Your Cortisone Stopped Working. Now What?
Cortisone works fast, but for a lot of people it wears off sooner each time. PRP uses a concentrated dose of your own platelets, placed with ultrasound right where you're injured, to help your tendon or joint heal.
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How Relief Usually Plays Out
Illustration only, based on how the research generally trendsWhat Is PRP Therapy?
PRP (platelet-rich plasma) therapy concentrates platelets and growth factors from a patient's own blood and injects them under ultrasound guidance into an injured tendon, ligament or joint. At the Osteopathic Center for Healing in Rockville, MD, Dr. Neil Spiegel, DO, MBA uses PRP as his first regenerative option for tendon and soft tissue injuries and early arthritis. The visit usually takes under an hour.
How Does PRP Compare to Cortisone?
Cortisone
- Works within days
- Calms inflammation
- Relief often fades in weeks to a few months
- Repeated shots can weaken tendons and cartilage
PRP
- Takes a few weeks to kick in
- Supports your body's own repair
- Relief often builds and lasts longer
- Made from your own blood
In clinical trials, cortisone usually works faster in the first few weeks. PRP tends to hold up better at three to six months and beyond, especially for tendon problems like tennis elbow and plantar fasciitis.
Research: PRP vs. corticosteroid for tendinopathy, BMC Musculoskeletal Disorders (2025) and PRP vs. corticosteroid for knee osteoarthritis, systematic review (2025).
What Does PRP Treat?
Tennis elbow, golfer's elbow, rotator cuff tendinopathy, Achilles and patellar tendinopathy.
Plantar fasciitis that hasn't gotten better with orthotics or PT.
Sprains and looseness in the knee, ankle and wrist.
Strains that keep coming back or are slow to heal.
In the shoulder, hip or knee.
Mild cartilage changes in the knee, hip or shoulder.
If your cartilage is more worn down, Dr. Spiegel may recommend adipose therapy or BMAC instead of PRP, or with it. Tendon problems? See joint and tendon injuries.
Recovering from surgery or a soft tissue injury? Learn about PRP for soft tissue recovery.
How Does PRP Work?
Blood Draw
A small sample from your arm, like a routine blood test.
Spin
A centrifuge separates and concentrates the platelets.
Ultrasound-Guided Injection
Dr. Spiegel watches the needle on ultrasound and places the PRP exactly where you're injured.
Home Within the Hour
Most visits take under an hour.
Why Guidance Matters
An injection only works if it gets to the right spot. Dr. Spiegel uses ultrasound for every PRP injection, so he can see the tendon or joint while he treats it.
What Should You Expect?
Back to light activity the same day or the next.
Soreness or stiffness while the healing response starts. That's expected.
Many people start to notice improvement.
Results keep building as the tissue heals.
Many people do best with two or three sessions, four to six weeks apart. Dr. Spiegel recommends a plan based on your exam and imaging.
How Long Does PRP Last?
It depends on what's being treated and how much damage there is. People with tendon injuries or early arthritis usually see the longest-lasting results. With more advanced arthritis, PRP may be repeated or combined with BMAC. Dr. Spiegel will tell you what's realistic for you.
Why Choose Dr. Spiegel?
What Do People Ask About PRP?
Is PRP Better Than Cortisone?
Cortisone usually works faster at first. PRP tends to give longer-lasting relief, especially for tendon problems. Many people come to us after cortisone stopped helping.
Do I Need an MRI First?
Not always. Dr. Spiegel starts with an exam and ultrasound here in the office. If those don't tell the whole story, he'll order an MRI or other diagnostic testing, or refer you to get it. If you already have imaging, bring it.
How Many PRP Injections Will I Need?
Many people need two or three, spaced four to six weeks apart. Some need only one.
Does PRP Work for Plantar Fasciitis and Achilles Problems?
Yes. Tendon and fascia problems are some of the most common things we treat with PRP.
Does a PRP Injection Hurt?
You'll feel the injection and some soreness for a few days after. We numb the skin to keep you comfortable.
How Is PRP Different From BMAC?
PRP comes from your blood and is best for tendons, soft tissue and early arthritis. BMAC comes from bone marrow and is used for more advanced joint wear.
Can PRP Help Me Avoid Surgery?
For some people, yes, especially with tendon injuries and early arthritis. It isn't a guarantee, and Dr. Spiegel will tell you plainly if surgery makes more sense.
Is PRP Covered by Insurance?
Most plans don't cover PRP. We'll go over costs at your consult.
Still Hurting? Could PRP Be Your Next Step?
A plain-language guide to what PRP can and cannot do, who it tends to help, and the questions to ask before you decide.
Get the guideStill
Hurting?
Could PRP be your next step?
- What PRP can and cannot do
- Who it tends to help
- The questions to ask first
Request an Appointment
Tell us about your injury and what you've tried so far, and our team will reach out to schedule your consult.
Let's Find Out if PRP Is Right for You
Book a consult with Dr. Spiegel in Rockville, MD.
Not ready to book? Start with a free 15-minute call