Rotator-cuff tears (RCTs) are typically associated with
chronic pain. The most common treatment for reducing
pain is the injection of
cortisone into the injury site. An alternative and increasingly used technique is the injection of autologous platelet-rich plasma (PRP). A limitation of
cortisone is its
pain relief is short-lived, while PRP has the limitation of providing
pain relief to only about 50% of patients, making its efficacy questioned, although when it is effective, its efficacy is longer than
cortisone. Little is known about what accounts for these limitations. This paper presents results from a patient with RCTs causing excruciating
pain who received an injection of PRP into that shoulder resulting in complete
pain elimination that was ongoing at 2 years and 2 months. When 7-month severe posttrauma
pain associated with the RCT developed in the contralateral shoulder, PRP prepared the same way and injected by the same person who performed the first injection provided no
pain relief. However, a subsequent single
cortisone injection resulted in complete
pain elimination, which was ongoing at >15 months. These observations indicate that PRP can have inconsistent effects in reducing
pain, not only between patients but also within the same patient. Further, although the
pain relief induced by
cortisone is normally not long-lasting, when given following a PRP injection, it can induce complete
pain relief lasting >15 months. This paper discusses possible reasons for the variability in PRP efficacy on
pain relief and addresses the possibility that when administered together, PRP and
cortisone may act in a complementary manner, leading to significantly greater and longer-lasting
pain relief.