What joint pain usually means
Every joint has the same basic parts: cartilage, a lining that makes fluid, ligaments, tendons and small cushioning sacs called bursae. Pain comes from one or more of them, and the exam is how we tell which.
- Shoulder. The rotator cuff, the group of tendons that lift and rotate the arm, is the usual culprit. It can be inflamed, pinched under the bone above it (impingement) or partly torn. Bursitis in the shoulder feels similar: pain on the outside of the upper arm, worse when reaching overhead or lying on that side. A frozen shoulder is stiff as well as painful. Arthritis of the shoulder joint itself causes a deep ache with grinding.
- Hip. Hip arthritis is felt in the groin and the front of the thigh, worse with walking and getting out of a car. Pain on the outside of the hip that hurts to lie on is more often trochanteric bursitis or tendon irritation than arthritis. Some "hip" pain is really coming from the lower back.
- Elbow. Tennis elbow and golfer's elbow are tendon problems at the bony points on either side of the elbow, common in anyone who grips or lifts for a living.
- Ankle and foot. Old sprains that never settled, arthritis after a fracture, and tendon pain around the ankle are all treatable.
Age and wear are the biggest factors, but work, sport and old injuries all leave their mark. The sooner a joint is examined properly, the more options there are.
How our pain physicians treat it
The consultation at Davie or Boynton Beach starts with your history and a hands-on exam of the joint, the joints on either side of it and the spine, since pain travels. The doctor reviews any X-ray or MRI you have and orders imaging if needed. Ultrasound in the exam room shows tendons and bursae directly and guides the needle when an injection is the right step.
Depending on what we find, the plan may include:
- Joint and bursa injections. A corticosteroid injected into the shoulder, hip, elbow or ankle joint, or into an inflamed bursa, usually gives weeks to months of relief and confirms where the pain is coming from.
- Nerve blocks, including a suprascapular nerve block for shoulder pain that has not settled with injections, or for patients with rotator cuff tears or shoulder arthritis who are not candidates for surgery.
- PRP injections for tendon problems such as rotator cuff tendinopathy, tennis elbow and hip tendon pain, where the goal is to support the tendon's own repair rather than only calm inflammation. PRP is a cash service.
- StemWave shockwave therapy for tendon and soft tissue pain around the shoulder, elbow, hip and ankle, for patients who prefer a non-drug, non-injection option. Available at our Davie clinic.
- Medication management with anti-inflammatories and, where appropriate, other non-controlled options at the lowest effective dose.
If the exam or imaging shows a full-thickness tendon tear or advanced arthritis that would do better with surgery, we say so and coordinate a referral to an orthopedic surgeon while continuing to manage your pain.
Does insurance cover it? Consultations, imaging, steroid joint and bursa injections and nerve blocks are covered by Medicare, Aetna, Blue Cross Blue Shield and Cigna when medically necessary. Some plans require prior authorization for injections, which our front desk handles. PRP and StemWave are cash services and are not covered by insurance. Workers' compensation and auto injury claims are accepted. Read more about insurance and self-pay.
What to expect
- Before you come in, we verify your insurance and ask you to bring photo ID, your medication list and any imaging or orthopedic reports.
- At the consultation, the doctor examines the joint, checks the neck or back as appropriate, and explains what is causing the pain.
- You leave with a plan. Many patients have a joint or bursa injection at that first visit. Others start with imaging or medication and return once results are in.
- Follow-up is scheduled based on the plan, usually every four to twelve weeks, so we can measure how long each treatment holds and adjust.
Rotator cuff pain: what actually helps
Most rotator cuff pain comes from an irritated or partly torn tendon, not a complete tear, and most patients improve without surgery. A guided injection settles the inflammation, and gentle strengthening keeps the shoulder moving. For persistent pain, a suprascapular nerve block can give lasting relief.
Is my shoulder pain a rotator cuff tear?
Possibly, but many painful shoulders have tendon inflammation or bursitis rather than a tear, and even partial tears often improve without surgery. The exam, and ultrasound or MRI where needed, sorts this out.
How long does a steroid joint injection last?
It varies. Many patients get several weeks to a few months of relief. The doctor limits steroid injections to a joint, usually no more than three or four a year, which is why PRP, nerve blocks and StemWave are also part of the plan.
Can hip pain really come from my back?
Yes. Pain from the lower back or sacroiliac joint often shows up in the buttock and the outside of the hip. The consultation includes an exam of the spine so we treat the right source.
Are PRP injections covered by insurance?
No. PRP is a self-pay service. The clinic will explain the cost before you decide. Steroid injections and nerve blocks are covered by in-network plans.
Which clinic treats joint pain?
Both. Davie serves Broward County and Boynton Beach serves Palm Beach County, and both offer consultations, joint injections, nerve blocks and PRP. StemWave shockwave therapy is available at Davie only.