Arthritis and Pain Beyond the Joints

When it comes to arthritis, the most common issue that people mention is pain and inflammation in the joints of your hands, hips, shoulders, fingers or other parts. It is no surprise that most medical care for arthritis centers around the joints, as this is where the swelling is. However, though inflammation and reduced range of motion are issues, it is soreness that is the most common issue with many arthritis sufferers. The key to treating this may not lie in the joints, but the brain, which is sending signals to the inflamed joints in your knee, hand, or other body part.

Arthritis and Pain Beyond the Joints

How the Brain Decides on Joint Pain Levels

A spasm or soreness is usually felt at the site of an injury, but the signal to feel an ache is created somewhere else. Your body has a wiring of nerves throughout it, all of which lead to the brain. An injury, or in the case of arthritis an inflammation, is detected by the nerve and this information is sent to the brain. The brain must then judge how dangerous this issue is to you, and try and give a fair pain response. In the case of osteoarthritis where the bone is breaking down and changing the way that your knee or other area can support itself, the arthritis in knee likely comes off as a severe danger to your brain and is therefore very painful. The osteoarthritis may be less severe than the brain realizes, however, and because of this it is often more successful to focus on the way the brain processes the information instead of reducing swelling at the site.

A Better Treatment Plan

If your arthritis symptoms include severe knee pain or other soreness, an alternate response is to first get a clearer idea of how the nervous system is responding to your osteoarthritis. Though the brain tries to coordinate pain with level of trauma, this is not always correct, and there can be both heightened and low reactions to the same response in different people. Looking for these nerves that might be responding with too large a reaction can do a lot to lessen the pain. Once this is done, it makes it easier to evaluate the correct level of osteoarthritis treatment for you. In some cases, it will allow for a less invasive treatment plan, and a more natural healing regime. In other cases, it will make it clearer that a knee or other part needs replacement as mobility and function don’t improve when soreness is no longer as great a factor.

Telltale Signs

Looking at brain function in regard to how the nerves perceive an area doesn’t work for everyone, but there are signs that might suggest that it might work for you. A sense that a portion of your body is bigger, smaller, or disconnected from the rest of it is one good sign that there is something amiss in your nervous processing system. This may be subtle, so it is always a good idea to come in with an open mind, whether enhanced nerve response seems likely to you or not.


In this instance, an athlete was originally diagnosed with minor quadriceps muscle strain and was treated for four weeks, with unsatisfactory results. When he came to our clinic, the muscle was not healing, and the patients’ muscle tissue had already begun to atrophy.

Upon examination using MSUS, we discovered that he had a full muscle thickness tear that had been overlooked by his previous provider. To mitigate damage and promote healing, surgery should have been performed immediately after the injury occurred. Because of misdiagnosis and inappropriate treatment, the patient now has permanent damage that cannot be corrected.

The most important advantage of Ultrasound over MRI imaging is its ability to zero in on the symptomatic region and obtain imaging, with active participation and feedback from the patient. Using dynamic MSUS, we can see what happens when patients contract their muscles, something that cannot be done with MRI. From a diagnostic perspective, this interaction is invaluable.

Dynamic ultrasonography examination demonstrating
the full thickness tear and already occurring muscle atrophy
due to misdiagnosis and not referring the patient
to proper diagnostic workup

Demonstration of how very small muscle defect is made and revealed
to be a complete tear with muscle contraction
under diagnostic sonography (not possible with MRI)


Complete tear of rectus femoris
with large hematoma (blood)


Separation of muscle ends due to tear elicited
on dynamic sonography examination

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