If you’re dealing with persistent foot or ankle pain, you may be offered an injection — but not all injections do the same thing. Two of the most talked-about options, cortisone and PRP, work in nearly opposite ways. Understanding the difference helps you have a better conversation with your podiatrist.
How cortisone works
A corticosteroid (cortisone) injection is a powerful anti-inflammatory. It calms inflammation in the treated area, which can reduce pain relatively quickly. For certain conditions, that short-term relief is genuinely useful — for example, to break a painful cycle so you can participate in rehab.
How PRP works
PRP takes the opposite approach. Instead of suppressing inflammation, it uses concentrated growth factors from your own blood to support the body’s natural repair process in injured tissue. The goal isn’t rapid symptom masking — it’s healing over time. Our PRP page explains the process in detail.
The trade-offs
- Speed: Cortisone often works faster; PRP works gradually.
- Tissue effects: Repeated cortisone can weaken tendons and soft tissue over time; PRP aims to support tissue rather than weaken it.
- Best use: Cortisone can be helpful for inflammatory flare-ups; PRP is often considered for chronic tendon or soft-tissue problems that keep returning.
- Evidence: Both have supporting and mixed evidence depending on the condition.
Which is right for you?
There’s no universal answer. The right choice depends on your exact diagnosis, how long you’ve had the problem, what you’ve already tried, and your overall health. For a recurring tendon problem, a healing-focused option like PRP may make sense; for a specific inflammatory flare, cortisone might be the better tool. A proper evaluation is what determines the plan.
Why the diagnosis comes first
Both injections are only as good as the diagnosis behind them. Injecting the wrong thing — or injecting when a different treatment is needed — wastes time and money. That’s why any injection should follow a careful exam, not precede it.
Frequently Asked Questions
Is PRP better than cortisone?
Neither is universally better. They do different things — cortisone reduces inflammation, PRP supports healing — and the right one depends on your diagnosis.
Can you have both PRP and cortisone?
They’re typically used for different situations and usually not at the same time. Your podiatrist will recommend what fits your condition.
Does cortisone weaken tendons?
Repeated cortisone injections can weaken tendon and soft tissue over time, which is one reason PRP is sometimes considered for chronic tendon problems.
Not sure which injection is right for you?
Dr. Shawn S. Rabbani, DPM · My Foot Clinic, Reseda · Serving the San Fernando Valley.
This article is for general education and is not a substitute for a diagnosis. Medically reviewed by Dr. Shawn S. Rabbani, DPM.