Millions of people are affected by Joint pain. It is one of the most common reasons adults seek medical care. According to the Centers for Disease Control and Prevention (CDC), there are more than 58 million adults in the U.S. alone with doctor-diagnosed arthritis. In addition, more than 25 million people suffer from daily limitations caused by joint pain. (CDC, 2024).
Perhaps even more concerning is the fact that an estimated 15 million adults experience severe joint pain that scores seven or higher on a ten-point scale (Barbour et al., 2016).
Joint Pain Causes
Joint pain is more than just an inconvenience. It is something that limits mobility, affects sleep, reduces productivity and significantly reduces quality of life. The real problem is that despite the impact it has on people, treatments are often more focused on relieving the discomfort, rather than solving the biological problems that reside in the joints.
To gain a better understanding of why this happens, and also where joint care is headed, we need to look at the pathology and anatomy of the joints to realize how exactly healing works.
The pathology of joint pain: a slow breakdown
Joint pain is not normally sudden. It develops over time and is not often caused by a single event. It is usually the result of repetitive stress, poor movement patterns, inflammation, old injuries, or age-related tissue decline.
Small injuries begin to accumulate when the joints are overloaded, and it is these micro-injuries that cause inflammation, which is intended to promote the healing process. It’s important to note that inflammation is a good thing in the short term because it increases blood flow, delivers nutrients, and activates joint repair.
The problem occurs when the inflammation does not stop.
Inflammation that becomes chronic damages tissue instead of repairing it. This causes the cartilage to thin, the ligaments to weaken, the joint capsules to stiffen and the tendons to lose their elasticity. As time goes on, pain begins to become an everyday occurrence and movements that were once easy become limited.
It is precisely this process that explains why joint pain often starts again, even after we have rested, taken medicine or injected it. The end result? The superficial symptoms have been addressed, but the underlying tissue damage remains.
Joint anatomy: multiple tissues, one problem
Think of a joint as a living system made up of several structures that need to work together, not just bone meeting bone. Let’s explain in more detail:
- Cartilage is the cushioning in the joints that makes smooth movement possible. If it has little blood supply, it heals very slowly.
- Ligaments are used to stabilize joints, but unfortunately weaken when injured or overloaded.
- Tendons connect muscles to bones and are extremely vulnerable to overload.
- The joint capsule and synovium control joint nutrition and produce lubricating fluid.
- Bone underneath the cartilage absorbs force and changes when cartilage is lost.
People living with joint pain are most often affected when more than one of these tissues is affected. Unfortunately, treating pain without restoring tissue health is ineffective at restoring joint function.
Why most creams only mask pain
Products such as topical pain creams have become extremely popular because they provide quick relief and are easy to use. The problem is that these products only mask the pain and do nothing to heal the tissue.
These products stimulate the nerve endings in the skin to create sensations such as cooling, heating or tingling, but it is these sensations that begin to compete with the pain signals traveling to the brain. In other words, when the brain is distracted, pain is reduced.
While these products provide short-term comfort, they do not work at repairing cartilage, strengthening ligaments, or repairing tissue that has already been damaged. In fact, masking pain without proper healing can become both problematic and risky.
Pain is there to serve as a warning sign, and when the pain disappears or subsides without proper repair, people are quick to put stress on their damaged joints, further accelerating their degeneration. It’s clear: pain relief is not the same as healing.
Why damaged joint tissue stops healing
Most people believe that joint tissue is “dead,” but in reality, most joint tissue is inactive, but still very much alive.
Cells in cartilage, ligaments and tendons need biological signals to know when to:
- Reduce inflammation
- Produce collagen
- Rebuild structure
- Restore normal function
Cells enter a state of low activity when these signals are weak or missing, and healing slows or stops altogether. This is because the tissue waits for instructions that never come.
Healing happens through signals
Healing is powered by cellular communication rather than tissue replacement, and modern regenerative science has proven that bioactive messages or signals tell our cells how to behave. These signals have a significant impact on inflammation, repair activity and tissue remodeling.
Bioactive biomolecules have attracted much interest because they act as messengers rather than building blocks. They do not become tissue themselves, but instead activate the body’s own repair systems.
A well-studied source of biological signaling comes from Wharton’s Jelly-derived mesenchymal signaling environments. These systems contain extracellular vesicles (EVs) that help cells communicate. EVs do not contain DNA and do not form tissue.
Their role is signaling, and research suggests that these signals may influence inflammation control, tissue repair pathways and cellular activity. This makes them an attractive option for joint recovery.
The problem: science without regulation
The science supporting regenerative signaling is promising, but the industry has moved ahead of regulations and the US Food and Drug Administration (FDA) has clearly stated that no exosome or EV product has been approved by the FDA as a drug. This in turn has led to multiple warnings being issued about misleading regenerative medicine claims (FDA, 2019; FDA, 2020).
Due to limited supervision, products often vary widely in quality, raising concerns about:
- Poor or unclear provenance
- Inconsistent processing
- Broken down or inactive signaling molecules
- Contamination risks
- Claims that exceed the available evidence
Scientific reviews have repeatedly called for stronger regulatory frameworks to ensure the safety, consistency and transparency of EV-based products (Wang et al., 2024).
The bottom line: Patients have to sort through confusing claims, damaging their trust in legitimate science when these regulations are weak.
A safer direction: activation without hype
Many physicians and researchers are looking for safer ways to activate tissue repair without having to rely on poorly regulated biological products due to regulatory and procurement concerns.
Interestingly, nature already provides signaling systems that interact with human biology, and there are certain plant-derived bioactive biomolecules that can engage in overlapping repair pathways. These are the exact same pathways that deal with inflammatory balance, cellular energy, and tissue response.
When properly formulated and responsibly sourced, these natural signaling systems provide:
- Better safety profiles
- More consistent purchasing
- Lower regulatory risk
- Improved accessibility
The goal is not to copy the biology exactly, but to activate similar healing pathways in a safer, more controlled way.
Science is ready for it, but the industry is not yet
The science of joint regeneration is real, but lack of proper regulation, poor purchasing and exaggerated claims are reducing patient safety and public trust in an area that could really help millions of people with joint pain.
Joint pain is not just something to be silenced, it is a signal that tissue communication has failed. The future of shared care must go beyond masking symptoms and demand transparency, responsible sourcing and realistic biobased claims. Because if we focus on restoring that communication, we can go from temporary relief to real healing.
References:
- Centers for Disease Control and Prevention (CDC). Basics of Arthritis. Updated 2024.
- BarbourKE, et al. Prevalence of severe joint pain in adults with arthritis. MMWR, 2016.
- US Food and Drug Administration (FDA). Public Safety Notice for Exosome Products. 2019.
- FDA. Consumer warning about regenerative medicine products. 2020.
- Wang CK, et al. Regulatory challenges of extracellular vesicles as biologics. 2024.
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