PRP Injections for the Shoulder in London

PRP injections for the shoulder offer a powerful, evidence-based alternative to steroids. If you have been told you need a shoulder injection but are concerned about the effects of repeated steroid injections, or if you have already had steroid injections that have stopped working, regenerative injection therapies — particularly PRP (platelet-rich plasma) and hyaluronic acid — offer a powerful, evidence-based alternative. This guide explains exactly what these treatments involve, what the evidence says, and who they are most suitable for.

The Limitations of Repeated Steroid Injections

Corticosteroid injections are effective for many shoulder conditions, particularly in the short term. However:

• Their effect typically lasts 6–12 weeks before wearing off
• Repeated steroid injections can weaken tendons and accelerate cartilage breakdown over time
• Steroid is not suitable for all patients (diabetics, immunocompromised patients, or those with concerns about hormonal effects)
• For tendon damage (rotator cuff tears), steroid reduces pain but does not repair the underlying tissue

This is why, at London Sports and Rheumatology Imaging, we offer a full range of regenerative options for patients whose conditions require more than pain management.

PRP (Platelet-Rich Plasma) Injection for the Shoulder

What Is PRP?

PRP is produced from your own blood. A small blood sample (typically 20–60ml) is drawn from your arm and placed in a centrifuge, which separates the blood components. The platelet-rich layer is then extracted and concentrated — producing a solution containing 3–5 times the normal platelet count of whole blood.

Platelets contain growth factors — naturally occurring proteins that stimulate tissue healing, collagen production, and reduction of inflammation. When injected under ultrasound guidance directly into a damaged tendon or joint, PRP harnesses these biological signals to promote genuine tissue repair.

What Does the Evidence Show?

• A 2025 systematic review of 30 randomised controlled trials involving approximately 2,500 patients confirmed that PRP significantly reduces pain and improves function in rotator cuff tendinopathy compared to placebo and cortisone
• A 2025 prospective study of 90 patients with partial-to-full thickness rotator cuff tears found 69% achieved complete tendon healing on ultrasound at 12 weeks after a single PRP injection
• PRP shows significantly better long-term outcomes than steroid at 24 weeks — function scores continue to improve at 6 months post-injection

What Is PRP Best For?

• Rotator cuff tendinopathy — the strongest evidence base
• Partial thickness rotator cuff tears — particularly where surgery is not yet desired
• Shoulder osteoarthritis — as an alternative to steroid or hyaluronic acid
• Patients who want a steroid-free, regenerative approach
• Athletes seeking tissue repair rather than symptom suppression

Hyaluronic Acid (Viscosupplement) Injection

Hyaluronic acid (HA) is a naturally occurring component of joint fluid, providing lubrication and cushioning within the shoulder joint. In arthritic joints, the natural hyaluronic acid becomes degraded and less effective — HA injection replenishes this.

Benefits of Hyaluronic Acid

• Sustained pain relief lasting 6–12 months from a single injection
• Reduces friction within the joint — particularly effective in early-to-moderate glenohumeral osteoarthritis
• Completely steroid-free
• Can be combined with PRP for enhanced effect in appropriate cases
• Suitable for patients with diabetes, where steroid would cause blood sugar concerns

PRP vs Steroid vs Hyaluronic Acid: Which Is Right for You?

PRP focuses on stimulating healing and provides long-term relief (12-24+ months). Hyaluronic Acid lubricates the joint for medium-term relief (6-12 months). Steroids provide rapid inflammation reduction for short-term relief (6-12 weeks).

What to Expect at Your LSRI Appointment

For PRP:

• Blood is drawn from your arm at the clinic (15 minutes)
• The sample is centrifuged and prepared (15–20 minutes)
• Dr Sankaye performs a real-time ultrasound of your shoulder
• PRP is injected under live ultrasound guidance into the precise target structure
• Total appointment time: approximately 60 minutes

For Hyaluronic Acid:

• Simpler and faster — no blood draw needed
• Ultrasound-guided injection into the glenohumeral joint — approximately 20 minutes total

Learn more about ultrasound-guided injections, get a shoulder MRI, manage a frozen shoulder, or see our shoulder injections page.

Dr Prashant Sankaye is a specialist musculoskeletal radiologist and CPD Approved Trainer at London Sports and Rheumatology Imaging (LSRI Ltd), CPD Provider #790052.