Which options make sense for my sore joint?

What can I try before a procedure?

Choose a shorter walk or lighter task on a sore day. Stop if soreness lasts all day or feels worse next morning.

Build exercise slowly as your strength grows. If an earlier program hurt, tell the doctor exactly what happened.

A brace may steady some joints, while a cane can reduce weight on them. Your doctor can check whether either one suits you.

Ask about the risks of your usual pain medicine. Don't change it after reading general advice online.

Feeling fine during exercise isn't the only test. Check your joint again that evening and the next morning.

How do I compare procedures with surgery?

Ask what each choice requires from you. Compare time away from driving, work and usual tasks.

Judge relief by walking and sleep, not soreness alone. Those tasks show whether care helps your day.

A steroid shot can ease symptoms for weeks or a few months. Surgery may fit better when the joint is badly worn.

Your X-ray and exam show how much wear is present. They'll also help your doctor check for another cause.

Compare cost, risks and recovery with more exercise or a surgery visit. A newer name by itself doesn't make care better.

Sources

1. The OARSI non-surgical management guideline evaluated 60 interventions with GRADE methodology and built its recommendations around core treatments - structured exercise, weight management and self-management education - for every patient with knee osteoarthritis, regardless of what else is added.

   Bannuru RR, et al. — OARSI guidelines for the non-surgical management of knee, hip, and polyarticular osteoarthritis. Osteoarthritis Cartilage, 2019. DOI: 10.1016/j.joca.2019.06.011.

2. In a 480-patient, four-arm, multicenter randomized phase 2/3 trial, none of three orthobiologic cell injections - autologous bone marrow aspirate concentrate, autologous adipose stromal vascular fraction, or allogeneic umbilical cord tissue-derived mesenchymal stromal cells - was superior to any other, or to a corticosteroid injection control, on pain at 12 months.

   Mautner K, et al. — Cell-based versus corticosteroid injections for knee pain in osteoarthritis: a randomized phase 3 trial. Nat Med, 2023. DOI: 10.1038/s41591-023-02632-w.

3. A 2025 meta-analysis of 73 double-blind placebo-controlled injection trials in 5,895 knee osteoarthritis patients found placebo responder rates above 50 percent at 1, 3 and 6 months, declining by 12 months - which is why any uncontrolled 'our patients improved' claim from a clinic is uninterpretable.

   Previtali D, et al. — Placebo response to intra-articular injections in knee osteoarthritis: magnitude, evolution over time, and influencing factors. A systematic review and meta-analysis with meta-regression. EFORT Open Rev, 2025. DOI: 10.1530/EOR-2025-0022.

4. A randomized trial comparing commercially available systems in 71 patients found microfragmented adipose tissue equivalent to leukocyte-rich PRP on KOOS pain at 12 months.

   Baria M, et al. — Microfragmented Adipose Tissue Is Equivalent to Platelet-Rich Plasma for Knee Osteoarthritis at 12 Months Posttreatment: A Randomized Controlled Trial. Orthop J Sports Med, 2024. DOI: 10.1177/23259671241233916.

5. In a Level I randomized trial of arthroscopic rotator cuff repair, augmenting the repair with concentrated bone marrow aspirate was compared against a sham incision with MRI assessment of structural healing at one year - the rare cell-therapy question asked with a proper blinded control.

   Cole BJ, et al. — Prospective Randomized Trial of Biologic Augmentation With Bone Marrow Aspirate Concentrate in Patients Undergoing Arthroscopic Rotator Cuff Repair. Am J Sports Med, 2023. DOI: 10.1177/03635465231154601.

6. A phase I single-arm study of 10 patients with chronic discogenic low back pain found a single intradiscal injection of adipose-derived MSCs with hyaluronic acid produced no procedure-related or cell-related adverse events over 12 months - a safety signal in 10 people, not an efficacy result.

   Kumar H, et al. — Safety and tolerability of intradiscal implantation of combined autologous adipose-derived mesenchymal stem cells and hyaluronic acid in patients with chronic discogenic low back pain: 1-year follow-up of a phase I study. Stem Cell Res Ther, 2017. DOI: 10.1186/s13287-017-0710-3.

7. FDA states in its consumer alert that the only FDA-approved stem cell products in the United States are blood-forming stem cells derived from umbilical cord blood, approved for disorders of the blood-forming system, and that NONE of these products - stem cells, stromal vascular fraction, umbilical cord blood, Wharton's jelly or amniotic fluid - has been approved for the treatment of any orthopedic condition, including osteoarthritis, tendonitis, disc disease, tennis elbow, back pain, hip pain, knee pain, neck pain or shoulder pain.

   US Food and Drug Administration, Center for Biologics Evaluation and Research — Consumer Alert on Regenerative Medicine Products Including Stem Cells and Exosomes. , 2020.

8. 21 CFR 1271.10(a) sets the four criteria a human cell or tissue product must meet to be regulated SOLELY under section 361 of the Public Health Service Act: it must be minimally manipulated; intended for homologous use only, as reflected by labeling and advertising; not combined with another article beyond water, crystalloids or a preserving agent; and either have no systemic effect and not depend on the metabolic activity of living cells, or else be for autologous use, use in a close blood relative, or reproductive use.

   US Code of Federal Regulations, Title 21 — 21 CFR 1271.10 - Are my HCT/P's regulated solely under section 361 of the PHS Act. , 2004.

9. FDA's final guidance for industry, issued July 2020 by CBER and CDRH under docket FDA-2017-D-6146, sets out how the agency applies the minimal manipulation and homologous use criteria that determine whether a cell or tissue product is a 361 HCT/P or an unapproved 351 biological product requiring a license.

   US Food and Drug Administration, CBER and CDRH — Regulatory Considerations for Human Cells, Tissues, and Cellular and Tissue-Based Products: Minimal Manipulation and Homologous Use - Guidance for Industry and Food and Drug Administration Staff. , 2020.