Conditions Evaluated
Joint Pain
Evaluation.
Joint pain is among the most common reasons patients are referred for pain medicine evaluation. It can arise from mechanical, degenerative, or inflammatory processes and may involve one or several joints. Dr. Dardashti evaluates joint pain in the context of the patient's full clinical picture — to identify the most likely contributing factors before treatment is planned.
In Brief
Multiple Contributing Mechanisms
Joint pain can arise from mechanical wear, degenerative changes, inflammatory processes, prior injury, or referred pain from adjacent structures. Identifying the likely mechanism guides evaluation and treatment.
Location and Context Matter
The character, location, onset, and associated features of joint pain — including its relationship to activity, rest, and prior treatment — provide important clinical information.
Individualized Evaluation
A clinical evaluation incorporating history, physical examination, and relevant imaging findings is needed to determine the most appropriate treatment approach for each patient.
Overview
What Is Joint Pain?
A joint is the interface between two or more bones, supported by cartilage, ligaments, and surrounding soft tissue. Pain can arise from within the joint itself — its cartilage, synovium, capsule, or supporting structures — as well as from adjacent structures such as bursae, tendons, or referred pain from the spine or other joints.
Degenerative joint disease, sometimes called osteoarthritis, is one of the most common sources of joint pain and involves progressive wearing of the cartilage surfaces. Inflammatory conditions — including rheumatoid arthritis and related diagnoses — can also produce significant joint pain and are typically managed in coordination with rheumatology. Post-traumatic joint pain following injury, surgery, or prolonged mechanical stress is another common presentation.
Pain that appears to originate in a joint may sometimes be referred from a nearby structure — for example, hip pain may originate from the sacroiliac joint or lumbar spine, and knee pain may have a component from the hip or from adjacent soft tissue. Accurate evaluation helps distinguish local joint pathology from referred sources.
Evaluation
Common Reasons for Evaluation.
Patients are commonly referred or present for evaluation due to:
- Persistent joint pain that has not responded adequately to conservative measures
- Joint pain that limits daily function, mobility, or quality of life
- Pain that is disproportionate to findings on imaging or prior workup
- Joint pain in the setting of known degenerative changes that has not been well managed
- Pain referred to a joint from another source that has not been clearly identified
- Prior joint procedures or surgeries with persistent or recurrent pain
Approach
How Dr. Dardashti Evaluates Joint Pain.
Evaluation begins with a thorough history — including the affected joint or joints, the onset and character of pain, aggravating and relieving factors, prior treatments and their responses, and any relevant history of injury, surgery, or systemic inflammatory disease.
Physical examination assesses range of motion, palpation findings, joint line tenderness, and signs of inflammation. It also looks for evidence of referred pain from adjacent structures or the spine. Imaging — such as X-ray or MRI — is reviewed when available to help characterize the degree of structural involvement, though imaging findings are interpreted alongside the clinical presentation rather than in isolation.
When inflammatory joint disease is suspected, coordination with rheumatology may be appropriate. Pain medicine evaluation focuses on identifying pain generators and developing a treatment plan to reduce pain and support function.
Treatment
Treatment Options That May Be Considered.
Treatment is individualized based on the specific joint, suspected mechanism, severity of symptoms, and prior treatment history. Options that may be considered include:
- Physical therapy and activity modification to reduce mechanical joint stress
- Medication management when clinically appropriate
- Image-guided joint injections for selected patients to reduce pain and support function
- Sacroiliac joint injections when the sacroiliac joint is a primary contributor
- Facet joint injections when spinal facet joints are the suspected source
- Coordination with orthopedics or rheumatology when indicated by clinical findings
- Multimodal pain management planning when joint pain is part of a broader chronic pain picture
Not every patient with joint pain requires an injection. Recommendations are based on the individual patient's clinical presentation, prior treatment history, and functional goals.
Limitations
Important Limitations.
Joint pain has many possible causes and contributing factors. Imaging findings such as degenerative changes do not always correlate directly with the degree of pain, and treatment response varies among patients.
A formal clinical evaluation is required to determine an appropriate treatment approach for any individual patient. This page is for general informational purposes only and does not constitute medical advice or create a physician-patient relationship.
Dr. Dardashti sees patients in Mission Hills, California, serving patients from the San Fernando Valley, Santa Clarita Valley, and surrounding Los Angeles communities.