By Modern Movement Medicine · Published October 7, 2026
Our care team is led by Dr. Alyssa Kurth, DC, a Gonstead chiropractor and Palmer College of Chiropractic graduate. Read more about Dr. Alyssa Kurth, DC.
A cortisone shot is a steroid anti-inflammatory that often calms joint or tendon pain within days, but its effect usually fades and repeated shots carry trade-offs. Platelet-rich plasma (PRP) uses concentrated platelets from your own blood to support tissue repair; it works more gradually, the evidence is strongest for certain chronic tendon problems and mild to moderate knee osteoarthritis, and it is generally not covered by insurance. Neither is the right answer for everyone, and the best choice depends on your diagnosis, your goals, and what you have already tried.
A cortisone shot places a steroid, often combined with an anesthetic such as lidocaine or bupivacaine, directly into a joint or around a tendon. According to the American Academy of Orthopaedic Surgeons' guide to cortisone shots, relief can last several weeks, some people have a pain "flare" for a day or two before the steroid takes effect, and people with diabetes may see temporarily higher blood sugar readings.
There is no formal cap on how many cortisone shots a person can receive, but AAOS notes that many providers set a practical limit of 3 to 4 per year because of diminishing returns and the added risk of infection and tendon problems with more injections.
PRP starts with a standard blood draw. The blood is spun in a centrifuge to separate its parts, and the platelet-rich portion is injected into the injured area. Platelets carry growth factors involved in healing, which is the reason researchers study PRP for tendon and joint problems.
One honest caveat: PRP is not one standardized product. The AAOS overview of PRP points out that the effectiveness of different PRP formulations (for example, leukocyte-rich versus leukocyte-poor) has not been settled. That variability is one reason studies do not always agree.
This is where the comparison is clearest. A large 2010 systematic review in The Lancet found that corticosteroid injections for tendon pain often helped in the short term, but for tennis elbow (lateral epicondylalgia) results at intermediate and long-term follow-up were worse than doing nothing. Corticosteroid injections were also linked to a higher risk of tendon thinning in the Achilles and patellar tendons.
PRP has performed better over longer time frames in some head-to-head trials. In a randomized trial of 100 patients with chronic tennis elbow, the PRP group did better than the cortisone group at one year, and a two-year follow-up of the same trial found the difference held. The pattern across studies: cortisone tends to win early, PRP tends to do better later.
Here the expert groups disagree, and it's worth knowing that before anyone recommends an injection:
The 2021 AAOS knee osteoarthritis guideline says cortisone injections could provide short-term relief (moderate strength) and that PRP may reduce pain and improve function (limited strength).
The 2019 American College of Rheumatology and Arthritis Foundation guideline strongly recommends against PRP for knee and hip osteoarthritis, largely because PRP preparations aren't standardized.
A 2017 JAMA trial gave people with knee osteoarthritis a cortisone or saline injection every 3 months for 2 years. The cortisone group lost more cartilage and had no meaningful difference in pain.
Taken together, cortisone can be a reasonable short-term tool for an arthritic knee, frequent repeat shots deserve caution, and PRP is a real option with evidence that is promising but not settled.
For many other uses, including low back pain, the evidence for PRP is thinner, and AAOS notes that more research is needed before PRP can be called effective for conditions beyond certain tendon injuries and knee osteoarthritis. If someone recommends PRP for a problem outside those areas, it's fair to ask what evidence they're relying on.
PRP is considered experimental by insurers, so it is not covered by insurance at Modern Movement Medicine; see our FAQs and payment and insurance page. AAOS makes the same point nationally: few plans reimburse PRP even partially. Cortisone injection coverage varies by plan, so check with your insurer.
At Modern Movement Medicine, your full plan, including cost, is reviewed with you at your second visit, before you commit to anything.
We don't start with the injection. We start with the diagnosis. At your first visit, the team takes your history, examines you, and reviews any imaging you already have. Then our integrated team reviews your case together before recommending a plan.
When an injection might help, the questions we weigh include:
What is the tissue problem? A chronic tendon problem and an inflamed arthritic joint are different, and the evidence differs with them.
What have you already tried? Several prior cortisone shots with shorter and shorter relief is useful information.
What does the rest of the plan look like? Injections tend to work best as one part of a plan that includes rehabilitative therapy and, where appropriate, chiropractic care. Neither PRP nor cortisone replaces strengthening and movement.
Is an injection the right tool at all? Sometimes trigger point injections fit better, sometimes no injection is needed, and sometimes the honest answer is a referral to an orthopedic specialist. If that's the case, we'll say so.
Learn more about regenerative medicine and PRP at Modern Movement Medicine, or read how a pain management chiropractor differs from a pain doctor.
What exactly is my diagnosis, and how was it confirmed?
What does the research show for this condition specifically?
How many injections are you expecting, and how far apart?
What else is part of the plan (exercise, rehab, activity changes)?
What does it cost, and is any of it covered?
What's the next step if it doesn't help?
A provider who answers these clearly is treating you as a partner, which is how good care should work.
If you're weighing PRP, cortisone, or neither for a knee, elbow, shoulder, or tendon problem, start with a full evaluation. Request an appointment or call or text (503) 628-9082. You'll leave your second visit knowing what we found, what we recommend, how long it should take, and what it costs.
Is PRP better than cortisone? It depends on the problem. For chronic tennis elbow, trials suggest cortisone helps sooner and PRP does better over the longer term. For knee osteoarthritis, major guidelines disagree about PRP. The right choice depends on your diagnosis and goals.
How many cortisone shots can I get? There's no formal limit, but many providers cap it at 3 to 4 per year in one area, according to AAOS, because the benefit tends to shrink and the risk of side effects rises with more injections.
Is PRP covered by insurance? Rarely. At Modern Movement Medicine, PRP is not covered by insurance, and we review the full cost with you before treatment.
Is PRP safe? Because PRP comes from your own blood, allergic reactions are not the main concern. As with any injection, there is a small risk of infection, bleeding, and irritation of nearby tissue, and soreness at the injection site is common for a short time. Your provider should review your personal risks with you.
This article is general information, not medical advice, and it doesn't create a patient relationship. Talk with a licensed provider about your specific situation. If you have severe or sudden symptoms, such as a hot, swollen joint with fever, seek urgent care. Insurance coverage varies by plan.
