What to check when a knee, hip, shoulder or ankle hurts

What to try for a sore knee

A worn knee may feel stiff after rest and sore on stairs. An old injury may change how you place weight on it. For a few days, shorten outings and avoid deep bends that sharply raise soreness. Keep up easy movement and strength work that doesn't hurt. A cane may take some weight off the knee during a bad spell.

Tell the clinician the distance you manage and whether the knee aches later.

What to try for a stiff hip

You may feel hip soreness in the groin, thigh or outer hip. Notice whether standing, walking or turning starts it. Break one long walk into several shorter walks. Regular exercise can build support around the hip, but don't force a painful movement. Arrange an exam when sleep or daily movement remains hard.

The hip needs its own exam because knee findings don't explain hip soreness.

What to try for shoulder or ankle soreness

A shoulder often hurts during reaching, lifting or repeated swings. Ease that movement while keeping the shoulder moving comfortably. This can limit added stiffness. Uneven ground may bother an ankle after an old sprain. Firm shoes and shorter outings may reduce strain. Note any weakness or sudden buckling in either joint.

Get the shoulder or ankle examined when these home steps don't help.

What to ask if you want another option

Have the clinician name the sore joint part and explain the exam finding. Then ask about the steps, cost and recovery time for each choice. The name PRP means platelet-rich plasma. A clinician spins your blood to gather more platelets, then places that portion at the sore joint. It isn't the same as medicine, physical therapy or surgery.

After examining you, QC Kinetix medical providers may offer PRP or a marrow-fluid procedure as a surgery alternative.

Sources

1. The RESTORE trial - a participant-, injector- and assessor-blinded RCT of 288 adults aged 50+ with symptomatic medial knee OA (Kellgren-Lawrence 2-3) - compared three weekly intra-articular PRP injections against saline placebo, with co-primary endpoints of 12-month knee pain and medial tibial cartilage volume on MRI. PRP did not beat placebo on either. It is the single best-designed test of the specific claim that PRP changes joint structure, and it was negative.

   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.

2. A GRADE-rated systematic review and meta-analysis of 16 randomized trials (807 participants) found that MSC therapy for chronic knee OA pain PROBABLY RESULTS IN LITTLE TO NO DIFFERENCE in pain relief at 3-6 months (WMD -0.74 cm on a 10 cm VAS against a minimally important difference of 1.5 cm) or physical functioning (WMD 2.23 on the SF-36 100-point subscale against a 10-point MID), both moderate certainty; at 12 months pain was again probably little-to-no-different (WMD -0.73 cm). The measured effect is real but sits BELOW the threshold at which a patient would notice it.

   Sadeghirad B, et al. — Mesenchymal stem cells for chronic knee pain secondary to osteoarthritis: A systematic review and meta-analysis of randomized trials.. Osteoarthritis and cartilage, 2024. DOI: 10.1016/j.joca.2024.04.021.

3. A 2026 systematic review and meta-analysis of 28 randomized trials of intra-articular mesenchymal stem cell-based therapies in knee OA found significant improvements in several pain and function measures (delta-VAS MD -1.67; KOOS pain MD 15.37) but NO significant difference in WOMAC, KOOS quality of life or the Lequesne index, and MRI-based WORMS scores were non-significant - indicating no consistent structural benefit. Its own conclusion: these therapies serve a primarily SYMPTOM-modifying rather than STRUCTURE-modifying role, with higher frequencies of local reactions to weigh against the symptomatic benefit.

   Awad G, et al. — Efficacy and safety of intra-articular mesenchymal stem cell-based therapies in knee osteoarthritis: A systematic review and meta-analysis of randomized controlled trials.. Clinical rheumatology, 2026. DOI: 10.1007/s10067-026-08042-w.

4. A randomized controlled study of 111 patients aged 18-65 with hip osteoarthritis compared three weekly ultrasound-guided injections of PRP, hyaluronic acid, or both. PRP had the lowest VAS at every follow-up and beat HA significantly at 6 months (mean VAS 21 vs 44). But the WOMAC advantage present at 2 and 6 months was NO LONGER significant at 12 months, and the combination arm did worse than PRP alone.

   Dallari D, et al. — Ultrasound-Guided Injection of Platelet-Rich Plasma and Hyaluronic Acid, Separately and in Combination, for Hip Osteoarthritis: A Randomized Controlled Study.. The American journal of sports medicine, 2016. DOI: 10.1177/0363546515620383.

5. The PRIMA trial randomized 100 patients with ankle osteoarthritis to two ultrasound-guided intra-articular PRP injections or saline placebo. AOFAS scores improved 10 points with PRP (63 to 73) and 11 points with placebo (64 to 75); the adjusted between-group difference over 26 weeks was -1 (95% CI -6 to 3, p=0.56). The authors state the results do not support using PRP for ankle osteoarthritis. The evidence for a biologic in one joint does not transfer to another.

   Paget LDA, et al. — Effect of Platelet-Rich Plasma Injections vs Placebo on Ankle Symptoms and Function in Patients With Ankle Osteoarthritis: A Randomized Clinical Trial.. JAMA, 2021. DOI: 10.1001/jama.2021.16602.

6. A systematic review and meta-analysis of randomized trials found that augmenting arthroscopic rotator cuff repair with platelet-rich plasma reduces the retear rate and improves clinical function scores, whereas platelet-rich FIBRIN gives no clinically meaningful benefit - with the authors cautioning about the small number and heterogeneity of studies. The shoulder's best biologic evidence is for PRP used ALONGSIDE a repair operation, not as a substitute for one.

   Peng Y, et al. — Efficacy of platelet-rich plasma and platelet-rich fibrin in arthroscopic rotator cuff repair: A systematic review and meta-analysis.. PM & R : the journal of injury, function, and rehabilitation, 2023. DOI: 10.1002/pmrj.13049.

7. A pairwise and network meta-analysis of 18 randomized trials in rotator cuff TENDINOPATHY found corticosteroid helps at 3-6 weeks but not beyond 24 weeks, while PRP and prolotherapy may yield better outcomes in the long term (over 24 weeks) - with the authors warning that heterogeneity requires cautious interpretation. Tendon and joint-surface problems do not behave the same way, and a shoulder page should not borrow knee-OA evidence.

   Lin MT, et al. — Comparative Effectiveness of Injection Therapies in Rotator Cuff Tendinopathy: A Systematic Review, Pairwise and Network Meta-analysis of Randomized Controlled Trials.. Archives of physical medicine and rehabilitation, 2019. DOI: 10.1016/j.apmr.2018.06.028.

8. The evidence overview underpinning the 2020 EULAR recommendations on intra-articular therapies pooled 29 quality-appraised systematic reviews. Hyaluronic acid showed a small effect on pain and function in KNEE OA but not in hip OA or shoulder capsulitis; intra-articular glucocorticoid showed small effects in knee OA and on function in hip OA and shoulder capsulitis; PRP showed benefit in knee OA but NOT in hip OA, and mesenchymal stem cells behaved similarly. Overall conclusion: most intra-articular therapies exert SMALL effects and are well tolerated.

   Rodriguez-García SC, et al. — Efficacy and safety of intra-articular therapies in rheumatic and musculoskeletal diseases: an overview of systematic reviews.. RMD open, 2021. DOI: 10.1136/rmdopen-2021-001658.

9. The AAOS third-edition clinical practice guideline for non-arthroplasty management of knee osteoarthritis is the orthopedic profession's own GRADE-style appraisal of the same options a regenerative clinic sells; it is the benchmark against which any 'regenerative' claim on this topic should be read, and it rates the strongest support for exercise, weight loss and self-management rather than for injectables.

   Brophy RH, et al. — AAOS Clinical Practice Guideline Summary: Management of Osteoarthritis of the Knee (Nonarthroplasty), Third Edition.. The Journal of the American Academy of Orthopaedic Surgeons, 2022. DOI: 10.5435/JAAOS-D-21-01233.