Joint Pain That Won't Go Away and What You Can Do About It
Chronic joint pain changes how you move through the world. Simple activities like climbing stairs, lifting shopping bags, or playing with your children become sources of discomfort or outright pain. Over time, you adapt by avoiding certain movements, which leads to stiffness, muscle weakness, and further functional decline.
If you're dealing with persistent joint pain that hasn't responded adequately to rest, physiotherapy, or over-the-counter painkillers, you're likely frustrated and uncertain about what options remain besides surgery or long-term medication.
This guide explains why joint pain becomes chronic, why standard treatments often fall short, and which evidence-based regenerative therapies can genuinely reduce pain and improve function.
Why Joint Pain Becomes Chronic
Acute joint pain (from a sprain, minor injury, or overuse) typically resolves within weeks as the body repairs damaged tissue. Chronic joint pain, lasting months or years, signals that the normal healing process has failed or that ongoing degeneration is outpacing repair.
Osteoarthritis is the leading cause of chronic joint pain. It's often described as "wear and tear," but that oversimplifies a complex disease process involving cartilage breakdown, chronic inflammation, bone changes, and alterations in the joint's biochemical environment.
Healthy cartilage provides a smooth, low-friction surface that allows bones to glide effortlessly past one another. In osteoarthritis, cartilage gradually deteriorates, becoming rough and thin. Eventually, bone surfaces make direct contact, causing pain, swelling, and restricted movement. The synovial fluid inside the joint, which normally lubricates and nourishes cartilage, becomes inflamed and less effective.
Osteoarthritis commonly affects weight-bearing joints (knees, hips, spine) and the hands. Risk factors include age, genetics, previous joint injuries, obesity, and repetitive occupational or athletic activities.
Tendinopathy involves degenerative changes in tendons, the fibrous tissues that connect muscles to bones. Overuse, repetitive strain, or inadequate recovery between activities causes micro-tears in tendon fibres. When the damage outpaces the body's ability to repair it, the tendon develops disorganised collagen, reduced tensile strength, and persistent pain.
Common tendinopathies include tennis elbow (lateral epicondylitis), golfer's elbow (medial epicondylitis), Achilles tendinopathy, and rotator cuff tendinopathy. These conditions are notoriously stubborn and can persist for months or years despite rest and physiotherapy.
Inflammatory arthritis includes conditions like rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis. These autoimmune diseases cause the immune system to attack joint tissues, leading to inflammation, pain, swelling, and eventually joint damage if not controlled with medication. Inflammatory arthritis requires medical management with disease-modifying drugs and biologics, but regenerative therapies can complement conventional treatment by promoting tissue repair and reducing localised inflammation.
Why Standard Treatments Often Aren't Enough
Most people with chronic joint pain follow a stepwise treatment approach starting with conservative measures and progressing to more invasive interventions if symptoms persist.
NSAIDs (non-steroidal anti-inflammatory drugs) like ibuprofen and naproxen reduce inflammation and pain temporarily. They're effective for acute flare-ups but come with risks when used long-term, including gastrointestinal bleeding, kidney damage, and increased cardiovascular risk. Moreover, they don't promote healing or address the underlying tissue damage.
Physiotherapy is valuable for improving strength, flexibility, and joint mechanics. Strengthening the muscles surrounding a joint reduces stress on damaged structures and can alleviate pain. However, if the cartilage, tendon, or ligament is significantly degraded, exercise alone won't regenerate it.
Corticosteroid injections provide temporary relief by powerfully suppressing inflammation. However, repeated cortisone injections can weaken tendons, accelerate cartilage breakdown, and increase the risk of infection. Research shows that whilst cortisone offers short-term pain relief, it doesn't improve long-term outcomes and may worsen the underlying condition.
Hyaluronic acid injections aim to supplement the joint's natural lubricant. They're commonly used for knee osteoarthritis, but clinical evidence is mixed. Some studies show modest pain relief and improved function, whilst others find no significant benefit compared to placebo. Effects, when present, are typically short-lived (a few months at most).
Surgery is sometimes necessary for severe joint damage, such as complete ligament tears, large meniscus tears, or end-stage osteoarthritis. However, procedures like arthroscopic debridement (cleaning out damaged tissue) have been shown to offer no benefit over sham surgery for osteoarthritis. Joint replacement is highly effective for advanced arthritis but involves significant recovery time, risks, and a prosthetic with a finite lifespan.
How Platelet-Rich Plasma Addresses Joint Pain
Platelet-rich plasma (PRP) therapy offers a different approach by harnessing your body's natural healing mechanisms. Rather than suppressing symptoms or replacing damaged structures, PRP aims to regenerate tissue and restore function.
PRP is derived from your own blood. A small sample is drawn and processed in a centrifuge to concentrate the platelets, which contain powerful growth factors including platelet-derived growth factor (PDGF), transforming growth factor-beta (TGF-β), and insulin-like growth factor (IGF). These proteins drive tissue repair by stimulating stem cell recruitment, promoting collagen synthesis, modulating inflammation, and enhancing blood supply to damaged areas.
When PRP is injected into a joint, tendon, or ligament, it changes the local biochemical environment. Pro-inflammatory cytokines that perpetuate pain and tissue breakdown are downregulated, whilst regenerative signals are amplified. Damaged cartilage begins producing new extracellular matrix, tendons rebuild organised collagen fibres, and overall tissue quality improves.
For osteoarthritis, PRP has been extensively studied. A comprehensive meta-analysis in the American Journal of Sports Medicine evaluated multiple randomised controlled trials and found that PRP injections produced significant improvements in pain and function compared to placebo, hyaluronic acid, and corticosteroids. Benefits typically lasted 6 to 12 months, with some studies showing effects persisting up to 24 months.
Research indicates PRP works best for early to moderate osteoarthritis (grades 1-3). Patients with advanced arthritis (grade 4, bone-on-bone contact) show less consistent improvement, highlighting the importance of intervening before cartilage is completely destroyed.
For tendinopathy, PRP accelerates healing by promoting organised collagen formation. Studies on tennis elbow, Achilles tendinopathy, and rotator cuff issues demonstrate that PRP, often combined with physical therapy, produces superior outcomes compared to rest, NSAIDs, or cortisone injections alone.
What to Expect from PRP Treatment
PRP therapy is performed as an outpatient procedure, typically taking 30 to 45 minutes. After your blood is drawn and processed, the concentrated plasma is injected into the affected joint or tendon using ultrasound guidance to ensure precise placement.
Some discomfort or swelling is common for the first few days following injection. This is part of the healing response and can be managed with ice and paracetamol (avoid NSAIDs, as they may interfere with the inflammatory healing cascade). Most patients resume light activities within a few days, though high-impact exercise should be avoided for two to four weeks.
Improvement is gradual rather than immediate. Some patients notice reduced pain within two to three weeks, whilst others see gradual improvement over two to three months. Full benefits typically manifest between three and six months as tissue regeneration proceeds.
Most protocols recommend one to three injections spaced four to six weeks apart, depending on the condition's severity. Maintenance injections every 6 to 12 months may be needed to sustain benefits for chronic conditions like osteoarthritis.
Who Benefits Most from PRP
PRP is most effective for specific conditions and patient profiles.
Ideal candidates include individuals with early to moderate osteoarthritis, chronic tendinopathy that hasn't responded to conservative treatment, partial ligament or meniscus tears that don't require surgery, and those seeking to delay or avoid more invasive interventions.
Less ideal candidates include those with very advanced joint damage (complete cartilage loss, severe bone-on-bone osteoarthritis), acute infections, blood disorders affecting platelet function, or significant mechanical instability (complete ligament ruptures, large unstable meniscus tears) that require surgical repair.
PRP is particularly valuable for patients who want to avoid surgery, cannot tolerate long-term NSAID use, or need to maintain function for work or athletic pursuits without the prolonged downtime associated with surgical intervention.
Complementary Strategies to Support Joint Health
PRP therapy works best when combined with lifestyle measures that optimise joint health and reduce ongoing stress.
Weight management is critical, especially for lower limb joints. Every kilogram of excess body weight places approximately 4 kilograms of additional force on the knees during walking. Even modest weight loss (5-10% of body weight) significantly reduces pain and improves function in people with osteoarthritis.
Strength training rebuilds muscle around joints, providing stability and absorbing forces that would otherwise stress damaged structures. Focus on exercises that strengthen without aggravating symptoms. Eccentric exercises (controlling the lowering phase of a movement) are particularly effective for tendinopathy.
Low-impact cardiovascular exercise maintains fitness without worsening joint pain. Swimming, cycling, and elliptical training are excellent options. Avoid high-impact activities like running or jumping during the recovery phase.
Anti-inflammatory nutrition supports joint health. Omega-3 fatty acids (found in oily fish, flaxseed, walnuts) have anti-inflammatory properties. Vitamin D and calcium support bone health. Antioxidant-rich fruits and vegetables combat oxidative stress that contributes to joint degeneration.
Adequate sleep supports tissue repair. Growth hormone, which drives tissue regeneration, is primarily released during deep sleep. Chronic poor sleep impairs healing and increases pain sensitivity.
Making an Informed Decision
Chronic joint pain limits your life in ways that extend far beyond physical discomfort. It affects your mood, your relationships, and your ability to participate in activities you enjoy.
The decision to pursue regenerative treatment like PRP therapy should be based on a clear understanding of your condition, realistic expectations, and evidence for efficacy. PRP isn't a miracle cure, but for appropriately selected patients, it offers meaningful pain relief, improved function, and the possibility of delaying or avoiding more invasive interventions.
If you're ready to explore whether PRP therapy could help your specific situation, a consultation with a qualified practitioner can assess your condition, explain realistic outcomes, and create a treatment plan tailored to your needs.
