Injections are a common treatment for tendon problems. Different types of injections including cortisone and PRP injections are commonly used to treat tendon conditions. Cortisone is a powerful anti-inflammatory medication often used to treated acute inflammation (tendonitis) or chronic tendon problems (tendinosis). PRP is a recent development that uses your own cells to stimulate healing in areas of chronic tendon damage.
A recent study from The Lancet, one of the leading medical journals, has tried to compile data from many other studies to determine the best use of injections for tendon problems. While the findings varied, there were a few take home points. Of note, this type of study is called a meta-analysis, and attempts to combine the data from many studies to make the results more meaningful. The researchers found:
For the treatment of tennis elbow, injections of cortisone helped in the short-term, but led to a worse long-term prognosis.
PRP was no more effective than placebo for treatment of Achilles tendinosis.
The effect of cortisone injection on the treatment of rotator cuff tendonitis is unclear, but it is probably not harmful.
These were several of the take-home points of the article. I think cortisone is a useful treatment in cases of acute inflammation. However, many tendon problems represent a chronic tendinosis, not acute inflammation, and therefore cortisone injections are likely prescribed too often. Furthermore, short-term relief should be balanced with long-term goals--cortisone injections may not always be the best for long-term relief. Lastly, PRP has yet to show any consistent effects of curing chronic tendon problems.