Dr. Blake Ohlson discusses the key differences between Platelet-Rich Plasma (PRP) and cortisone injections, outlining how they function, their risks, and why they should never be combined.
Cortisone Injections
- Mechanism: Cortisone is a very strong anti-inflammatory agent that works by suppressing the immune response to take down inflammation. It is not regenerative .
- Benefits: It has been used for decades, is covered by most insurance plans, and is widely available.
- Risks & Drawbacks: Cortisone is generally a temporary fix rather than a long-term solution. Repeated usage carries risks, including transient spikes in blood sugar for diabetics, the breakdown of cartilage or joint tissue, and potential tendon rupture or soft tissue atrophy.
PRP (Platelet-Rich Plasma) Injections
- Mechanism: PRP is a regenerative technology that uses a concentrated sample of the patient's own blood. Instead of suppressing inflammation, it works by facilitating a highly aggressive tissue healing response in a joint or tendon.
- Benefits: It features an excellent safety profile with very few risks because it utilizes the patient's own biological material.
- Risks & Drawbacks: PRP is typically not covered by insurance. The longevity of the treatment varies, and medical guidelines are still evolving regarding the optimal concentration of platelets.
Can PRP and Cortisone Be Used Together?
Dr. Ohlson states a resounding no. Because cortisone actively suppresses the immune and inflammatory response while PRP relies on generating a vigorous tissue response to heal, using them together is completely counterproductive.
In clinical practice, patients who have received a cortisone injection must wait a minimum of 90 days for the cortisone to clear before undergoing any regenerative therapies like PRP.