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Tri State Area Pain Management for

Knees, Hips & Shoulders

Get Relief For Your Joint Pain

There are multiple causes and many treatment options for those suffering from painful knee, hip and shoulder pain syndromes. Here you can find out more about the individual syndromes and the options available to help you gain relief.

Knee Pain

We have an entire page dedicated to providing information on knee pain including common causes such as arthritis, bursitis, and knee injury.

Arthritis Pain of the Hip

Arthritis of the hip is a common condition that’s encountered in patients starting in their 50’s. Because it’s a large joint, in fact the largest in the body, the hip joint is susceptible to development of arthritis from multiple causes. Osteoarthritis, rheumatoid arthritis and post-traumatic arthritis are all common causes of hip joint pain. Less frequent causes include collagen vascular diseases, infection and Lyme Disease.

Hip pain is characterized by pain in the groin, upper thigh and low back and is typically felt on the same side as the affected hip. A common test for hip joint pain is the FABER test, which includes flexion, abduction, external rotation and extension of the hip joint. Hip pain may be ill-defined and activity such as walking or movement can worsen the pain. Rest and heat often relieve hip pain. Oftentimes hip ailments cause aching pain that can interfere with sleep. Other complaints include a grating or popping sensation in the hip joint. As hip pain progresses typically function is decreased. Walking, climbing stairs, getting in and out of a car can be difficult for those with hip joint pain.

Diagnosis of hip pain usually starts with X-rays of the hip joint. MRI of the hip is also used commonly. Treatment of hip pain typically starts with non-steroidal anti-inflammatory medications. Physical therapy and injection of steroids directly into the hip joint can be both used as a diagnostic and therapeutic tool. Other physical modalities include heat, and range of motion exercises. Orthopedic surgeons can replace the hip by removing the head of the femur and replacing it. Hip joint pathology can be confused with bursitis, tendonitis, muscle strain or sprain, or infections that do not involve the hip joint. Knee and low back conditions can refer pain to the hip.

Advancements in hip joint arthritis treatment include the addition of PRP (protein rich plasma), and stem cell therapy. Protein rich plasma contains growth factors which help to reduce inflammation and increase the cartilage and joint health. Stem cells are believed to regenerate cartilage. These are taken from the patient, concentrated and injected directly into the joint space providing significant and long lasting relief for sufferers with hip joint pain.

Shoulder Pain Syndromes

Shoulder pain is common in the United States. The shoulder is a complex joint that is susceptible to arthritis and injuries. The most common cause of shoulder pain is osteoarthritis. The common signs and symptoms include pain that is localized around the shoulder and upper arm. Activity makes the pain worse, heat and rest relieve the pain. The pain is described as constant and is characterized as a deep, aching pain. It may interfere with sleep. Patients may notice a popping sensation or grinding sensation in the shoulder joint.

There are a number of anatomical structures that can cause pain in the shoulder joint. These include arthritis of the shoulder joint, acromioclavicular joint pain, subdeltoid bursa pain, bicipital tendonitis, adhesive capsulitis or frozen shoulder, a tear of the biceps tendon, supraspinatis syndrome, rotator cuff tear, deltoid syndrome, teres major syndrome, scapulocostal syndrome, and avascular necrosis of the glenohumeral joint.

There is a gradual reduction in the functional ability because of reduced range of motion of the shoulder. This can make even everyday tasks difficult and painful. These tasks may include simple tasks such as fastening a bra, reaching overhead, or combing one’s hair.

Diagnostic workup includes x-rays of the shoulder, MRI, bone scan, laboratories. Differential diagnosis includes rheumatoid arthritis, post-traumatic arthritis, rotator cuff arthropathy, collagen vascular disease, infection, Lyme disease.

Treatment includes nonsteroidal anti-inflammatory medications, application of heat and cold, range of motion, physical therapy, and intrararticular injections of steroids. Recently PRP and stem cells have started to gain usage for treating shoulder disorders.

Platelet-Rich Plasma

Recently, Platelet Rich Plasma (PRP) has been identified as a way to treat multiple pain problems. It’s been a secret that elite athletes have known about for years but has just become available to regular patients. Indications for platelet-rich plasma include those with knee pain, hip pain, shoulder pain, tennis elbow pain, pain in the lumbar spine, pain in the tendons, ligaments, and bursa. There’s recently been research done that shows that it is effective for areas of the body affected by arthritis.

What is PRP? PRP is platelet-rich plasma. A patient’s own blood is taken and placed in a centrifuge spun down and only the platelet-rich plasma portion is taken and that is injected into the affected area of pain. Typically, the injection is done under X-ray guidance in order to ensure that there is accurate placement of the PRP. PRP is regenerative medicine because it builds up the cartilage with the addition of stem cells and growth factors from the platelet-rich plasma. Many patients are able to avoid surgery. This is considered conservative therapy and should be employed as a part of pain therapy prior to considering surgery.

It is safe, effective, easy to do and typically, takes only one session. Research on PRP has shown that most are able to avoid knee replacement surgery even with severe arthritis and that cartilage is not degraded after this procedure.