Your knee and shoulders contain complex joints that can make pain difficult to diagnose and treat. But with help from pain management specialists, you can find relief.
In this Q&A, Gary Esses, MD, Assistant Professor of Anesthesiology, Perioperative, and Pain Medicine at the Icahn School of Medicine at Mount Sinai and a leader of the Pain Management Service at Mount Sinai Brooklyn, answers common questions about managing knee and shoulder joint pain and explains when to seek help from a pain management specialist.
Gary Esses, MD
Why does my knee hurt?
Knee pain is typically caused by injuries, arthritis, and mechanical problems. Injuries often include an ACL injury (ligament tear), a fracture, a torn meniscus (tear in the cartilage between the shinbone and thighbone), bursitis, and patellar tendinitis (irritation or inflammation of knee tendons).
Types of knee arthritis include osteoarthritis (a breakdown of cartilage in the knee), rheumatoid arthritis (an autoimmune disease causing tissue deterioration), and gout (caused by uric acid crystals in the knee joint).
Mechanical problems can include loose bone or cartilage that might go into the knee joint space causing irritation, dislocation of the knee, and hip or foot pain that affects your gait, possibly impacting the knee joint.
What treatments are available for knee pain?
Depending on the cause of your knee pain, your doctor will likely recommend some treatment options to start, including:
- Rest, ice, compression, elevation (RICE), as well as activity modification
- Anti-inflammatory medication or injections
- Gel (hyaluronic acid) injections to cushion your knee joint
- Stem cell therapy
- Radio frequency ablation, a type of heat therapy, to silence painful nerves in the knee
- Physical therapy
- Wearing a brace
- Weight loss
What can I do at home to ease my knee pain?
In addition to medications, your pain management specialist may recommend low-impact, at-home exercises such as stretches, walking, cycling, and swimming, or using the RICE method. The specialist might suggest using a heating pad and, if there is swelling, applying cold compresses. Following a routine pain management plan will strengthen the muscles around your knee over time and reduce the pressure on the knee joint. Notify your doctor if you further injure your knee, or if you experience pain or a return of symptoms during exercises.
Why does my shoulder hurt?
The most common causes of shoulder pain include osteoarthritis, rheumatoid arthritis, bursitis, dislocation, injury (broken collarbone, rotator cuff tear, torn cartilage, sprain, tendon rupture), and tendinitis. It is important to note that shoulder pain can be caused by referred pain from the heart, lung, or respiratory system, which is why it is important to seek a proper diagnosis.
A family physician or orthopedic surgeon can help determine a course of treatment. Your physician will use X-rays and magnetic resonance imaging (MRI) to pinpoint the cause of the pain. Then, your doctor will advise you on treatment options. If you don’t need surgery, you will likely be referred to a pain specialist.
What kinds of treatments are available for shoulder pain?
Your pain specialist will work with you to decide on a personalized treatment plan based on your individual needs. The pain specialist will review X-rays or MRIs to assess which approach will best manage the pain. The pain specialist might recommend non-surgical options including muscle relaxants, prescription oral anti-inflammatory medications, and over-the-counter pain medications. The specialist’s recommendation for a shoulder injection will depend on the severity of your pain. They may also recommend physical therapy.
How can I treat my shoulder pain at home?
The pain specialist might recommend a number of ways to manage pain at home including:
- cold compresses
- heat therapy
- compression
- massages
- over-the-counter pain medications
The specialist might also recommend limiting activity directly affecting your shoulder. Gradually increasing the level and intensity of exercise will reduce the likelihood of placing stress on the shoulder and prevent the likelihood of your pain returning.
When should I see a pain management specialist?
If you have seen a regular doctor and your pain isn’t healing, it may be time to see a pain management specialist. There are board certified medical specialists dedicated to diagnosing and treating pain-related disorders. Your pain management specialist will consider multidisciplinary approaches to treating your pain, and they will discuss possible therapies and help coordinate your care with other health care professionals. If needed, they will perform interventional therapies, such as administering an epidural injection in the spine.
To make an appointment with a Mount Sinai Brooklyn pain management specialist, call 718-758-7072.