Joint pains especially shoulder, elbow, hip and knee pains are often quite complex and there are often multiple structures that can cause pain. The reality is that the joint arthritis is often not the only source of pain yet that is the only thing that is thought about commonly when one gets pain in their shoulder, elbow, hip or knee. Often, the first port of call is your GP and physiotherapist, who may suggest onward referral to a surgeon.
However, we have realised now that in the last 10 years there are so many other strategies and newer techniques that have come that can help you with your shoulder, elbow/hip or knee pain. These can help you get your quality of life back, and these may involve less invasive treatment options that can make a big difference and reduce your pain.
What is it that a pain consultant can do for hip/knee or shoulder/elbow pain that may not be coming from the joint?
Structures such as ligaments, tendons and the joint capsule (covering) can all be potential pain generators and sometimes the nerves can be sensitised as is often seen in repetitive strain injury or what is often called work related upper limb disorder in the case of elbow or shoulder pain. You may have something as simple as an inflammation of a bursa. You may have a frozen shoulder which has tightness of the muscles around there, or it may be a referred pain from your neck that comes into your shoulder. Similarly pain around the lower back or gluteal muscles can radiate to hip or sometimes down to knee.
So, it’s important that you have a comprehensive examination and a thorough investigation so that the treatment strategies can be personalized and individualized for you and that’s where a pain consultant is able to bring all of those treatments under one roof.
What are the treatments that pain consultants can offer for joint pain that has been chronic and persistent and bothersome?
It may be something as simple as looking at your medications and reviewing and optimizing them. It would be looking at other conservative measures such as physiotherapy and other complementary therapies that could be added in. It would be addressing the biopsychosocial aspect. So, looking at how stress and how your workplace or vehicle posture changes can sometimes make a difference to your joint pain and where needed you would have interventions such as muscle trigger point injections or joint injections.
We also offer regenerative medicine techniques like platelet-rich plasma and other drugs like Botox as well as prolotherapy in selected patients.