Physical Therapy Services

Joint Pain

Most cases of joint pain, such as those occurring in the shoulder, hip, or elbow are the result of trauma, micro trauma, or arthritis.

The basic construction of a joint involves two bones joined by a ligamentous capsule and moved by several muscle attachments. The ends of the bones are covered with cartilage—a pliable but firm material that does not have its own blood supply. A thin layer of tissue called the synovium lines the interior of the joint. The synovium produces and holds synovial fluid—the joint’s lubrication. When everything is working correctly, the joint moves as it was designed. If the joint is subject to trauma, for example, a fall that moves it past its mechanical limitation, soft tissue structures get damaged and the joint’s mechanics are altered, very much like a wobbly wheel on a car. This leads to accelerated wear and tear as the cartilage thins and bone starts to contact bone.

Since ligaments and tendons are not vascularized (blood supply) to the degree that muscle and skin are vascularized, it takes a longer time for them to heal. When ligaments and tendons tear (microscopic or major), inflammation sets in. This is a major source of pain, as internal pressure and chemical agents irritate nerves in the region. In addition, fibrosis sets in. Fibrosis is the overproduction of collagen and elastin and can interfere with the joint’s proper movement.

Repetitive use of a joint, like those demanded by tennis and golf, strain certain joints. This can lead to microtears, which can generate pain as well.

Treatment for joint disorders can include manual therapy, extremity adjustments, light wave therapy, exercises and nutritional supplements.