It might be a knee, an elbow, an ankle or a shoulder. It still feels painful long after you’ve healed from an injury. Why does this pain continue in a joint for months—or even years—after that injury? Sometimes the reasons are obvious, but other times, the source of pain is not what you might think. A clear understanding of these root causes will make it easier to successfully treat the pain for lasting, sustainable relief. Let’s consider a few of these causes. 

Tissue Damage

The most obvious culprits of chronic joint pain is permanent tissue damage. This can include changes like osteoarthritis, bone spurs, spinal disc degeneration, torn ligaments, or posture and alignment conditions like scoliosis.

However, while these issues might be present in a chronically painful joint, they are not necessarily the source of pain. In fact, research shows a relatively low correlation between how much spinal arthritis someone has and how much pain they deal with.

Many patients at our clinic experience tremendous relief despite having scar tissue and arthritis in or near their joints—and yet, after the relief, this scar tissue and arthritis are still present. This means those issues were not the main causes of pain. In our clinic, we see that, while arthritis and scar tissue might cause stiffness or discomfort, other factors are more likely to result in intense or chronic joint pain. 

Inflammation

Another likely suspect is inflammation—a normal part of injury healing. However, sometimes a joint will remain inflamed long after the recovery process ends. This can lead to swelling, tenderness, and chronic pain. Anti-inflammatory medications might offer temporary relief, but in many cases, the symptoms return without medication. For lasting relief, it is important to locate and resolve the root cause of inflammation. 

Instability

Chronic joint pain can also be caused by joint instability. If a joint moves in directions that it’s not supposed to—even a small amount—this can result in mild to severe pain. Think of the joint as a wheel on a car or bicycle. It should rotate smoothly without shakes or wobbles. If a slight wobble occurs, it can ruin bearings and even cause damage to other body parts.  

Fascia Restriction

Finally, restrictions in the body’s connective tissue called fascia can lead to chronic joint pain as well. Fascia is a network of fibrous sheets and web-like structures, covering the muscles, bones, joints, and other tissues. Fascia contains nerve endings that give us position sense, which makes coordinated motion possible. All muscular balance, joint alignment, and joint stability require accurate position sense. When fascia restrictions or distortions occur, all those functions can be altered by faulty position sense and unstable joint mechanics. 

Identifying the Root Cause

These four major causes of chronic joint pain can be intertwined. Structural damage, such as torn ligaments might cause instability, then lead to inflammation and new fascia restriction. On the other hand, pain from inflammation could activate muscle tension, which leads to instability, new fascia restriction, and possibly arthritis. In other words, any of these factors can also develop or exacerbate the others. Successful treatment often requires temporary symptom treatment, but permanent relief necessitates finding the root cause wherever possible. Let’s break down at each of these four factors again from a treatment point of view. 

Treating Fascia Restrictions

Treating joint pain is a large component of my practice. Due to fascia restriction’s ability to disrupt muscle or joint function, I find that treating these issues can offer powerful joint pain relief. Restoring position sense often returns joint stability and quenches inflammation. I have seen hundreds of cases in which a weak or painful joint became more stable with the release of fascia restriction. Successful fascia treatment can also reduce or eliminate swelling and tenderness in previously inflamed joints. 

Treating Structural Damage

Structural damage is usually not reversible—but, as I mentioned earlier, research has found low correlation between joint degeneration and chronic pain. Often, the pain is due to fascia restrictions and the subsequent instability or inflammation.

If the structural damage is severe enough, a person might need to wear a supportive brace or even undergo surgery, but in my practice, those patients generally find pain relief with fascia treatment. Their joints continue to look the same on an X-ray or MRI, but their pain is relieved. They often become more flexible and resilient in the problem area. Also, patients whose arthritis has been worsening each year (as seen on X-ray or MRI) often see the progression halt after a thorough course of fascia therapy. 

Treating Joint Instability

Sometimes joint instability is due to permanent ligament issues, and therefore, can only be treated with muscular exercises, orthopedic braces, or surgical procedures. However, 95 percent of the joint instability that I see in my practice is due to position sense distortions from abnormal fascia restriction. When these restrictions are released, the muscular balance can be restored, which helps the joint regain its stability. 

Treating Inflammation

For reasons poorly understood, it seems that inflammation can become stuck within its own feedback loop. This prevents the inflammation from resolving after an injury heals. In such cases, a steroid injection is sometimes given to halt the feedback loop and soothe inflammation. However, steroid injections usually do not offer permanent relief.

Oral anti-inflammatory medications, such as ibuprofen, can be helpful in relieving pain, but they do not resolve chronic pain at its source—and sometimes, they produce troubling side-effects. Fascia therapy, on the other hand, can often remove the underlying stresses that activate chronic inflammation. In fact, I see long-term pain relief from treating fascia restrictions more often than from using steroids or anti-inflammatories. 

The Bottom Line for Lasting Pain Relief

Because multiple factors are involved in chronic pain after a joint has been injured, each case is unique—but the most effective relief comes from identifying the root causes. At times surgery, orthopedic supports, or steroid injections might be required. However, in my experience, the less invasive option of fascia therapy is usually the most effective treatment.

Releasing fascia restriction frequently helps to achieve sustainable pain relief even in cases where surgery or orthopedic supports are also required. Of course, physical therapy to strengthen the affected areas can be quite helpful, too—as long as the root problems are being treated. Ultimately, each patient needs careful assessment to find a type of treatment that will successfully heal the root causes of their chronic injury-related joint pain. 

Dr. Eric Winder has been practicing chiropractic for 27 years, with a focus on relieving pain and restoring alignment and motion through gentle soft tissue therapies. For more information, call 941-957-8390 or visit https://gentlebay.com/