Why might you want to avoid cortisone injections?
Cortisone injections are still a standard of care for degenerative joint pain, but some recent studies suggest repeated injections may damage joints. Regenerative medicine injections are an alternative that aim to stimulate healing and tissue growth in damaged tissue, using prolotherapy, platelet-rich plasma, adult stem cells or amniotic derived allografts.
Did you know that recent studies show that cortisone injections damage joints? While still considered the “standard of care” for managing pain from degenerative joints, regenerative medicine is becoming the more favorable option amongst the medical community, and patients are starting to realize the benefits of these injections as well.
So what is a Regenerative Medicine Injection?
Regenerative Medicine procedures stimulate a healing and tissue growth response inside damaged tissue using 1 of 4 techniques: Prolotherapy, Platelet Rich Plasma, Adult Autologous Mesenchymal Stem Cells, or Amniotic Derived Allografts.
Prolotherapy:
Prolotherapy uses a concentrated dextrose (sugar-based) or saline (salt based) solution that is injected into the area of degeneration such as joint arthritis, tendon/ligament/muscle tearing, or spinal disc. The solution acts as an irritant which promotes healing by stimulating the body to provide additional blood supply to the injured area. This additional blood flow brings the nutrients and repair cells that lead to regeneration and healing of the injured tissue. Of the regenerative treatment options, prolotherapy is the weakest. The average treatments are 3-5 and treatments are space 6 weeks apart. For this reason, most patients do not choose this treatment option.
Platelet Rich Plasma (PRP):
PRP stimulates a more intense healing response than prolotherapy because instead of injecting a concentrated dextrose solution, we draw your own blood, isolate the portion that is responsible for stimulating growth and healing (the platelet rich plasma portion), then re-inject the growth solution into the area of degeneration. The amount of blood drawn will varying based on the area of concern as well as concentration of PRP desired. Average amount of blood drawn is 120cc, which is comparable to 1/5 of the amount for blood donation. Your blood is processed and separated out into platelets, growth factors and a small amount of stem cells in our lab using a specialized centrifuge and flow cytometer. The solution is then injected approximately 30 minutes after it is drawn using ultrasound or fluoroscopic (x-ray) guidance, inserting your body’s healing cells directly at the sites of degeneration. The healing cells cause regeneration/healing of chronic injuries, sports injuries, or other natural degenerative processes. Average treatments for PRP are only 1-2 making them much for time and cost effective for patients than prolotherpay. The difference between Prolotherapy and PRP is that Prolotherapy stimulates the body’s healing cells to target the area of degeneration, whereas PRP takes your healing cells, concentrates them, and then directly injectes them to the areas of degeneration. PRP is a much stronger stimulus for healing, and therefore will require fewer treatments to achieve the same end result much faster. If repeat injections are needed, treatments are generally spaced at least 6-8 weeks apart, allowing for proper healing cascade to take effect. Some personal factors that may inhibit maximum healing include age over 80, smoking, poor nutrition, diabetes and other immune suppressing conditions.
Adult Autologous Mesenchymal Stem Cells (MSCs):
The term stem cell elicits some potential ethical concerns. I want to start the description of this procedure by first assuring you we are not talking about embryonic stem cells, cloning, or harvesting cells from anyone other than yourself for your own use. The cells we obtain are the same cells that are designed to repair tissue in your body, we are simply isolating them, concentrating them in a syringe, and injecting them exactly where we want them to go. In other words, we are simply augmenting your body’s natural ability to heal itself. The MSC procedure is a 3 step procedure, all conducted on the same day. Step 1 is the identical blood draw procedure and process described in the PRP section above where, on average, 120cc of blood is drawn and put through our lab to create the PRP. Step 2 involves a bone marrow aspiration to obtain your own stem cells. This sounds painful, but if done with the proper technique and proper equipment, it is NOT. We use ultrasound or fluoroscopy to identify the point on the back side of your hip bone called your posterior superior iliac spine (PSIS), and then use sufficient local anesthetic to numb all the tissues between your skin and your PSIS. The bone needle (called a trochar) is then gently inserted into the bone and the marrow is aspirated. I have had my bone marrow harvested, and can attest that the procedure is not painful. After the harvest, the bone marrow is then immediately transferred to the centrifuge machine in our lab which then isolates the MSCs out of the bone marrow and places them in a separate syringe. Step 3 involves the actual injection of the PRP and the Stem Cells into the targeted areas of injury. This injection is also done with either ultrasound our fluoroscopic guidance to assure it is injected into the exact proper location. Wondering about pricing? Learn how much PRP treatment costs in Michigan.
Amniotic Derived Allograft (aka Umbilical Cord Stem Cells):
In cases where a patient’s PRP or MSCs are not of sufficient quality due to age or other medical conditions, we may consider using a solution or a graft obtained from donors of amniotic membranes, amniotic fluid, or umbilical cords. I again will begin this section by addressing the potential ethical concerns surrounding this regenerative procedure tissue source. The only source for this tissue is from consented mother’s of term delivered babies who gave birth by a scheduled c-section in the United States. No children or mothers are put at risk or exploited to obtain this tissue and solution. This tissue and solution are acellular, meaning that they contain no cells, and are certified to be disease free by the same process that blood donations must pass. The umbilical cord tissue and solution contains many of the same growth factors found in PRP, and can stimulate growth and healing similar to PRP. I recommend this treatment for cases that have not responded to PRP or MSC procedures because of patient related factors such as age, diabetes, smoking, heart failure, or immune suppressing conditions that can all reduce the potency of injected cells that come from the patient.
The Cortisone Cycle: Why Temporary Relief Isn’t Enough
Cortisone injections work by reducing inflammation, which provides welcome pain relief. But here’s the catch – they don’t actually heal the underlying problem. Think of it like putting a bandage over a leaky pipe. The bandage might stop the drip for a while, but eventually, you’ll need to fix the pipe itself.
Common limitations of cortisone injections:
- Effects typically last only 3-6 months
- Repeated injections can weaken surrounding tissues
- No actual tissue repair or regeneration occurs
- Pain often returns, sometimes more intensely
Real Results That Last
The beauty of this approach is that you’re not just buying time – you’re actually addressing the root cause of your pain. Instead of needing injections every few months, many patients experience lasting relief because their body has genuinely healed the damaged area.
What this means for you:
- Potential for long-term pain relief
- Improved joint function and mobility
- Reduced need for ongoing treatments
- Return to activities you’ve had to avoid
Is This Right for You?
If you’re tired of the cortisone cycle and ready to explore a treatment that works with your body instead of against it, regenerative medicine might be the answer you’ve been looking for. These treatments have helped countless patients with knee pain, shoulder injuries, hip problems, back pain, and many other conditions finally break free from the temporary relief trap.
The best part? Recovery is typically much easier than surgery, with many patients returning to normal activities within weeks rather than months.
Take the Next Step Toward Lasting Relief
Ready to explore whether regenerative medicine could help you reclaim your active lifestyle? Our board-certified doctors at Michigan Center for Regenerative Medicine specialize in helping patients find long-term solutions to chronic joint pain.
Common Uses for Cortisone Shots
Below are some common uses for cortisone injections:
- Tendinitis
- Bursitis
- Arthritis flare-ups
- Acute injuries
- Quick relief before important events (sports, weddings, etc.)
The Regenerative Medicine Difference – Healing vs. Masking
The primary goal of regenerative medicine as opposed to corticosteroids is to heal the affected area as opposed to simply mask the pain. For those looking for alternatives to surgery and powerful medications, regenerative medicine may help you get back to your active lifestyle.
There are several different regenerative medicine approaches that you can discuss with one of our board-certified physicians, including Platelet-Rich Plasma (PRP), Regenerative Orthobiologics using bone marrow concentrate, Lipoaspirate, Shockwave, as well as prolotherapy.
At The Michigan Center for Regenerative Medicine our team has been working on providing the highest level of care to our patients for over 10 years. In this time, we’ve developed our processes, launched a modern in-house lab and began to track our patient outcomes using DataBiologics, which is a third-party, impartial patient reporting tool. Our patient results have been completely transparent since Day 1, which is why we continue to be excited about the future of this burgeoning field.
Cortisone Injections Have Their Place but Regenerative Medicine is the Future
There’s no doubt that cortisone has its place for acute relief, but repeated use can cause long term damage. Regenerative medicine offers a different approach focused on healing as opposed to masking symptoms. If you’ve had multiple cortisone injections and are seeing reduced results, it’s likely time to try a different approach. Schedule a comprehensive evaluation today with one of our board-certified physicians by calling (248) 216-1008. We’ll help you determine whether regenerative medicine is the proper path for you based on your history and current condition.
More Questions Patients Ask
What are longer-term options than cortisone for joint pain?
Cortisone reduces inflammation and may ease joint pain for about 3 to 6 months, but it does not repair the underlying tissue, and repeated shots can weaken nearby tissue. Regenerative treatments such as stem cells or platelet-rich plasma (PRP) aim to support the body’s own healing process in the injured area, rather than only masking symptoms.
Are repeated cortisone injections a problem?
Cortisone injections reduce inflammation and often relieve pain quickly, but they do not heal or repair damaged tissue. Used repeatedly for the same injury over a long period, they may do more harm than good. If cortisone only helps temporarily, regenerative treatments that aim to repair the tissue may be worth discussing with a physician.
By Board-certified Doctor Thomas Nabity, MD
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