What to try for joint pain relief

What to try at home

Gentle strength work and regular movement can support a stiff or overworked joint. Use an easy amount that won’t cause a lasting flare, then watch the next day.

A brace, walking aid, or easier grip may take strain off the sore area. Try one change at a time, so its effect is easier to judge.

What to ask before using medicine

Medicine placed on the skin may suit some joints close to the surface. Some pills can upset your stomach or affect the kidneys and heart.

Ask your doctor or pharmacist how long to try a medicine and what help to expect. If it isn’t helping, don’t leave it in your routine without another discussion.

What to ask about PRP and other office procedures

PRP means platelet-rich plasma, a shot made by concentrating part of your own blood. The hoped-for benefit is less soreness and easier movement, yet the best studies show only slight help and can’t tell which patients will improve most after this kind of shot.

Ask the doctor how the shot is given, what recovery may be like, and how relief is checked. Ask about cost too, along with the next choice if soreness remains.

When to discuss surgery

A badly damaged joint may lead you to discuss surgery when daily life becomes hard. Choosing it isn’t defeat, and avoiding it at every cost isn’t always wiser.

A fair talk covers your exam, scan, health risks, goals, and likely recovery. For knee or hip surgery alternatives, the doctor checks whether the sore joint on the exam is the damaged joint on the scan.

Sources

1. OARSI's 2019 guideline is the only major osteoarthritis guideline that grades treatments separately for people with disease in MULTIPLE joints. Its Core Treatments for polyarticular OA are arthritis education and structured land-based exercise. Critically, intra-articular corticosteroid and intra-articular hyaluronic acid were Level 1B/2 options for knee OA only and were NOT recommended for hip or polyarticular OA; oral NSAIDs were not recommended at all for people with cardiovascular comorbidity or frailty; and paracetamol/acetaminophen was conditionally not recommended.

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

2. A Cochrane overview of 21 systematic reviews (381 studies, 37,143 participants) covering rheumatoid arthritis, osteoarthritis, fibromyalgia, low back pain, neck disorder and other chronic pain conditions concluded that physical activity and exercise are interventions with few adverse events that may improve pain severity and physical function - but that the quality of the evidence is low, effects on pain were inconsistent across reviews, and physical function improved significantly in 14 reviews with only small-to-moderate effect sizes. The commonest reported adverse event was increased muscle soreness that settled within weeks.

   Geneen LJ, Moore RA, Clarke C, Martin D, Colvin LA, Smith BH — Physical activity and exercise for chronic pain in adults: an overview of Cochrane Reviews.. Cochrane Database of Systematic Reviews, 2017. DOI: 10.1002/14651858.CD011279.pub3.

3. FDA states verbatim that of the products marketed as regenerative medicine - stem cell products, stromal vascular fraction from adipose tissue, umbilical cord blood, Wharton's jelly, amniotic fluid and exosome products - 'None of these products have been approved for the treatment of any orthopedic condition, such as osteoarthritis, tendonitis, disc disease, tennis elbow, back pain, hip pain, knee pain, neck pain, or shoulder pain.' The only FDA-approved stem cell products in the United States are blood-forming (hematopoietic progenitor) cells from umbilical cord blood, approved only for disorders of blood production, and there are currently no FDA-approved exosome products.

   U.S. Food and Drug Administration — Consumer Alert on Regenerative Medicine Products Including Stem Cells and Exosomes. FDA (Center for Biologics Evaluation and Research), 2024.

4. A meta-analysis of 198 randomised osteoarthritis trials (16,364 patients in placebo groups, 1,167 in untreated control groups) found the placebo arm itself relieved pain with an effect size of 0.51 (95% CI 0.46-0.55), against 0.03 (95% CI -0.13 to 0.18) in untreated controls. Placebo also improved function and stiffness. The placebo effect was larger when the active treatment effect was larger, when baseline pain was higher, and - relevant to any injected treatment - when the placebo was delivered by injection rather than by mouth.

   Zhang W, Robertson J, Jones AC, Dieppe PA, Doherty M — The placebo effect and its determinants in osteoarthritis: meta-analysis of randomised controlled trials.. Annals of the Rheumatic Diseases, 2008. DOI: 10.1136/ard.2008.092015.

5. In 113 patients with end-stage hip disease undergoing hip replacement (patients with coexisting knee or spine pathology excluded), the commonest pain sites before surgery were groin, anterior thigh, buttock, ANTERIOR KNEE and greater trochanter. Pain was also recorded in areas not normally considered hip referral zones: lower back in 21.2%, shin in 7.1% and calf in 2.7%. Low back pain was significantly more common in patients with longer symptom duration. Regardless of pattern, 97.3% reported complete pain relief within 12 weeks of hip replacement.

   Hsieh PH, Chang Y, Chen DW, Lee MS, Shih HN, Ueng SWN — Pain distribution and response to total hip arthroplasty: a prospective observational study in 113 patients with end-stage hip disease.. Journal of Orthopaedic Science, 2012. DOI: 10.1007/s00776-012-0204-1.

6. The 2019 ACR/Arthritis Foundation guideline makes STRONG recommendations for exercise, weight loss in people with overweight or obesity, self-efficacy and self-management programmes, tai chi, cane use, hand orthoses for first-CMC joint OA, tibiofemoral bracing, topical NSAIDs for the knee, oral NSAIDs and intra-articular glucocorticoid injections for the knee; acupuncture, thermal modalities, radiofrequency ablation, acetaminophen, duloxetine and tramadol are only conditional.

   Kolasinski SL, et al. — 2019 American College of Rheumatology/Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee.. Arthritis Rheumatol, 2020. DOI: 10.1002/art.41142.

7. The Cochrane review of land-based therapeutic exercise for knee osteoarthritis extracted data from 54 studies, with high-quality evidence from 44 trials (3,537 participants) that exercise reduces pain immediately after treatment, and further high-quality evidence that it improves physical function. Benefit attenuates but persists for at least two to six months after the programme ends.

   Fransen M, et al. — Exercise for osteoarthritis of the knee.. Cochrane Database Syst Rev, 2015. DOI: 10.1002/14651858.CD004376.pub3.

8. The 2010 ACR/EULAR classification criteria define 'definite rheumatoid arthritis' by confirmed synovitis in at least one joint, absence of a better alternative diagnosis, and a total score of 6 or more out of 10 across four domains: number and site of involved joints (0-5), serology (0-3), acute-phase response (0-1) and symptom duration (0-1). This is the formal boundary between inflammatory arthritis and degenerative joint disease.

   Aletaha D, et al. — 2010 Rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative.. Arthritis Rheum, 2010. DOI: 10.1002/art.27584.