When does a sore joint need medical care?

Which changes shouldn't wait?

Call your doctor soon when the joint swells without a known cause. A fever, broken skin, or fast-growing redness can mean infection. New numbness or loss of strength also needs quick medical help.

After a fall, watch for a joint that looks out of place. Don't force it straight or keep testing it. Hold it still and get medical help right away.

Chest pain, trouble breathing, or feeling faint is an emergency. Those signs may not come from the joint at all. Your safety comes before finding the cause of the soreness.

What if the change is slower?

Arrange a regular visit when the ache keeps returning. Call sooner if it often wakes you or limits dressing, walking, or driving. You don't need to wait until daily life stops.

Before the visit, write down where the joint hurts. Add which motion starts the ache and how long it lasts. That helps your doctor tell joint trouble from soreness in nearby muscles.

While waiting, ask which movements are safe for you. Gentle motion may help, but some injuries need rest. Your doctor can match that advice to the exam.

When discussing a procedure, ask about each risk in plain words. Find out who handles problems after you leave. A polished review doesn't replace clear instructions for getting help.

Evidence sources

1. A CDC public health investigation confirmed culture-positive bacterial infections in 20 patients who received umbilical cord blood-derived products marketed as stem cell treatment between August 2017 and September 2018; whole-genome sequencing matched patient isolates to the product.

   Hartnett KP, et al. — Investigation of Bacterial Infections Among Patients Treated With Umbilical Cord Blood-Derived Products Marketed as Stem Cell Therapies. JAMA Netw Open, 2021.

2. A CDC Notes from the Field report in MMWR documented infections in US patients during 2018 after receipt of bacterially contaminated umbilical cord blood-derived products used for indications other than blood or immune reconstitution.

   Perkins KM, et al. — Notes from the Field: Infections After Receipt of Bacterially Contaminated Umbilical Cord Blood-Derived Stem Cell Products for Other Than Hematopoietic or Immunologic Reconstitution - United States, 2018. MMWR Morb Mortal Wkly Rep, 2018.

3. Three patients who received intravitreal injections of autologous adipose-derived 'stem cells' at a US clinic for macular degeneration suffered severe bilateral vision loss; pre-injection acuity ranged from 20/30 to 20/200 and one year later ranged from 20/200 to no light perception.

   Kuriyan AE, et al. — Vision Loss after Intravitreal Injection of Autologous "Stem Cells" for AMD. N Engl J Med, 2017.

4. A comprehensive review of published case reports, clinical reports and media accounts catalogued the safety incidents associated with unproven stem cell interventions and the factors driving the global growth of the 'stem cell tourism' market.

   Bauer G, et al. — Concise Review: A Comprehensive Analysis of Reported Adverse Events in Patients Receiving Unproven Stem Cell-Based Interventions. Stem Cells Transl Med, 2018.

5. A retrospective comparison of 523 bone marrow aspiration procedures against 435 open iliac crest bone graft harvests found aspiration significantly reduced complications - relevant because marrow aspiration for a joint injection is a real procedure with a real, if low, complication rate.

   Hernigou P, et al. — Morbidity of graft harvesting versus bone marrow aspiration in cell regenerative therapy. Int Orthop, 2014.

6. A phase I single-arm study of 10 patients with chronic discogenic low back pain found a single intradiscal injection of adipose-derived MSCs with hyaluronic acid produced no procedure-related or cell-related adverse events over 12 months - a safety signal in 10 people, not an efficacy result.

   Kumar H, et al. — Safety and tolerability of intradiscal implantation of combined autologous adipose-derived mesenchymal stem cells and hyaluronic acid in patients with chronic discogenic low back pain: 1-year follow-up of a phase I study. Stem Cell Res Ther, 2017.