What may help arthritis soreness, and what may not

What to try before a procedure

Choose movement you can repeat. A steady routine usually helps more than a hard burst followed by days of rest.

A cane or brace can take some pressure off a sore joint. Physical therapy can help you choose how much movement is safe.

If extra weight adds pressure, losing some may ease the strain. Your routine still has to fit your balance, heart, and other health needs.

What to ask about medicine

Medicine may lower soreness, but there's a catch. Some pills can harm your stomach, kidneys, or heart.

An anti-inflammatory gel is medicine rubbed on a sore knee to lower swelling and soreness. Less of it travels through your whole body than a pill.

Check labels before you combine products. Your doctor or pharmacist can spot repeated drugs or unsafe mixes.

What to know about joint procedures

Some procedures may ease soreness for a while. The relief can help you move, but it may not last.

PRP uses a concentrated part of your blood. A provider draws the blood and places the prepared part in the sore joint.

Some smaller studies found less knee soreness, but one large study found no clear improvement in knee soreness or cartilage after PRP was compared with salt water over time. You may also pay the full bill yourself.

Ask how many visits you'll need. Also ask what happens if the change is small.

When to weigh surgery

Discuss surgery when you still can't walk, sleep, dress, or do daily work. Getting an opinion doesn't mean you've agreed to an operation.

Ask what may improve, what the healing work takes, and which risks matter. If you want to delay an operation, ask whether knee or hip surgery alternatives still fit your case.

A scan alone doesn't set the date. Your daily limits and exam matter more than the harshest line in a report.

QC Kinetix offers visits to discuss non-surgical regenerative care; concentrated PRP is prepared by separating one part from blood drawn from you.

Sources

1. 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.

2. OARSI designates arthritis education plus structured land-based exercise (with dietary weight management for the knee) as CORE treatments for knee, hip and polyarticular OA. Topical NSAIDs are Level 1A for knee OA. Intra-articular corticosteroids, intra-articular hyaluronic acid and aquatic exercise are Level 1B/2 for the KNEE only and are NOT recommended for hip or polyarticular OA. Acetaminophen is conditionally not recommended, and no oral NSAID is recommended for people with cardiovascular comorbidity or frailty.

   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.

3. 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.

4. A BMJ systematic review of 13 randomized placebo-controlled trials found HIGH-quality evidence that paracetamol (acetaminophen) is ineffective for low back pain, and high-quality evidence that for hip or knee osteoarthritis it provides a statistically significant but NOT clinically important effect on pain (weighted mean difference -3.7 on a 0-100 scale, 95% CI -5.5 to -1.9) and disability (-2.9, 95% CI -4.9 to -0.9).

   Machado GC, et al. — Efficacy and safety of paracetamol for spinal pain and osteoarthritis: systematic review and meta-analysis of randomised placebo controlled trials.. BMJ, 2015. DOI: 10.1136/bmj.h1225.

5. A BMJ systematic review and meta-analysis of 169 trials (21,163 participants) found that in the pre-specified main analysis of 24 large placebo-controlled trials (8,997 participants), viscosupplementation reduced pain by only SMD -0.08 (95% CI -0.15 to -0.02) - about 2.0 mm on a 100 mm scale - with the confidence interval excluding the minimal clinically important difference of -0.37. Trial sequential analysis indicated conclusive evidence of clinical equivalence to placebo since 2009.

   Pereira TV, et al. — Viscosupplementation for knee osteoarthritis: systematic review and meta-analysis.. BMJ, 2022. DOI: 10.1136/bmj-2022-069722.

6. The RESTORE randomized clinical trial (n=288) compared three weekly intra-articular injections of leukocyte-poor PRP with saline placebo in symptomatic mild-to-moderate medial knee OA. At 12 months the mean change in knee pain was -2.1 versus -1.8 points (difference -0.4, 95% CI -0.9 to 0.2, P=.17) and the mean change in medial tibial cartilage volume was -1.4% versus -1.2% (P=.81). Twenty-nine of 31 prespecified secondary outcomes showed no significant between-group difference.

   Bennell KL, et al. — Effect of Intra-articular Platelet-Rich Plasma vs Placebo Injection on Pain and Medial Tibial Cartilage Volume in Patients With Knee Osteoarthritis: The RESTORE Randomized Clinical Trial.. JAMA, 2021. DOI: 10.1001/jama.2021.19415.

7. FDA states verbatim that stem cell products, stromal vascular fraction (adipose-derived), umbilical cord blood, Wharton's jelly, amniotic fluid and exosome products have NOT 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 derived 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), 2020.