Treatments · Oakville Pain Clinic Blog
PRP vs Cortisone: Which Is Right for Your Joint or Tendon Pain?
Cortisone gives quick relief; PRP heals tissue. They work very differently — and the right choice depends on your condition, age, history and goals.
Almost every patient who comes to our Oakville pain clinic asks us some version of the same question: “Which is better — cortisone or PRP?” The honest answer is that they're very different treatments that work very differently. The right choice depends on your condition, age, history and goals. Here's how we think about it.
How they actually work
Cortisone is a powerful synthetic steroid that suppresses inflammation. Inject it into a joint or near a tendon and the inflammatory cells calm down within days. The pain relief comes from suppressing the body's response to the underlying problem — not from fixing the underlying problem.
PRP (platelet-rich plasma) is concentrated platelets from your own blood, rich in growth factors. Inject it into a damaged joint or tendon and those growth factors stimulate a controlled healing response — your body actually starts repairing the tissue. The pain relief comes from healing the underlying problem.
Speed of relief
Cortisone wins on speed. Most patients feel meaningful relief within days to a week. Cortisone is the right choice when the priority is rapid pain control — for example, in the painful freezing phase of frozen shoulder, or when chronic shoulder pain is preventing physiotherapy from progressing.
PRP is slower. Most patients notice improvement at 2–6 weeks, with continued benefit building over 3–6 months as tissue remodels. PRP is rarely the right choice when you need relief tomorrow.
Duration of relief
Cortisone relief is temporary. Typical duration is weeks to a few months — sometimes longer for inflammatory joint conditions, but for tendinopathies and osteoarthritis, the effect usually fades.
PRP relief lasts longer. A 2024 meta-analysis of randomized controlled trials for knee osteoarthritis showed PRP produces clinically significant pain relief sustained at 3, 6 and 12 months from a treatment course, with benefit often lasting up to 24 months. Tendinopathy benefit is similarly durable when PRP works.
Side effects and tissue health
Cortisone has cumulative downsides. Repeated cortisone injections in the same area can thin cartilage, weaken tendons (and in rare cases cause tendon rupture, particularly the Achilles), and cause local fat-pad atrophy. Cortisone also affects blood sugar — a consideration for diabetics. The AAOS overview of PRP notes these limitations.
PRP uses your own blood — no synthetic medication. Side effects are typically limited to soreness at the injection site for a few days. There's no cartilage or tendon weakening with repeated treatment.
Cost and access
Cortisone is OHIP-covered when performed by a licensed Ontario physician with a valid health card. PRP is private-pay, though many extended-health benefit plans cover a portion under regenerative medicine, sports medicine or specialist injection benefits. We provide detailed receipts for insurance.
How we actually choose between them
For each patient we think about:
- What's the condition? Inflammatory joint flares often respond beautifully to cortisone. Chronic tendinopathies usually do better with PRP. Knee osteoarthritis can benefit from either, but PRP gives longer-lasting results.
- How urgently do you need relief? If you have a wedding next weekend, cortisone. If you have a 6-month rehab horizon, PRP.
- How many cortisone injections have you already had? If multiple cortisone injections in the same area haven't lasted, that's a strong signal to consider PRP — both because cortisone is no longer working and because cumulative cortisone carries tissue risks.
- Are you diabetic? Cortisone can spike blood sugar. We discuss alternatives earlier in diabetic patients.
- Are you trying to delay surgery? PRP can meaningfully delay knee replacement and other surgeries. Repeated cortisone usually doesn't — and may make a future surgery harder.
Common patient pattern: cortisone first, then PRP
A very common path is to start with cortisone (covered by OHIP, fast relief, low commitment), see whether it lasts, and move to PRP if the pain comes back or if cortisone has stopped helping. There's nothing wrong with this sequence — for many patients it's exactly right.
For some patients — particularly chronic tendinopathies (tennis elbow, Achilles, patellar tendon, gluteal tendinopathy) — we'd skip cortisone and go straight to PRP. Cortisone in these tendons can actively make the tissue worse over time.
When to ask us
If you're weighing cortisone vs PRP for a specific condition, the right answer depends on your specific situation. Self-refer at any time — call 647-910-5359 or book online and our team will reach out within 24 hours.
Common Questions
Frequently Asked Questions
Is PRP better than cortisone?
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It depends on the condition and your goals. Cortisone gives faster, OHIP-covered relief that doesn't last. PRP gives slower-onset, longer-lasting relief that helps tissue heal. For knee osteoarthritis and chronic tendinopathies, PRP often produces more durable results. For acute inflammatory flares or when rapid pain control matters, cortisone is often the right first choice.
Can I have both PRP and cortisone?
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Yes, but generally not at the same time. A common path is cortisone first for fast relief, then PRP later if the cortisone effect fades. We don't typically combine them in the same injection because cortisone can blunt PRP's healing inflammatory response.
How many cortisone shots is too many?
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There's no hard rule, but most pain physicians limit cortisone in the same joint to roughly 3–4 per year, and we generally avoid repeated cortisone in tendons (especially Achilles, due to rupture risk). If you've had multiple cortisone injections in the same area without lasting relief, that's usually a signal to consider PRP or another approach.
Is PRP covered by OHIP?
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No — PRP is a private-pay procedure not covered by OHIP. Many extended-health benefit plans cover a portion under regenerative medicine, sports medicine or specialist injection benefits. We provide detailed receipts for insurance.
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Have a specific condition you want to discuss?
Self-refer at any time — our team contacts you within 24 hours to schedule your consultation at Oakville Pain Clinic.