Conditions & Diagnoses

According to the American Association of Neurological Surgeons, 75-80% of Americans will experience back pain in their lifetime. Of those, 50 percent will have more than one episode within a year. In 90 percent of all cases, the pain gets better without surgery. Back disorders are nearly always accompanied by time lost from work and can be a disruption in normal routines. Chronic pain can lead to loss of mobility, decrease in daily activities, depression and anxiety, reliance on powerful painkillers, and reduced quality of life.

Acute back pain is sudden onset pain that lasts less than three months. Treatments for acute back pain usually involve a combination of rest, ice, and over-the-counter medications such as ibuprofen and acetaminophen. At US Pain Relief, PLLC, we DO NOT treat acute back pain.

Chronic back pain is back pain that lasts for more than three months, which we DO treat at US Pain Relief, PLLC. Chronic low back pain is the most common type of chronic back pain. It is usually caused by a combination of factors such as arthritis, degenerative disc disease, muscle spasms or strains, and/or bulging, herniated or ruptured discs, and may result from a problem with one or more parts of the lower back, such as: the bony structures that make up the spine called vertebral bodies or vertebrae, ligaments and muscles, nerves, intervertebral discs and can also be due to a problem with nearby organs such as the kidneys.

COMMON SYMPTOMS

Back pain can vary significantly from person to person. Some people experience mild discomfort, while others experience debilitating pain. These symptoms can get worse over time. This is why it's important to seek treatment to prevent a more severe back issue from developing. The most common back pain symptoms of include:

• Dull, aching sensation or stiffness in the lower back
• Inability to stand up straight without pain
• Pain that worsens with movement or wakes you up at night
• Pain that radiates down the legs or to the feet
• Decreased range of motion and reduced ability to flex the back
• Pain that gets better with heat application, but worsened by activity
• Pain that is not relieved by over-the-counter medications or rest
• Pain that worsens with bending, lifting, standing, or walking
• Pain that improves with resting in a reclined position

Some symptoms that can indicate a more serious medical problem are:

• Loss or bowel/bladder,
• Pain associated with a throbbing sensation in the abdomen
• Back pain after trauma (injury), such as a fall or a blow to the back
• Unexplained weight loss or fever

DIAGNOSING BACK PAIN

A physical exam is typically all that’s needed to diagnose back pain. During the physical exam, your healthcare provider may test your:

• Ability to stand and walk
• Spine’s range of motion
• Reflexes
• Leg strength
• Ability to detect sensations in your legs

Your healthcare provider might order other tests, including: 

• Blood and urine tests to check for underlying conditions

• X-rays of the spine to show alignment of your bones and check for breaks
• MRI or CT scan to assess your discs, muscles, ligaments, nerves, and blood vessels
• Bone scan to look for abnormalities in the bone tissue
• Electromyography (EMG) to test nerve signals

RISK FACTORS

You may have an increased risk for back pain if you:

• Slouch or sit improperly which can strain the back muscles and spine.
• Work in a sedentary (inactive) environment or don’t exercise
• Engage in high impact activity without stretching or warming up first
• Are older or have been diagnosed with a specific condition like arthritis
• Are overweight

MANAGING BACK PAIN

Over-the-counter pain medications are often sufficient enough for most people experiencing back pain. In more severe cases however, stronger and extensive treatments may be necessary under the supervision of your healthcare provider. Our team will work with you on a treatment plan to help relieve your symptoms with an emphasis on functionality using one or more of the following:

Medications

The majority of back pain episodes are treated with nonsteroidal anti-inflammatory drugs (NSAIDS) like ibuprofen or naproxen, but may be avoided for those patients with a history of gastrointestinal bleeding or kidney problems. Analgesics, such as acetaminophen (Tylenol), are another category of pain relievers are also an option for back pain, though they don’t have anti-inflammatory properties. It is important to never exceed the recommended dose of over-the-counter medications without a doctor’s recommendation, as even these medications may have severe side effects if taken incorrectly.

Muscle relaxants

While not a first-line treatment at US Pain Relief, PLLC, muscle relaxants such as Baclofen and Tizanidine can also be used for lower back pain, especially if muscle spasms, muscle stiffness or muscle strains occur alongside pain. These medications act on the central nervous system to reduce pain but often have side effects such as drowsiness, dizziness and potential for misuse.

Opioids

Opioids, also not a first-line treatment at US Pain Relief, PLLC, are stronger pain medications that can be prescribed for more severe pain. These medications, such as a combination of acetaminophen and hydrocodone, act on the brain cells and body to reduce pain. Opioids should be used with caution, however, due to a risk of addiction.

Topical Rubs and Ointments

Topical products may be highly effective at reducing back pain. Many of these contain ingredients like ibuprofen and lidocaine and come in the form of:

• Gels
• Lotions or creams
• Patches
• Sprays

Alternative therapies that may relieve back pain include:

• Acupuncture
• Massage
• Chiropractic adjustments
• Cognitive behavioral therapy (CBT)
• Relaxation techniques

Steroid and non-steroidal injections

Your healthcare provider might also recommend nonsteroid injections such as TPI or SI injections, and in more severe cases may refer you out for interventional therapies which consist of specialized injections with the use of a fluoroscope.

Physical Therapy

Physical therapists can teach patients exercises to relieve and eventually eliminate chronic back pain. PT treatment often involves exercises to improve posture, emphasize proper lifting techniques, strengthening core muscles and stretching muscles to improve flexibility to be completed both in the PT office as well as at home. US Pain Relief partners with several physical therapy offices in the area that accept our patient’s insurance.

Here at US Pain Relief, PLLC, we specialize in providing comprehensive care for chronic back pain. We also understand the importance of finding the root cause of the back pain. Our team will work with you on a treatment plan to help relieve your symptoms with an emphasis on functionality.

Fibromyalgia is a chronic disorder characterized by widespread musculoskeletal pain, fatigue, and sleep disturbances. It's often accompanied by other symptoms like cognitive dysfunction ("fibro fog"), mood issues, and increased sensitivity to pain and stimuli. While the exact cause is unknown, it's believed to involve a combination of genetic predisposition, environmental factors, and altered pain processing in the nervous system. 

Anyone can get fibromyalgia, but more women get it than men. It can affect people of any age, even children, but it usually starts in middle age, and the chance of having it increases as you get older. It occurs in people of all racial and ethnic backgrounds.

If you have other diseases, especially rheumatic diseases, mood disorders, or conditions that cause pain, you may be more likely to have fibromyalgia. These diseases include:

• Rheumatoid arthritis.
• Lupus
• Ankylosing spondylitis.
• Osteoarthritis.
• Depression or anxiety.
• Chronic back pain.
• Irritable bowel syndrome.

The cause of fibromyalgia is not known, but studies show that people with the disorder have an increased sensitivity to pain, so they feel pain when others do not. Brain imaging studies and other research have uncovered evidence of altered signaling in neural pathways that transmit and receive pain in people with fibromyalgia. These changes may also contribute to the fatigue, sleep troubles, and "fibro fog" issues that many people with the disorder experience.

COMMON SYMPTOMS

• Widespread Pain: Pain is felt on both sides of the body, above and below the waist, and in the axial skeleton (neck, back, chest, or stomach area). 
• Migraines or other headaches
• Numbness or tingling in extremities
• Fatigue/Exhaustion: A significant and often debilitating symptom, impacting daily activities. 
• Depression and/or anxiety
• Sleep Disturbances: Difficulty falling asleep, staying asleep, or experiencing restful sleep. 
• Cognitive Dysfunction: Problems with memory, concentration, and thinking clearly, sometimes referred to as "fibro fog". 
• Increased Sensitivity: Heightened sensitivity to pain, touch, light, noise, and odors. 

DIAGNOSING FIBROMYALGIA

Fibromyalgia is diagnosed based primarily on having pain all over the body, along with other symptoms. Currently, there are no specific laboratory or imaging tests for fibromyalgia. The main symptoms—pain and fatigue—are similar to many other conditions, so doctors typically try to rule out other causes for your symptoms.

Extensive Medical History: Your medical provider will likely ask about the location, severity, and duration of pain, and whether you have experienced severe fatigue or cognitive problems, such as confusion or memory issues. They may also ask if you have other conditions, because some people with fibromyalgia have other diseases at the same time.

Diagnostic Criteria: Widespread Pain Index (WPI) and Symptom Severity (SS) Scale tools are used to assess pain distribution and symptom severity to determine if the criteria for fibromyalgia are met. 

Physical Examination: Healthcare providers check for tender points and assess other symptoms, as well as examine your joints to see if you may have another condition

Your medical provider may order laboratory or imaging tests to help rule out other diseases and conditions.

MANAGING FIBROMYALGIA

There is no cure for fibromyalgia, so treatment focuses on relieving the symptoms. Your treatment plan will likely include a combination of psychological and behavioral therapy, medications, and self-management approaches, such as physical exercise and other movement therapies

Medications: A number of medicines can help relieve the pain and improve sleep. Your doctor may prescribe more than one type of medication at the same time.

• Antidepressants: Drugs that treat depression may also work for fibromyalgia even if you are not depressed. Doctors may prescribe one of several classes of antidepressants.
• Anti-seizure medicines: These medicines can lessen pain and improve sleep. They work by interfering with the transmission of pain signals to the brain.
• Analgesics (pain-relieving medicines): These may be used for people who need additional pain relief. Anti-inflammatory pain medications are usually not effective because fibromyalgia does not cause tissue inflammation, but they may help with other painful conditions that a person with fibromyalgia may have. 
• Opioids: Fibromyalgia is a complex condition with a pain mechanism that doesn't seem to involve opioid analgesic pathways. Clinical trials have not shown opioids to be effective in treating fibromyalgia pain. Long-term opioid use in fibromyalgia is associated with negative outcomes, including increased risk of adverse events and dependence, and can worsen pain sensitivity (hyperalgesia) and increase the risk of experiencing pain even with normal stimuli (allodynia) While there is no evidence that pure opioids are effective in fibromyalgia, there is some evidence that opioids with additional actions on the norepinephrine-related pain modulatory pathways, such as tramadol, can be clinically useful in some patients.

Physical/Occupational Therapy: Physical therapist can provide an exercise plan to improve strength, mobility, and stamina, while the occupational therapist can provide you with techniques to reduce discomfort at work and home.

Cognitive Behavioral Therapies: Due to the psychological effect of fibromyalgia, your healthcare provider may also refer you to a counselor to help you better understand the condition and work with you on developing techniques that give you more control over your body and pain.

REFERENCES

Littlejohn GO, Guymer EK, Ngian GS. Is there a role for opioids in the treatment of fibromyalgia? Pain Manag. 2016 May;6(4):347-55. doi: 10.2217/pmt-2016-0012. Epub 2016 Jun 14. PMID: 27296831.

Fibromyalgia Symptoms, Causes, & Risk Factors|National Institute of Arthritis and Musculoskeletal and Skin Diseases.

Hip pain is a common symptom that can be described as aching, sharp, or burning. It can range in intensity from mild to severe. Hip pain can severely limit daily activities and diminish your overall quality of life. The hip is a large "ball-and-socket" joint. The "socket" is a bone in your pelvis called the acetabulum and the "ball" is the head of your femur.

The hip joint is held in place by ligaments and covered in cartilage, a smooth, white tissue. Fluid-filled sacs called bursae provide cushioning to prevent friction between muscles, tendons, and bones in the hip joint. The hip also contains a network of muscles that enable movement and support. Problems with any of these structures can contribute to hip pain.

Finding relief starts with identifying the root cause of hip pain and developing personalized treatment plans to relieve inflammation and restore mobility. There are common patterns of hip pain. The location of your hip pain—anterior, lateral, or posterior—and how the pain feels can help your healthcare provider pinpoint the problem.

When the problem is within the hip joint, the pain tends to be on the inside of the hip. Anterior hip pain affects the inside of your hip and groin area.³

• Osteoarthritis or degenerative changes of the hip occurs when the cartilage in the hip joint slowly wears away over time.
• Inflammatory arthritis may affect the hip, resulting in dull, aching pain. This type of hip pain often will ease with activity.
• Stress fractures of the hip can develop due to recurrent physical pressure.
• Bursitis is an irritation or inflammation of the bursa (small, fluid-filled sacs that serve as a cushion between joints, muscles, and tendons).
• Hip flexor strain refers to a stretch or tear of a muscle, its nearby tendon, or both. 

When the pain is on the side of the hip,

• Trochanteric bursitiscauses sharp lateral hip pain that often spreads down into the thigh and knee. The pain is usually worse at night when sleeping on the affected hip, and over time, the pain may evolve into a deep aching pain that spreads over a larger area of the hip.
• Snapping hip syndrome causes a snapping or popping sensation, possibly with lateral hip pain when walking or getting up from a chair. This condition is most common in people who engage in sports or activities that involve frequently bending at the hip and is also is known as "dancer's hip."

When the pain is on the outside of the hip closer to your buttocks, the problem tends to be with muscles, ligaments, tendons, and/or nerves that surround the hip joint.

• Hamstring muscle strains are small tears in the hamstring that are usually caused by a quick twist or pull to the muscle, causing buttock pain and/or pain in the back of the hip.
• Sacroiliac joint problems can include arthritis of the joint, infection of the joint, and injury to the joint ligaments, may cause posterior hip pain that may spread out from the hip and down the back of the leg, with sharp or burning pain often worse with standing and walking.
• Piriformis syndrome occurs when the sciatic nerve becomes irritated or compressed by the piriformis muscle. The burning or aching pain of this syndrome usually begins in the posterior hip and buttock region and moves down the back of the thigh.

DIAGNOSING HIP PAIN

A medical history and physical exam by a healthcare provider are essential for a proper diagnosis. Your healthcare provider will likely order imaging as well as questions about your pain that may include:

• Describe your hip pain – burning, shooting, stabbing, numbness or stinging?
• What particular movements cause pain including prolonged walking or standing?
• What brings relief? What exacerbates the pain?

Your US Pain Relief, PLLC provider will likely move your hip around to evaluate its range of motion, look at the way you walk (your gait), and check your overall posture and ability to bear weight. They may also perform more specific tests, such as the FABER, straight leg, leg roll and other tests.

MANAGING HIP PAIN

The treatment of hip pain depends on the diagnosis and treatment plan which may include self-care, medication, physical therapy and when necessary, surgery.

Your healthcare provider may recommend a number of self-care strategies, such as:

• Limiting or avoiding activities that make your hip pain worse, like climbing stairs
• Using an aid, like a cane or walker, to improve independence and mobility
• R.I.C.E. protocol: If you experience hip pain while performing a sport or other activity, follow the steps of Rest, Ice, Compression, and Elevation
• For those engaged in sports that place repetitive stress on the hip, discussing exercises with a physician to strengthen and support the hip area is important.
• Incorporating stretching can also improve flexibility and help prevent pain related to muscles, ligaments, and soft tissues

Depending on your situation, our providers will identify the best path for your healthcare and quality of life, including:

• Oral or topical over the counter (OTC) medications or supplements
• Physical therapy
• Injections
• Prescription medications when deemed medically appropriate
• Surgery when deemed medically appropriate and necessary

Our goal at US Pain Relief, PLLC, is to provide hip pain solutions starting with the most conservative treatment pathways. Various treatment options are available to help manage and alleviate hip pain effectively - you’ll learn what works best in managing your hip pain with an emphasis on improving/maintaining functionality.

When you’re dealing with joint pain, everyday tasks such as getting in and out of the shower, getting dressed, climbing stairs or getting a restful night’s sleep can feel like a struggle. A joint is where two or more bones meet, and they allow the bones of your skeleton to move. Joints include: shoulders, hips, elbows, knees, hands and feet.

Joint pain refers to discomfort, aches, and soreness in any of the body’s joints. Joint pain is a common complaint. Sometimes, joint pain is the result of an illness or injury, however, it can also be due to other conditions or factors.

COMMON CAUSES

Joint pain can be caused by:

• Inflammatory forms of arthritis such as rheumatoid arthritis and Still's disease
• Lyme disease
• Bursitis, or inflammation of the cushioning pads around joints
• Lupus
• Gout
• Certain infectious diseases, such as mumps, influenza, and hepatitis
• Chronic pain from inflammation or cartilage damage
• Degenerative joint conditions
• Tendinitis, or inflammation of the tendon
• An infection of the bone or joint
• Overuse of a joint
• Cancer
• Fibromyalgia
• Osteoporosis
• Sarcoidosis

COMMON SYMPTOMS

• Swelling: Inflammation around the joint area
• Stiffness: Difficulty moving the joint, especially after periods of inactivity
• Trouble bending or straightening the joint
• Numbness: A tingling sensation or loss of feeling in the joint area
• Loss of motion: Reduced ability to move the joint through its full range
• Discomfort: General soreness or pain in the affected joint

DIAGNOSING JOINT PAIN

A medical history and physical exam by a healthcare provider are essential for a proper diagnosis. Your healthcare provider will likely order imaging as well as questions about your pain that may include:

• Describe your hip pain – burning, shooting, stabbing, numbness or stinging?
• What particular movements cause pain including prolonged walking or standing?
• Diagnostic imaging starting with an X-ray of your affected joint may be necessary
• If your doctor suspects there’s another cause, they may order a blood test to screen for certain autoimmune disorders.
• They may also request a sedimentation rate test to measure the level of inflammation in the body or a complete blood count.

MANAGING JOINT PAIN

From sports injuries and arthritic flair ups, to complex regional pain syndrome and degenerative conditions, the common causes of joint pain are as unique as the patients who walk through our doors – and so are the treatments.

Joint pain can range from mild to severe. Acute pain lasts only a few weeks, while chronic joint pain can last months or longer. Even short-term pain and swelling in the joints can have negative effects on your quality of life. Whatever the cause of joint pain, you can usually manage it with medication, physical therapy, or alternative treatments. Treatment options include:

Physical Therapy: A physical therapist can help you strengthen the muscles around the joint, stabilize the joint, and improve your range of motion. The therapist will teach you strength and flexibility exercises to do at home. 

Joint pain supplements: Glucosamine and chondroitin are components of the healthy cartilage, which normally cushions the bones and protects joints. Some research shows that glucosamine and chondroitin supplements can improve pain from knee, hip, and hand arthritis. These supplements come in capsule, tablet, powder, or liquid form. 

Joint pain medicine: For moderate-to-severe joint pain with swelling, an over-the-counter or prescription nonsteroidal anti-inflammatory drug (NSAID) such as aspirin, celecoxib (Celebrex), ibuprofen (Advil, Motrin), or naproxen (Aleve) can offer relief. NSAIDs can cause side effects, possibly increasing your risk for stomach ulcers and heart problems.

Joint pain relief cream: Other medicines come as creams or gels that you rub onto the skin over painful joints. These include:

• This substance from chili peppers blocks chemicals that transmit pain signals, creating a feeling of warmth on the skin. Side effects of capsaicin cream include burning or stinging in the area where you apply it.
• Topical NSAIDs. These medicines work in the same way as NSAID pills, but they’re less likely to cause side effects such as stomach upset and heart problems.
• Products like Asper creme and Bengay contain methyl salicylate, a pain-relieving ingredient.
• Creams, gels, sprays, and patches containing the anesthetic lidocaine numb the painful area.
• Products such as Icy Hot and Biofreeze distract you from the pain by making your skin feel cold or warm.

Joint pain injections: If you don't find joint pain relief from oral or topical medications, your doctor may suggest injections such as:

• Corticosteroids. The doctor can inject a steroid medication, sometimes combined with a local anesthetic, directly into the joint once every 3 to 4 months. A steroid injection can ease pain for 1-3 months, but getting too many of these shots could further damage cartilage, ligaments, and tendons in the joint.
• Hyaluronic acid. This substance replaces the natural fluid that lubricates your joints. Most people get one injection every 3-5 weeks. Hyaluronic acid injections ease pain and stiffness with fewer side effects than corticosteroids. This treatment works best for osteoarthritis.
• Platelet-rich plasma (PRP) therapy. PRP is a substance your doctor makes by condensing plasma and proteins from your blood. These substances reduce the inflammation that causes joint pain and stiffness. They may also boost healing in the damaged joint. PRP might help with arthritis pain and stiffness for short periods, but doctors still don’t know its long-term effects. Plus, this treatment is very expensive and insurance doesn’t usually cover the cost.

Joint pain isn’t just about discomfort—it can limit your independence, lower your energy, and chip away at your mental health. From aching knees and swollen joints to sharp shoulder pain and stiff neck pain. No matter the symptoms, severity, or common causes, our team is committed to crafting a solution that fits your life, goals, and daily routine. Our team will work with you on a treatment plan with various treatment options available to help manage and alleviate joint pain effectively - you’ll learn what works best in managing your joint pain with an emphasis on improving/maintaining functionality.

The knee is one of the most complex joints in your body. It can flex, extend, and twist from side to side. Your knees make it possible for you to walk, run, jump, and bend. Because of its complex range of motion and the weight that’s often distributed through the joint, the knee is vulnerable to injury.

COMMON CAUSES

Pain above your knee can be caused by:

• Quadricep or hamstring tendonitis: Tendonitis happens when the tendons that attach muscles to your bones (quadriceps and hamstrings) become inflamed.
• Arthritis: Knee arthritis happens when the cartilage supporting your knee joint wears out. Although the actual arthritis is at the joint, the pain often radiates above the joint.
• Bursitis: Knee bursitis is the inflammation of sacs of fluid (bursae) located between your knee muscles, bones, and tendons.

The kneecap, or patella, is a bone that covers your knee joint. Pain in this area is most commonly caused due to the following:

• Patellofemoral syndrome: Patellofemoral syndrome, aka “runner’s knee,” is the excessive use of the knee joint that can happen if you abruptly start putting strain on your knee, for example, through a new workout routine.
• Chondromalacia patellae: Chondromalacia is the deterioration of the cartilage that covers your kneecap.
• Patellar tracking disorder: Also known as patellar maltracking, this condition occurs when your kneecap isn’t properly aligned.
• Patellar instability: Also known as patellar subluxation, this is a partial dislocation of your kneecap.
• Hoffa’s fat pad impingement: This conditionTrusted Source affects a layer of fatty soft tissue just under your kneecap.
• Patella stress fracture: This is a hairline break in the patella, which remains in one piece.
• Patellofemoral osteoarthritis: This type of arthritis affects the underside of the patella and the groove in the femur in which the patella sits.

Inner knee pain is typically caused by cartilage deterioration due to injuries. Common conditions related to inner knee pain are:

• Medial collateral ligament (MCL) injury: The MCL runs along the outside of your inner knee to stabilize the joint. An MCL sprain or tear happens if it becomes overstretched.
• Meniscus injury: The meniscus is cartilage that provides a cushion between bones in a joint. A meniscus tear happens if your knee is rotated or put under excessive pressure.
• Pes anserine bursitis: This is an inflammation of the bursa located between the shinbone and three tendons of the hamstring at the inside of the knee.
• Plica syndrome: The plica is a fold in the membrane surrounding your knee joint. Its injury and inflammation can cause plica syndrome. You may notice a snapping in your knee.
• Knee contusion: A knee contusion is a bruise that results from a direct blow to your knee.
• Osteochondritis dissecans (OCD): OCD happens when bone dies due to avascular necrosis and leads to bone collapse and cartilage damage. It typically affects the medial femoral condyle — the round part at the end of the femur on the inside of your knee.

Pain on the outer side of the knee (lateral pain). Many causes of lateral knee pain are similar to those of inner knee pain:

• meniscus tear
• knee contusion
• arthritis

Other causes include:

• Iliotibial band syndrome (ITBS): The iliotibial band is a strip of connective tissue that connects the outer hip to the shinbone. ITBS can happen if you put strain on your iliotibial band by repetitively bending and straightening it. You may notice a snapping in your knee.
• Lateral collateral ligament (LCL) injury: The LCL is located in the knee joint and can become strained, sprained, or torn.
• Lateral tibial plateau fracture: A tibial plateau fracture happens when you break or crack the top of the shinbone at the knee.

Pain below the knee can be caused by:

• Patellar tendonitis: Also known as “jumper’s knee,” this condition is caused by injury to the tendon that connects your kneecap to your shinbone.
• Osgood-Schlatter disease: This condition usually happens during growth spurts in children. It causes inflammation in the area where the tendon from the kneecap attaches to the shinbone.
• Sinding-Larsen-Johansson syndrome: Common in children, this condition is caused by inflammation due to excessive use of the patellar tendon.

Pain behind the knee can be caused by some of the conditions discussed below:

• Patellar tendinitis
• Hamstring tendinitis
• Meniscus injury
• Chondromalacia
• Arthritis

Other conditions include:

• Baker’s cyst: A Baker’s cyst is a fluid-filled sac that occurs when there’s an excess of fluid between the joints that builds up in your knee, usually due to osteoarthritis.
• Gastrocnemius tendonitis: This condition causes inflammation or degeneration of the tendon of the calf muscle.
• Cruciate ligament injuries: Anterior and posterior cruciate ligament tears happen due to a direct hit to your knee, usually while playing contact sports.

COMMON SYMPTOMS

Knee pain is a common problem that can be caused by a wide variety of factors. When you experience knee pain it may be sharp and sudden, or it may be a dull ache that gradually worsens over time. It can also vary in intensity, from mild to severe. There are also a number of different knee pain symptoms, which can include:

• Redness: If the knee is red and warm to the touch, this could be a sign of inflammation
• Swelling: This is often one of the first signs of knee joint pain and is usually caused by fluid buildup around the knee joint
• Stiffness: Joint stiffness is common after periods of inactivity, such as after a long car ride or flight. However, if the stiffness persists or gets worse over time, it could be a sign of arthritis or another condition.
• Weakness: If the knee feels weak or unstable, this could be a sign of instability or muscle weakness.
• Popping or clicking: If the knee makes sounds like popping or clicking, this could be due to cartilage damage or other issues.

DIAGNOSING KNEE PAIN

To diagnose your knee pain, a medical professional will perform a physical exam and may order diagnostic imaging. During your physical examination your provider may:

• Inspect your knee for swelling, pain, tenderness, warmth and visible bruising
• Check to see how far you can move your lower leg in different directions
• Push on or pull the joint to evaluate the integrity of the structures in your knee

MANAGING KNEE PAIN

Knee pain can make it difficult to perform even the most basic activities and can lead to a sedentary lifestyle. Our goal is to help our patients find relief from their knee injuries so they can get back to living their lives. We offer a variety of knee treatments to relieve pain, including:

• Physical therapy: A customized physical therapy program can help to strengthen the muscles around the knee and improve the range of motion to see how far you can move your lower leg in different directions
• Joint injections: Steroid injections can help to reduce inflammation and pain in the knee joint.
• Oral or topical over the counter (OTC) medications: Many of these contain ingredients like ibuprofen and lidocaine
• Prescription nonsteroidal anti-inflammatory drugs (NSAIDS) which have anti-inflammatory properties

• Surgery when deemed medically appropriate and necessary
• Acupuncture: Acupuncture is a proven treatment for chronic pain, and can be very effective for knee pain.
• Chiropractic care: Chiropractic adjustments can help to relieve pressure on the nerves and joints, providing relief from knee pain.

Our goal at US Pain Relief, PLLC, is to provide knee pain solutions starting with the most conservative treatment pathways. Our team will work with you on a treatment plan helping you increase your strength, flexibility, and range of motion is crucial for keeping your knee stable. Various treatment options are available to help manage and alleviate hip pain effectively - you’ll learn what works best in managing your hip pain with an emphasis on improving/maintaining functionality.

Myofascial pain syndrome is a musculoskeletal condition characterized by regional pain within the muscle, fascia, or surrounding soft tissue. This condition often presents with localized or referred pain, typically associated with hyperirritable trigger points within taut bands of skeletal muscle. Chronic Myofascial pain syndrome persists for 6 months or longer and having a worse prognosis.

Diagnosis is primarily clinical, based on the presence of trigger points, specific pain referral patterns, and local twitch responses. A trigger point, also known as a myofascial trigger point, is a localized area of tight, tender muscle fibers that can cause pain, both locally and in other parts of the body (referred pain). A trigger point is a taut band of skeletal muscle inside a muscle group that sometimes feel like little marbles or knots just under your skin. They can feel tender and cause pain at the trigger point location or elsewhere in the body.

Common risk factors of myofascial pain syndrome include:

• Traumatic factors, such as muscle injury
• Ergonomic factors, such as overuse activities and poor posture
• Structural factors, such as spondylosis, scoliosis, and osteoarthritis
• Systemic factors, such as hypothyroidism, vitamin D deficiency, and iron deficiency

KEY CHARACTERISTICS OF MYOFASCIAL TRIGGER POINTS

• Location: Trigger points can occur in various muscles throughout the body, with common sites including the neck, shoulders, back, and hips. 
• Pain: Trigger points can cause localized pain when pressed (palpated) or during certain movements. They can also cause referred pain, meaning pain felt in a different area from the trigger point. 
• Taut Bands: Trigger points are often found within a taut band of muscle fibers, which is a noticeable area of muscle stiffness. 
• Referred Pain: Trigger points can cause pain in areas distant from the actual trigger point location. 
• Causes: Trigger points can develop due to various factors including muscle overuse, injury, poor posture, stress, and repetitive movements. 
• Symptoms: Beyond pain, trigger points can also lead to reduced range of motion, muscle weakness, and stiffness. 

DIAGNOSING MYOFASICAL PAIN SYNDROME

No one really knows why some people are more susceptible to trigger point-related pain. It's also unclear what causes trigger point pain in general. One theory is that trigger points become so tense that they limit blood flow to muscle tissue. This prevents oxygen and nutrients from reaching the muscle. Because the muscle needs them to heal, a cycle is created in which decreased circulation causes pain, which causes more decreased circulation.

A physical examination by a healthcare professional, involving palpation of the muscle to identify tender spots and taut bands, is typically used for diagnosis. 

Trigger points are categorized by where in the body they cause pain. There are two types.

Passive trigger points hurt at their exact location. If you have a painful muscle knot in your hamstring and someone presses on it, the pain will be felt right where the pressure is on the knot.

Active trigger points cause pain in that location as well as another part of the body. If someone presses on an active trigger point in your shoulder, you may feel pain in your shoulder along with symptoms in your chest or arm.

MANAGING MYOFASCIAL PAIN SYNDROME

A healthcare provider may recommend medication to alleviate pain. Most often they'll suggest painkillers such as nonsteroidal anti-inflammatory drugs, which include over-the-counter pain relievers like ibuprofen or aspirin.

Other medications used to treat muscle pain include

• Muscle relaxants
• Antiseizure medications (ASMs)
• Antidepressants

Therapies like physical therapy, trigger point injections, and dry needling can be effective in managing myofascial pain syndrome.

Trigger point injections might be helpful for you if you’re unable to improve your pain with other treatments, such as medication, massage, or heat therapy. US Pain Relief often recommend trigger point injections to allow your muscles to relax so that physical therapy is much less painful.

Your US Pain Relief provider will want to rule out other causes of pain before suggesting trigger point injections, such as:

• Pinched nerves (radiculopathy)
• Structural causes of pain
• Muscle strain
• Spinal problems that can cause back pain, such as spinal stenosis, herniated discs, or degenerative arthritis

At US Pain Relief, PLLC, we understand the importance of finding the root cause of your pain. Our team will work with you on a treatment plan starting with the most conservative treatment pathways, and by working together get you back to your everyday life.

REFERENCES:

Desai, M. J., Saini, V., & Saini, S. (2013). Myofascial pain syndrome: A treatment review. Pain and Therapy, 2(1), 21–36. https://doi.org/10.1007/s40122-013-0006-y

Dua A, Chang KV. Myofascial Pain Syndrome. [Updated 2025 Apr 13]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK499882/

Neck pain, also known as cervicalgia, is a common ailment that can range from a minor ache to a debilitating condition. The neck consists of a combination of support structures that include vertebrae, cervical discs, ligaments, and muscles. The top seven bones in the spinal column form your neck, and these are called the cervical vertebrae. The bones are linked together by facet joints. These are small joints between your vertebrae that, together with your neck muscles and ligaments both help provide support and move your head in any direction, and because the neck supports the weight of the head, it can be at risk of injuries and conditions that cause pain and restrict motion. 

In some cases, persistent neck pain has a specific cause, such as a damaged facet joint or disc. It's often caused by muscle strain, poor posture, or injuries, but can also be a symptom of more serious underlying conditions. However, neck pain quite often continues even after the original problem has settled down. Lack of movement can cause your neck muscles to become weak and stiff. They will then tire more easily and will be more likely to hurt when you move them.

Most neck pain is associated with poor posture combined with age-related wear and tear. Some other possible causes include:

• Neck sprain from sleeping awkwardly
• Whiplash injury from a motor vehicle accident
• Impact during a contact sport
• Neck strain from poor posture
• Muscle spasms
• Herniated discs
• Fall from a ladder or other elevated height
• Blunt force trauma
• Infection
• Flare-up of cervical spondylosis (cervical osteoarthritis); which can happen as the discs and joints in the spine age

COMMON SYMPTOMS

The most common symptoms are pain and stiffness, additionally:

• You may feel pain in the middle or on either side of your neck, but it may also extend to the shoulder or to the upper chest.
• You may have pain or weakness in your arms.
• You may have tension headaches, where the pain can travel to the back of your head and sometimes into your ear or behind your eye.
• It may be painful to move your neck and your muscles may feel tight, especially if you’ve been sitting or sleeping in one position for a long time.
• You may notice that your neck won’t turn as far as it normally does, for example when you try to look over your shoulder while reversing the car.

DIAGNOSING NECK PAIN

Accurate patient history, physical examination, neurological examination and imaging are critical elements in diagnosing neck pain. During the physical exam, your provider:

• May test for localized bony tenderness or prominence
• May test for soft tissue tenderness or myofascial pain
• May test for range of motion
• Conduct the Spurling test for lateral flexion and extension of the neck with axial compression
•  Appropriate diagnostic imaging
• Bone scan to look for abnormalities in the bone tissue
• Electromyography (EMG) to test nerve signals

Pain can be subjective, but a person may consider neck pain serious if:

• Over-the-counter (OTC) medications do not help improve it
• There is no improvement after 1 week
• The pain occurs after a blow to the head or injury
• A person experiences numbness, tingling, or weakness in the arms or hands
• It comes on with severe stiffness
• The pain shoots down one arm
• A fever or a headache accompanies the neck pain
• The pain comes on with weakness in the legs or loss of coordination in the legs or arms

MANAGING NECK PAIN

Chronic pain that persists in the neck for more than three months may be felt all the time or worsen with certain activities. Although its source may be hard to determine, contributing factors include nerve damage, tissue scarring, arthritis, or emotional effects of pain. If you are living with the symptoms of neck pain, our goal is to develop a treatment plan and provide solutions to reduce the amount of pain you’re experiencing and prevent additional damage to the joints while preserving joint function.

Depending on your situation, our specialists will identify the best path for your healthcare and quality of life, including:

• Stopping or reducing activities
• Chiropractic adjustments
• Physical therapy
• Anti-inflammatory medications
• Acupuncture
• Cortisone shots
• Physical/Massage therapy
• Oral or topical over the counter (OTC) medications
• Trigger point and/or interventional injections
• Prescription pain medications when deemed medically appropriate
• Radiofrequency denervation (after steroid injections have successfully reduced pain)
• Transcutaneous electrical nerve stimulation (TENS)
• Soft collar
• Neck surgery (if necessary)

Our goal at US Pain Relief, PLLC, is to provide neck pain solutions starting with the most conservative treatment pathways, and by working together get you back to your everyday life - you’ll learn what works best in managing your neck pain with an emphasis on improving/maintaining functionality.

Neuropathic pain stems from a wide variety of causes that can be broadly organized into two basic categories: peripheral and central. Common peripheral neuropathic conditions include diabetic peripheral polyneuropathy, chemotherapy-induced peripheral neuropathy, radicular pain and postsurgical chronic neuropathic pain. Central conditions include multiple sclerosis, poststroke pain, spinal cord injury–related pain, postherpetic neuralgia, complex regional pain syndrome (CRPS) and trigeminal neuralgia.

The clinical presentation of neuropathic pain commonly includes descriptions of burning, pins and needles (paresthesia), tingling, numbness, electric shocks/shooting, crawling (formication), itching, and intolerance to temperature.

COMMON CAUSES

The most common causes for neuropathic pain can be divided into four main categories:

• Disease or Medications: Neuropathic pain can be a symptom or complication of several diseases to include multiple sclerosis, diabetes, long-term and excessive alcohol intake, multiple myeloma and other cancers and medications used in cancer treatments such as chemotherapy drugs
• Injury: Injuries to muscles, tissue or joints that cause lasting damage to the nerves as well as injuries to the back that can damage nerve fibers around your spine.
• Infection: While rarely the cause of neuropathic pain, complications with an infection such as shingles can trigger postherpetic neuralgia
• Limb loss: Phantom limb syndrome can occur when the nerves near the amputation are misfiring and sending faulty signals to your brain which may be felt in arms, legs, fingers, toes or other body parts.

COMMON SYMPTOMS

Common symptoms of neuropathic pain may vary slightly and include:

• Shooting, stabbing or burning pain
• Tingling and numbness often described as feeling like “pins and needles”
• Spontaneous pain, or pain that occurs without a trigger
• Evoked pain, or pain that’s caused by events that are typically not painful — such as rubbing against something, being in cold temperatures, or brushing your hair
• Difficulty sleeping or resting as nerve pain is often worse at night
• Increased sensitivity to touch or temperature

DIAGNOSING NEUROPATHIC PAIN

To diagnose your neuropathic pain, a medical professional will obtain a detailed account of symptoms, onset, and potential triggers, perform a physical exam and may order diagnostic imaging. During your physical examination your provider may:

• Examine the patient checking for muscle strength, coordination and reflexes
• Check for sensitivity to touch, pain and temperature
• Refer you out for nerve conduction study, electromyography (EMG)
• Order blood tests to rule out underlying conditions 

MANAGING NEUROPATHIC PAIN

Neuropathic pain is a chronic pain condition caused by damage or dysfunction of the nervous system. It's characterized by abnormal sensations, often described as burning, shooting, or electric-like pain that tends to get worse over time.

Neuropathic pain isn’t typically triggered by an event or injury, but rather the body sends unprompted pain signals to your brain and can be triggered by stimuli that wouldn't normally cause pain.

MANAGING NEUROPATHIC PAIN

Often, a combination of medications and non-pharmacological approaches provides the most effective pain relief. Medications that might help target neuropathic pain include: 

• Tricyclic antidepressants (TCAs) like amitriptyline and nortriptyline are frequently used, and some studies have shown the efficacy of other antidepressants such as duloxetine for treating neuropathic pain. Prescription NSAIDs do not seem to play a supportive role in managing neuropathic pain.
• Gabapentin and pregabalin are commonly used, with gabapentin showing efficacy in diabetic neuropathy and postherpetic neuralgia. Other antiepileptics like carbamazepine, oxcarbazepine, topiramate, and lamotrigine are also used. Oral and injected corticosteroids to help reduce inflammation 
• Lidocaine patches and creams, and capsaicin, provide localized pain relief. 
• Opioids like tramadol, and strong opioids like oxycodone and morphine, can be considered as a fourth-line therapy, but their use requires careful monitoring due to potential side effects and risks of abuse. 

Physical Therapy: A physical therapist can offer various nonsurgical therapies to help you improve physical function and provide strategies for managing pain

Lifestyle Modifications: Regular exercise, a balanced diet, stress management techniques (like mindfulness and relaxation) to assist with adequate sleep are crucial for managing chronic pain. 

Nerve Blocks: Injections of local anesthetics and steroids near affected nerves can help block pain signals. 

Spinal Cord Stimulation: This invasive procedure involves implanting a device that sends electrical impulses to the spinal cord to modulate pain signals. 

Neuropathic pain can negatively impact your life leading to complications, including depression and problems sleeping. No matter the symptoms, severity, or common causes, our team is committed to tailoring to the individual's specific condition, symptoms, and overall health. You’ll learn what works best in managing your joint pain with an emphasis on improving/maintaining functionality.

REFERENCES

Finnerup NB, Kuner R, Jensen TS. Neuropathic Pain: From Mechanisms to Treatment. Physiol Rev. 2021 Jan 1;101(1):259-301. doi: 10.1152/physrev.00045.2019. Epub 2020 Jun 25. PMID: 32584191.

Bates D, Schultheis BC, Hanes MC, Jolly SM, Chakravarthy KV, Deer TR, Levy RM, Hunter CW. A Comprehensive Algorithm for Management of Neuropathic Pain. Pain Med. 2019 Jun 1;20(Suppl 1):S2-S12. doi: 10.1093/pm/pnz075. Erratum in: Pain Med. 2023 Feb 1;24(2):219. doi: 10.1093/pm/pnac194. PMID: 31152178; PMCID: PMC6544553.

Occipital Neuralgia is a condition in which the occipital nerves, the nerves that run through the scalp, are injured or inflamed.

Occipital neuralgia is a condition characterized by pain in the back of the head and neck, often described as sharp, shooting, or stabbing, and is caused by irritation or inflammation of the occipital nerves. These nerves run from the upper neck to the scalp.

• Occipital neuralgia can be mistaken for other headache disorders like migraines or tension headaches.
• It's crucial to get an accurate diagnosis to determine the appropriate treatment.
• Many individuals find relief with non-invasive treatments, but some may require more advanced interventions.

• Occipital neuralgia can be a symptom of other conditions such as migraines, arthritis, or nerve damage from trauma.

COMMON CAUSES

Occipital Neuralgia can be caused by:

• Nerve compression
• Inflammation
• Secondary headache disorder

COMMON SYMPTOMS

• Sharp, shooting, or stabbing pain in the back of the head and neck, sometimes radiating to the scalp.
• Increased sensitivity to touch in the area of the occipital nerves.
• Numbness or tingling that may occur in the scalp.
• Dizziness
• Nausea
• Visual disturbances

DIAGNOSING OCCIPITAL NEURALGIA

To diagnose your occipital neuralgia, a medical professional will obtain a detailed account of symptoms, onset, and potential triggers, perform a physical exam and may order diagnostic imaging. During your physical examination your provider may:

• Examine the patient's neck and head for tenderness, range of motion, and nerve function.
• Check for tenderness and pain by pressing on the occipital nerves
• Perform a nerve block which is an Injection with local anesthetic used to diagnose and treat occipital neuralgia
• Order appropriate diagnostic imaging used to rule out other conditions and assess the spine.

MANAGING OCCIPITAL NEURALGIA

Occipital neuralgia (ON) is a painful condition affecting the posterior head in the distributions of the greater occipital nerve (GON), lesser occipital nerve (LON), third occipital nerve (TON), or a combination of the three.

There are multiple treatment options for occipital neuralgia. The most conservative treatments, such as immobilization of the neck by the cervical collar, physiotherapy, and cryotherapy, have not been shown to perform better than placebo.

Home Therapy: Applying heat or ice to the affected area may help in reducing pain and inflammation.

Medications: Pain relievers (NSAIDs), muscle relaxants and nerve pain medications may help in managing symptoms of occipital neuralgia.

Physical Therapy: Exercises and stretches can help relieve muscle tension

Injections: Nerve blocks or steroids may provide pain relief

When OTC pain relievers are no longer effective and pain is persistent or severe, our team will work with you on a treatment plan with various treatment options available to help manage and alleviate occipital neuralgia effectively pathways with an emphasis on improving/maintaining functionality before recommending surgery.

REFERENCES:

Djavaherian DM, Guthmiller KB. Occipital Neuralgia. [Updated 2023 Mar 6]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK538281/

Jose A, Nagori SA, Chattopadhyay PK, Roychoudhury A. Greater Occipital Nerve Decompression for Occipital Neuralgia. J Craniofac Surg. 2018 Jul;29(5):e518-e521. [PubMed]

American Association of Neurological Surgeons. Occipital Neuralgia (https://www.aans.org/en/Patients/Neurosurgical-Conditions-and-Treatments/Occipital-Neuralgia). Accessed 5/21/2022.

American Migraine Foundation. Occipital Nerve Blocks (https://americanmigrainefoundation.org/resource-library/occipital-nerve-blocks/). Accessed 5/21/2022.

American Migraine Foundation. Occipital Neuralgia: A Guide (https://americanmigrainefoundation.org/resource-library/occipital-neuralgia/). Accessed 5/21/2022.

National Institute of Neurological Disorders and Stroke. Occipital Neuralgia Information Page (https://www.ninds.nih.gov/disorders/all-disorders/occipital-neuralgia-information-page). Accessed 5/21/2022.

Sacroiliac joint (SIJ) dysfunction describes pain due to abnormal movement (too much or too little) or misalignment of the SI joint. It can cause sharp, stabbing pain that starts in the hips and pelvis and radiates into the lower back and down the thighs.

The sacroiliac joints are located where the sacrum (tailbone) and ilium meet in the lower back. The sacrum is the triangular bone near the bottom of the spine. The ilium is one of the three bones of the hip bones at the uppermost point of the pelvis. Every individual has two SI joints connecting the pelvis to the lower part of the spine. They support the body's weight and function as shock absorbers to reduce spinal pressure. Inflammation of one or both SI joints, called sacroiliitis, is sometimes to blame for SI joint pain.

SI joint dysfunction can be caused by various conditions, including osteoarthritis (OA) ankylosing spondylitis (AS), trauma, repetitive stress to the joints, older age, pregnancy, abnormal walking patterns, leg length differences, and scoliosis (abnormal curvature of the spine).

COMMONS SYMPTOMS

The most common symptoms of SI joint dysfunction are:

• Low-back pain that is dull, achy, and ranges from mild to severe on one or both sides 
• Pain that spreads into the buttocks, groin, or upper thighs 
• Worsening pain with movement or putting pressure on the SI joint (i.e., walking, climbing steps, or bending down)
• Stiffness that affects range of motion in the lower back, hips, and pelvis
• Sciatica-like pain starting in the lower back and going into the buttocks and thighs—pain might feel hot, sharp, or stabbing and may include numbness and tingling 
• Pelvic instability, in which the pelvis feels like it will give way with standing and walking or getting up from a sitting position
• Excruciating pain with transitional movements (i.e., climbing stairs or getting up from a sitting position)
• Severe lower back, hip, and buttock pain after sitting for extended periods 
• A low-grade fever with prolonged morning stiffness and inflammatory pain if sacroiliitis is present 

SI joint pain is triggered by activities that involve the lower back, hips, pelvis, and legs. This can include walking, climbing steps, and sitting and standing for long periods.

Certain physical activities can cause sacroiliitis, including:

• Jobs where you sit, stand, or walk around for long periods
• Heavy labor jobs that require heavy lifting or repetitive movements that put stress on the SI joints
• Sports that involve repetitive movements, including gymnastics, ice skating, and tennis
• High-impact exercises, such as running and jumping, that put stress on the back and pelvis
• Bicycling because it involves sitting in a front-leaning position 

SI dysfunction flare (worsening symptoms) triggers include:

• Poor posture 
• A sedentary lifestyle 
• Footwear, including high heels and footwear without proper arch support 
• Eating a diet high in inflammation-producing foods (such as processed and junk foods), especially if you already live with inflammatory arthritis 
• Pregnancy because of hormonal and physical body changes 
• Being overweight as excess body weight can add to excess stress on the SI joints

DIAGNOSING SACROILIAC JOINT DYSFUNCTION

A physical examination should include gait analysis (i.e., reporting of pain with walking, shortened stride length, antalgic gait), range of motion, provocation testing, strength, flexibility, and palpation assessments. Lower extremity neurologic screening (i.e., reflexes, sensation, strength, straight leg raise) is helpful when considering differential diagnoses. Provocative maneuvers to help in the diagnosis such as FABER, Gaenslen’s, and thigh thrust tests may also be beneficial in assessing diagnosis of Sacroiliac joint (SIJ) dysfunction.

A diagnostic method that can help confirm SI joint dysfunction involves injecting a numbing medicine into the affected SI joint. If the injection brings relief, the SI joint is likely the source of pain. If it does not, other tests will be done to ascertain the cause of your symptoms.

MANAGING SACROILIAC JOINT DYSFUNCTION

Treatment starts with conservative care including physical therapy modalities and anti-inflammatory medications. Manipulative therapies have also been described.

Medications that might help target SI joint and sacral back pain include: 

• Prescription NSAIDs
• Muscle relaxers to relax tense muscles and reduce muscle spasms
• Oral and injected corticosteroids to help reduce inflammation 
• Disease-modifying antirheumatic drugs (DMARDs) to manage inflammatory conditions like AS and rheumatoid arthritis (RA)

Physical Therapy: A physical therapist can offer various nonsurgical therapies to help you manage pain and build strength in the pelvis, spine, and hips.

Chiropractic Care: A chiropractor can diagnose and treat SI joint dysfunction. They use spinal manipulation techniques to help relieve pain and improve mobility and function.

A US Pain Relief, PLLC, professional can offer advanced treatment techniques to help you avoid surgery. Treatments include steroid injections, pain medicines, behavioral therapies, and alternative therapies like acupuncture and spinal manipulation. Our team will work with you on a treatment plan starting with the most conservative treatment pathways, and by working together get you back to your everyday life.

Shoulder pain is a very common issue, affecting a significant portion of the population, and is also the third most common musculoskeletal complaint seen in primary care, following back and knee pain. Persistent, or chronic, shoulder pain can interfere with a person’s day-to-day activities and quality of life.

The shoulder is a complex joint that allows for a wide range of movement. However, the complexity of the shoulder joint's structure and range of motion make it vulnerable to injury and pain. Many jobs and activities involve repetitive shoulder movements, increasing the risk of overuse injuries and pain, according to a systematic review of shoulder disorders and occupation. 

Injury to the shoulder can result from repetitive motion, trauma, or age-related wear and tear. Weakness in the shoulder structures (bursae, bones, tendons, cartilage, etc.), sports injuries, or degenerative conditions like arthritis can all affect how well your shoulder works and feels, leading to different types of pain and mobility issues.

DIAGNOSING SHOULDER PAIN

Diagnosing chronic shoulder pain varies somewhat accordingly:

Bursitis - A person who has bursitis of the shoulder may experience the following symptoms:

• A dull, aching pain in the shoulder joint
• Swelling, flushing, or tenderness of the shoulder joint
• Increased pain when moving or pressing on the joint

Tendinitis - The term “tendinitis” refers to inflammation of a tendon. The most common form of shoulder tendinitis is rotator cuff tendinitis.

Injury to the shoulder joint - Shoulder pain can sometimes occur due to a dislocation, a fracture, or another acute injury to the shoulder joint.

Tendon tear - Sometimes, a tendon can tear as a result of overuse or acute injury. Common tendon tears of the shoulder area include rotator cuff, labral and bicep tendon tears.

Nerve problems - A pinched nerve occurs when a nerve becomes compressed by its surrounding tissues, such as bones, cartilage, or tendons.

Arthritis - Two types of arthritis may affect the shoulder and other joints in the body: osteoarthritis and rheumatoid arthritis.

Shoulder Instability – Patient experiences pain with abduction and external rotation, feeling of the shoulder slipping out of the front of the socket, possible nerve symptoms popping or grinding sounds, and a feeling of looseness or weakness

MANAGING SHOULDER PAIN

Treatment of the shoulder may involve the following:

• Resting or joint immobilization with a sling

• Avoiding activities that cause or exacerbate pain
• Referral to a physical therapist
• Taking NSAIDs, to alleviate pain and inflammation
• Receiving corticosteroid injections into the joint, to temporarily alleviate pain and inflammation
• Applying ice or moist heat to the affected joint several times per day
• Doing some light exercises, to help manage pain
• Local anesthesia injections
• Anti-inflammatory medications
• Acupuncture
• Transcutaneous electrical nerve stimulation (TENS) therapy
• In severe cases, a doctor may recommend debridement, surgery or joint replacement. Postsurgical rehabilitation takes time, and complete pain relief may take up to a year.

At US Pain Relief, PLLC, one of the key things we strive for is reducing the likelihood of reinjury to your shoulder. Our team will work with you on a treatment plan helping you increase your strength, flexibility, and range of motion is crucial for keeping your shoulder stable. We focus on solutions starting with the most conservative treatment pathways with an emphasis on improving/maintaining functionality before recommending surgery to help you find relief from your shoulder pain.