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PRP (Platelet-Rich Plasma) Therapy

Your Cortisone Stopped Working. Now What?

Cortisone injections work quickly, but most patients notice they wear off faster with each round, and some stop working altogether. If you’re in that position, dealing with chronic knee, shoulder, or tendon pain that keeps coming back, PRP (platelet-rich plasma) therapy is often the logical next step. Unlike cortisone, which suppresses inflammation temporarily, PRP uses growth factors concentrated from your own blood to support actual tissue repair, and 2025 clinical data consistently shows it outperforms cortisone for lasting pain relief at six to twelve months.

At The Osteopathic Center for Healing, PRP is the most common entry point for patients in Rockville, Bethesda, Potomac, and Gaithersburg who are done managing their pain and ready to work on healing it. If you’ve been searching for “why did my cortisone shot stop working,”“PRP injection near Rockville MD,” “best alternative to cortisone for knee pain Bethesda,” or “non-surgical tendon treatment Potomac,” this page will give you straight answers.

PRP (Platelet-Rich Plasma) Therapy

What Does PRP Treat?

PRP is Dr. Spiegel’s preferred first-line regenerative option for tendon injuries and soft tissue conditions. It is also used for early joint pain where cartilage degeneration is mild. When degeneration is more significant, meaning the cartilage has meaningfully worn down or a labral injury is involved, Dr. Spiegel will typically recommend adipose autograft therapy or BMAC instead, or in combination.

  • Tendon injuries: tennis elbow, Achilles tendinopathy, patellar tendinopathy, and rotator cuff tendinopathy
  • Plantar fasciitis: chronic heel pain from fascia irritation that hasn’t resolved with orthotics or physical therapy
  • Shoulder osteoarthritis and labral injuries: cartilage wear, labral tears, or post-injury joint degeneration
  • Muscle strains and soft tissue injuries: acute or recurring injuries that are slow to heal
  • Ligament sprains: joint instability following injury, particularly in the knee, ankle, and wrist
  • Early joint pain with mild cartilage changes: early-stage osteoarthritis of the knee, hip, or shoulder where significant degeneration has not yet occurred
  • Bursitis and joint inflammation: shoulder, hip, or knee bursitis contributing to chronic pain and limited movement

PRP is generally the starting point for patients with tendon and soft tissue pain, and a strong option for early joint changes. For patients with established cartilage degeneration or osteoarthritis of any joint, Dr. Spiegel will discuss whether PRP alone is appropriate or whether adipose or BMAC therapy is a better fit.

PRP is generally recommended as a first-line regenerative option for mild to moderate conditions, or as the starting point of a layered treatment plan for more complex cases.

PRP vs. Cortisone: What the 2025 Research Shows

Many patients come to us after getting repeated cortisone shots that provided diminishing returns. This is consistent with what the research shows: cortisone injections tend to outperform PRP in the first four weeks, but PRP consistently delivers better outcomes at six to twelve months, with less wear on the joint over time. A 2025 meta-analysis of 56 randomized controlled trials confirmed that PRP significantly outperforms both placebo and corticosteroids for chronic joint pain at six and twelve months. Unlike cortisone, PRP doesn’t suppress tissue or mask pain. It works by delivering a concentrated dose of your body’s own growth factors directly to the injured area to stimulate actual tissue repair.

How PRP Therapy Works

A small blood sample is drawn from your arm, similar to a routine blood draw. The sample is placed in a centrifuge that separates and concentrates the platelet-rich layer. This concentrated plasma, which contains up to five times the normal concentration of growth factors, is then injected directly into the affected joint, tendon, or soft tissue using ultrasound or fluoroscopic guidance for precision. Research shows that non-guided injections miss the joint up to 30% of the time. Image-guided injections, like the kind performed at Osteopathic Center for Healing, significantly improve accuracy and clinical outcomes. The entire process, blood draw to injection, is typically completed in under an hour.

What to Expect After a PRP Injection

  • Quick, in-office procedure, typically under one hour
  • Mild soreness or stiffness at the injection site for two to five days
  • Minimal downtime: most patients return to light activity the same day or next
  • Initial improvement often noticeable within two to six weeks
  • Results continue building as tissue heals over the following months
Response time and degree of improvement vary by individual and condition. Many patients benefit from two to three sessions spaced four to six weeks apart. Dr. Spiegel will recommend a protocol based on your assessment.

How Long Does PRP Therapy Last?

One of the most searched questions about PRP is how long the results hold. Based on current clinical data, PRP relief for knee, hip, and shoulder conditions typically lasts 12 to 24 months when the procedure is performed with high-platelet, image-guided technique. This is significantly longer than cortisone, which averages four to twelve weeks of meaningful relief.

Patients with earlier-stage arthritis or tendon injuries often see the most durable results. For more advanced conditions, PRP may be combined with BMAC or used as part of a maintenance strategy. Dr. Spiegel will help you understand what’s realistic for your specific situation.

Why Patients in Rockville, Bethesda, Potomac & Gaithersburg Choose Us

  • Board-certified physician performing image-guided PRP with advanced regenerative medicine protocols
  • High-platelet concentration protocols for optimal results
  • Collaborative care: we combine BMAC with physical therapy and other supportive treatments when appropriate
  • Personalized treatment plans: your PRP plan is based on your imaging, diagnosis, and goals, not a standard protocol
  • We explain what the research actually shows, no overpromising

Frequently Asked Questions About PRP

For short-term relief (under four weeks), cortisone often acts faster. But 2025 research consistently shows PRP outperforms cortisone at the six- and twelve-month marks for chronic knee, shoulder, and hip conditions, with fewer concerns about tissue damage from repeated injections. Dr. Spiegel will help you determine which is more appropriate for your situation.
For short-term relief (under four weeks), cortisone often acts faster. But 2025 research consistently shows PRP outperforms cortisone at the six- and twelve-month marks for chronic knee, shoulder, and hip conditions, with fewer concerns about tissue damage from repeated injections. Dr. Spiegel will help you determine which is more appropriate for your situation.
Most patients start with one to three sessions spaced four to six weeks apart. Research suggests sequential PRP treatments can achieve results comparable to more complex therapies. The right number depends on your condition and how your body responds.
Yes, tendon conditions are among the most well-supported uses of PRP. Clinical studies show meaningful improvements in pain and function for patients with Achilles tendinopathy, lateral epicondylitis (tennis elbow), patellar tendinopathy, and plantar fasciitis, particularly when PRP is combined with structured rehabilitation.
PRP therapy is generally not covered by most commercial insurance plans, including Medicare, and is typically an out-of-pocket expense. Costs vary by the number of injections and the condition being treated. Our team will discuss pricing transparently before your procedure.
PRP concentrates growth factors from your blood to stimulate healing. BMAC uses concentrated regenerative cells drawn from your own bone marrow or fat tissue and delivers a broader biological toolkit. PRP is generally the more accessible starting point; BMAC may be recommended for more advanced conditions or when PRP hasn’t delivered sufficient results.
For patients with mild to moderate osteoarthritis of the knee, hip, or shoulder, or chronic tendon conditions such as tennis elbow, Achilles tendinopathy, or rotator cuff injuries, PRP is one of the strongest evidence-based non-surgical options available. It can meaningfully delay or help avoid the need for surgery in appropriate candidates. It is not a guaranteed surgical alternative, but it is a legitimate, research-supported strategy for managing joint and soft tissue pain without an operation.

Platelet-rich plasma and corticosteroid injection for tendinopathy: a systematic review and meta-analysis (2025)
https://link.springer.com/article/10.1186/s12891-025-08566-3

The information on this page is for educational purposes only and does not constitute medical advice. Only a licensed healthcare provider can evaluate whether PRP therapy is appropriate for your individual condition, imaging findings, and health history

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Still Hurting? Could PRP Be Your Next Step? guide cover Free patient guide Rest, PT and a cortisone shot, and the pain is still there. Dr. Spiegel wrote this for people who have been told to wait it out. Seven pages: worksheets that put your history in order, an honest comparison of rehab, cortisone, PRP and surgery, and the questions most people leave an appointment wishing they had asked. Get the guide Most people who come to us for pain have already done the obvious things. This guide is the prep work we wish everyone had before that first conversation. Free to read, nothing to commit to. You do not need to know whether PRP is right for you before you open it.