What it is
A cortisone shot is an injection of a corticosteroid, a medicine designed to calm inflammation. It is usually given into or near a joint, tendon or other sore area, often along with a numbing medicine. Corticosteroid injections are FDA-approved medicines, though how and when they are used is a decision for a licensed clinician.
PRP stands for platelet-rich plasma. It is made from a person's own blood, which is processed to concentrate platelets, and then injected into an area of concern. The idea behind it is that platelets contain natural growth-related substances that may influence the way tissue responds.
The two are often compared, but they are not the same kind of thing. Cortisone is a drug. PRP is a biologic preparation. Many PRP uses in orthopedics are not FDA-approved, and insurance often does not cover them, so it's worth asking about both.
How it’s traditionally been approached
Cortisone injections have been used in orthopedics for a long time. They are traditionally used when inflammation is thought to be a main source of pain in places like the shoulder, knee, hip or tendon sheaths. Many people notice that the effects are temporary and vary from person to person.
PRP is newer in everyday orthopedic care and is often discussed for tendon problems and joint wear such as knee osteoarthritis. Because preparation methods differ from clinic to clinic, results and approaches can look quite different. Research on it is still developing, and opinions among clinicians vary.
Both options are usually discussed alongside other approaches, such as activity changes, physical therapy, bracing, oral medicines, and sometimes surgery. Neither one is right for everyone, and many people never need either.
How the right orthopedic doctor may help
The right orthopedic doctor may help you sort through these options by first listening to your story, asking about your symptoms and doing a physical exam. They may also suggest imaging such as X-rays or an MRI. This helps clarify what is going on before any injection is discussed.
Good questions to bring to a visit include: What do you think is causing my pain? Is this injection FDA-approved for my condition? What are the possible risks and limits? How might it fit with physical therapy? What would we do if it doesn't help? Is it covered by my insurance, and what would I pay out of pocket?
Ask how often the clinic performs the procedure and how it prepares PRP, if that is offered. If a larger step like surgery comes up, a second opinion is a reasonable and common choice. A trustworthy provider will explain the pros and cons of each option and won't promise a particular outcome.
The whole-person view
Pain and stress are closely linked. Long-lasting joint or tendon pain can affect sleep, mood and motivation, and stress can make the body feel more sensitive to pain. Looking at the whole person, not just the joint, can help you make decisions that feel right.
Some people find that body-based support, such as the approaches offered through Somatic Experiences, helps them feel more at ease in their bodies while they're dealing with pain. Others find talk therapy through Therapists.plus useful for coping with the worry and frustration that can come with a long recovery. These can be options alongside your orthopedic care, not replacements for it.
Somatic Experiences: embodiment and movement →Therapists.plus: mind body connection →
Keep in mind
- Only a licensed clinician can decide whether a cortisone shot, PRP or any other treatment is appropriate after an evaluation.
- Many PRP and other "regenerative" injections (including stem cell, amniotic, umbilical and exosome products) are not FDA-approved for orthopedic uses, and insurance often does not cover them.
- Recovery and results vary widely from person to person, and no provider can guarantee an outcome.
- For sudden severe pain, signs of infection, or a serious injury, call 911. If you are in emotional crisis, call or text 988.
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Frequently asked questions
What is the difference between a cortisone shot and PRP?
A cortisone shot is a corticosteroid medicine that is used to calm inflammation, while PRP is a preparation made from your own blood that is concentrated and injected. Cortisone is an FDA-approved drug, but many PRP uses in orthopedics are not FDA-approved. A licensed clinician can explain which, if either, may fit your situation.
Is PRP better than a cortisone shot?
Neither is better for everyone, because they are used for different reasons and people respond differently. Cortisone is traditionally used to calm inflammation, and PRP is more often discussed for tissue-related concerns. An orthopedic doctor can talk through the possible benefits and limits for your specific situation.
Is PRP covered by insurance?
Often it is not. Many PRP uses in orthopedics are not FDA-approved, and insurance plans frequently decline to cover them. Ask the clinic and your insurer about costs before you decide on anything.
How do I find an orthopedic doctor near me who offers injections?
Start by looking for a licensed orthopedic doctor near you and check whether they treat the body area that bothers you. Directories like this one can help you find providers, and you can ask each office which injection options they offer and why. It's reasonable to speak with more than one doctor.
Are there risks to cortisone shots or PRP?
Yes, all injections carry some possible risks, such as soreness, infection or an unwanted reaction. The specific risks depend on the treatment, the area and your health history. Your provider can explain them to you before you decide.
Should I get a second opinion before surgery or an injection?
A second opinion is a common and sensible step, especially before major surgery. Different doctors may see your options differently, and hearing more than one view can help you feel more confident in your decision.
Educational resource. Best Orthopedic Doctors shares general information and connects people with independent orthopedic doctors. It is not medical advice, diagnosis or treatment. Talk with a licensed professional about your health.