Ways to help an aching joint

Start with movement you can repeat

Begin with a brief walk, easy bending, or exercises from an earlier visit. Keep the movement steady and stop before soreness becomes sharp. You aren't trying to prove anything. Please get help if the joint gives way, swells quickly, or won't hold your weight.

Small gains still count.

Change only one thing at first: walking distance, pace, or rest time. If you change all of them together, you won't know which choice helped. A wrapped cold pack may calm swelling after use, while warmth may loosen stiffness beforehand. Good sleep and a fitted cane can also make daily movement easier.

Review medicines and joint pain supplements

Pain-relief gels and pills help some people, but your health affects which ones are safe. Tell your doctor about stomach or kidney trouble, heart concerns, blood pressure, and falls. Don't add or stop a medicine because it helped a friend. Ask what benefit to expect and which side effects mean it's time to stop.

The same caution fits joint pain supplements.

A bottle on a store shelf may look harmless, yet a supplement can affect other medicines. It may also cost more than you expect. You can bring each bottle to your doctor or pharmacist. Ask what is known about it, how long you'll try it, and what result would make you stop.

Ask what goes into the sore joint

Some clinics use natural pain treatments, regenerative treatments, biologic therapies, or orthobiologics as names for office procedures that put blood- or tissue-based preparations into a sore joint. PRP means platelet-rich plasma, made after staff draw some of your blood, gather more platelets into one prepared portion, and place that portion into the joint during the office procedure. Concentrated PRP means still more platelets are gathered in the prepared portion.

An exam comes first.

Joint preservation means trying to keep your present joint working without surgery. Knee or hip surgery alternatives are non-surgical choices discussed before an operation. You'll want to ask exactly what is in the preparation, what happens during the procedure, and whether a driver is needed. Cost, follow-up, and the way improvement will be judged also belong in that talk.

Sources

1. 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.

2. 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.

3. A 2025 Bayesian network and dose-response meta-analysis of 92 randomised trials in 6,079 people with knee or hip osteoarthritis found aerobic training most likely to rank first for pain relief (SUCRA 84.7%; SMD -1.00, 95% CrI -1.50 to -0.62), ahead of strength plus flexibility (SUCRA 73.0%), yoga (63.7%), strength alone (55.9%) and flexibility alone (39.8%) - but with NO statistically significant difference between exercise types. Pooled across modalities, the dose-response relationship was U-shaped, meaning more exercise is not linearly better.

   Liang Z, Wang C, Zhang X, et al. — Optimal modality and dose of exercise for relieving pain in patients with knee or hip osteoarthritis: Bayesian pairwise, network, and dose-response meta-analyses.. Seminars in Arthritis and Rheumatism, 2025. DOI: 10.1016/j.semarthrit.2025.152855.

4. A network meta-analysis of 192 randomised trials in 102,829 patients with knee or hip osteoarthritis found that five oral preparations - diclofenac 150 mg/day, etoricoxib 60 and 90 mg/day, and rofecoxib 25 and 50 mg/day - had a 99% or greater probability of exceeding the minimal clinically important reduction in pain. Topical diclofenac (70-81 and 140-160 mg/day) had a 92.3% or greater probability. Every opioid studied had a 53% or LOWER probability of exceeding that threshold.

   da Costa BR, Pereira TV, Saadat P, et al. — Effectiveness and safety of non-steroidal anti-inflammatory drugs and opioid treatment for knee and hip osteoarthritis: network meta-analysis.. BMJ, 2021. DOI: 10.1136/bmj.n2321.

5. 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.

6. A 2025 Cochrane living review of 25 randomised trials (1,341 participants) found that compared with placebo injection, stem cell injections for knee osteoarthritis MAY slightly improve pain and function up to six months, on LOW-certainty evidence: mean pain was 4.5 of 10 with placebo and 1.2 points better with stem cells; function 46.3 of 100 with placebo and 14.2 points better. Certainty was downgraded for indirectness (source, preparation and dose of cells varied across studies) and suspected publication bias - up to three larger trials were conducted and then withdrawn before reporting. Radiographic progression was not assessed in ANY included study, and the review remains uncertain about harms.

   Whittle SL, Johnston RV, McDonald S, et al. — Stem cell injections for osteoarthritis of the knee.. Cochrane Database of Systematic Reviews, 2025. DOI: 10.1002/14651858.CD013342.pub2.

7. 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.

8. Medicare's national coverage policy states that CMS covers autologous platelet-rich plasma only for patients with chronic non-healing diabetic, pressure and/or venous wounds, and only inside an approved coverage-with-evidence-development clinical research study. There is no Medicare national coverage for PRP in osteoarthritis or any other joint indication, which is why these injections are billed to the patient as cash-pay.

   Centers for Medicare & Medicaid Services — Autologous Platelet-rich Plasma (Coverage with Evidence Development). CMS.gov, 2024.

9. A meta-analysis of 13 randomised trials in 4,201 participants across four countries found duloxetine statistically superior to placebo for 24-hour average pain, quality of life, physical function and global impression in chronic musculoskeletal pain, with no difference in serious adverse events.

   Ma X, Zhou S, Sun L, et al. — Efficacy and safety of duloxetine in chronic musculoskeletal pain: a systematic review and meta-analysis.. BMC Musculoskeletal Disorders, 2023. DOI: 10.1186/s12891-023-06488-6.

10. A review of the published literature on the systemic effects of intra-articular corticosteroid injection found that serum cortisol falls within hours, reaching a nadir 24-48 hours after injection, and takes one to four weeks - sometimes longer - to return to baseline, depending on the preparation, the dose and how many joints were injected. In controlled diabetic patients with knee osteoarthritis, injection produced a transient rise in blood glucose over several days, peaking around 300 mg/dL. Injections also lowered inflammatory markers such as C-reactive protein and ESR.

    Habib GS — Systemic effects of intra-articular corticosteroids.. Clinical Rheumatology, 2009. DOI: 10.1007/s10067-009-1135-x.