What to know before choosing cortisone or PRP

What to expect from cortisone

Cortisone may fit when you need relief sooner. The clinician places this medicine right at the sore area. You'll still need to ease activity for a while. Cortisone doesn't remove every cause of soreness.

Ask how long the relief might last for you. Repeat use can also raise questions about the joint. Your other health needs may affect the choice. The exam matters along with the date you need relief.

What to expect from PRP

PRP begins with your blood, so it isn't a manufactured drug. The spinning step can leave different amounts of platelets in the plasma. You might feel sore after the clinic procedure. Any relief often takes more time to appear.

The catch is that one clinic's PRP may differ from another's. Cost varies too, and insurance often doesn't pay. Ask what's kept in the plasma after the spinning step. Get a written price that says exactly what's included.

What to ask before you choose

Tell the clinician when relief would matter most. Ask which choice matches the cause found during your exam. Find out what happens if you get no relief. Another exam or a talk about surgery may follow.

After examining you, QC Kinetix medical providers may discuss concentrated PRP and care without surgery. Concentrated means the spinning step gathers more platelets into the plasma. Take your current medicines and records from earlier care. Ask when you can try your usual movement again.

Sources

1. A meta-analysis of 8 trials (648 patients, judged at low risk of bias overall) comparing intra-articular PRP with intra-articular corticosteroid found PRP significantly better for pain, stiffness and function at 3, 6 and 9 months (P<0.01), with the largest effects at 6 months (SMD -0.78) and 9 months (SMD -1.63). Three PRP injections a week apart outperformed a single injection over 12 months.

   McLarnon M, Heron N. — Intra-articular platelet-rich plasma injections versus intra-articular corticosteroid injections for symptomatic management of knee osteoarthritis: systematic review and meta-analysis.. BMC Musculoskeletal Disorders, 2021. DOI: 10.1186/s12891-021-04308-3.

2. A meta-analysis of 34 RCTs (1,403 PRP knees vs 1,426 controls) found WOMAC favoured PRP over placebo at 12 months and over hyaluronic acid at 6 and 12 months, and favoured PRP over steroids on VAS pain, KOOS pain, daily function and quality of life at 6 months. Crucially, the authors state that the superiority of PRP DID NOT REACH the minimal clinically important difference for any outcome and the quality of evidence was low.

   Filardo G, et al. — PRP Injections for the Treatment of Knee Osteoarthritis: A Meta-Analysis of Randomized Controlled Trials.. Cartilage, 2021. DOI: 10.1177/1947603520931170.

3. The largest head-to-head trial of cell-based orthobiologics to date randomised 480 patients with KL II-IV knee OA across four arms: autologous bone marrow aspirate concentrate, autologous adipose stromal vascular fraction, allogeneic umbilical cord tissue-derived MSCs, and a corticosteroid injection control. At 12 months NONE of the three orthobiologic injections was superior to another or to the corticosteroid control on either co-primary endpoint (VAS pain, KOOS pain), and none of the four groups showed a significant change in MRI osteoarthritis score from baseline. No procedure-related serious adverse events were reported.

   Mautner K, et al. — Cell-based versus corticosteroid injections for knee pain in osteoarthritis: a randomized phase 3 trial.. Nature Medicine, 2023. DOI: 10.1038/s41591-023-02632-w.

4. A meta-analysis of 11 RCTs (730 patients) with lateral epicondylitis found the timing reverses the answer: corticosteroid was significantly BETTER than PRP in the short term (under 2 months: VAS mean difference 0.93 favouring steroid; DASH 10.23 favouring steroid), the two did not differ at 2-6 months, and PRP was significantly better at 6 months or more (VAS -2.18; DASH -8.13; Mayo Elbow +16.53).

   Xu Y, et al. — Platelet-Rich Plasma Has Better Results for Long-term Functional Improvement and Pain Relief for Lateral Epicondylitis: A Systematic Review and Meta-analysis of Randomized Controlled Trials.. American Journal of Sports Medicine, 2024. DOI: 10.1177/03635465231213087.

5. A meta-analysis of 27 RCTs (1,779 patients) across rotator cuff injury, lateral epicondylitis, plantar fasciitis and tenosynovitis found no PRP advantage at one month anywhere, and in some tendons corticosteroid was better early; PRP overtook corticosteroid at 3 months for rotator cuff VAS and at 6 months for plantar fasciitis VAS and AOFAS and for tenosynovitis VAS.

   Ye Z, et al. — Platelet-rich plasma and corticosteroid injection for tendinopathy: a systematic review and meta-analysis.. BMC Musculoskeletal Disorders, 2025. DOI: 10.1186/s12891-025-08566-3.

6. A meta-analysis of 24 RCTs (1,653 participants) with plantar fasciitis found PRP produced significantly better VAS pain than corticosteroid at 3 and 6 months but not at 1 month or 12 months, and better AOFAS function scores at 3, 6 and 12 months. Plantar fascia thickness did not differ significantly at any time point.

   Zuo A, et al. — Platelet-Rich Plasma Versus Corticosteroids in the Treatment of Plantar Fasciitis: A Systematic Review and Meta-analysis.. American Journal of Physical Medicine & Rehabilitation, 2025. DOI: 10.1097/PHM.0000000000002677.

7. The ESSKA-ORBIT European consensus on blood-derived orthobiologics graded 28 question-statement sets; only 9 of 28 had high-level scientific support. Three statements reached grade A: that there is enough preclinical and clinical evidence to support PRP use in knee OA; that clinical evidence shows effectiveness in MILD TO MODERATE knee OA (KL grade 3 or lower); and that PRP provides a longer effect than the short-term effect of corticosteroid with a safer profile. The panel regarded PRP as a valid and possible first-line injectable option for KL grades 1-3.

   Laver L, et al. — The use of injectable orthobiologics for knee osteoarthritis: A European ESSKA-ORBIT consensus. Part 1-Blood-derived products (platelet-rich plasma).. Knee Surgery, Sports Traumatology, Arthroscopy, 2024. DOI: 10.1002/ksa.12077.