Stem cell clinic Tempe: plain answers about joint soreness

Wear can make a joint stiff after rest

A worn knee may ache after sitting. Your first steps won’t feel smooth. It often loosens as you keep moving.

Hip soreness may reach your groin or side. Shoes and stairs won’t feel as easy. You’ll sometimes take shorter steps too.

Strong cords connect shoulder muscles to bone. They help you lift and turn your arm. Sudden reaching doesn’t give those cords time to adjust.

Walking and chores can keep soreness going

Too much activity can stir up your joint. Too little can leave it stiff. You’re aiming for movement that doesn’t raise the ache.

Try shorter walks or easier chores first. Pause if the ache climbs fast. Don’t add time unless your joint settles by tomorrow.

Warmth may help the joint bend. Cool the sore area after extra activity. It shouldn’t hurt your skin.

Gentle strength work can support the joint. You don’t need a hard workout. A physical therapist can change painful moves for you.

Heat, swelling, or weakness needs an exam

Call your doctor if swelling won’t settle. Fever and joint heat can’t wait. Call promptly for new weakness or lost feeling.

Your doctor can check the joint, muscles, and bones. An X-ray may show worn bone ends. You’ll have clearer choices after that exam.

Write down when the soreness started. Note what eases it and what worsens it. That’ll help your doctor focus on the joint.

Sources

1. In 96 patients, concentrated bone marrow aspirate contained a mean of 26.3 million nucleated cells per mL but only about 1,422 colony-forming units of connective tissue progenitors, and the nucleated cell count had negligible predictive value for how many progenitor cells were actually present (r-squared 0.28).

   Muench LN, et al. — Nucleated Cell Count Has Negligible Predictive Value for the Number of Colony-Forming Units for Connective Tissue Progenitor Cells (Stem Cells) in Bone Marrow Aspirate Harvested From the Proximal Humerus During Arthroscopic Rotator Cuff Repair. Arthroscopy, 2021. DOI: 10.1016/j.arthro.2021.01.064.

2. Mesenchymal stromal cells make up only about 0.001 to 0.01 percent of the nucleated cells in bone marrow, so the harvesting and processing technique - aspiration site, syringe size, centrifuge speed and time - materially determines what ends up in the syringe, and no consensus protocol exists.

   Jeyaraman M, et al. — Impact of the Process Variables on the Yield of Mesenchymal Stromal Cells from Bone Marrow Aspirate Concentrate. Bioengineering (Basel), 2022. DOI: 10.3390/bioengineering9020057.

3. The 2018 AAOS/NIH consensus work group recommended that minimally manipulated mixed cell preparations be called CELL THERAPY rather than stem cell therapy, and that their untested and uncharacterised nature be clearly communicated to patients and the public, because stem cells have properties these preparations do not meet.

   Chu CR, et al. — Optimizing Clinical Use of Biologics in Orthopaedic Surgery: Consensus Recommendations From the 2018 AAOS/NIH U-13 Conference. J Am Acad Orthop Surg, 2019. DOI: 10.5435/JAAOS-D-18-00305.

4. The OARSI non-surgical management guideline evaluated 60 interventions with GRADE methodology and built its recommendations around core treatments - structured exercise, weight management and self-management education - for every patient with knee osteoarthritis, regardless of what else is added.

   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.

5. In a 480-patient, four-arm, multicenter randomized phase 2/3 trial, none of three orthobiologic cell injections - autologous bone marrow aspirate concentrate, autologous adipose stromal vascular fraction, or allogeneic umbilical cord tissue-derived mesenchymal stromal cells - was superior to any other, or to a corticosteroid injection control, on pain at 12 months.

   Mautner K, et al. — Cell-based versus corticosteroid injections for knee pain in osteoarthritis: a randomized phase 3 trial. Nat Med, 2023. DOI: 10.1038/s41591-023-02632-w.

6. FDA states in its consumer alert that the only FDA-approved stem cell products in the United States are blood-forming stem cells derived from umbilical cord blood, approved for disorders of the blood-forming system, and that NONE of these products - stem cells, stromal vascular fraction, umbilical cord blood, Wharton's jelly or amniotic fluid - has been approved for the treatment of any orthopedic condition, including osteoarthritis, tendonitis, disc disease, tennis elbow, back pain, hip pain, knee pain, neck pain or shoulder pain.

   US Food and Drug Administration, Center for Biologics Evaluation and Research — Consumer Alert on Regenerative Medicine Products Including Stem Cells and Exosomes. , 2020.