When we recommend Platelet Rich Plasma (PRP) injections to a client, a common question we are asked is what is the difference between a steroid and PRP. While we do not offer steroid injections for joint pain management, we feel our clients should be well-informed about the risks and benefits of both treatments. Both work to alter the immune system to decrease the inflammatory response in order to reduce pain. However, each works differently to achieve that goal.
Steroids work to decrease inflammation by inhibiting cellular processes that create inflammatory mediators, decrease the activity of immune cells involved in creating inflammation, and help shift fluid out of a cell and into the bloodstream to decrease swelling to a localized area. In a nutshell, a steroid works by shutting off components of the immune system responsible for creating inflammation to decrease pain. With any treatment, there are always risks and benefits that need to be weighed by you and your provider. Some of the possible side effects of a steroid injection include increased blood sugar (a problem for diabetic clients), increased risk for cataracts, increased risk for osteoporosis in the injected area and can increase ligament instability to the injected site. When a steroid injection is administered, clients may begin to notice a change in pain starting 24-48hr after the injection but it can even take up to 7 days to see the full effect. The length of time a steroid injection will last vary from 1 week to more than 2 months.
PRP works slightly differently. We innately have cell signaling processes that send platelets to an area of injury to help begin the process of repair. However, as we age, acquire sub-optimal health conditions, etc, our innate ability to recruit platelets to an area of injury or pain decreases. In the process of PRP, we draw your blood, spin it in a centrifuge, and use the liquid (plasma) for injecting. Through the process of separating the liquid and solid components of blood, we increase the concentration of platelets and therefore increase the concentration of growth factors that promote collagen growth, bone formation, cartilage growth, hyaluronic acid production, and decrease inflammatory factors.
When explaining the difference to clients, I often refer to the story of the tortoise and the hare. In this scenario, a steroid is the hare and PRP is the tortoise. Steroids typically work quicker than PRP but results also don’t last as long as PRP.
Clients receiving PRP treatments may notice results as early as 1-2 weeks however this treatment can take 3-4 weeks for a client to notice changes in pain. The duration of effectiveness can be upwards of 6-9 months. Risks for PRP are minimal as it is your own blood, but it is rare but possible to react to a solution in the blood that prevents clotting.
Regardless of what treatment you decide is best, we are here to guide you through managing your chronic joint pain.