Arthritis Pain Management

• Morning stiffness that improves as you move

• Deep, activity-related ache with flares after overuse

• Swelling, warmth, or tenderness around a joint

• Pain with stairs, gripping, or getting up from a chair

• “Locking,” catching, or instability in knees/shoulders/thumb base

• Osteoarthritis (OA): wear-and-tear cartilage loss (knee, hip, shoulder, thumb CMC, spine facet)

• Inflammatory arthritis: rheumatoid, psoriatic—often multiple joints with morning stiffness

• Crystal arthritis: gout/CPPD with sudden, very painful flares

• Post-traumatic OA: after prior injury or surgery

• Sacroiliac joint arthritis/dysfunction contributing to low-back/buttock pain

We match care to your goals—work, sport, family life—not just X-ray findings.

• Focused exam to localize the true pain generator (joint, tendon, bursa, nerve)

• Imaging as needed: X-ray for joint space/osteophytes; ultrasound for effusions/bursae; MRI when it changes management

• Lab tests if inflammation or crystals are suspected

• Joint aspiration (when indicated) to analyze fluid for crystals or infection

• Selective diagnostic injections (local anesthetic) to confirm the source

1) Conservative First

• Targeted physical therapy: mobility, strength, gait/form retraining

• Activity pacing & ergonomics; footwear/orthotics as appropriate

• Weight management & conditioning to reduce joint load

• Topicals (NSAID gel), heat/ice, and bracing/taping for select joints

2) Medications (personalized)

• Acetaminophen; short courses of NSAIDs if safe

• Duloxetine (knee/hip OA select cases)

• For inflammatory arthritis, we co-manage with rheumatology for DMARDs/biologics

3) Image-Guided Joint Procedures (when indicated)

• Corticosteroid injections for painful flares (arthritis/bursitis/synovitis)

• Hyaluronic acid (viscosupplementation) for knee OA (select patients)

• PRP for certain mild OA or tendinopathies (case-by-case)

4) Advanced Interventions

• Genicular nerve blocks → radiofrequency ablation (RFA) for chronic knee OA pain

• Hip/shoulder articular branch blocks/RFA in select cases

• SI joint injection if the SI joint is a contributor

5) Surgical Referral

• When structural repair or joint replacement is clearly the best option, we coordinate referral and optimize pre-/post-op care.

Seek urgent care/ER for a hot, very swollen joint with fever/chills, inability to bear weight after injury, or a sudden severe flare in one joint (possible infection or crystal arthritis).

Is surgery the only option for “bone-on-bone” OA?
Not always. Many patients improve with therapy, load management, and targeted injections. Surgery is reserved for persistent, function-limiting pain.

Do injections just mask pain?
Used strategically, they reduce inflammation so you can rehab effectively and confirm the pain source. They’re one part of a broader plan.

Do supplements help (glucosamine, turmeric, collagen)?
Evidence is mixed. Some patients report modest benefit. We’ll review safety and interactions before you try anything new.

Should I stop activity?
Complete rest usually backfires. We guide joint-friendly movement and progressive loading that support cartilage and strength.