Recovery & Aftercare: What to Expect, and What to Watch For

Read This First

Do not start, stop, pause or resume any prescribed medication on the basis of this page, or of any website.

That instruction comes first because it is the one that matters most. If you take a daily medicine — an anticoagulant, low-dose aspirin for your heart, an immunosuppressant, a diabetes drug — only the doctor who prescribed it can decide whether it should be interrupted around a procedure, and when it should be restarted. They know your history; a web page does not. If anyone has advised you to pause something, confirm the plan for restarting it with your prescriber before you travel home.

The rest of this page is about what recovery usually feels like, when to seek help, and what the evidence supports doing.

When to Seek Help

This section is deliberately near the top.

Contact the clinic or seek urgent care immediately

• Signs of a severe allergic reaction
• Fever above 38.5°C / 101°F, or any fever that persists beyond the first couple of days
• Shortness of breath
• Chest pain
• Spreading redness, swelling, warmth or discharge at a treatment site
• Calf pain or swelling, particularly after a long flight

Arrange an appointment

• Symptoms that were improving and have started to worsen
• New symptoms you cannot account for
• Any uncertainty about your medication
• Emotional distress — this is a common and under-reported part of recovery

If you cannot reach the clinic and you are worried, use local emergency services. International distance is not a reason to wait.

What Is Usually Unremarkable

These are common after a procedure and after long-haul travel, and generally settle on their own.

• Fatigue, particularly in the first week or two
• Tenderness at the treatment site
• Mild fever in the first day or two. This is worth understanding properly: transient fever is the one adverse event significantly associated with mesenchymal stromal cell therapy in the largest pooled safety analysis — odds ratio 16.82 (95% CI 5.33–53.10) — in the context of no association with organ toxicity, infection, malignancy or death⁴. It is expected and usually short-lived. A fever that is high, or that persists, is not
• Disturbed sleep and appetite
• Mood fluctuation. Travelling a long way for a treatment you have paid for and waited for is emotionally demanding, and the anticlimax afterwards is common

Activity and Rest

The general shape

Rest in the first week or two, then a graded return to normal activity, is ordinary post-procedural advice and it is

sensible here. It is worth being clear about why: **it is what you would be told after any procedure and a long

flight.** It is not a claim that resting harder makes cells work better.

Early on, keep activity light — walking rather than training, avoiding heavy lifting and high-impact loading.

Move regularly rather than sitting still for long periods, particularly in the first days after a long flight.

Then build gradually. Increase walking distance, add gentle mobility work, and reintroduce resistance training

and higher-impact activity progressively. If a particular activity reliably makes your symptoms worse, that is

information — scale back and rebuild more slowly.

Your treating clinician's guidance overrides anything here, particularly if you have had an injection into a

specific joint, or if you have a condition that affects how you should load it.

Structured rehabilitation is the part with the best evidence

If this page recommends one thing, it is this.

Progressive resistance training has the largest measured effect of any intervention in this area. In a

randomised, placebo-controlled trial in 100 frail nursing-home residents with a mean age of 87.1, ten weeks of

high-intensity progressive resistance training increased muscle strength by 113 ± 8%, against 3 ± 9% in

those who did not train³.

That trial has a second finding worth stating plainly on a page like this one: **multinutrient supplementation

without concomitant exercise did not reduce muscle weakness or physical frailty**³. Nutrition supports

training; it does not substitute for it.

For joint problems specifically, structured non-surgical care is powerful. Among patients who were **eligible for

knee replacement** and randomised to twelve weeks of supervised exercise, education, dietary advice, insoles and

pain management, 16 of 50 (32%) had gone on to surgery within two years — meaning two in three had not. The

same structured programme also outperformed written advice alone by 7.0 KOOS4 points (95% CI 0.4–13.5)⁵.

If formal physiotherapy is appropriate for your condition, it has its own evidence base independent of anything

else you have had done, and it is worth pursuing on that basis.

Medication

Every item in this section is a decision for the doctor who prescribed the medicine.

Prescribed medications. Continue everything you have been prescribed unless your own prescriber has told you

otherwise. If you were advised to pause something before treatment, confirm the restart plan with that prescriber

— do not rely on a general timeline from any source, including this page.

⚠️ Low-dose aspirin taken for cardiovascular protection is not an as-needed anti-inflammatory. It is daily

secondary prevention, and interrupting it carries its own risk, which has to be weighed against the bleeding risk of

a procedure by someone who knows your cardiac history. **If it was paused, ask the prescribing doctor when to

restart it, and do not delay that conversation.**

Over-the-counter anti-inflammatories. If you have been asked to avoid them for a period, follow the clinical

advice you were given rather than a generic interval. If you need pain relief in the meantime, ask what is

appropriate for you.

Supplements. Supplements interact with prescribed medicines — anticoagulants and diabetes drugs particularly.

Discuss anything new with your prescribing physician or a pharmacist, not with a non-clinical coordinator. There

is no evidence that any supplement improves the outcome of cell therapy.

Long flights. Immobility on long-haul flights carries a venous thrombosis risk in its own right. That is worth

raising with your clinician before you fly home, particularly if you have received an intravenous infusion, and

particularly if you have other risk factors.

General Health During Recovery

Eating well, sleeping properly, staying hydrated and moderating alcohol are good for you. They are good for you

whether or not you have had any treatment, and that is the honest basis on which to recommend them.

What this page will not tell you is that your diet determines whether the treatment works. There is no evidence

for that. Laboratory research does show that the conditions cells are grown in — oxygen levels, priming stimuli,

two- versus three-dimensional culture — change what they secrete⁶, but that is a finding about

manufacturing, in a culture flask, before the cells reach you. It says nothing about what you eat afterwards.

The distinction matters because the alternative framing has a cost. **If a page tells you that your compliance

determines your result, then a disappointing result becomes your fault** — and that is neither true nor kind.

Tracking Your Own Progress

Keeping a simple record is genuinely worthwhile, both for you and for any clinician you see later. Note pain,

function, sleep, energy and anything unusual, at a regular interval rather than continuously.

Two things are worth knowing while you do it.

Most people improve somewhat after any treatment, and much of that is contextual. In pooled randomised trials of

mesenchymal stromal cell injection, contextual and placebo response accounted for approximately **63% of the

observed treatment response at six months and 50% at twelve months**¹. That does not make your

improvement imaginary — it means a large share of it would likely have occurred with a convincing sham procedure,

which matters for deciding whether to repeat or recommend the treatment.

Symptoms fluctuate in both directions. A good week is not proof it worked; a bad week is not proof it failed.

Trends over months are informative; single days are not.

What the Evidence Says About Timing and Durability

There is no established recovery timeline for cell therapy, and this page no longer offers one. Trials measure

outcomes at fixed points — commonly six and twelve months — rather than tracking a week-by-week curve.

On what improves. A 2026 meta-analysis of 28 randomised controlled trials found significant improvement in

pain and function, and no significant improvement in structural scores on imaging. Its conclusion: these

therapies are "primarily symptom-modifying rather than structure-modifying"².

On how long it lasts. The long-term data conflict. One five-year follow-up reported maintained benefit — in

11 patients, uncontrolled⁷. A double-blind, placebo-controlled trial with 60-month follow-up

found scores drifting back toward baseline by year five⁸.

On what the cells are doing. The current understanding is that mesenchymal stromal cells act as a short-lived

source of secreted signals — growth factors, cytokines and vesicles — rather than by becoming new tissue

themselves¹⁰. They are also immune evasive rather than immune privileged: the recipient's immune

system clears them, over days rather than months⁹. Whatever effect they have is exerted in a relatively

short window. That is why descriptions of cells "engrafting" and remodelling

tissue for a year do not fit what is known about them.

Some people do not improve at all. No measurement before treatment reliably predicts who will, and that is not a

failure of your recovery behaviour.

Follow-Up

Scheduled check-ins are part of the programme — typically a call in the first fortnight, then assessments at one,

three, six and twelve months, recorded in your portal.

These are useful for tracking your own trajectory and for raising concerns. Note that **repeat treatment has not

been tested in any trial**, in people who responded or in people who did not, so any discussion about a further

course is a clinical judgement rather than an evidence-based recommendation.

Frequently Asked Questions

When will I see results?

There is no established timeline, and any specific schedule you are given is not derived from trial data. Most

trials assess outcomes at six and twelve months. Some people improve; some do not.

Should I stop my anti-inflammatories? What about my aspirin?

Ask the doctor who prescribed them. Do not act on any general timeline — including any you may have been given

verbally — without confirming it with your own prescriber. Cardioprotective aspirin in particular is daily

prevention, not an optional painkiller.

Does what I eat affect whether the treatment works?

There is no evidence that it does. Eating well is worth doing on its own merits.

Should I be resting completely?

Rest early, then rebuild gradually — the same advice as after any procedure and a long flight. Prolonged

immobility has its own risks, so keep moving gently rather than lying still.

What is the single most useful thing I can do?

If it is appropriate for your condition, structured progressive strength training. It has the largest measured

effect of anything discussed on this page³, and for joint problems, structured non-surgical care has

randomised evidence behind it⁵.

I had a mild fever. Is that normal?

Transient fever early on is the one adverse event significantly associated with this therapy⁴, and it is

usually short-lived. A high fever, or one that persists past the first days, warrants contact with the clinic.

When can I fly, drive, work, drink alcohol?

These depend on your condition, your procedure and your job, and they are questions for your treating clinician

rather than for a general schedule. Raise long-haul flights specifically, because of the thrombosis consideration.

What if it doesn't work?

Some people do not improve, and no assessment beforehand reliably predicts who. **It is not a failure of

compliance** — no evidence links rest, diet or follow-up attendance to whether cell therapy works. Your other

treatment options are unchanged, and a rehabilitation programme remains available and evidenced regardless.

Support

The programme includes a first-thirty-days contact line, scheduled follow-up calls, email support and access to a

guest community. These are business facts about the service rather than clinical findings.

For anything urgent, use the escalation guidance near the top of this page — and local emergency services if you

cannot reach the clinic.