Can I alternate between cortisone infiltration and PRP?

Yes, in some cases. For example, a cortisone injection can calm acute inflammation, followed by PRP sessions to stimulate regeneration. A gap of at least 4 to 6 weeks between the two types of injections should be respected. Dr Bolduc will determine the optimal sequencing for your case.

Is PRP covered by RAMQ?

No, PRP is considered experimental by RAMQ and is not covered by the public system. Some private insurance plans offer partial coverage. Check with your insurer. Cortisone infiltration is generally covered in public medical settings, but costs vary in private clinics.

How many PRP sessions are needed?

Most protocols recommend 2 to 3 sessions spaced 3 to 4 weeks apart. Results continue to improve up to 6 to 12 months after the last session, as PRP stimulates the ongoing healing process.

Infiltration or PRP: How to Choose the Right Treatment? Complete Comparison

Two Approaches, Two Philosophies

When dealing with tendinitis, bursitis, or persistent joint pain, two minimally invasive options are often available: cortisone infiltration and PRP (platelet-rich plasma) injection. Both treatments are offered at Dr Sébastien Bolduc's Musculoskeletal Medicine Clinic in Saint-Hubert, but they have different indications. Here is how to make the right choice.

What Is Cortisone Infiltration?

Cortisone infiltration is a powerful anti-inflammatory injected directly into the problem area under ultrasound guidance. It works by quickly calming inflammation. Its advantages:

Fast action: relief often felt within 48 to 72 hours
Effective for acute inflammation: ideal for intense inflammatory flares
Often effective in a single session
Moderate cost: typically between $150 and $400 per session in private Quebec clinics

Drawbacks: The effect is temporary (weeks to months). Cortisone does not treat the underlying cause and can weaken tendons if used too frequently (more than 3 to 4 times per year).

What Is PRP?

PRP is a concentrate of your own platelets, prepared from a blood draw, then injected into the injured area. It stimulates the body's natural healing mechanisms. Its advantages:

Regenerative action: promotes long-term tendon or tissue healing
Natural and safe: uses your own cells, virtually no allergy risk
Lasting effect: results improve progressively over 3 to 6 months
Treats the root cause: not just the symptoms

Drawbacks: The effect is not immediate (several weeks before noticeable). Often requires 2 to 3 sessions spaced 3 to 4 weeks apart. Higher cost: $400 to $800 per session in Quebec.

When to Choose Infiltration?

Cortisone infiltration is generally preferred in these situations:

Acute, disabling pain requiring rapid relief
Bursitis (inflammation of a bursa)
Tenosynovitis (inflammation of the tendon sheath)
Inflammatory arthritis (rheumatoid arthritis, pseudogout)
Acute epicondylitis (tennis elbow) in the inflammatory phase
Before surgery to reduce local inflammation

When to Choose PRP?

PRP is more appropriate in these cases:

Chronic tendinopathy (over 3 months) unresponsive to conservative treatment
Grade 1 or 2 ligament injury (sprain)
Muscle injury to accelerate regeneration
Athletic patients seeking complete and lasting healing
Tendon degeneration without marked inflammation

Recovery and Time Off

With cortisone infiltration, sports rest is 3 to 7 days with gradual return to activities. Time off work is rarely needed beyond 24 to 48 hours. With PRP, recovery is longer: avoid sports for 2 to 4 weeks after each session, with optimal results appearing after 3 to 6 months. Time off work may be necessary depending on the area treated.

And Other Treatments?

Physiotherapy and shockwave therapy are valuable alternatives or complements. At Dr Bolduc's clinic, a comprehensive evaluation determines the best strategy, which may combine several approaches for optimal results.