Which joint option fits your soreness?

What can you try before a procedure?

Gentle exercise and stronger muscles may help you move with less strain. Break up chores if long spells of work leave you aching. Physical therapy can teach safe ways to bend, lift, or walk. It isn't wasted effort.

A cream for the sore area or pills that lower swelling may also help. Those pills aren't safe for everyone. Ask your doctor about your stomach, kidneys, heart, and other medicine before taking them often.

Begin with care you'll be able to continue.

How do steroid and gel differ?

Steroid may act quickly, but its relief often fades soon. It can make blood sugar climb for a little while. Gel tends to act more slowly. Large reviews found little extra relief from gel on average.

Neither treatment repairs cartilage, the smooth covering over each bone end. Neither promises lasting relief. If surgery is near, tell the surgeon when you had a steroid shot. That date can affect the risk of infection after surgery.

Tomorrow's care matters just as much as today's relief.

What are PRP and prepared marrow?

PRP and prepared marrow carry the name regenerative treatments. At a clinic, your blood or marrow is spun, part is saved, and a clinician puts that material into the sore joint.

PRP is another name for platelet-rich plasma. Platelets are tiny pieces in blood that help stop bleeding and start healing. Clinics may keep unlike amounts of platelets and germ-fighting white cells in the finished liquid. Because those liquids aren't alike, study results are difficult to compare. That doesn't tell you which office will help.

You'll often pay cash for these treatments, so get the total cost first. When damage is severe and movement is poor, surgery may still make sense.

Sources

1. The 2019 ACR/Arthritis Foundation OA guideline makes a STRONG recommendation for intra-articular glucocorticoid injection in knee OA, alongside strong recommendations for exercise, weight loss, self-management, tai chi, cane use, bracing and NSAIDs; intra-articular steroid injection for HAND OA is only conditionally recommended.

   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. The 2015 Cochrane review of 27 trials (1,767 participants) found intra-articular corticosteroid better than sham for knee OA pain (SMD -0.40, 95% CI -0.58 to -0.22; NNTB 8), but the benefit decayed with time: moderate at 1-2 weeks, small at 13 weeks, and no evidence of any effect at 26 weeks. All outcomes were graded LOW quality.

   Jüni P, et al. — Intra-articular corticosteroid for knee osteoarthritis.. Cochrane Database Syst Rev, 2015. DOI: 10.1002/14651858.CD005328.pub3.

3. In a 2-year double-blind RCT of 140 patients with symptomatic knee OA and ultrasound synovitis, 40 mg intra-articular triamcinolone every 12 weeks produced significantly greater cartilage volume loss than saline (index compartment cartilage thickness change -0.21 mm vs -0.10 mm; between-group difference -0.11 mm, 95% CI -0.20 to -0.03) with no significant difference in knee pain.

   McAlindon TE, et al. — Effect of Intra-articular Triamcinolone vs Saline on Knee Cartilage Volume and Pain in Patients With Knee Osteoarthritis: A Randomized Clinical Trial.. JAMA, 2017. DOI: 10.1001/jama.2017.5283.

4. A 2022 BMJ systematic review and meta-analysis of 169 trials (21,163 participants) found viscosupplementation produced only a small pain reduction versus placebo (SMD -0.08, 95% CI -0.15 to -0.02; about -2.0 mm on a 100 mm VAS), below the minimal clinically important difference, and trial sequential analysis indicated conclusive evidence of clinical equivalence with placebo since 2009.

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

5. The RESTORE randomized trial (288 participants, leukocyte-poor PRP, 3 weekly injections) found no significant difference from saline placebo at 12 months in knee pain (-2.1 vs -1.8 points; difference -0.4, 95% CI -0.9 to 0.2) or in medial tibial cartilage volume (-1.4% vs -1.2%), with 29 of 31 secondary outcomes also showing no 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.

6. A 2024 network meta-analysis of 48 studies (9,338 knees) at minimum 6-month follow-up ranked PRP first for pain and function (SUCRA 91.5), then BMAC (76.5) and hyaluronic acid (53.1), with corticosteroid (15.2) barely above placebo (13.7) at that time point.

   Jawanda H, et al. — Platelet-Rich Plasma, Bone Marrow Aspirate Concentrate, and Hyaluronic Acid Injections Outperform Corticosteroids in Pain and Function Scores at a Minimum of 6 Months as Intra-Articular Injections for Knee Osteoarthritis: A Systematic Review and Network Meta-analysis.. Arthroscopy, 2024. DOI: 10.1016/j.arthro.2024.01.037.

7. The 2025 Cochrane living review of stem cell injections for knee OA (25 trials, 1,341 participants) found stem cell injection MAY slightly improve pain and function up to six months versus placebo (pain 1.2 points better on a 0-10 scale; function 14.2 points better on 0-100), but rated the evidence LOW certainty for both, downgraded for indirectness and suspected publication bias, with up to three larger RCTs withdrawn before reporting results.

   Whittle SL, et al. — Stem cell injections for osteoarthritis of the knee.. Cochrane Database Syst Rev, 2025. DOI: 10.1002/14651858.CD013342.pub2.

8. FDA's HCT/P guidance sets out the minimal-manipulation and homologous-use criteria that decide whether a human cell or tissue product is regulated solely under 21 CFR Part 1271 (section 361) or requires a biologics licence; cell-based orthopaedic injections that fall outside those criteria are unapproved drugs and biological products, and no cell-based product is FDA-approved to treat osteoarthritis.

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