Non-Surgical Care for Joint and Extremity Pain

Q: Can regenerative treatment help if I am bone-on-bone?

It depends. Severe, bone-on-bone joints have limited cartilage to work with, so results are less predictable and we may be honest that surgery is the better path. That said, some patients still get meaningful relief, and a consultation with imaging helps us give you a realistic answer rather than a guess.

Q: Am I too old for this?

Age by itself is not a disqualifier. What matters more is your overall health and how much healthy tissue remains in the joint. We have treated a wide range of ages and will tell you honestly whether it is a reasonable option for you.

Q: How long does relief last?

It varies from person to person and by joint. Some patients feel better for many months to a couple of years, and some choose periodic maintenance treatments. We set honest expectations at your visit.

Q: Which joints do you treat?

Knees, hips, shoulders, elbows, wrists and hands, ankles and feet, and the SI joint, among others. If your problem is a fit for what we do, we will say so, and if it is not, we will tell you that too.

Q: Do I need imaging before my visit?

Existing imaging is helpful but not required. We can review what you have and order or perform additional imaging, including in-office ultrasound, when it will help your plan.

Joint pain in a knee, hip, shoulder, or hand does not always mean surgery is your only path. At Interventional Orthopedics of Washington in Bellevue, WA, Dr. Otoño Silva treats joint and extremity pain with precise, image-guided regenerative injections that support the cartilage, tendons, and ligaments around the joint. The goal is to help you move better and delay or avoid joint replacement when that is a reasonable option for you.

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Full-body musculoskeletal anatomy highlighting major joints, with detailed joint, connective-tissue and ultrasound insets.

Key Takeaways

We treat joint pain throughout the body, from the shoulder and knee to the hand and foot.
Treatments are non-surgical, outpatient, and placed with ultrasound or fluoroscopy guidance.
Many patients come to us to explore options before joint replacement.
Age alone does not rule you out, though remaining cartilage and overall health matter.
Regenerative care may help, but results vary and it is not right for everyone.

Joints and Areas We Treat

01Knee pain, osteoarthritis, and meniscus injuries

02Hip pain, osteoarthritis, and SI joint pain

03Shoulder pain, rotator cuff injuries, and labral (SLAP) issues

04Elbow pain and tendon problems such as tennis and golfer's elbow

05Wrist and hand pain, including thumb arthritis and trigger finger

06Ankle and foot pain, including osteoarthritis and forefoot problems

An Option Before Joint Replacement

Joint replacement can be life-changing for the right patient, but it is a major, permanent step. For many people with mild to moderate joint wear, it makes sense to first try a treatment that supports the joint rather than removes it. Regenerative injections use your body's own healing signals to support cartilage, tendons, and ligaments.

We are honest about what this can and cannot do. We cannot regrow a joint that is fully worn out, but earlier and healthier joints tend to respond better, which is why waiting until end-stage is usually not the best plan.

How Our Approach Works

We treat the joint as a working unit, rather than a single spot on a scan. That means we look at the ligaments, tendons, muscles, and joint capsule around the joint, not only the cartilage. Every plan starts with a precise diagnosis, uses image guidance for accurate placement, and considers whole-body factors like metabolic and hormonal health that affect healing.

Comparison: Your Options at a Glance

This table is general education. What fits you depends on your diagnosis and goals, which we review at a consultation.

Option	What it does	Best suited for
Cortisone injection	Reduces inflammation short-term; may weaken tissue with repeated use	Short-term flare relief
Joint replacement surgery	Removes and replaces the joint; permanent	Severe, end-stage joint damage
Regenerative injections (PRP, prolotherapy, BMC)	Supports the joint's own tissues and healing signals	Mild to moderate joint problems, patients exploring options before surgery

Want to Know if You Can Treat Your Joint Pain Without Surgery?

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