Randomized Controlled Trial shows PRP has Better Long Term Effects than Corticosteroids for Shoulder Pain
A Randomized Controlled Trial (RCT) published in The Orthopedic Journal of Sports Medicine compared the effectiveness of Platelet Corticosteroid injections and Platelet Rich Plasma for the treatment of rotator cuff injuries [2]. The RCT showed significant differences in pain levels after six months.
What is Platelet Rich Plasma or PRP?
So, what is Platelet Rich Plasma and why would you want to use it for shoulder pain? Platelet Rich Plasma (PRP) is a concentration of human platelets harvested from a patient’s own blood, then concentrated and injected into the sight of an injured joint, tendon, ligament, or muscle. It contains healing growth components that augment your body’s natural ability to repair itself. The Platelet injection works to stimulate the cells already present at the site of an injury, and increase natural healing. It has been suggested that injecting PRP into the tendon at the site of a rotator cuff injury can decrease pain and increase function.
About Randomized Controlled Trials and This Study
In clinical research, randomized controlled trials (RCTs) are the best way to study the safety and efficacy of new treatments. RCTs are used to answer patient-related questions and are required by governmental regulatory bodies as the basis for approval decisions.
The study was conducted with 32 patients, randomly assigned into two groups. One group would receive PRP injections, while the other would receive corticosteroid injections. The two groups would allow us to compare the two treatment methods, when done in the same environment and by the same doctor. All patients had a partial tear of their rotator cuff, and had a history of tears from repetitive trauma or overuse only.
The Procedure
All procedures were done in the operating theater by the same experienced pain physician, and a non-study involved nurse, who prepared the injections. The two injection procedures did differ due to the injection needing to be done in two different parts of the shoulder, but both were guided by real-time ultrasound.
Pain level and shoulder function were assessed before the procedure, as well as at 1 month and 6 months later. The Visual analog scale or VAS was used to assess pain, while the Oxford Shoulder Score or OSS was used to measure functionality.
The Results
This study showed that at the 1-month assessment, there was no statistically significant difference between the pain level and function of the two procedures. Both showed significant improvement in pain level and function from the pre-procedure measure.
At the 6-month follow-up the group that received the PRP treatment showed continued improvement in pain level and function. The corticosteroid group seemed to plateau and showed little to no improvement versus the 1-month follow-up.
As reported by the RCT:
“Conclusion: An injection using either a corticosteroid or LP-PRP resulted in a similar reduction in pain and improvement in function at 1 month in patients with a partial supraspinatus tear. However, PRP showed superior benefits over the corticosteroid at 6-month follow-up.”[2]
What Did We Learn?
This RCT study is looking to improve the treatment of partial rotator cuff tears. After reading this blog and/or the RCT, ask yourself, are corticosteroid injections–the most-often go-to treatment–really the most effective method? This study clearly shows evidence that PRP treatments have better long term outcomes.
We’ve written in the past that many don’t know about the long term issues that corticosteroids might cause. You can read about it in an earlier blog: CORTISONE SHOTS = LONG TERM SUCCESS? MORE LIKE LONG TERM MESS
Before you accept a corticosteroid injection for the first, or even second or third time, please consider an alternative non-surgical solution.
Investigate Regenexx Pittsburgh’s PRP Procedures
Consider these differences in Regenexx vs. other PRP therapy clinics:
- Regenexx® doctors have performed more than 142,000 highly specific image-guided PRP and/or bone marrow concentrate procedures
- Regenexx patient outcomes are tracked in a registry, and with that information, Regenexx physicians provide transparent outcome data for those who may be considering PRP procedures. View outcome data.
If you have joint pain and think PRP might help, find out if you’re a candidate today –Tap the “TALK TO AN EXPERT” BUTTON below.
References
[1] Veritas health. https://www.sports-health.com/sports-injuries/shoulder-injuries/rotator-cuff-injections
