From the Guidelines
I strongly advise against proceeding with a corticosteroid injection followed by 5 PRP treatments without consulting a specialist, as the current evidence does not support the use of PRP for most conditions, with uncertain benefits for various clinical scenarios, including tendon injuries, acute muscle injuries, bone healing, and osteoarthritis 1. The use of corticosteroids and PRP together may be counterproductive, as corticosteroids can reduce inflammation but also inhibit healing, while PRP aims to promote tissue healing through growth factors. Key considerations include:
- The nature and severity of your condition
- Previous treatments and their outcomes
- Your overall health status
- The potential risks and benefits of combining corticosteroid injections with PRP treatments Given the uncertainty surrounding the effectiveness of PRP for various conditions, as noted in the study published in the Journal of Thrombosis and Haemostasis 1, it is crucial to consult with a specialist who can evaluate your specific situation and provide an evidence-based treatment plan tailored to your needs. Some general guidelines suggest waiting at least 2-4 weeks between a steroid injection and PRP treatment to avoid the steroid negating PRP's benefits, and most protocols recommend 1-3 PRP treatments spaced weeks apart, not necessarily five. It is essential to prioritize your health and well-being by seeking expert advice before proceeding with any treatment plan.
From the Research
Corticosteroid Injection Followed by PRP Treatment
- The effectiveness of a corticosteroid injection followed by platelet-rich plasma (PRP) treatment for various conditions has been studied in several research papers 2, 3, 4, 5, 6.
- A study published in the British medical bulletin found that PRP injections are more effective than corticosteroid injections at approximately 2 years follow-up for greater trochanter pain syndrome 2.
- Another study published in The American journal of sports medicine found that PRP can be clinically useful with a corticosteroid as a treatment for tendinopathy, as it does not interfere with the anti-inflammatory effects of the corticosteroid but avoids its deleterious side effects 3.
- A study published in the Journal of orthopaedic surgery (Hong Kong) found that PRP appeared to enable biological healing of the lesion, whereas corticosteroid appeared to provide short-term, symptomatic relief but resulted in tendon degeneration for recalcitrant lateral epicondylitis 4.
- A study published in Foot & ankle international found that PRP was more effective and durable than cortisone injection for the treatment of chronic recalcitrant cases of plantar fasciitis 5.
- However, a study published in The Journal of foot and ankle surgery found that in obese patients with plantar fasciitis, injection with corticosteroid was more effective than PRP at reducing pain and improving function 6.
Treatment Frequency and Duration
- The optimal frequency and duration of PRP treatment are not well established, but a study published in Foot & ankle international used a single ultrasound-guided injection of PRP, while another study published in The Journal of foot and ankle surgery used 3 separate injections of PRP, with each injection administered 1 week apart 5, 6.
- The proposed treatment of 5 times for PRP treatment may be beneficial, but more research is needed to determine the optimal treatment protocol.
Potential Benefits and Risks
- The potential benefits of a corticosteroid injection followed by PRP treatment include reduced pain and improved function, as well as the avoidance of deleterious side effects associated with corticosteroid use 3.
- However, the potential risks and side effects of PRP treatment, such as infection or allergic reactions, must also be considered 2, 3, 4, 5, 6.