Opposite tools that look identical
Both arrive by needle; that's where the similarity ends. Cortisone is a powerful anti-inflammatory: it shuts down the local immune response, quieting an inflamed joint or nerve within days. PRP (platelet-rich plasma) is your own blood spun to concentrate platelets, then injected to flood a degenerated tissue with growth factors that restart repair. Cortisone silences; PRP rebuilds. The right choice depends on whether your problem is noisy inflammation or exhausted tissue.
Where each one wins
Cortisone wins when inflammation itself is the roadblock: an arthritic joint too angry for rehab, a Morton's neuroma resisting padding, a gout flare needing rapid control. Relief in days, at pharmacy-injection cost, usually insurance-covered. PRP wins for chronic degeneration: months-old plantar fasciitis, Achilles tendinosis, tissue that's quit rather than flared, where cortisone has little to suppress and real weakening risk with repetition. PRP costs more, hurts more for a week, isn't usually covered, and aims at durable repair rather than fast quiet; studies in fasciitis often show PRP ahead of cortisone by the one-year mark.
The decision pattern we actually use
Fresh, inflamed problems that need a window of relief: cortisone, precisely placed (ultrasound-guided when the target is small), bundled with the mechanical fix that makes it last. Chronic degenerated tissue: shockwave or PRP, because rebuilding beats silencing when there's nothing left to silence. Hard lines: no cortisone in or near the Achilles, ever (rupture risk), and a spot that keeps needing cortisone every few months is a spot voting for a repair strategy instead. And with either needle: the injection buys time or biology; the orthotics, stretching, and load fixes are what spend it well.
Questions readers still ask
Why won't insurance cover PRP if it works?
Coverage lags evidence, and PRP's trials, while encouraging for fasciitis and several tendinopathies, are newer and more varied than insurers require. So it's typically self-pay; we quote the exact fee upfront and tell you honestly whether your condition sits in the well-supported group.
Can I have cortisone now and PRP later?
Yes, sequencing happens often: cortisone to break a severe flare, then a repair strategy for the underlying degeneration once things calm. We usually space them, since fresh cortisone in the tissue can blunt the biology PRP is trying to spark.
This article is general education, not personal medical advice. For an evaluation in Sugar Land, call (281) 494-0572.