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Joint Protection

Bleeding disorders can have a significant impact on your joints. When a bleed occurs in the joints (called hemarthrosis), it can cause lasting damage that eventually causes joint damage and arthritis—a condition called hemophilic arthropathy. Much like other forms of arthritis, hemophilic arthropathy is painful and debilitating, can lead to mobility issues, pain, and decreased quality of life. Therefore, one of the main goals of treatment is to prevent or minimize the impact of hemarthrosis.

How Do Bleeding Episodes Damage Joints?

When bleeding occurs in joints, the lining of the joint (called the synovium or synovial membrane), swells, which can damage the cartilage. Gradually, the joint damage becomes permanent. There are several large joints that are particularly susceptible to bleeds: the elbows, knees, ankles, hips, and shoulders.

Treating Bleeding Episodes in Joints

There is much you can do to help minimize the long-term damage caused by bleeding in the joints. Here are a few of the treatment that are used to address joint bleeds:

Factor Replacement Therapy

This is the mainstay of treatment for a bleeding episode. It's recommended that you administer factor as soon as possible after the onset of a bleed—preferably within minutes and, at least, within 1 to 2 hours—and that the correct dosage is used. Speak with your healthcare provider or Hemophilia Treatment Center (HTC) team as soon as possible. They can help you determine whether a more intensive treatment regimen is needed.


Rest, Ice, Compression, and Elevation.

To learn more about R.I.C.E., go to Treating Pain.

Joint Aspiration

For some severe bleeding episodes, particularly those that are extremely painful and/or not responding to factor, your healthcare provider may consider a joint aspiration. This is a procedure that uses a needle to remove blood and fluid from the joint. In certain situations, joint aspiration may help alleviate severe swelling, severe pain, hasten improvement, and avoid long-term damage.

Rehabilitation and Physical Therapy

After the bleeding episode resolves and the pain symptoms have been controlled, your healthcare provider may recommend rehabilitation or physical therapy to help protect joint function.

Pain Relief

Bleeding episodes in joints can cause pain, but a number of options are available to manage pain.

To learn more about acute pain management, go to Over-The-Counter Pain Relievers.

Arterial Embolization

This may be a treatment option for certain bleeding episodes that do not respond to factor replacement therapy in the absence of an inhibitor, low platelets, or other bleeding problem. However, this is an invasive procedure that must be undertaken with caution and is only of use when bleeding is from an artery.

Everyday Joint Health

It's important to think about how to keep your joints healthy every day—not just if you experience a bleeding episode.

Some of the best ways to keep joints healthy for people with bleeding disorders are no different from those for people without bleeding disorders: exercise, stay at a healthy weight, and eat right.