. It is most commonly used for:
- Tendon injuries (like tennis elbow or Achilles tendinopathy)
- Ligament sprains
- Osteoarthritis
- Muscle tears
- Post-surgical recovery
What Are Cortisone Injections?
Cortisone injections are a form of corticosteroid medication used to reduce inflammation and suppress immune system activity. They don’t promote healing but instead provide symptomatic relief by decreasing swelling and irritation.
Common uses include:
- Arthritis (especially in knees, hips, and shoulders)
- Bursitis
- Tendinitis
- Back pain or nerve inflammation (like sciatica)
Mechanism of Action: Relief vs. Regeneration
This is the key point of differentiation between PRP and cortisone.
- Cortisone works like a fire extinguisher: it quickly reduces inflammation and pain. However, this effect is temporary, and repeated use can actually degrade tissue over time, especially tendons and cartilage.
- PRP, in contrast, aims to heal the underlying problem. By stimulating the body’s natural healing processes, PRP supports long-term recovery rather than just short-term pain relief.
Efficacy: What Does the Research Say?
Short-Term Relief
Cortisone generally outperforms PRP in the short term. Within days of the injection, patients often report significant pain relief. This makes cortisone a go-to treatment for acute flare-ups or when quick pain reduction is critical.
PRP, on the other hand, has a delayed onset of action. It can take a few weeks to start seeing improvement, with the best results often appearing several months after treatment.
Long-Term Results
Multiple studies suggest that PRP may provide superior long-term outcomes for certain musculoskeletal conditions:
- A 2020 meta-analysis published in The American Journal of Sports Medicine showed that PRP injections yielded better long-term relief for knee osteoarthritis compared to corticosteroids.
- In cases of tendinopathy, like tennis elbow or patellar tendinitis, PRP has demonstrated more sustainable improvements in pain and function over 6-12 months.
- A 2015 study in the Journal of Orthopaedic Surgery and Research found that PRP significantly improved pain and mobility in chronic plantar fasciitis patients, while cortisone offered only short-term relief with diminishing benefits.
Risks and Side Effects
Cortisone Injections:
While cortisone is generally safe for occasional use, repeated injections can have side effects, including:
- Tissue degeneration (especially in tendons and cartilage)
- Joint infection (rare but serious)
- Elevated blood sugar (in diabetic patients)
- Skin discoloration or thinning
Repeated cortisone use has been linked with weakened tendons, potentially leading to ruptures. Because of this, doctors often limit cortisone injections to 3-4 times per year per site.
PRP Injections:
Since PRP uses the patient’s own blood, allergic reactions are virtually nonexistent. Side effects are typically mild:
- Temporary soreness or swelling at the injection site
- Bruising
- Mild inflammation (as healing response begins)
Because it doesn’t introduce synthetic substances, PRP is considered low-risk, even with multiple treatments.
Cost and Accessibility
One of the biggest barriers to PRP therapy is cost.
- Cortisone injections are widely covered by insurance and are relatively inexpensive.
- PRP injections, on the other hand, are not usually covered by insurance and can cost $500 to $2,000 per session, depending on location and complexity.
However, when factoring in the potential need for repeated cortisone injections and long-term degeneration risks, PRP might be more cost-effective over time—particularly if it helps you avoid surgery or further interventions.
Recovery Time
- Cortisone typically requires little to no downtime, and patients often resume normal activity quickly.
- PRP may involve short-term rest and modified activity for a few days to a week as the healing process begins. Some patients benefit from physical therapy in conjunction with PRP to optimize outcomes.
Who Should Consider PRP?
PRP is especially promising for:
- Athletes who want to recover without relying on long-term steroid use
- Middle-aged adults with early osteoarthritis hoping to avoid joint replacement
- Active individuals with tendon injuries or ligament sprains
- Patients who’ve had limited relief from cortisone injections or other conservative treatments
Because it promotes actual healing rather than masking symptoms, PRP can be a game-changer for long-term joint and soft tissue health.
When Is Cortisone the Better Option?
Cortisone may be a better choice if you:
- Need quick pain relief for a flare-up
- Have acute inflammation that needs to be controlled
- Are not a candidate for PRP due to cost or blood disorders
- Have a short timeline (e.g., trying to manage symptoms before an important event or surgery)
It’s also worth noting that cortisone can sometimes be used in conjunction with other treatments (like physical therapy or bracing) as part of a larger strategy.
Combination Therapy: Can You Use Both?
Some clinicians explore combined approaches, where cortisone is used initially for pain relief, followed by PRP to promote healing. While more research is needed in this area, early anecdotal reports suggest that staggered treatments may offer the best of both worlds in certain cases.
However, injecting cortisone before PRP may reduce the effectiveness of PRP due to steroid-induced suppression of the body’s healing response. Therefore, timing and sequence matter, and this approach should only be considered under the guidance of an experienced physician.
Final Verdict: PRP vs. Cortisone for Long-Term Healing
So, which is better for long-term healing?
- If you’re looking for fast pain relief and temporary control of inflammation: Cortisone is your best bet.
- If you’re aiming for lasting improvement and true healing of damaged tissue: PRP is likely the better choice.
While cortisone has its place in managing inflammation, PRP aligns more closely with regenerative medicine goals—not just suppressing symptoms, but addressing the root cause.
That said, every patient is different. Factors like age, injury severity, medical history, and financial resources should all play into your decision. Always consult with a knowledgeable sports medicine or orthopedic specialist to determine the best approach for your unique situation.
Conclusion
As medical science advances, patients now have more options than ever to manage pain and support healing. PRP therapy represents a shift toward regenerative treatment strategies, while cortisone remains a reliable tool for managing acute symptoms.
In the end, choosing between PRP and cortisone isn’t just about “which is better”—it’s about choosing the right tool for the job, with an eye toward both short-term comfort and long-term recovery.
If you’re dealing with a chronic injury or joint issue and want to explore your options, talk to a healthcare provider familiar with both approaches. With the right guidance, you can chart a path to recovery that fits your goals, your lifestyle, and your body’s unique needs.