What to try after the scan

Try walking with arthritis at an easy pace

Begin with a distance you know you can manage on level ground. Notice whether the joint grows much sorer or more swollen by bedtime. If it settles normally, you might use the same distance again. If soreness is clearly worse, make the next walk shorter.

There's no need to rush.

Some people find water exercise gentler during a sore day. Strength work can also help with stairs, chairs, and errands. A physical therapist can show you safe motions and help choose a steady pace. Rest belongs after a busy day, but staying still for too long may add stiffness.

Review medicine and supports with your doctor

Pain cream stays near the sore spot, so less medicine spreads through your body than with a pill. Pills may also ease soreness. Kidney, stomach, heart, or bleeding trouble can make some pills unsafe for you. A pharmacist or doctor can check those risks against the medicines you take now.

Familiar doesn't always mean safe.

A fitted cane, brace, or hand support may take strain off the joint. Warmth can soothe stiffness before activity. Cold may settle swelling afterward. If you try one change at a time, it'll be easier to know which one truly helped.

Compare shots and surgery without being rushed

For joint soreness, QC Kinetix offers you a consultation with medical providers, the health staff who examine you, about non-surgical regenerative treatments made from your own blood before deciding about surgery. PRP means platelet-rich plasma: your blood is spun, and the platelet-rich part goes into the shot, while concentrated PRP puts more platelets into the part used for the shot.

You may take time to ask.

These treatments may come up as knee or hip surgery alternatives. The phrase joint preservation means keeping your own joint in use and perhaps putting off surgery. It doesn't promise to save cartilage or avoid an operation. Ask what result you might feel, what it costs, and when you'll know whether it helped. When severe joint damage makes daily life hard, a talk about surgery may be timely. Your quality of life matters in that choice.

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 meta-analysis of nine randomized trials (898 participants) found dietary interventions improved osteoarthritis pain (SMD -0.67, 95% CI -1.01 to -0.34) and physical function (SMD -0.62). The benefit was concentrated in REDUCED-ENERGY diets (pain SMD -0.85); the Mediterranean diet subgroup did NOT significantly change pain (SMD -0.27, 95% CI -1.14 to 0.60, P=0.54).

   Asadi S, et al. — The effectiveness of dietary intervention in osteoarthritis management: a systematic review and meta-analysis of randomized clinical trials.. Eur J Clin Nutr, 2025. DOI: 10.1038/s41430-025-01622-0.

5. An updated systematic review and meta-analysis of six trials (2,059 patients) found duloxetine significantly reduced Brief Pain Inventory 24-hour average pain (MD -0.74, 95% CI -0.92 to -0.57) and improved the WOMAC physical function subscale (MD -4.22, 95% CI -5.14 to -3.30) in knee osteoarthritis.

   Chen B, et al. — An Updated Systematic Review and Meta-analysis of Duloxetine for Knee Osteoarthritis Pain.. Clin J Pain, 2021. DOI: 10.1097/AJP.0000000000000975.

6. In a two-year double-blind randomized trial of 140 patients with symptomatic knee OA and ultrasonic synovitis, intra-articular triamcinolone 40 mg 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 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.

7. 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.

8. 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.

9. 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.

10. CMS covers autologous platelet-rich plasma ONLY for patients with chronic non-healing diabetic, pressure and/or venous wounds, and only when the patient is enrolled in an approved clinical research study under the coverage-with-evidence-development National Coverage Determination. There is no national Medicare coverage for PRP in osteoarthritis of any joint.

    Centers for Medicare & Medicaid Services — Autologous Platelet-rich Plasma (Coverage with Evidence Development). CMS Coverage with Evidence Development, 2014.

11. A prospective cross-sectional study contacted 273 of 317 US direct-to-consumer stem-cell centres posing as a 57-year-old man with knee osteoarthritis. The mean advertised price of a unilateral same-day stem-cell knee injection was $5,156 (SD $2,446; 95% CI $4,550-5,762, n=65), and the mean claimed clinical efficacy was 82% (SD 9.6%, n=36) - a figure the authors describe as a gap between the published literature and marketing claims.

    Piuzzi NS, et al. — The Stem-Cell Market for the Treatment of Knee Osteoarthritis: A Patient Perspective.. J Knee Surg, 2018. DOI: 10.1055/s-0037-1604443.

12. Federal district court orders announced 8 January 2025 permanently ban the co-founders of the Stem Cell Institute of America and several related companies from marketing stem cell therapy, and require payment of $5,155,146 in civil penalties and consumer refunds. On summary judgment in March 2024 the court found the defendants created and published false and misleading advertisements about the efficacy and approval of stem cell injection treatments for conditions including osteoarthritis and joint pain. The clinic charged up to $5,000 per injection and its customers were almost exclusively elderly and disabled people.

    Federal Trade Commission — Stem Cell Institute Co-Founders and Companies Banned from Marketing Stem Cell Treatments and Ordered to Pay More Than $5.1 Million for Refunds and Civil Penalties. FTC press release, 2025.