The core difference
One suppresses, one stimulates
Corticosteroid is a potent anti-inflammatory. It reduces the inflammatory response in a joint or around a tendon, and it does that quickly and reliably. It is not repairing anything — it is turning down a signal.
PRP does close to the opposite. It concentrates the growth factors in your own platelets and delivers them into the tissue, deliberately provoking a healing response. That is why PRP hurts more for a few days afterwards, and why the benefit builds over weeks rather than arriving immediately.
Get an examination before an injectionHead to head
How they compare
| Cortisone | PRP | |
|---|---|---|
| What it does | Suppresses inflammation | Stimulates a repair response |
| Onset | Days | Weeks |
| Duration | Weeks to a few months | Benefit strongest at 3–6 months in the trials |
| Discomfort after | Usually minimal | Several days of increased ache is normal |
| Repeat use | Limited — associated with tendon and cartilage deterioration | No equivalent tissue-thinning concern |
| Cost | Usually covered by insurance | Usually self-pay |
| Anti-doping | Restricted in competition | Permitted |
Cortisone
When a steroid injection is the right answer
- An acutely inflamed joint where you need function back quickly
- A flare that needs settling so you can actually do physical therapy
- A first injection for a problem you have not treated before
- Situations where cost is the deciding factor and insurance covers it
There is nothing wrong with cortisone. The problem is not the drug — it is using it repeatedly as a long-term strategy for a chronic problem.
PRP
When platelet-rich plasma is the better fit
- Chronic tendon problems — tennis elbow is one of PRP's strongest indications in the trial literature
- Mild-to-moderate knee osteoarthritis, where comparative analyses generally favour PRP over both cortisone and hyaluronic acid at three to six months
- Anyone who has already had two or three steroid injections into the same structure
- Athletes subject to anti-doping rules
- Plantar fasciitis that has persisted for months, where PRP performs comparably to cortisone without the same repeat limit
The tradeoff nobody mentions
Why repeat cortisone becomes a problem
Repeated corticosteroid injections into the same tendon or joint are associated with deterioration of the tissue over time. For an acute flare that is an acceptable trade. For a problem you have had for three years and injected four times, it is worth asking whether you are managing the pain while quietly making the tissue worse.
This is the single most common reason patients arrive here asking about PRP. Not because they read about it — because they have run out of steroid injections they are comfortable having.
Choosing
The questions that actually decide it
Work through these before you choose
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That fourth question matters more than the choice of injection. Lateral hip pain is usually gluteal tendinopathy rather than hip arthritis; knee pain sometimes originates at the hip or back. An injection into the wrong structure fails regardless of what is in the syringe.
FAQ
Frequently Asked Questions
Can I have PRP if I have already had cortisone?
Yes. Many PRP patients have had steroid injections previously. There is usually a recommended interval between the two, which depends on how recently you were injected.
Is PRP just a more expensive cortisone shot?
No — they work by opposite mechanisms. Cortisone suppresses inflammation for faster short-term relief. PRP provokes a repair response with slower onset. They suit different problems.
Which one works better for tennis elbow?
Lateral epicondylitis is one of the better-supported PRP indications, particularly in chronic cases that have not responded to rest, bracing and therapy. A 2026 systematic review of randomised trials also found PRP complication rates comparable to corticosteroid and saline.
Do I have to stop anti-inflammatories?
For PRP, usually yes, for a window before and after treatment — NSAIDs blunt the inflammatory signalling the treatment depends on. You will be given specific timing.
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