Vice Chairman and Head of Department, Orthopaedics, BLK-Max Super Speciality Hospital, New Delhi, India
Part 3 of 9 in Joint Pain in the Younger Population: Causes, Prevention and Modern Treatments
The Nutrition Gap Behind Joint Pain: Vitamin D, Calcium, Magnesium and Protein
May 3, 2026
According to Dr. Mahajan, vitamin D is deficient in more than 90% of the population worldwide, largely because most food lacks it and modern lifestyles do not provide enough sun exposure to trigger cholecalciferol synthesis in the skin. He recommends supplementing through dietary sources such as fish, or through vitamin D syrups, capsules or sachets, rather than waiting on sunlight alone. Calcium is needed alongside it for absorption (a minimum daily intake equivalent to 200 to 400 IU) to maintain bone mass and bone stock.
Magnesium prevents the muscle cramps that are a very common complaint in younger patients when calcium and magnesium levels run low, often presenting as night cramps or cramps during exercise. Protein intake at 15 to 20% of total daily caloric intake is sufficient to maintain muscle mass and bone stock and prevent daily body and joint pain, but Dr. Mahajan is clear that more is not automatically better: standard guidance is 0.8 to 1.2 g/kg for sedentary adults and 1.2 to 1.5 g/kg for those in athletic training, with intake above 2 g/kg risking renal damage without medical guidance.
This guide is based on a live Jivo Masterclass — Dr. Rakesh Mahajan taught doctors across Africa on May 3, 2026.
FROM THE LIVE Q&A
Dr. William Gaduga, Zimbabwe
How is PRP prepared?
Dr. Rakesh Mahajan
Around 10 to 14 ml of blood is drawn from the patient into a kit-supplied vial containing heparin, then centrifuged to separate the platelet-rich plasma from the rest of the blood. This typically yields about 5 ml of PRP solution, which is injected as multiple pricks around the tendon or ligament rather than as a single injection, to achieve the best results.
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Frequently Asked Questions
How does PRP promote healing at the cellular level, and what growth factors such as PDGF and TGF-beta are involved?▼
Platelets contain multiple growth factors, including PDGF and TGF-beta, that promote healing through two mechanisms: increasing vascularisation of the target tissue and stimulating cellular regeneration. One group of factors increases local blood supply, while another increases cellular activity — together they drive ligament, tendon and articular cartilage repair.
What nutraceuticals do you recommend for joint pain treatment?▼
For articular cartilage involvement, collagen type 2, often combined with Boswellia, promotes cartilage cell multiplication and needs to be taken long-term. For partial tears of ligaments and tendons — which are rich in collagen type 1 and 3 — separate collagen 1 and 3 formulations are more appropriate, since they support healing of that specific tissue.
Fitness influencers push weight training for long-term bone density, but there's a real risk of injury from bad form or pushing beyond one's capacity. How do you balance that?▼
Go in a graded way and know your own limits — the simple principle is Young's modulus: push a muscle or tendon beyond its elastic limit and it will fail. Many young patients doing heavy weights on a gym instructor's encouragement end up damaging their elbows and shoulders. Proper training for gym instructors would prevent a lot of this. That said, if instruction is proper and progression is graded, strength training in younger years does directly help maintain bone strength into old age.
Fitness influencers often push up to 2 grams of protein per kilogram of body weight, while doctors generally recommend 0.8 to 1.5 g/kg. What is your view on overuse?▼
Overuse will definitely damage the kidneys, and can even cause kidney shock with permanent damage. There is also a real risk that commercial protein products are contaminated with anabolic steroids. Gym users should consult a nutritionist or dietitian to be guided on protein source and dose relative to body weight and activity level, rather than following generic online advice.
Is there an age limit for using PRP injections for joint pain?▼
No, there is no age limit — it can be given from young patients up to the 60s or 70s without a problem. The only practical consideration is the blood volume required: around 14 to 15 ml for PRP and 10 ml for GFC.
How widespread is vitamin D deficiency, and why does it happen even with regular daylight exposure?▼
Vitamin D is deficient in more than 90% of the population worldwide, largely because most food lacks it and modern lifestyles do not provide enough sun exposure to trigger cholecalciferol synthesis in the skin.
Why is calcium intake important alongside vitamin D supplementation?▼
Calcium is needed for vitamin D absorption, and a minimum daily intake equivalent to 200 to 400 IU helps maintain bone mass and bone stock.
What role does magnesium play in joint and muscle health?▼
Magnesium helps prevent the muscle cramps that are a very common complaint in younger patients when calcium and magnesium levels run low, often showing up as night cramps or cramps during exercise.
How much protein should someone eat daily to support joint and bone health?▼
Protein at 15 to 20% of total daily caloric intake is sufficient to maintain muscle mass and bone stock, with standard guidance of 0.8 to 1.2 g/kg for sedentary adults and 1.2 to 1.5 g/kg for those in athletic training.
Is more protein always better for building muscle and bone?▼
No. Intake above 2 g/kg of body weight risks renal damage without proper medical guidance.
In This Series: Joint Pain in the Younger Population: Causes, Prevention and Modern Treatments
- 1.Joint Pain in the Younger Population
- 2.Why Joint Pain Is Rising in Younger Patients: Overuse, Sedentary Life and Autoimmune Disease
- 3.The Nutrition Gap Behind Joint Pain: Vitamin D, Calcium, Magnesium and Protein
- 4.Physiotherapy for Joint Pain: Ultrasonic Therapy, Diathermy and TENS Explained
- 5.NSAIDs, Nutraceuticals and DMARDs: The Medical Treatment Ladder for Joint Pain
- 6.Steroid Injections for Joint Pain: When to Give Them and When to Wait
- 7.PRP vs GFC: Regenerative Therapy for Chronic Tendon and Ligament Injuries
- 8.The Weight Training Debate: What Sports Medicine Says About Building Muscle Safely
- 9.Bilateral Shoulder Pain in a Young Patient: A Case-Based Approach to Diagnosis