To Cortisone or not to Cortisone is the question. One the one hand Cortisone provides the much needed relief from pain and inflammation that soothes the cries of an injured sportstar. While at the same time, it is known to shut down healing altogether.
Apart from the standard side-effects of the drug, the second scenario keeps ligaments and joints from healing fully causing injuries to return several months later. And in some cases it’s known to have caused the degeneration of nearby bones and ligaments as a direct result of shutdown of the healing mechanism.
Turns out, pain and inflammation are two of body’s tactics to heal. Pain restricts your movement. The inflammation recruits stem cells and other growth factors to heal.
More Than Half A Century Of Fame
Edward Kendall and Philip Hench was made up of genuine hero material. On the morning of September 21, 1948, they injected their newest drug, called compound E at that time, on a 29-year-old woman who was suffering from chronic rheumatoid arthritis. She couldn’t walk. After three daily injections, the woman left the hospital on her own and immediately went on a 3-hour shopping spree. It was miraculous. It was Cortisone.
This huge win bagged Kendall and Hench a Nobel Prize (which they shared with another swiss scientist) and sparked a global revolution in the way sports injuries were treated.
The Bad Side Of Cortisone
A landmark study that looked at the reports of over 2,700 patients who’d suffered tendon injuries (conditions like tennis elbow, rotator cuff issues) found that Cortisone injection actually produces worse long-term results than “doing nothing.” In some cases, repeated Cortisone injections proved to have allowed the tendons to completely rupture because healing wasn’t happening. Sort of like a bad love-affair, where love was shut down from the beginning.
In another study comparing Cortisone and PRP side-by-side for the treatment of chronic plantar fasciitis, researchers found that PRP is not only as effective as Steroid injection at 3 and 6 months post-injection, but at 12 months, PRP is significantly more effective than cortisone injection.
However, this may only be the case for patients who never had Cortisone injections in the first place, as suggested in this study. Meaning, PRP or no PRP, healing is significantly better for patients who never had Cortisone.
This is in addition to its other known side-effects which include:
- Flare reaction where cortisone crystallizes in joints resulting in more severe pain.
- Massive rise in blood sugar levels.
- Infection of the injected joint.
- Hypercortisolism or Cushing’s syndrome from increased Cortisone levels in the body — a condition which can cause obesity, weak bones, hair growth and fertility problems.
PRP Injections, The New Cortisone Minus The Harmful Effects?
For any injection, the primary side-effect that physicians look for is infection. But since PRP uses patient’s own blood components, that is unlikely. So that’s a big win over Cortisone which is a synthetic drug extracted mostly from soybeans.
The rest of the battle (over supremacy) is easy.
Although the pain-relief from PRP is lower than from Cortisone, PRP provides significantly better healing experience. It actually alleviates pain by triggering rapid healing instead of taking the Cortisone’s “mad-man” strategy of shutting down healing.
Some physicians even argue that PRP is works better than Cortisone. “Platelet-rich plasma is significantly more effective than cortisone both in the short-term and the long-term treatment of these difficult patients.” says award-winning orthopedic surgeon and sports medicine specialist, Raymond R. Monto, MD.
Still there’s a major hurdle for PRP in terms of cost. Since it’s not a synthetic drug mass-produced in a manufacturing lab, the costs are significantly higher. To raise the hurdle even higher, PRP injections are not covered by insurance. (Although insurance companies are starting to sponsor certain pre-approved PRP injections.)
Ultimately, PRP injections may not be better for alleviating pain instantly like how Cortisone does, but it will definitely heal faster than most other treatments of it’s kind. And it’ll definitely lower the chances of surgery, which many Cortisone recipients end up having.