Non-Surgical Procedure Halves Knee Pain Over 12-Month Trial

From sciencealert.com

Osteoarthritis in the knees can be very painful and very hard to treat. It often occurs when the protective cartilage around the bones wears away, and in the most severe cases, it may require surgery and a knee replacement to provide relief for patients.

As the most common form of arthritis, it brings discomfort to hundreds of millions of people worldwide.

                                                                                                    (Quantic69/iStock/Getty Images Plus)

Now, in a bid to tackle that health crisis, researchers led by a team from the Charité - Universitätsmedizin Berlin in Germany have developed a new treatment approach that's minimally invasive, safe, and impressively effective.

It's based on a procedure called genicular artery embolization (GAE), which targets the abnormal blood vessels and additional pain-sensing nerves associated with osteoarthritis. Close off those blood vessels, the thinking goes, and the nerves (and pain) quieten down.

The treatment was designed to restrict blood flow in specific arteries (shown with arrows). (Fleckenstein et al., Radiology, 2026)

GAE itself isn't new — it's been used for several years — but the material used to block the blood vessels in this observational study is still in its early days.

Previous blocking agents were antibiotics, which risked further inflammation and raised concerns about the spread of antibiotic resistance, but here the team used microscopic gel beads that gradually dissolve in the bloodstream.

"GAE is a whole new treatment regimen that targets abnormal hypervascularity around the joint and, in turn, modulates the pathological neurovascular environment," says radiologist Florian Nima Fleckenstein, from Charité - Universitätsmedizin Berlin.

"By reducing both inflammation and pain, GAE with resorbable microspheres may be the first procedure that alters the course of the disease, slowing its progression."

These "resorbable microspheres" are injected into the knee in a procedure that doesn't need lengthy preparation or an extended hospital stay.

They then get to work blocking blood flow specifically through the additional blood vessels and nerves that have appeared with osteoarthritis — not interfering with blood flow to the knee in general.

Measurements, including quality of life (QOL), improved over time. (Fleckenstein et al., Radiology, 2026)

The blockage (embolization) isn't permanent, as the microscopic gelatine balls disappear within hours, but they help to break the cycle of inflammation and joint pain.

"By embolizing the pathological vessels, we're able to normalize the vessel structure – and, in turn, the neuronal structure of the knee," says Fleckenstein.

"In our cohort, we saw a significant drop in pain and a significant increase in function, including sports and recreation and daily activity. Most importantly, their quality of life significantly increased."

The numbers show how effective the treatment was.

The study followed 194 people receiving the treatment for osteoarthritis-related knee pain, with a mean age of 69, and who hadn't previously responded to treatment with physiotherapy, anti-inflammatory drugs, or intra-articular injections.

At the start of the 12-month study period, the average baseline pain intensity was 7 out of 10; by the end, it was 3 out of 10. Scores for daily activity, involvement in sports and recreation, quality of life, and osteoarthritis-related symptoms all improved significantly. No notable side effects were reported either.

"We believe these results carry real weight because they come from real-world data. With this broad, inclusive study design, our participants are exactly the patients that physicians encounter every day in their practices," says Fleckenstein.

"For the right patient, it can mean lasting relief from a single, minimally invasive procedure – a meaningful new option between injections and joint replacement."

While the study didn't involve a control group for comparison, and all the participants came from one hospital, the fact that the treatment worked across the board is hugely encouraging – and means it's an option that's definitely worth pursuing.

Future research can look at larger groups of people for longer periods of time (past the 12-month mark), while a fully randomized clinical trial would prove its effectiveness compared to an alternative treatment or a placebo.

There's still work to do then, but together with other promising treatments, there's fresh hope for treating this debilitating disease.

"For many patients with knee osteoarthritis, there is a real treatment gap today," says Fleckenstein. "Conservative measures such as intra-articular injections no longer provide sufficient relief, but joint replacement is not an option for medical or personal reasons."

The research has been published in Radiology.

https://www.sciencealert.com/a-new-non-surgical-procedure-provides-lasting-relief-for-knee-pain 

Joint pain isn’t always arthritis: 7 warning signs women shouldn’t ignore

From healthshots.com

By Dr Sharmila Tulpule 

Joint pain is a warning, not a diagnosis. Checking early signs of join pain will help you identify the cause and get the right treatment 

Joint pain is one of those things that many people think, “Oh, that’s just part of getting older” or “That’s just part of working too hard” or “I may have arthritis”. But for women, when they are in the middle of juggling their careers, keeping their homes running, and taking care of their families, it’s easy for them to sweep their constant discomforts or joint pain issues under the rug. Osteoarthritis is one of the leading causes of joint pain in women, but there are several other types of medical conditions, such as autoimmune disorders, hormonal changes, infections, and nutritional deficiencies, among others, that cause this pain.

The sooner these warning signs are recognized, the better the chance of avoiding any long-term problems from these underlying medical conditions, Dr Sharmila Tulpule, orthopaedic surgeon and regenerative medicine specialist, tells Health Shots.

Persistent joint pain, swelling, or morning stiffness may indicate more than arthritis and should be evaluated by a doctor. Image courtesy: Adobe Stock

Warning signs that women in joint pain should not ignore

1. Stiffness of the joints in the morning for longer than an hour with pain

It is typically normal to experience some stiffness after being inactive, but if, after sleeping, you find that your joints are stiff beyond an hour each day, this could be a sign of an inflammatory disease (such as rheumatoid arthritis or RA) rather than simply a degenerative joint type of arthritis. Early identification of these issues is critically important because if diagnosed quickly, the treatment can prevent severely damaged joints and enable the patient to retain function in those same joints.

2. Swelling, redness, and warmth in the area of the joint

Noticeable swelling, redness, or warmth in a joint can indicate that there is an inflammatory process taking place, or an infection or autoimmunity. They should not be self-treated with just over-the-counter pain relievers, especially if they have occurred recently or have worsened over time.

3. The pain is caused by multiple joints being affected

Arthritis from age is mostly found in the larger bones of the skeleton that bear our body weight—for example, hips and knees. However, when several joints are involved at the same time, especially smaller joints—hands, wrists, ankles, and feet—this might indicate a systemic disease like lupus, rheumatoid arthritis, or thyroid issues.

4. Feeling tired continuously along with pain in the joints

If you are always tired no matter how well rested you are, it should raise a red flag. Fatigue, when there is joint pain present, could be from an autoimmune disease, chronic inflammation, and/or a vitamin deficiency. Many women mistakenly identify fatigue as a stress-related reason. However, if you have had fatigue for an extended period of time, you should consult your doctor.

                                                 Persistent tiredness can be linked to many health problems. Image courtesy: Adobe Stock

5. Joint pain following fever or infection

Following a viral or other type of infection, a feverish experience will often leave behind rheumatic joint pain that should be considered very seriously. Some infections can create acute inflammatory reactions in your joints, and if not adequately treated, will potentially lead to chronic inflammatory conditions of your joints.

6. Unexplained weight loss or loss of appetite

If you experience any unexplained weight loss or a lack of appetite, there may also be a systemic disease process underlying your arthritic joint pain. It should therefore require immediate evaluation to determine if there are serious underlying illnesses.

7. Difficulty performing everyday activities

Difficulty with daily activities due to joint pain is a sign of how poorly the patient’s condition impacts their quality of life as well as their ability to live independently. Obtaining timely medical counsel at this stage should allow for determining the cause and then starting an appropriate treatment course.

In many cases, women place the wellness of their family’s health ahead of their own. Nevertheless, chronic or atypical joint discomfort should not go unrecognized or be treated as a natural consequence of advancing years. Timely evaluation by a qualified physician will assist in evaluating the cause of the problem and potential risk for future development, as well as increase mobility and create an environment that enhances overall quality of life.

https://www.healthshots.com/preventive-care/self-care/joint-pain-isnt-always-arthritis-7-warning-signs-women-shouldnt-ignore/

Triggers for Rheumatoid Arthritis Flares

From everydayhealth.com

People with rheumatoid arthritis (RA) often cycle between times when their symptoms are relatively well controlled and when pain, stiffness, swelling, and fatigue suddenly worsen. These episodes, known as flares, can last for days or weeks and may interfere with daily life.

While flares can seemingly come out of nowhere, certain factors may increase the likelihood of symptoms worsening. Identifying your personal triggers may help you avoid them, or at least reduce their frequency, severity, or duration.

Common Triggers to Look Out For

The exact cause of an RA flare isn't always clear. Over time, many people with RA notice that certain circumstances tend to precede a flare. Although triggers differ from one person to the next, experts have identified many common culprits.

Environmental Triggers

“One of the most common questions I get from patients with rheumatoid arthritis is whether certain environmental factors can trigger their symptoms,” says Priyanka Dongare, MD, a fellow in Stony Brook Medicine’s Division of Rheumatology in New York. “While environmental triggers don’t cause RA flares in every patient, many people notice patterns.” These triggers include:

• Weather Changes “Cold weather and sudden weather changes are probably the most frequently reported triggers,” says Dr. Dongare. But the weather may not have as much of an impact as patients may think. A meta-analysis found only that weather’s impact on RA symptoms appears to be minimal.
• Air Pollution Higher levels of air pollution have been linked to an increased risk of RA flares. One study found that exposure to pollutants including PM2.5, PM10, nitrogen dioxide, and ozone was associated with greater disease activity and higher levels of inflammation.
• Occupational Exposures Dust, fumes, and chemical irritants may aggravate symptoms in some people with RA. But most research has examined these exposures as risk factors for developing RA rather than triggers for flares.
• Cigarette Smoke and Secondhand Smoke Tobacco smoke causes whole-body inflammation, one of the main triggers for arthritis. “Multiple studies have demonstrated that smoking not only increases the risk of developing RA, particularly seropositive RA, but can also worsen disease activity and reduce response to treatment,” says Dr. Dongare. 

Physiological Triggers

Changes in the body, some of which you can manage through lifestyle modifications, can affect inflammation and increase your risk of a flare.

• Sleep Deprivation “Poor sleep is one of the most common triggers I see in clinical practice,” says Dr. Dongare. Research has shown that inadequate or disrupted sleep can increase inflammatory cytokines such as IL-6 and TNF-alpha, which are key drivers of RA inflammation. “Patients often say that after several nights of poor sleep, they experience increased pain, stiffness, and fatigue.”
• Physical Overexertion There’s a fine line between exercise and overdoing it. While regular movement is recommended for people with RA, pushing your body too hard can temporarily increase joint pain, stiffness, and fatigue. Repetitive motions, heavy lifting, or unusually strenuous activity may aggravate already sensitive joints, making flare symptoms feel worse.
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• Hormonal Shifts Hormones help regulate immune function. Sharp drops in oestrogen, such as after childbirth, around menstruation, and during menopause, may increase disease activity and trigger flares.

• Inconsistent Medication Skipping doses, delaying refills, or stopping medication because you think you feel fine can increase the risk of a flare. Disease-modifying antirheumatic drugs (DMARDs) and biologics help keep the immune system's inflammatory activity under control, and can worsen symptoms if not taken as prescribed.
• Added Sugars and Ultra-Processed Foods Diets that include these foods may promote inflammation and worsen RA symptoms over time. These foods have been linked to immune dysregulation and increased inflammatory signalling, which may contribute to greater disease activity.

Emotional Triggers

The state of your mental health can also affect your RA symptoms. 

• Stress “While stress doesn't directly cause RA, it can amplify inflammation and make symptoms feel significantly worse,” says Dongare. One long-term study found that those with greater perceived stress had worse pain, greater fatigue, and lower physical function.
• Grief Research suggests that intense grief is associated with higher levels of inflammation, and experts note that the emotional strain of losing a loved one may increase disease activity and flares.
• Anxiety A systematic review found that about 1 in 5 people with RA experience clinically significant anxiety symptoms. Research has linked anxiety to greater pain, fatigue, and disease burden.
• Depression Depression and RA have a bidirectional relationship. One review found depression is associated with higher disease activity and worse treatment outcomes in inflammatory arthritis, suggesting that depressive symptoms can make flares more difficult to manage.

Track Your Triggers

Because RA affects everyone differently, tracking your triggers and symptoms can help you identify patterns that may otherwise go unnoticed. Dongare suggests keeping a symptom diary or using a smartphone app to track these variables:

• Pain levels
• Stiffness
• Fatigue
• Sleep quality
• Stress
• Diet
• Exercise
• Environmental concerns

“Tracking can also help rheumatologists distinguish between inflammatory disease activity and other contributors to pain such as osteoarthritis, fibromyalgia, sleep disorders, or mood disorders,” says Dongare.

Tracking is a tool, not a diagnosis. She cautions against assuming that every flare has a clear cause, since RA symptoms can naturally fluctuate. If you consistently notice the same pattern, though, you should discuss it with your rheumatologist.

How to Avoid Your Trigger(s)

While you can't prevent every RA flare, addressing common triggers may help reduce their frequency and severity. The key, says Dongare, is to focus on factors you can control.

• Prioritize sleep. Poor sleep can worsen inflammation, pain, and fatigue, so maintaining good sleep habits may help keep symptoms in check. 
• Manage stress. "Stress management should be part of every patient’s treatment plan,” says Dongare. Meditation, counselling, exercise, and strong social support systems can help reduce the physical toll of chronic stress.
• Stay physically active. “Many patients worry that exercise will worsen their arthritis, but the evidence consistently shows the opposite,” she says.
• Follow a healthy eating pattern. Dongare says maintaining a healthy weight and following a Mediterranean-style diet may support overall health and help reduce systemic inflammation.
• Quit smoking. It’s not good for any part of your body — joints or otherwise.
• Take medications as prescribed. Skipping doses or stopping treatment can increase the risk of disease activity and flares.

“Avoiding triggers can help manage symptoms, but controlling the underlying inflammation with appropriate medical treatment remains the foundation of RA care,” she says. Keep up with regular rheumatology appointments and talk with your healthcare provider before making changes to your treatment plan.

Questions to Ask Your Doctor

If you notice possible RA flare triggers, share them with your healthcare professional. They can interpret symptoms, adjust treatment if needed, and keep your disease under control.

• What symptoms or patterns should I track to better identify my RA flares?
• Could my current medications or dosing schedule be adjusted to better prevent flares?
• Are there environmental or lifestyle triggers I should be most cautious about?
• How can I safely modify my diet, activity level, or daily routine without making my symptoms worse?
• Should I adjust or pre-plan treatment around known triggers like stress, illness, or travel?
• When should I contact you if I think I’m having a flare?

The Takeaway

• RA flares are periods of worsening pain, stiffness, swelling, and fatigue. While they can seem unpredictable, research suggests they’re often linked to environmental, physical, and emotional triggers that vary by person.
• Common triggers include weather changes, air pollution, smoking, workplace irritants, poor sleep, overexertion, hormonal shifts, missed medications, diet, and stress-related factors like anxiety or grief.
• Because triggers differ widely, tracking symptoms alongside daily habits can help identify personal patterns. Working with a healthcare provider can help confirm flare patterns and guide more effective treatment.

 https://www.everydayhealth.com/rheumatic-conditions/triggers-for-rheumatoid-arthritis-flares/