Understanding Tendinopathy
Tendinopathy is a common condition that affects the tendons, which are the strong connective tissues that attach muscles to bones. It often develops from repetitive stress, overuse, or ongoing strain. Common examples include rotator cuff tendinopathy, tennis elbow, plantar fasciitis, and tenosynovitis.
People with tendinopathy may experience pain, stiffness, weakness, and difficulty with normal movement. For some, symptoms can interfere with work, exercise, sports, and daily activities.
Treatment often includes rest, physical therapy, stretching, activity changes, anti-inflammatory medication, and injections. Two injection-based options commonly studied are corticosteroid injections and platelet-rich plasma, also known as PRP.
Why PRP Is Being Studied
Corticosteroid injections are often used because they can help reduce inflammation and provide short-term pain relief. However, researchers are also interested in treatments that may support the body’s natural repair processes over time.
PRP is made from a patient’s own blood. The blood is processed to concentrate platelets, which contain growth factors and signaling proteins involved in healing. These biological signals may help support tissue repair, inflammation balance, blood vessel formation, and collagen production.
For tendon-related conditions, PRP is being studied because tendons can heal slowly and may benefit from biologic signals that support repair at the tissue level.
What This Study Reviewed
This 2025 systematic review and meta-analysis compared PRP injections with corticosteroid injections for tendinopathy. The researchers searched PubMed, Embase, the Cochrane Library, Scopus, and Web of Science for randomized controlled trials.
In total, the review included 27 randomized controlled trials with 1,779 patients. The studies focused on four major tendinopathy-related conditions:
- Rotator cuff injuries
- Lateral epicondylitis, commonly known as tennis elbow
- Plantar fasciitis
- Tenosynovitis
The researchers compared outcomes such as pain, physical function, treatment effectiveness, and adverse events. They also looked at short-term, mid-term, and longer-term follow-up when available.
What Researchers Found
Overall, the review found that PRP may offer meaningful benefits for pain and function in several tendinopathy conditions, especially during the mid-term recovery period.
For rotator cuff injuries, the study found no major difference between PRP and corticosteroid injections at 1 month. However, by 3 months, PRP showed greater improvement in pain scores compared with corticosteroid treatment. Shoulder function results were more similar between the two groups during the follow-up period.
For lateral epicondylitis, or tennis elbow, PRP and corticosteroid injections had similar short-term pain outcomes at 1 month. However, PRP showed better pain improvement at 3 and 6 months. PRP also showed stronger functional improvements on DASH scores at 3 and 12 months.
For plantar fasciitis, PRP and corticosteroid injections showed similar results at 1 and 3 months. By 6 months, PRP was associated with better pain improvement and better foot function scores. This suggests PRP may provide stronger mid-term support for this condition.
For tenosynovitis, corticosteroid injections showed better short-term pain improvement at 1 month. However, by 6 months, PRP showed greater pain improvement. Functional scores were similar between groups.
Across the included studies, the researchers also found that PRP had a higher overall treatment effectiveness rate and fewer reported adverse events compared with corticosteroid injections.
How PRP May Support Tendon Healing
Tendons are strong but relatively slow-healing tissues. They do not have the same rich blood supply as some other tissues, which may make recovery more difficult after repeated stress or injury.
PRP may help support tendon healing by delivering concentrated platelets and growth factors directly to the affected area. These growth factors may help stimulate cell activity, encourage collagen production, support new blood vessel formation, and guide tissue remodeling.
Collagen is especially important because it gives tendons their structure and strength. In tendinopathy, the tendon structure may become irritated or weakened over time. By supporting collagen-related repair pathways, PRP may help create a healthier environment for tendon recovery.
Rather than simply masking pain, PRP is being studied for its potential to support the biological repair process behind tendon healing.
Why These Findings Matter
This study is meaningful because tendinopathy can be frustrating and slow to improve. Many people are looking for options that not only reduce discomfort but also support longer-term recovery and function.
The findings suggest that corticosteroid injections may still have value for short-term relief in some conditions, while PRP may offer stronger mid-term benefits for pain and function in certain types of tendinopathy.
This distinction is important. A person seeking quick symptom relief may have different treatment goals than someone focused on tissue support and longer-term recovery. Research like this helps clinicians and patients better understand how different therapies may fit into a broader treatment plan.
Looking Ahead
The review highlights PRP as a promising biologic option in regenerative orthopedic medicine. Future research will help refine which tendon conditions respond best, which PRP preparation methods are most effective, and how dosing and injection technique may influence results.
As PRP research continues to develop, the goal is to better personalize treatment based on the specific tendon condition, stage of injury, and patient needs.
Takeaway
This systematic review and meta-analysis suggests that platelet-rich plasma may provide meaningful support for tendinopathy, especially for mid-term pain relief and functional improvement. Across multiple tendon conditions, PRP was associated with encouraging outcomes compared with corticosteroid injections.
While treatment decisions should always be individualized, this study adds to the growing interest in PRP as a regenerative approach that may support tendon healing, reduce pain, and improve function over time.
Source
Ye Z, Yuan Y, Kuang G, Qiu L, Tan X, Wen Z, Lu M. Platelet-rich plasma and corticosteroid injection for tendinopathy: a systematic review and meta-analysis. BMC Musculoskeletal Disorders. 2025 Apr 8;26(1):339. doi: 10.1186/s12891-025-08566-3. PMID: 40200209. Available from: https://link.springer.com/article/10.1186/s12891-025-08566-3
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