Joint Pain

Direct answers — no jargon.

If your question isn’t here, ask us at your consultation.

• Which joints do you treat?
  Most peripheral joints — shoulder, hip, knee, elbow, wrist and hand, ankle and foot — as well as the spinal facet and sacroiliac joints. Where a joint needs surgery, we say so and refer to an orthopedic colleague we trust.
• Is my joint pain actually coming from my back?
  Sometimes. Referred pain from the lumbar spine and sacroiliac joint is one of the most common causes of "hip pain" we see, and cervical problems can present as shoulder pain. Pattern, exam, and a diagnostic injection separate them.
• Do I need imaging before my visit?
  Bring what you have. X-ray is usually the first useful step and MRI is best reserved for a specific question. Imaging findings are common in painless joints, so we read them alongside the exam rather than instead of it.
• Is PRP right for my joint?
  PRP has the strongest evidence in tendinopathy — tennis elbow, patellar tendon, partial rotator cuff tears — and in mild-to-moderate knee osteoarthritis. We will tell you honestly when the evidence does not support it, and it is generally not covered by insurance.
• How often can I have a steroid injection?
  We limit corticosteroid to a small number of injections per region per year. Repeated steroid into the same tendon can degrade tissue over time, which is one reason we prefer biologics for tendon problems when they are appropriate.
• Can you help if I have already had surgery?
  Yes. Persistent pain after joint surgery is common and often treatable — sometimes nerve-mediated, sometimes from a structure that was never the problem. We work alongside your surgeon.
• What if more than one joint hurts?
  Widespread joint pain raises different questions, including inflammatory and systemic causes that belong with rheumatology. We will say so and coordinate rather than treating joint by joint.