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April 29th, 2019
Samples in a medical laboratory

I get asked this question from most of my patients. The better question to ask is Cortisone or PRP, which is the right treatment for me?

So traditionally, cortisone, or in other words a “steroid shot” has been used for the treatment of joint pain and tendinitis. Cortisone/steroids are powerful anti-inflammatory medications that actually do a very good job of taking away the pain, whether it is from an acute arthritis exacerbation, tendinitis or bursitis. They also work very fast. It usually takes 2-3 days for the effects of the steroid to set in and make you feel a lot better.

The problem is that cortisone does not help repair the site of injury. In fact, repeated cortisone shots are highly discouraged. In the joints, repeated shots can contribute to progression and development of early osteoarthritis. In the tendons, steroids will actually weaken the structure of the tendon and may cause the tendon to rupture after repeated injections.

Platelet rich plasma, on the other hand is derived from your own blood, and is injected into the effected joint or tendon. Unlike Steroids which are anti-inflammatory, PRP it actually pro-inflammatory and helps stimulate healing, growth and regeneration of the injured area. As it is derived from your own blood, it is very safe, and can be used multiple times as a regenerative treatment.

Now PRP does not work as fast as cortisone, usually the positive effects including pain relief are seen after a few weeks rather than a few days as seen with cortisone. However, in the long run, studies are showing that long term benefits of PRP outlast cortisone treatment.

So then you might ask the question, why do we even use cortisone/steroids?

Cortisone is still a very effective method for good pain control. Look at these 2 knee x rays below and I will explain why in case #1, I prefer to give a cortisone shot and why in case # 2, I prefer to give PRP.

X-ray of bones

As you seen in this picture, this patient has complete joint space loss of the medial and lateral knee compartments. This patient will need to have knee replacement surgery. This patient will have more immediate and better pain control with a cortisone shot rather than PRP treatment. There is no cartilage left, so PRP will not be able to slow down the progression osteoarthritis, as it is already advanced “bone on bone” arthritis. In this patient, we are aiming for adequate pain control, until the patient gets knee replacement surgery.

X-ray of bones

This knee, on the other hand is a very good candidate for a PRP injection. Patient had acute exacerbation of arthritis and was in a lot of pain after a few weeks of persistent exercise and lack of adequate rest. You can see that the patient has mild narrowing of both knee compartments. There is still a good amount of cartilage that we can protect and help heal. Here PRP can help take away the pain and also help slow or even stop the progression osteoarthritis. We don’t want to give cortisone in this case just to help ease the pain, as we may also contribute to deteriorating the remaining cartilage in the long run.

So the learning point is, if you can catch your arthritis early, you can treat it and slow down its progression with PRP. Advanced arthritis cases without significant cartilage will not respond well to PRP and cortisone is a faster and better treatment for pain relief.

Posted on behalf of Advanced Healing Institute

22972 El Toro Road
Lake Forest, CA, 92630

Phone: (949) 239-3206

Our Patient Reviews

Advanced Healing Institute

5 / 5.0

Based on 39 reviews

Rich G.

Dr. Reza is a genius. My knee has been bothering me for YEARS since I tore my meniscus playing football. Achy, bothersome, with occasionally a limp. I went in to to get PRP (Platelet Rich Plasma) and it was everything I thought it would be and then some. The whole procedure took less than an hour, very little to no pain and in less than 24 hours my knee felt brand new. If you are looking for a quality Doctor who offers PRP -- go here! The rates are very on point. He is literally THOUSANDS of dollars less than some other clinics and believe me he does such an amazing job, he could charge 10x's and it would still be worth it. Don't sit there suffering, get up and get help. I am actually thinking of getting my other knee done and its not really necessary. Lol.. 10 STARS...

E Y.

Dr Reza is FANTASTIC. Staff is friendly and very accommodating. I was in such pain. He diagnosed the issue (Bursitis) and clearly understood everything about it from A-Z. So efficient and understanding, not to mention making the procedure painless. I barely slept a hour the night before, saw Dr. Reza at 5pm and was feeling a million times better by 7pm. It's been 36 hours and I went from practically a frozen shoulder in pulsating pain to gaining back 70% of my movement range and most importantly "NO PAIN". just stiffness which is the normal symptoms as kindly explained to me by Dr. Reza. Everything is as promised, I am fully confident that I will be back to 100% range of motion within 3 days. I'm still gonna take it easy and slowly stretch my shoulder back to full strength. Without his service, I would probably be feeling like I was hit by a truck laying in bed miserable. Thank you very much Dr. Reza for helping my aging old bones. Cheers!

Geri C.

I can’t say enough about how intelligent Dr. Reza Dehdari is! I came to him to read my MRI for my ankle and he found a tear that multiple Doctors missed!!!! Simply incredible and I trust him throughly. Thank you so much!

Marina S.

Had the PRP procedure and I have to say no pain at all, going on 6 weeks, if you decide to have the PRP listen to Dr. Dehdari's instructions thoroughly and do the physical therapy, it works and I am so pleased and it's getting better and better as days go on, Dr. Reza Dehdari is the best and very emphatic in explaining all your questions soothing away your doubts, and he checks up on you to make sure all is well, after the PRP procedure. Very trustworthy PRP procedure and his assistant Sandy is also the sweetest caring person you will ever meet. I'm a satisfied customer and patient.

Micheal W.

Dr. Reza Dehdari you are an amazing person. Thank you for going the extra mile on my shoulder after three Doctors told me I needed surgery. You took your time and explained everything about what to expect and to be patient while I heal. And that’s exactly what I did was heal, I can’t thank you enough for what you did for me.

Helena L.

Within the last 6 months I've suffered two minor injuries on the same knee which have restricted my mobility and caused me a lot of pain. I've seen an orthopedic dr.,, a pain management dr., and a sports medicine dr., all of which simply told me either surgery or learn to live with the pain! I've heard about PRP as an alternative with a high percentage of success. Thus, I made an appointment to see Dr. Dehdari, and was pleasantly surprised by his high level of knowledge, professionalism and thoroughness. Dr. Dehdari reviewed my MRI (previously ordered by the Orthopedist) explained the extent of my injuries, took X-Rays and an ultrasound to carefully determined if I was a good candidate for PRP. I can only say that I wish more doctors will give you the time, attention and care that Dr. Dehdari provides. Thank you Dr Dehdari, thank you for such high work ethics and patient care. Many thanks to his staff as they are as attentive and caring as Dr. Dehdari. It has been only 24 hrs since I received my PRP treatment and my pain levels have drastically gone down! I highly recommend Dr. Dehdari.

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