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PRP injection or cortisone shot:
Technical comparison for medical professionals
Two procedures, two therapeutic approaches—guidance for making clinically appropriate decisions in practice.
Two approaches, two concepts
In orthopedics, sports medicine, and aesthetic and regenerative medicine, injection therapies have been used for many years as part of personalized treatment plans. Cortisone injections and PRP treatments are particularly frequently discussed in this context.
Both methods are used in clinical practice, but they follow different therapeutic approaches. Cortisone is primarily used for its anti-inflammatory effects. PRP—platelet-rich plasma—is derived from the patient’s own blood and is considered a biological procedure in the medical field.
Key clinical question
For doctors, it is not a matter of which procedure is generally “better.” What matters is the specific indication: Is it an acute inflammatory condition? Is the primary issue a degenerative structural change? What are the patient’s expectations—and are they realistic?
PRP – Platelet-Rich Plasma
Cortisone injection
Mechanism of action Autologous blood product; platelets release signaling molecules that are being studied in biological repair processes.
Mechanism of action Pharmacological inhibition of local inflammatory reactions by corticosteroids.
Primary Indication Degenerative changes, musculoskeletal issues, certain tendon disorders.
Primary Indication Acute inflammatory conditions, inflamed joints, short-term symptom relief.
Effective period The course of the disease is generally medium-term; it depends on the quality of treatment and the indication.
Effective period Effective in the short term; effectiveness depends on the findings and the level of inflammation.
Product quality Not a standard procedure—results depend on the tube, centrifuge, RCF value, and protocol.
Product quality Pharmacologically defined active ingredient; standardized dosage and formulation.
Risk Profile Autologous blood-based; possible local reactions; risk of infection if procedures are not performed under sterile conditions.
Risk Profile Known side effects (tissue reactions, increased blood sugar, flushing); use with caution when repeating the treatment.
Reimbursement (DE) Often provided as a non-covered service; not typically reimbursed by statutory health insurance.
Reimbursement (DE) Depending on the indication, this can be billed through health insurance.
What is PRP?
PRP stands for platelet-rich plasma. It is produced from the patient's own blood: After the blood is drawn, it is processed in a suitable PRP tubes transferred and centrifuged. During this process, the blood components separate based on their density. The goal is to obtain plasma with a higher platelet concentration than whole blood.
Platelets release various signaling molecules that are studied in the scientific literature in connection with biological repair and regulatory processes.
Not a standard preparation
The final PRP preparation depends heavily on the preparation process. The type of tube, anticoagulant, separation gel, centrifuge, rotor radius, RCF value, centrifugation time, and collection technique all have a decisive influence on the result. Anyone offering PRP should not only master the injection technique but also standardize the preparation process.
What are cortisone injections?
Cortisone injections contain corticosteroids and are used medically to reduce local inflammatory reactions. When appropriately indicated, this can lead to short-term relief from pain, swelling, and limited mobility—for example, in cases of active joint conditions or acute inflammation.
Cortisone is not a method of biological tissue regeneration. Repeated use should be carefully considered, particularly in the case of delicate tendons, cartilage, or soft tissue structures. Factors such as diabetes mellitus, the risk of infection, planned surgeries, and the patient’s history of previous injections must be taken into account.
Classification
Cortisone is neither inherently problematic nor suitable for indiscriminate use. It is an effective medication with clear indications, known benefits, and known limitations.
Why PRP processing is so important
With PRP, the quality of the procedure isn't determined solely by the injection. A significant part of the process takes place beforehand: during blood collection, tube selection, and centrifugation. Suitable PRP tubes are a central component of the system.
RPM vs. RCF
A protocol specifying 3,500 RPM is of little technical significance without specifying the rotor, because the same rotational speed results in different centrifugal forces depending on the rotor radius. RCF (relative centrifugal acceleration) is the more precise parameter for reproducible protocols.
To ensure consistent PRP procedures, practices should keep the following points in mind:
- A suitable PRP system for professional use
- Validated tube-centrifuge combination
- RCF value specified in the report
- Specified centrifugation time
- Standardized blood draw
- Aseptic techniques
- Documented collection technique for the plasma obtained
For medical facilities, the quality of these processes is not a minor detail, but rather part of their professional responsibility.
Indications: Contributing Factors
A doctor's decision for or against a procedure depends on several factors:
Diagnosis and Localization
Extent of inflammatory activity
Tissue structure (tendon, cartilage, joint)
Age and activity level
Concomitant conditions (e.g., diabetes mellitus)
Injection history to date
Concomitant medication
Scheduled surgery or physical therapy
Individual risk-benefit profile
Realistic patient expectations
Risks and Side Effects
PRP is derived from the patient’s own blood—which distinguishes its risk profile from that of synthetic or pharmacological agents. Nevertheless, PRP should not be portrayed as “risk-free.” Possible side effects include pain and bruising at the injection site, short-term local irritation, and infections if non-sterile procedures are used.
In addition, cortisone is known to cause local tissue reactions, temporary increases in blood sugar levels, flushing, and structural side effects with repeated use.
Technical Classification
The correct statement is not: PRP is harmless and cortisone is dangerous. Both procedures must be medically indicated, performed properly, and explained to the patient on an individual basis.
Costs and Reimbursement
Depending on the indication, cortisone injections are often covered by existing billing systems. In Germany, however, PRP treatments are frequently offered as individual health services (IGeL). Private or public insurers may cover the costs on a case-by-case basis, but this should not be assumed.
For medical practices, it is recommended to provide clear information about costs, the procedure, the potential number of sessions, and the limitations of the method. From a medical ethics perspective, caution is advised: patients should not be persuaded with promises of guaranteed results or blanket claims of superiority.
For medical practices: three requirements
For clinics that offer PRP, three things are particularly important:
Indications Medically sound determination of indications – not every set of symptoms is suitable for PRP.
Education Transparent patient education with realistic expectations.
Processing A reproducible protocol using appropriate PRP tubes and defined RCF values.
Conclusion
Cortisone is a well-established anti-inflammatory medication that can be helpful in the short term when used for the appropriate condition.
PRP is an autologous blood product that is being considered as part of regenerative treatment approaches. Its quality depends largely on proper processing—including the use of appropriate PRP tubes, a suitable centrifuge, and defined RCF values.
PRP and cortisone are not a matter of “modern versus outdated” or “natural versus harmful.” The decision is always made by a doctor—based on the diagnosis, tissue type, level of inflammation, and the individual patient’s situation.
FAQ
What is the difference between PRP and cortisone?
PRP is derived from the patient's own blood and contains platelet-rich plasma. Cortisone is an anti-inflammatory agent belonging to the group of corticosteroids. PRP is being considered as part of biological therapy approaches; cortisone is primarily used for local anti-inflammatory treatment.
Is PRP better than cortisone?
It would not be medically sound to make a blanket statement. Both procedures have different mechanisms of action and indications. The appropriate option depends on the diagnosis, treatment goal, inflammatory activity, and the individual patient’s situation.
Does cortisone work faster than PRP?
When used for the appropriate indication, cortisone can provide short-term anti-inflammatory relief. PRP is generally considered for the medium term. The actual course of treatment depends heavily on the findings and the individual treatment plan.
Does PRP have any side effects?
No. Side effects can also occur with PRP—such as pain, redness, swelling, or bruising. Since PRP is derived from the patient’s own blood, its risk profile differs from that of synthetic agents. Maintaining sterile conditions remains absolutely essential.
Why are PRP tubes important?
PRP tubes, along with the centrifuge, RCF value, centrifugation time, and collection technique, influence the separation of blood components and thus the quality of the plasma obtained. They should always be considered in the context of the overall protocol.
How important is the RCF value in PRP?
This is very important. Specifying only the RPM is imprecise because the actual centrifugal force depends on the rotor radius. RCF (relative centrifugal force) is more technically meaningful for reproducible protocols.
Can PRP replace surgery?
This should not be stated as a blanket assertion. Depending on the indication, PRP can be part of a treatment plan, but it does not replace a specialist’s diagnosis or treatment decision.
This article is intended for healthcare professionals and is provided for informational purposes only. It is not intended to replace a medical diagnosis, an individual assessment of indications, or a treatment decision.
