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After surviving hemophilia, hepatitis C, and HIV, Joseph Burke considers himself a walking miracle. But the medical odyssey that saved his life has also ravaged his joints, and now each day begins in pain, whether from his ankles, knees, shoulders, or all of the above.

“I just white-knuckle it, grit my teeth, and here I am, you know?” said Burke, 41.

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Burke suffers from a side effect of hemophilia called hemophilic arthropathy, a buildup of blood in the joints that leads to pain, inflammation, and tissue damage. There are no approved therapies, and the most commonly prescribed pain treatments are opioids. Burke’s prescription is a single daily tablet of Percocet.

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