From the Research
Patients should generally wait at least 2-4 weeks after receiving steroid injections before undergoing platelet-rich plasma (PRP) therapy. This waiting period is important because corticosteroids have anti-inflammatory and immunosuppressive effects that can inhibit the healing and regenerative properties of PRP. Steroids like methylprednisolone, triamcinolone, or dexamethasone work by suppressing inflammation and immune responses, while PRP therapy aims to promote healing by delivering concentrated growth factors to stimulate tissue repair. The conflicting mechanisms of these treatments mean that administering them too close together may render the PRP less effective. For optimal results, some practitioners recommend waiting even longer—up to 6-8 weeks—particularly after higher-dose steroid injections.
According to a study published in 2021 1, PRP showed the best overall outcome compared to steroids, hyaluronic acid, and placebo for patients with knee osteoarthrosis at 3,6, and 12-months follow-up. Another study published in 2020 2 found that postinjection NSAID restriction was more common (56%), with a typical restriction of greater than 2 weeks (38%). However, the exact waiting period may vary based on the specific steroid used, dosage administered, and individual patient factors.
Some studies suggest that PRP can be clinically useful with a corticosteroid as a treatment for tendinopathy, as it can avoid the deleterious side effects of a corticosteroid 3. However, the combined effects of a corticosteroid and PRP on the anti-inflammatory, matrix synthesis, and cytoprotective potential of tenocytes in conditions simulating tendinopathy have not been fully investigated.
In terms of post-PRP protocols, a systematic review published in 2020 2 found that the majority of protocols instituted a period of stretching (51%) and strengthening (54%), with stretching programs generally beginning 2-7 days following injection, and strengthening programs beginning within 2-3 weeks. However, the clinical effectiveness of PRP remains controversial, and even less is known about the effect of post-PRP protocols, which may affect the outcomes attributed to PRP itself.
Overall, the waiting period between steroid injections and PRP therapy is crucial to ensure optimal results and minimize potential interactions between the two treatments. Patients should inform their healthcare provider about any recent steroid injections before scheduling PRP treatment to ensure appropriate timing and maximize therapeutic benefits.