Short-Term Relief or Long-Term Repair: A Narrative Review of Corticosteroid and Platelet-Rich Plasma Injections in Rotator Cuff Tendinopathy.

Abstract

Rotator cuff tendinopathy is a common cause of shoulder pain and disability in adults over 40. Corticosteroid injections provide short-term pain relief but may impair tendon healing with repeated use. Platelet-rich plasma (PRP) aims to promote tissue repair; however, comparative evidence remains heterogeneous. We conducted a narrative review of comparative studies of corticosteroid versus PRP injections for rotator cuff tendinopathy. Ovid MEDLINE, Embase, and PubMed were searched for English-language studies (2010-25). Eligible designs included randomised controlled trials (RCTs), prospective comparative studies, and systematic reviews/meta-analyses. Of 263 records, 60 full texts were screened, and 17 studies were included. Reviews/meta-analyses consistently found corticosteroids superior for short-term relief (<3 months), with several suggesting PRP may be favoured for mid- to long-term outcomes (6-12 months), though results were inconsistent. Among RCTs, early evidence showed no benefit of PRP over placebo, whereas more recent trials reported improved pain and function with PRP versus corticosteroids; other RCTs found no difference. Prospective studies generally suggested more sustained outcomes with PRP. Heterogeneity in PRP preparation and protocols limits comparability. Corticosteroids remain useful for rapid symptom control, but benefits wane and repeated use may pose risks. PRP may offer more durable improvements for selected patients, albeit with variable effect sizes across studies and higher cost.