Understanding Arthritis Treatment
Osteoarthritis is caused by breakdown of the cartilage protecting the ends of your bones over time. It typically affects the bigger weight bearing joints, like the knees and hips, but can also affect other joints. People often experience joint pain and stiffness with reduced range of movement – pain often gets worse the more you use the joint. Osteoarthritis is common in people older than 45.
Rheumatoid arthritis is a type of autoimmune disease where the immune system wrongly mistakes the cells that line your joints as foreign, causing your body to attack them. This causes inflammation and joint damage, with swelling, pain and stiffness. With rheumatoid arthritis, you may also experience other symptoms like tiredness, a fever, weight loss and reduced appetite. This condition usually starts between the age of 30-60 and is more common in women.
Traditional treatment focuses on pain management with painkillers and reducing inflammation with nonsteroidal anti-inflammatory drugs (NSAIDs) or steroids. For rheumatoid and other autoimmune types of arthritis, there are also some medications that help to slow down how fast the disease progresses by targeting the immune system. If arthritis progresses and a joint is severely damaged, surgery to replace it may be needed.
While these treatments can be effective, medications often come with side effects, and surgery is an invasive treatment that comes with several risks. Most of these standard treatments focus on the symptoms or disease impact rather than addressing the underlying causes, which is where regenerative therapies come in.
The Regenerative Medicine Approach
Regenerative and functional medicine focus on the underlying issues in the body that are contributing to a disease rather than just focusing on the symptoms. It recognizes that arthritis is driven by chronic systemic inflammation, cartilage breakdown, immune dysregulation (particularly with rheumatoid arthritis and other autoimmune types), and infection in some cases.
Metabolic dysfunction, poor diet and gut health (including the microbiome and gut permeability) all contribute to chronic inflammation within the body which can trigger or worsen arthritis (Longo et al., 2024).
Progressive cartilage breakdown leads to arthritis when the body's repair mechanisms can’t keep up with breakdown. This process is impacted by various factors, including hormone levels (especially around menopause) and disrupted cytokines/growth factor signalling (chemicals used to help cells communicate) (Bertoldo et al., 2021; Nishimura et al., 2020).
Immune dysregulation is also linked to several types of arthritis. Immune cells can help with tissue repair within the joints, but they can worsen joint inflammation and contribute to tissue destruction. In rheumatoid arthritis, the immune system wrongly identifies joint tissue as foreign and attacks it, leading to damage.
Lifestyle factors can also contribute to arthritis symptoms and severity. Being overweight, smoking, having poor metabolic health, stress and poor sleep can also worsen inflammation and worsen the load joints are under.
Functional and regenerative medicine sees the body in a more holistic way. This approach focuses on making lifestyle and foundational health changes that support joint, immune and gut health. Regenerative therapies involve supporting the body’s natural abilities to heal, repair joint tissue and support healthy immune function.
It’s an approach best used to compliment other arthritis treatments rather than replace them.
Treatments That May Help
Arthritis treatment includes a variety of lifestyle alterations and medications, but can also include regenerative therapies and surgery in some cases.
Lifestyle changes
Low to moderate-intensity exercise can help with various types of arthritis as it can improve muscle strength, flexibility, mobility and may even delay the need for joint replacement surgery (Nguyen et al., 2025). It’s important to cut out activities that are high-impact and put too much stress on the joints, like contact sports or sports involving jumping (like basketball). A physical therapist can help if you’re not sure where to start.
Anti-inflammatory diets, like the Mediterranean diet, are associated with lower inflammation and less severe disease, so it’s a good idea to base your diet around this. This means a diet that includes fish, nuts and seeds, olive oil, whole grains, and plenty of fresh fruit and vegetables. This diet contains antioxidants, anti-inflammatory compounds and omega-3 fatty acids that can be beneficial for osteoarthritis in particular (Veronese et al., 2024). Elimination diets, such as gluten elimination, may play a role in certain types of inflammatory arthritis.
Both diet and exercise changes support weight loss, which benefits overweight individuals with osteoarthritis in particular. Diet also influences the microbiome which plays an important role in inflammation.
Better sleep can also help with arthritis. Large-scale cohort studies have linked poor sleep to an increased risk of arthritis, possibly because disrupted sleep can directly contribute to inflammation and pain processing. So, getting more high-quality sleep may improve arthritis symptoms (Nguyen et al., 2025).
Medication
The most common treatment for arthritis is medication. Which type of arthritis you have and how severe it is will determine which medications are most effective for you.
Painkillers are common for most types of arthritis. You may start with paracetamol and step up to nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, naproxen or diclofenac. NSAIDs not only relieve pain, but they help to reduce inflammation too. When taken long term, they can lead to gastroesophageal reflux disease and stomach ulcers, so they’re often prescribed with stomach-protecting medications to avoid this. They can also cause kidney problems in certain people, so aren’t suitable for everyone.
Steroids are effective at providing temporary relief from swelling and pain associated with inflammatory arthritis, including rheumatoid arthritis, gout, and psoriatic arthritis. Steroids can also be used for temporary relief from osteoarthritis in some cases. Tablets or steroid joint injections are both available, but tablets tend to lead to worse systemic side effects (including bone loss and immune suppression) – they may be offered where inflammation is more generalized. Examples of steroids include prednisolone and cortisone.
Hyaluronic acid joint injections are also a common treatment to reduce pain and improve mobility.
Disease-specific medications include:
Colchicine and allopurinol – used to lower uric acid levels (allopurinol) and reduce inflammation (colchicine) associated with gout
Disease modifying antirheumatic drugs (DMARDs) – DMARDs (like methotrexate, hydroxychloroquine and sulfasalazine) are used to suppress the immune system and treat autoimmune arthritis types like rheumatoid, psoriatic and ankylosing spondylitis
Biologics – engineered proteins that target specific parts of the immune system and are used to treat autoimmune arthritis types
You’ll usually be prescribed painkillers/NSAIDs as the first line of treatment and then may progress to additional medications if these aren’t effective. Biologics are usually reserved for patients who haven’t responded well to other treatments as they’re very expensive, given via injection/intravenously and come with a variety of side effects.
DMARDs and biologics aren’t typically used for people with osteoarthritis as there’s minimal evidence that they’re effective for this condition.
Physical therapy
Physical therapy is a useful non-invasive way to reduce pain, strengthen muscles and improve joint mobility in people with arthritis. It’s helpful for people with most types of arthritis and, if done under the supervision of a trained physical therapist, evidence shows it does not worsen disease activity or joint damage (Allameen et al., 2024; Wang et al., 2022).
Surgery
Surgery is an invasive treatment that poses a risk of infection, damage to the joint and reaction to the anaesthetic. Due to this, it’s typically reserved for people whose symptoms can’t be managed using other treatments and where symptoms are limiting their daily activities.
Surgery may involve:
Replacing part of or the whole of a joint
Fusing some parts a joint together if it has become unstable
Removing diseased joint lining or a small section of bone
Smoothing or removing debris from a damaged joint
Resurfacing a joint
Not all surgeries are successful and replacement joints may need replacing again in the future.
Regenerative medicine
Regenerative medicine is a way to support your body’s own healing capacity. With arthritis, treatment focuses on encouraging joint repair via different methods, including:
Platelet-rich plasma (PRP) – concentrating platelets that are taken from your own blood sample and injecting them into the treatment area
Shockwave therapy – directing high-energy sound waves into the affected area
Stem cell therapy – taking your own cells with the ability to turn into any other cell and injecting them into the affected area to promote tissue healing and growth
Amniotic membrane injections – injecting tissue from the placenta into the joint to release helpful chemicals and support healing (such as anti-inflammatory cytokines and growth factors)
Some of these treatments have more evidence behind them while others are considered more experimental. None of these treatments currently have FDA approval for treating arthritis.
What the Evidence Supports
Regenerative therapies have the most evidence for treating osteoarthritis rather than inflammatory types.
PRP therapy
There’s a strong amount of evidence from multiple randomized controlled trials (RCTs) that PRP can help provide significant pain relief and improve knee function in people with knee osteoarthritis (Bensa et al., 2025). However, the effectiveness of PRP therapy depends on platelet quality and how the sample is prepared, with differences in preparation methods leading to variable results (Gato-Calvo et al., 2019).
Shockwave therapy
In a meta-analysis that included 32 RCTs, shockwave therapy was found to significantly improve pain and function in knee osteoarthritis compared to a placebo, other injections, and medications (Chen et al., 2020). Other meta analyses confirmed this, finding that shockwave therapy was associated with few side effects and that the effectiveness was linked to the energy level and treatment duration (Avendaño-Coy et al., 2020; Liao et al., 2019).
Where the Evidence Is Limited
Most of these therapies are recommended for osteoarthritis, with much less evidence around their effectiveness when treating other types of arthritis. Generally, most studies for osteoarthritis focus on the knee, with very few investigating whether treatments are effective for osteoarthritis of other joints.
PRP therapy
While some studies have found that PRP can help with rheumatoid arthritis symptoms, others have found that it increases inflammation and can worsen disease symptoms (Jacobs et al., 2023; Moeda et al., 2020). A 2023 review of current research found no evidence that PRP can help with gout (Jacobs et al., 2023).
Shockwave therapy
There is very limited evidence around shockwave therapy and rheumatoid arthritis. A small RCT and a case study found that treatment improved pain and function but further high-quality trials are needed (Liu et al., 2017). Data on treating other types of inflammatory arthritis is low and based mainly on case studies.
Stem cell treatment
A 2025 Cochrane review found low-quality evidence from RCTs that stem cell treatment may improve pain and function in people with knee osteoarthritis with few side effects (Whittle et al., 2025). There’s insufficient evidence around how effective stem cells are for osteoarthritis in other areas of the body.
Small early-phase trials investigating stem cell treatment for inflammatory arthritis, including rheumatoid arthritis, have shown promising short-term results at improving disease severity, but larger, long-term trials are needed (Mesa et al., 2023).
Amniotic membrane injections
Evidence for amniotic membrane-derived injections for arthritis mainly focuses on knee osteoarthritis, with promising results based on mostly small, low-moderate quality studies (Huddleston et al., 2020).
Combining Treatments
A combination of several treatments is likely to be the best option for treating arthritis, whether that’s osteoarthritis, rheumatoid or other types. Lifestyle changes, physical therapy, medication and potentially regenerative therapies can all be combined to target both the disease symptoms and underlying problems within the body.
Some medications can also be combined safely and this is often done for rheumatoid arthritis when one DMARD isn’t enough. For example, methotrexate can be combined with sulfasalazine or a DMARD can be taken with a biologic.
Finding the Right Provider
You may be able to access regenerative arthritis therapies through a hospital with orthopedic or rheumatology‑focused regenerative programs as part of a clinical trial or study, as these therapies are still considered experimental.
Some private clinics provide regenerative medicine in combination with standard arthritis treatments. This is also a good option as you’ll be treated by a qualified healthcare professional .
You may also choose to use a specific regenerative medicine clinic. They vary in quality and transparency, so you’ll want to check who is providing treatment, what their qualifications are, which joints they’ve worked with previously and what their outcome data looks like.
Unrealistic claims, lack of transparency around qualifications/experience and very low/high prices may be a red flag.
Takeaway
Arthritis is a group of conditions that cause swelling and pain in one or several joints,with treatment focusing on managing pain, reducing swelling and supporting normal function.
Standard treatments involve medication, physical therapy and sometimes surgery, but regenerative injection therapies can be an effective add-on in some cases.
Regenerative therapies support the body’s natural healing abilities, helping to stimulate joint healing and repair. Current evidence suggests they’re most effective for osteoarthritis, particularly of the knee, but there’s emerging evidence that some therapies help with inflammatory types of arthritis too.
