Stem Cell Therapy for Joint Pain: An Evidence-Based Review

Key Takeaways

Stem cell therapy for joints is still experimental—not FDA-approved for arthritis
Early research shows promise, but high-quality evidence is limited
Costs range from $5,000-$25,000+ and are not covered by insurance
Many clinics make claims that exceed the current evidence
Results vary widely, and there are no guarantees
Established treatments should typically be tried first

Stem cell therapy generates enormous hope for people with joint pain. The idea of regenerating damaged cartilage and reversing arthritis is tremendously appealing. But what does the science actually show?

This guide examines the current state of evidence, helping you separate legitimate research from marketing hype.

What Is Stem Cell Therapy?

The Concept

Stem cells are undifferentiated cells capable of becoming various specialized cell types. The theory behind stem cell therapy for joints is that injecting these cells might:

Regenerate damaged cartilage
Reduce inflammation
Repair injured tissues
Slow or reverse arthritis progression

Types of Cells Used

Bone marrow-derived stem cells (BMSCs):

Harvested from the patient’s hip bone
Processed to concentrate stem cells
Reinjected into the affected joint

Adipose-derived stem cells (ADSCs):

Harvested from the patient’s fat tissue (mini-liposuction)
Processed and concentrated
Reinjected into the joint

Umbilical cord/placental products:

Obtained from donor tissue (after birth)
May contain growth factors and other cells
FDA has expressed concerns about many of these products

PRP (Platelet-Rich Plasma):

Not stem cells, but often discussed alongside them
Concentrated platelets from patient’s own blood
Contains growth factors

What Does the Evidence Show?

The Challenge of Research

Studying stem cell therapy is challenging because:

No standardized protocols exist
Cell preparations vary widely between clinics
Patient populations differ between studies
Placebo effects are significant for pain outcomes
Most studies are small and lack control groups

Current Research Summary

Positive findings:

Some studies show pain improvement compared to baseline
A subset of patients report significant benefit
Early-stage arthritis may respond better than severe disease
Treatments appear generally safe in the short term

Limitations:

Few high-quality randomized controlled trials
Many studies lack proper control groups
Placebo injections also often improve symptoms
Evidence of actual cartilage regeneration is weak
Long-term outcomes are largely unknown

Specific Findings

For knee osteoarthritis:

Several studies show modest pain improvement
Benefits may not exceed other injections (like hyaluronic acid)
Cartilage regeneration on MRI is inconsistent
Best results in early to moderate arthritis

For other joints:

Less research available
Hip and shoulder studies are limited
Evidence is insufficient to draw conclusions

What the FDA Says

Current Regulatory Status

The FDA has not approved any stem cell therapy for treating arthritis or joint pain.

Key points:

Autologous cells (your own) minimally manipulated may be legal
Heavily processed or cultured cells require FDA approval
Many clinics operate in regulatory gray areas
The FDA has taken action against clinics making unsupported claims

Warning Signs

The FDA warns against clinics that:

Promise to cure arthritis or other diseases
Claim treatments are “FDA-approved” for arthritis
Use unproven products from other countries
Charge exorbitant fees for experimental treatments

Costs and Insurance

Typical Costs

Range: $5,000-$25,000+ per treatment
Average: $8,000-$15,000 for a single joint
Factors affecting cost: Cell source, processing, location, clinic

Insurance Coverage

Medicare: Does not cover stem cell therapy for joints
Private insurance: Generally does not cover (considered experimental)
Out-of-pocket: Most patients pay entirely themselves

Cost Considerations

Before paying thousands for stem cell therapy:

Have you tried established treatments?
What is the clinic’s success rate?
What happens if it doesn’t work?
Could this money be better spent on proven treatments?

Choosing a Clinic (If You Decide to Proceed)

Questions to Ask

What type of cells are used?
- Autologous (your own) vs. donor
- Source (bone marrow, fat, other)
What is your success rate?
- How do they measure success?
- Do they have outcome data?
What are the risks?
- Every procedure has risks
- Be wary of clinics that claim no risks
Who performs the procedure?
- Physician credentials
- Training and experience
What follow-up is provided?
- Post-procedure monitoring
- What if it doesn’t work?

Red Flags

Be cautious of clinics that:

Guarantee results
Pressure you to decide immediately
Offer discounts for same-day decisions
Claim to treat many unrelated conditions with the same therapy
Have minimal physician involvement
Won’t provide outcome data

Risks and Complications

Known Risks

From the injection:

Infection
Bleeding
Pain at injection site
Joint inflammation

From cell processing:

Contamination
Cell viability issues
Inconsistent preparations

Potential concerns:

Unknown long-term effects
Theoretical risk of tumor formation (though not documented in reputable studies)
Wasted money if ineffective

Safety Profile

When performed at reputable facilities using autologous cells:

Short-term safety appears acceptable
Serious complications are rare
Long-term safety data is limited

Current Recommendations

Medical Society Positions

American Academy of Orthopaedic Surgeons (AAOS):

Considers stem cell therapy for OA to be investigational
Recommends against routine use outside of clinical trials
Encourages participation in well-designed research

American College of Rheumatology:

Notes insufficient evidence for routine recommendation
Acknowledges ongoing research interest

Practical Guidance

Consider stem cell therapy cautiously if:

You’ve exhausted conventional treatments
You have early to moderate arthritis (not bone-on-bone)
You understand the experimental nature
You can afford it without financial hardship
You choose a reputable provider

Think twice if:

You haven’t tried established treatments
A clinic promises miraculous results
You’d go into debt for the treatment
You have severe, end-stage arthritis
The clinic uses unproven products

Alternative Established Treatments

Before considering stem cell therapy, ensure you’ve optimized:

Exercise and physical therapy: Still the foundation of arthritis treatment
Weight management: Significant impact on knee and hip OA
Medications: NSAIDs, acetaminophen, topical treatments
Injections: Corticosteroids, hyaluronic acid
Assistive devices: Braces, supports, mobility aids
Surgery: When appropriate, joint replacement is highly effective

The Future

Ongoing Research

Stem cell therapy for joints remains an active research area:

Better cell preparation protocols are being developed
Clinical trials are ongoing
Understanding of mechanisms is improving
Combination approaches are being explored

Realistic Expectations

Even if stem cell therapy proves effective:

It’s unlikely to be a “cure” for arthritis
Benefits may be modest rather than dramatic
It will probably work better for some patients than others
Cost and access will remain issues

Frequently Asked Questions

Can stem cells regrow cartilage?

Evidence of actual cartilage regeneration is limited and inconsistent. While some studies show improvements on MRI, it’s unclear whether meaningful cartilage regrowth occurs. Benefits may come from anti-inflammatory effects rather than regeneration.

How many treatments are needed?

Protocols vary widely. Some clinics recommend single treatments; others suggest series. There’s no evidence-based standard. Be wary of clinics that prescribe expensive treatment series without clear rationale.

How long do results last?

Unknown. Most studies have short follow-up periods (1-2 years). Long-term durability is not established. Some patients report benefits lasting years; others experience minimal or temporary improvement.

Is stem cell therapy better than joint replacement?

For end-stage arthritis, joint replacement is a proven, highly effective treatment. Stem cell therapy has not been shown to be an alternative to joint replacement for severe arthritis. The treatments address different patient populations.

Should I try PRP or stem cells?

PRP has more research behind it and is less expensive. For patients interested in regenerative approaches, PRP might be a reasonable first step. However, evidence for PRP is also mixed.

Looking for established treatment options? Explore our guides on hyaluronic acid injections or read about when knee replacement is necessary.

Last medically reviewed: February 2025

Medical Disclaimer: This article is for informational purposes only and is not a substitute for professional medical advice. Stem cell therapy for joints is experimental. Discuss any treatment decisions with your healthcare provider.