Use this arthritis treatment Scottsdale guide as a starting point

Bring the guide's limits into the visit

Use these pages for common causes, home steps, and warning signs. They can't review your medicines or tell why this joint changed today. A sudden hot joint, fever, or a new injury may need prompt care.

The listed studies can help you check a claim that affects your choice. A study tells what happened to a group of people. It cannot say exactly what will happen to you. Work on a knee may not answer a question about a shoulder.

Look for a study of the same joint and the same kind of soreness. Some results clearly show a benefit, while others only suggest one and leave questions unanswered. Ask the doctor to explain which description is fair.

Bring your health history, medicine list, scan reports, and notes about the soreness. Take them to your regular doctor or the doctor, nurse practitioner, or physician assistant examining you. Ask why the suggested care matches your joint, and ask about possible harm, cost, and other choices.

The guide can support that talk, but it cannot replace a careful exam today.

Sources

1. The Lancet Seminar on osteoarthritis states that diagnosis is clinically based despite widespread OVERUSE of imaging, that management should focus on core treatments - self-management and education, exercise, and weight loss where relevant - and that surgery should be reserved for people who have not responded appropriately to less invasive methods.

   Hunter DJ, et al. — Osteoarthritis.. Lancet, 2019. DOI: 10.1016/S0140-6736(19)30417-9.

2. 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.

3. 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.

4. 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.