If you have a painful knee, shoulder, or back, you have probably been
offered a cortisone shot. It is the standard first line of care in most
clinics, and for good reason — it works fast. But "fast" and
"good for you long-term" are not the same thing, and that distinction is
exactly where PRP comes in.
To understand the difference, you have to understand what each injection
is actually doing inside your body. They are not variations of
the same idea. They are opposites in many ways.
The short version: cortisone suppresses your body's
response. PRP provokes it — on purpose.
What a cortisone shot actually does
Cortisone is a steroid. Steroids suppress things — inflammation, immune
response, pain signaling. Think of it as telling your body to
stop. Stop reacting, stop signaling, stop hurting.
For pain that is severe and getting in the way of daily life, that
suppression can be genuinely useful. There is a time and place for it.
It can pull someone out of an acute flare, calm an angry joint, and
create a window where physical therapy and movement become possible
again. I am not against cortisone categorically — I am careful about it.
The concern is what happens when suppression becomes the
strategy
rather than a short-term tool. Steroids can decrease bone density. That
means repeated or long-term steroid use can make bone weaker over time —
more prone to fracture, not less. You are quieting a signal while the
underlying structure continues to lose ground.
Why this matters for joints
Pain is your body's message. Suppressing it is not the same as
resolving it. If the tissue and structure are not addressed, the pain
tends to return — and you may have traded a short-term relief for a
long-term cost.
What PRP actually does
PRP stands for platelet-rich plasma. We draw a small amount of your own
blood, concentrate the platelets, and inject that concentrate into the
injured area. Platelets carry growth factors — the signaling molecules
your body uses to repair tissue.
Here is the part people are rarely told, and it is the most important
part to understand before you book:
PRP works by creating inflammation, not removing it.
Yes, you read that correctly. The regenerative process is
started by inflammation. We deliberately provoke a healing
response in the tissue so that your body sends in the repair cells and
rebuilds. That means the first few days can feel worse. More
sore. More swollen. More aggravated. You have to ride it out.
For some people, that temporary worsening is a dealbreaker — and it is
completely fair to say so. For others, understanding that the flare is
the mechanism rather than a failure is what makes it tolerable.
