Knees, hips and shoulders become sore in different ways

Knee soreness often grows with standing and stairs

Knee arthritis can cause stiffness after sitting and aching during a long walk. Getting up from a chair may become harder, as can stairs or standing. Some knees swell after a busy day, while a sudden twist can cause sharp pain.

The exam checks motion, swelling, strength and the way you walk. An X-ray may show how much arthritis is present. Those results can suggest why you hurt, but they can’t predict how sore the knee feels each day.

Hip soreness may be felt in the groin, side or back

Soreness from the hip joint is often felt in the groin or front of the thigh. An ache along the outside may come from a tendon or muscle beside the hip. Back trouble can also travel toward the hip, so the exam checks each area.

Tell the clinician whether walking, lying on one side or putting on shoes is hard. Mention back soreness, numbness or weakness as well. An X-ray may help when arthritis is suspected, but the hands-on exam is still needed.

Shoulder soreness may begin in a tendon or the joint

A shoulder tendon can become sore with reaching, lifting or sleeping on that side. Arthritis may cause a deeper ache and less movement. New weakness after an injury needs timely care because a tendon may be torn.

The exam checks where the pain starts and which motion feels weak. An X-ray may show arthritis, while a torn tendon can require another test. A knee study can’t tell you whether treatment will help a sore shoulder.

Sources

1. The 2025 Cochrane review of stem cell injections for knee osteoarthritis pooled 25 randomised trials (1,341 participants) and found that, compared with placebo injection, stem cell injection MAY slightly improve pain (1.2 points better on a 0-10 scale, 7 studies, 445 participants) and function (14.2 points better on a 0-100 scale, 7 studies, 432 participants) up to six months - both rated LOW-certainty evidence, downgraded for indirectness (cell source, preparation and dose varied across studies) and suspected publication bias, since up to three larger RCTs were conducted and withdrawn before reporting results. Radiographic progression was not assessed in any included study.

   Whittle SL, et al. — Stem cell injections for osteoarthritis of the knee.. Cochrane Database of Systematic Reviews, 2025. DOI: 10.1002/14651858.CD013342.pub2.

2. The ESSKA-ORBIT European consensus on blood-derived orthobiologics graded 28 question-statement sets; only 9 of 28 had high-level scientific support. Three statements reached grade A: that there is enough preclinical and clinical evidence to support PRP use in knee OA; that clinical evidence shows effectiveness in MILD TO MODERATE knee OA (KL grade 3 or lower); and that PRP provides a longer effect than the short-term effect of corticosteroid with a safer profile. The panel regarded PRP as a valid and possible first-line injectable option for KL grades 1-3.

   Laver L, et al. — The use of injectable orthobiologics for knee osteoarthritis: A European ESSKA-ORBIT consensus. Part 1-Blood-derived products (platelet-rich plasma).. Knee Surgery, Sports Traumatology, Arthroscopy, 2024. DOI: 10.1002/ksa.12077.

3. The companion ESSKA-ORBIT consensus on cell-based therapy (77 experts, 22 countries, 27 statements) found only 5 of 27 statements reached recommendation level A or B; 22 were rated C or D. It concluded that cell-based therapy shows clinical benefit in pain and function up to 12 months for KL grades 1-3 with some benefit in selected KL 4, but that because of limited high-quality studies and NO clear superiority over other injectables it should be considered a SECOND-LINE option, after other non-operative treatment fails.

   de Girolamo L, et al. — The use of injectable orthobiologics for knee osteoarthritis: A formal ESSKA-ORBIT consensus. Part 2-Cell-based therapy.. Knee Surgery, Sports Traumatology, Arthroscopy, 2025. DOI: 10.1002/ksa.70001.

4. A meta-analysis of 18 Level I trials (811 PRP vs 797 HA patients, mean follow-up 11.1 months) found mean WOMAC total improvement of 44.7% with PRP versus 12.6% with HA (P<.01). Six of 11 VAS-based studies and 3 of 6 IKDC-based studies favoured PRP significantly. In the subanalysis, leukocyte-POOR PRP was associated with significantly better subjective IKDC scores than leukocyte-rich PRP.

   Belk JW, et al. — Platelet-Rich Plasma Versus Hyaluronic Acid for Knee Osteoarthritis: A Systematic Review and Meta-analysis of Randomized Controlled Trials.. American Journal of Sports Medicine, 2021. DOI: 10.1177/0363546520909397.

5. A network meta-analysis of 11 RCTs (1,353 patients) with HIP osteoarthritis found that at 2-4 and 6 months NO intervention - corticosteroid, hyaluronic acid or PRP - significantly outperformed intra-articular saline placebo for either pain or function, while all interventions including placebo produced improvement exceeding the minimal clinically important difference from baseline. Evidence from the knee does not transfer to the hip.

   Gazendam A, et al. — Intra-articular saline injection is as effective as corticosteroids, platelet-rich plasma and hyaluronic acid for hip osteoarthritis pain: a systematic review and network meta-analysis of randomised controlled trials.. British Journal of Sports Medicine, 2021. DOI: 10.1136/bjsports-2020-102179.

6. FDA states verbatim of stem cell products, stromal vascular fraction (adipose-derived cells), umbilical cord blood, Wharton's jelly, amniotic fluid and exosome products: 'None of these products have been approved for the treatment of any orthopedic condition, such as osteoarthritis, tendonitis, disc disease, tennis elbow, back pain, hip pain, knee pain, neck pain, or shoulder pain.' The only FDA-approved stem cell products in the United States are blood-forming (hematopoietic progenitor) cells derived from umbilical cord blood, approved only for disorders of blood production, and there are currently NO FDA-approved exosome products.

   U.S. Food and Drug Administration — Consumer Alert on Regenerative Medicine Products Including Stem Cells and Exosomes. FDA (Center for Biologics Evaluation and Research), 2020.

7. RESTORE, the largest and most rigorously blinded placebo-controlled PRP trial in knee OA (n=288, participant-, injector- and assessor-blinded), gave three weekly injections of a commercial leukocyte-poor PRP or saline. At 12 months the change in knee pain was -2.1 vs -1.8 points (difference -0.4; 95% CI -0.9 to 0.2; P=.17) and the change in medial tibial cartilage volume was -1.4% vs -1.2% (difference -0.2%; P=.81). Twenty-nine of 31 prespecified secondary outcomes showed no between-group difference. The authors concluded the findings do not support the use of PRP for knee OA.

   Bennell KL, et al. — Effect of Intra-articular Platelet-Rich Plasma vs Placebo Injection on Pain and Medial Tibial Cartilage Volume in Patients With Knee Osteoarthritis: The RESTORE Randomized Clinical Trial.. JAMA, 2021. DOI: 10.1001/jama.2021.19415.

8. A meta-analysis of 34 RCTs (1,403 PRP knees vs 1,426 controls) found WOMAC favoured PRP over placebo at 12 months and over hyaluronic acid at 6 and 12 months, and favoured PRP over steroids on VAS pain, KOOS pain, daily function and quality of life at 6 months. Crucially, the authors state that the superiority of PRP DID NOT REACH the minimal clinically important difference for any outcome and the quality of evidence was low.

   Filardo G, et al. — PRP Injections for the Treatment of Knee Osteoarthritis: A Meta-Analysis of Randomized Controlled Trials.. Cartilage, 2021. DOI: 10.1177/1947603520931170.