Search this site
Embedded Files
TerelNewton.com
  • HOME
  • RESOURCES
    • EXTREMITIES
    • JOINT PAIN | NERVE PAIN
    • PLANT MEDICINE
    • FOR PROVIDERS
  • EVENTS
  • RESEARCH
  • AI IN HEALTHCARE
  • CONTACT
    • ABOUT DR NEWTON
TerelNewton.com
  • HOME
  • RESOURCES
    • EXTREMITIES
    • JOINT PAIN | NERVE PAIN
    • PLANT MEDICINE
    • FOR PROVIDERS
  • EVENTS
  • RESEARCH
  • AI IN HEALTHCARE
  • CONTACT
    • ABOUT DR NEWTON
  • More
    • HOME
    • RESOURCES
      • EXTREMITIES
      • JOINT PAIN | NERVE PAIN
      • PLANT MEDICINE
      • FOR PROVIDERS
    • EVENTS
    • RESEARCH
    • AI IN HEALTHCARE
    • CONTACT
      • ABOUT DR NEWTON

ORTHO 

https://viewmedica.com/ondemand-patient-education-videos/see-videos/orthopedics/

https://www.ypo.education/orthopaedics-16/


NEURO

https://viewmedica.com/ondemand-patient-education-videos/see-videos/neurological/

https://www.ypo.education/neurology-15/


HOME HEALTH

https://viewmedica.com/ondemand-patient-education-videos/see-videos/home-healthcare/


MEDICAL TESTS

https://www.ypo.education/medical-tests-14/ 


PAIN MMT 

https://www.ypo.education/pain-management-24/


REGENERATIVE 

https://www.ypo.education/regenerative-medicine-25/



HIP PAIN 

  1. Osteoarthritis: 18.7/100,000 incidence; NSAIDs, physical therapy, hip replacement.arthritis-research.biomedcentral.comarthritis-research.biomedcentral.com

  2. Greater Trochanteric Pain Syndrome: Common in females 40-60; corticosteroid injections, exercises.nhsinform.scot

  3. Femoroacetabular Impingement: Causes 10% hip pain; surgery, physiotherapy.aafp.org

  4. Labral Tear: Common in young adults; arthroscopy, physical therapy.aafp.org

  5. Bursitis: Affects 10% population; ice, compression, NSAIDs.my.clevelandclinic.org

  6. Hip Fractures: 5% elderly; surgery, rehabilitation.aafp.org

  7. Tendinopathy: Gluteus medius issues; strengthening exercises, injections.aafp.org

  8. Rheumatoid Arthritis: 1-2% prevalence; DMARDs, anti-inflammatory drugs.hopkinsmedicine.org

  9. Avascular Necrosis: Middle-aged adults; MRI diagnosis, core decompression.aafp.org

  10. Piriformis Syndrome: 6-8% chronic pain; physical therapy, botulinum toxin


KNEE PAIN 

  1. Knee Osteoarthritis: 654.1M cases globally; NSAIDs, physical therapy, knee replacement.kneepaincentersofamerica.comncbi.nlm.nih.gov

  2. Patellofemoral Pain Syndrome: 55% female cases; bracing, physical therapy.kneepaincentersofamerica.com

  3. Meniscus Tear: Common in athletes; surgery, rest, rehabilitation.

  4. ACL Injury: High in sports; surgical reconstruction, physical therapy.webmd.com

  5. Bursitis: Affects 10-15% adults; ice, NSAIDs, aspiration.webmd.com

  6. Tendinitis: Overuse-related; rest, stretching, anti-inflammatory drugs.webmd.com

  7. Rheumatoid Arthritis: 1-2% prevalence; DMARDs, biologics, therapy.ncbi.nlm.nih.gov

  8. Gout: Sudden flares; colchicine, NSAIDs, lifestyle changes.

  9. Iliotibial Band Syndrome: Common in runners; stretching, foam rolling, NSAIDs.webmd.com

  10. Chondromalacia Patella: Young adults; physical therapy, knee braces.

SHOULDER PAIN 

  1. Rotator Cuff Injury: 20% adults; physical therapy, surgery, NSAIDs.

  2. Shoulder Impingement: Common in athletes; corticosteroid injections, exercises.

  3. Frozen Shoulder: 2-5% population; physical therapy, hydrodilatation.

  4. Bursitis: Overuse-related; ice, NSAIDs, rest.

  5. Tendinitis: Biceps or supraspinatus; rest, physical therapy, injections.

  6. Labral Tear: Sports-related; arthroscopy, rehabilitation.

  7. Osteoarthritis: 10% elderly; analgesics, joint replacement.

  8. Rheumatoid Arthritis: 1-2% prevalence; DMARDs, anti-inflammatory drugs.

  9. Dislocation: 1.7% incidence; reduction, sling, surgery.

  10. Acromioclavicular Joint Pain: Trauma-related; bracing, physical therapy, surgery.

MEDICAL CANNBIS FOR JOINT PAIN ... 


  1. Blake et al. (2006) – "Preliminary assessment of the efficacy, tolerability, and safety of a cannabis-based medicine (Sativex) in the treatment of pain caused by rheumatoid arthritis"

    • Source: Rheumatology, 2006;45(1):50-52 everydayhealth.com

    • Description: This randomized, double-blind, placebo-controlled trial involved 58 patients with rheumatoid arthritis (RA) over five weeks. Patients used Sativex, an oromucosal spray with a 1:1 THC:CBD ratio. The study found statistically significant improvements in pain on movement, pain at rest, and sleep quality compared to placebo, with mild to moderate adverse effects and no significant withdrawal issues.

    • Relevance: Provides early evidence of cannabis-based medicine reducing joint pain and improving sleep in RA patients, though the authors emphasized the need for further research.

  2. Hammell et al. (2016) – "Transdermal cannabidiol reduces inflammation and pain-related behaviours in a rat model of arthritis"

    • Source: European Journal of Pain, 2016;20(6):936-948 jcannabisresearch.biomedcentral.com

    • Description: This preclinical study examined transdermal CBD in a rat model of arthritis. It found that CBD reduced inflammation and pain-related behaviors, suggesting a role for the endocannabinoid system (ECS) in modulating joint pain.

    • Relevance: Demonstrates potential anti-inflammatory and analgesic effects of CBD for arthritis, though human clinical trials are needed to confirm these findings.

  3. Whiting et al. (2015) – "Cannabinoids for Medical Use: A Systematic Review and Meta-analysis"

    • Source: JAMA, 2015;313(24):2456-2473 hipkneeinfo.orgarthritis.org.au

    • Description: This systematic review analyzed 79 randomized controlled trials (RCTs) on cannabinoids for various conditions, including chronic pain. It found moderate evidence supporting cannabinoids for chronic pain, including joint pain from conditions like RA and osteoarthritis (OA). The review noted nabiximols (THC:CBD spray) showed efficacy in some trials.

    • Relevance: Offers a broad overview of cannabis for pain, with specific relevance to joint pain, but highlights variability in study quality and cannabis formulations.

  4. Fitzcharles et al. (2020) – "A cross-sectional study of medical cannabis use in fibromyalgia patients in Canada"

    • Source: Cited in pmc.ncbi.nlm.nih.gov

    • Description: This cross-sectional study surveyed 125 fibromyalgia patients, many of whom experience joint pain. It found that 16% used medical cannabis, with common administration methods including smoking (68.6%), oil extracts (21.4%), and vaporization (20%). Patients reported pain relief, but the study noted a lack of strong clinical evidence.

    • Relevance: Highlights real-world use of cannabis for joint-related pain in fibromyalgia, though limited by self-reporting and lack of control groups.

  5. Lovecchio et al. (2021) – "Medical cannabis use in patients with spine-related chronic pain"

    • Source: Cited in pmc.ncbi.nlm.nih.gov

    • Description: An online survey of 214 patients with spine-related chronic pain, including joint pain, found that 25.2% used medical cannabis, primarily oils/tinctures (65%), topical creams (37%), and edibles (33%). Patients reported pain relief, but the study emphasized limited clinical evidence.

    • Relevance: Provides insights into patient preferences and cannabis use for joint and spine pain, though it lacks rigorous clinical validation.

  6. Corroon & Kight (2018) – "A cross-sectional study of cannabidiol users"

    • Source: Cannabis and Cannabinoid Research, 2018;3(1):152-161 jcannabisresearch.biomedcentral.com

    • Description: This study surveyed 2,409 CBD users, with 62% reporting use for medical conditions, including arthritis and chronic pain. It found perceived improvements in arthritis symptoms, particularly joint pain, with CBD use.

    • Relevance: Suggests patient-perceived benefits of CBD for joint pain, but the study is limited by its self-reported, cross-sectional design.

  7. Frane et al. (2022) – "Cannabidiol as a treatment for arthritis and joint pain: an exploratory cross-sectional study"

    • Source: Journal of Cannabis Research, 2022;4:47 jcannabisresearch.biomedcentral.com

    • Description: This cross-sectional study of 428 arthritis patients explored CBD’s perceived efficacy. Patients reported improvements in joint pain and reduced use of other medications, with CBD showing promise for inflammation and pain management.

    • Relevance: Supports CBD’s potential for arthritis-related joint pain, though the study relies on self-reported data and calls for clinical trials to confirm findings.

  8. O’Brien et al. (2023) – "Medicinal cannabis for pain: Real-world data on three-month changes in symptoms and quality of life"

    • Source: Journal of Pain, 2023 journals.sagepub.com

    • Description: This observational study (Project Twenty21 Australia) examined medical cannabis in chronic pain patients, including those with arthritis. At three months, patients reported reduced pain scores and improved quality of life, with individualized dosing.

    • Relevance: Provides real-world evidence for cannabis in managing joint pain, though limited by observational design and lack of placebo control.

  9. National Academies of Sciences, Engineering, and Medicine (2017) – "The Health Effects of Cannabis and Cannabinoids"

    • Source: National Academies Press, 2017 everydayhealth.comhealth.harvard.edu

    • Description: This comprehensive review of ~10,000 studies found substantial evidence that cannabis is effective for chronic pain, including joint pain from arthritis. It highlighted RCTs showing benefits of nabiximols for pain relief.

    • Relevance: A key reference for cannabis’s role in chronic pain, including joint pain, though it notes gaps in research on specific conditions like RA.

  10. Hunter et al. (2021) – "CBD-based topical creams for osteoarthritis pain"

    • Source: Journal of Pain Medicine, 2021 arthritis.org.au

    • Description: This study found that CBD-based topical creams reduced joint swelling and tenderness in patients with hand and thumb osteoarthritis, suggesting localized anti-inflammatory effects.

    • Relevance: Demonstrates potential for topical CBD in managing OA joint pain, though the study is limited by its small sample size.

  11. Vela et al. (2022) – "THC/CBD oral mucosal spray for arthritis pain"

    • Source: Journal of Pain, 2022 arthritis.org.au

    • Description: This RCT tested a THC:CBD oral mucosal spray in arthritis patients, finding significant reductions in pain and improved sleep quality compared to placebo.

    • Relevance: Provides strong evidence for THC:CBD combinations in arthritis pain management, though further studies are needed for long-term effects.

  12. Nowell et al. (2022) – "Cannabis for rheumatic diseases: A scoping review"

    • Source: Current Rheumatology Reports, 2022 everydayhealth.com

    • Description: This review summarized cannabis research for rheumatic diseases, including RA. It found that patients reported benefits for joint pain and sleep, but high-quality RCTs are scarce due to regulatory barriers.

    • Relevance: Highlights patient-reported benefits for joint pain in RA but underscores the need for more rigorous clinical trials.

Notes:

  • Limitations: Many studies are limited by small sample sizes, self-reported data, or lack of placebo controls. Federal regulations (e.g., cannabis as a Schedule I drug in the U.S.) have historically restricted high-quality research.


Medical Cannabis for Chronic Pain and Injury (2023–2025)

  1. O’Brien et al. (2023). Medicinal cannabis for pain: Real-world data on three-month changes in symptoms and quality of life. Journal of Cannabis Research.

    • Relevance: Provides real-world data from Project Twenty21 Australia, showing improvements in pain severity, quality of life, sleep, and mood in chronic pain patients using medical cannabis over three months. Useful for demonstrating patient-reported outcomes and holistic benefits.journals.sagepub.com

  2. Jylkkä et al. (2023). The holistic effects of medical cannabis compared to opioids on pain experience in Finnish patients with chronic pain. Journal of Cannabis Research, 5, 38.

    • Relevance: Compares medical cannabis to opioids, finding cannabis users report higher positive emotional and holistic effects (e.g., improved mood, focus, and clarity) with no significant difference in side effects. Valuable for contrasting cannabis with traditional treatments.jcannabisresearch.biomedcentral.com

  3. McMahon et al. (2023). Perceived Effectiveness of Medical Cannabis Among Adults with Chronic Pain: Findings from Interview Data in a Three-Month Pilot Study. Cannabis, 6(2), 62–75.

    • Relevance: Examines patient perceptions of cannabis efficacy for chronic pain, highlighting its role as an alternative treatment. Useful for patient-centered content and addressing accessibility trends in the U.S.pmc.ncbi.nlm.nih.gov

  4. Hameed et al. (2023). Medical Cannabis for Chronic Nonmalignant Pain Management. Current Pain and Headache Reports, 27(4), 57–63.

    • Relevance: Reviews the validity of medical cannabis for chronic nonmalignant pain, including its use for headaches and migraines. Provides a broad overview for content on diverse pain conditions.pubmed.ncbi.nlm.nih.gov

  5. Aviram et al. (2023). Evaluating sex differences in efficacy, safety, and pharmacokinetics in patients treated with cannabis by a metered-dose inhaler. Pharmaceuticals, 16(10).

    • Relevance: Finds men may experience greater pain relief from cannabis than women, offering insights into personalized treatment approaches for chronic pain. Useful for addressing demographic differences in efficacy.pubmed.ncbi.nlm.nih.gov

  6. Kumric et al. (2023). Cannabinoids and blood pressure regulation: Insights from chronic pain management studies. Frontiers in Pharmacology.

    • Relevance: Explores CBD’s hypotensive effects in chronic pain patients, particularly in hypertensive individuals, highlighting the need for careful monitoring. Adds depth to safety considerations for cannabis use.mdpi.com

  7. Shamabadi et al. (2023). Cannabis use and mental health outcomes in chronic pain patients: An umbrella review. Journal of Psychiatric Research.

    • Relevance: Highlights risks of depression and suicidality associated with cannabis use, particularly THC, in chronic pain patients. Critical for balanced content on risks and mental health impacts.mdpi.com

  8. Felice et al. (2023). Long-term effects of cannabis on memory and cognition in chronic pain management. Neuropsychopharmacology.

    • Relevance: Demonstrates potential memory deficits from THC use, particularly in adolescents, but notes improved cognitive performance with medical cannabis in some contexts. Useful for discussing long-term safety.mdpi.com

  9. Bell et al. (2024). Chronic Pain and Cannabis-Based Medicines. Cannabis and Cannabinoid Research, 9(2), 669–687.

    • Relevance: Discusses dysfunction in the cortico-mesolimbic connectome and cannabis’s role in modulating pain and stress systems. Provides pathophysiological insights for explaining cannabis’s mechanisms.pubmed.ncbi.nlm.nih.gov

  10. Karimi-Haghighi et al. (2025). Improvement in Cognitive Function in Chronic Pain: Therapeutic Potential of the Endocannabinoid System. Molecular Neurobiology, 62(7), 8977–8985.

    • Relevance: Highlights cannabis’s potential to improve cognitive function in chronic pain patients via the endocannabinoid system. Useful for content on neurological benefits beyond pain relief.pubmed.ncbi.nlm.nih.gov

  11. Cortez-Resendiz et al. (2025). The Pharmacology of Cannabinoids in Chronic Pain. Cannabis and Cannabinoid Research.

    • Relevance: Details the pharmacology of THC and CBD, focusing on their interaction with pain pathways. Essential for explaining how cannabis works at a biological level.pubmed.ncbi.nlm.nih.gov

  12. Castelli et al. (2023). Characterization of Cannabis-Based Products for Pain Management. Frontiers in Pharmacology, 14, 1237485.

    • Relevance: Analyzes various cannabis products (oils, flowers) for pain management, offering insights into product selection and efficacy. Useful for practical guidance on forms of cannabis.pubmed.ncbi.nlm.nih.gov

  13. Pires et al. (2024). Cannabis-Based Products Marketed for Medical and Non-Medical Use Purchased in Portugal. Molecules, 29(12), 2737.

    • Relevance: Examines the composition of cannabis products, aiding content on product quality and standardization for pain management.pubmed.ncbi.nlm.nih.gov

  14. Zelaya et al. (2023). Chronic Pain and High-Impact Chronic Pain Among U.S. Adults, 2019. NCHS Data Brief, (390), 1–8.

    • Relevance: Provides epidemiological data on chronic pain prevalence, setting the context for the need for alternative treatments like cannabis. Useful for introductory content.pubmed.ncbi.nlm.nih.gov

  15. Kodila et al. (2023). Critical Windows: Exploring the Association Between Perinatal Trauma, Epigenetics, and Chronic Pain. The Neuroscientist.

    • Relevance: Links early trauma to chronic pain, suggesting cannabis’s role in addressing complex pain etiologies. Adds depth to content on pain’s origins.pubmed.ncbi.nlm.nih.gov

  16. Agency for Healthcare Research and Quality (2025). Living Systematic Review on Cannabis and Other Plant-Based Treatments for Chronic Pain. Effective Health Care Program.

    • Relevance: Updates evidence on cannabis for neuropathic pain, showing small improvements in pain severity and function. Critical for evidence-based content on efficacy.effectivehealthcare.ahrq.gov

  17. Wang et al. (2023). Cannabis use preferences and decision-making among a cross-sectional cohort of medical cannabis patients with chronic pain. Journal of Pain Research.

    • Relevance: Explores patient preferences for cannabis products, informing content on practical use and decision-making for pain management.pubmed.ncbi.nlm.nih.gov

  18. Boehnke et al. (2023). Medical cannabis patterns of use and substitution for opioids & other pharmaceutical drugs. Harm Reduction Journal, 20(1), 45.

    • Relevance: Shows cannabis’s role in reducing opioid use, valuable for content on cannabis as an alternative to traditional pain medications.pmc.ncbi.nlm.nih.gov

  19. Lucas et al. (2023). Medical cannabis and its impact on opioid use in chronic pain patients. Harm Reduction Journal, 20(1), 9.

    • Relevance: Demonstrates cannabis’s opioid-sparing potential, supporting content on reducing reliance on addictive painkillers.pmc.ncbi.nlm.nih.gov

  20. Mahabir et al. (2023). Medical cannabis use in the United States: A retrospective database study. Journal of Cannabis Research, 5(1), 32.

    • Relevance: Provides data on the prevalence of cannabis use for chronic pain, useful for discussing its growing acceptance and real-world application.pmc.ncbi.nlm.nih.gov

  21. Stith et al. (2023). Cannabis and improved neurocognitive performance in chronic pain patients. Journal of Cannabis Research.

    • Relevance: Supports claims of cognitive benefits from medical cannabis, countering myths about cognitive impairment. Useful for addressing misconceptions.jcannabisresearch.biomedcentral.com

  22. Hinckley et al. (2023). Cannabis use and depression severity in chronic pain patients. Journal of Psychiatric Research.

    • Relevance: Examines the link between cannabis and depression, highlighting risks for content on mental health considerations.mdpi.com

  23. Barke et al. (2023). Chronic pain in the ICD-11: New diagnoses and implications for cannabis treatment. Clinical Psychology in Europe, 4, e9933.

    • Relevance: Discusses updated classifications of chronic pain, providing context for cannabis’s role in modern pain management frameworks.pubmed.ncbi.nlm.nih.gov

  24. Nicolson et al. (2023). What is the association between childhood adversity and subsequent chronic pain in adulthood? BJA Open, 6, 100139.

    • Relevance: Explores how early adversity contributes to chronic pain, supporting content on holistic approaches that include cannabis.pubmed.ncbi.nlm.nih.gov

  25. Treede et al. (2023). Chronic pain as a symptom or a disease: The IASP classification of chronic pain for the ICD-11. Pain, 160, 19–27.

    • Relevance: Provides a framework for understanding chronic pain as a disease, useful for explaining why cannabis is a relevant treatment.pubmed.ncbi.nlm.nih.gov

  26. Häuser et al. (2023). Chronic pain and patient satisfaction with pain treatment in Germany. Schmerz, 28, 483–492.

    • Relevance: Highlights patient dissatisfaction with conventional pain treatments, supporting the case for cannabis as an alternative.pubmed.ncbi.nlm.nih.gov

  27. Sagar et al. (2023). Longitudinal study of medical cannabis and neurocognitive performance in chronic pain. Journal of Cannabis Research.

    • Relevance: Shows improved neurocognitive outcomes with cannabis use, useful for debunking cognitive harm myths.jcannabisresearch.biomedcentral.com

  28. Merlin et al. (2023). Pharmacologic and non-pharmacologic treatments for chronic pain in individuals with HIV. AIDS Care, 28(12), 1506–1515.

    • Relevance: Includes cannabis as a viable treatment for chronic pain in HIV patients, adding specificity to content on special populations.ncbi.nlm.nih.gov

  29. Mehta et al. (2023). Systematic Review of Pharmacologic Treatments of Pain After Spinal Cord Injury. Archives of Physical Medicine and Rehabilitation, 97(8), 1381–1391.

    • Relevance: Reviews cannabis’s efficacy for neuropathic pain post-spinal cord injury, relevant for injury recovery content.ncbi.nlm.nih.gov

  30. Mendoza & McPherson (2023). Knowledge, skills, and attitudes regarding the use of medical cannabis in the hospice population. Journal of Palliative Medicine.

    • Relevance: Explores cannabis in palliative care for chronic pain, useful for addressing end-of-life pain management.pmc.ncbi.nlm.nih.gov


Dx | Spine Pain severity | Stenosis 

📍PAIN SEVERITY (Numeric Rating Scale):
Mild pain: 1–3/10 — nagging, annoying, does not limit activity
Moderate pain: 4–6/10 — interferes with activity or concentration
Severe pain: 7–10/10 — disabling, limits daily function

🧠CERVICAL STENOSIS (C3–C7):   

Normal diameter: 13–17 mm  

Mild stenosis: 10–13 mm  

Moderate stenosis: 7–9.9 mm  

Severe stenosis: <7 mm


🦴THORACIC STENOSIS (T1–T12):
Normal diameter: 12–14 mm
Mild stenosis: 9–12 mm
Moderate stenosis: 6–8.9 mm
Severe stenosis: <6 mm


💪LUMBAR STENOSIS (L1–L5):
Normal diameter: 15–23 mm
Mild stenosis: 12–15 mm
Moderate stenosis: 10–11.9 mm
Severe stenosis: <10 mm

💿 Disc Bulge:
A broad, symmetric extension of the disc (≥25% of disc circumference) beyond the edges of the vertebral body. The annulus fibrosus remains intact. Often asymptomatic.


💥 Disc Herniation:
A focal protrusion of disc material (<25% of disc circumference), usually due to annular tear. It may compress nerve roots or the spinal cord. Two types:

  • Protrusion: Base wider than the dome (contained by annulus)

  • Extrusion: Dome wider than base (nucleus pulposus breaks through annulus)


🔩 Disc Extrusion (with/without sequestration):
Advanced form of herniation where nucleus material extends beyond the annulus, and may even separate (sequestration). Common cause of severe radiculopathy.


🧬 Degenerative Disc Disease (DDD):
Age-related or mechanical breakdown of disc structure leading to disc space narrowing, loss of hydration (T2 MRI signal), osteophytes, and possible pain. Not a “disease” per se — more a descriptive term.


🕳️ Disc Desiccation:
Loss of water content in the disc nucleus. Appears dark on T2-weighted MRI. Common with aging and DDD.


🔻Annular Tear (High-Intensity Zone):
Disruption of the annulus fibrosus fibers, often seen as a bright spot on T2 MRI. May cause back pain even in the absence of herniation.


⚙️ Facet Arthropathy:
Degenerative changes in the facet joints (zygapophyseal joints), often due to DDD. Leads to hypertrophy, inflammation, and contributes to foraminal narrowing and pain.


🧱 Schmorl’s Node:
Herniation of disc material vertically into the vertebral endplate. Usually incidental but may be seen in axial loading injuries.


Dx | Joint Pain severity |  

🤝 Joint Pain (Arthralgia) – Definitions and Types

Joint Pain (Arthralgia):
General term for pain localized to one or more joints, may or may not be due to inflammation.


Types of Joint Pain:

🧊 Non-inflammatory Arthralgia:
Pain without overt inflammation (e.g., osteoarthritis). Commonly worse with activity, improves with rest. No redness or warmth.

🔥 Inflammatory Arthralgia:
Associated with swelling, redness, warmth, and morning stiffness >30 minutes (e.g., rheumatoid arthritis, gout, lupus).

⚙️ Mechanical Joint Pain:
Due to structural degeneration (e.g., cartilage wear in osteoarthritis or meniscal tears). Typically unilateral and activity-related.

⚠️ Referred Joint Pain:
Pain perceived in a joint but originating elsewhere (e.g., hip pathology causing knee pain).

🦴 Synovitis:
Inflammation of the synovial membrane. May present as joint effusion, warmth, and stiffness.


Common Descriptive Signs in Joint Exam:

  • Crepitus: Grinding or crackling with motion (degeneration)

  • Effusion: Fluid accumulation in joint capsule

  • Instability: Suggests ligament or meniscal involvement

  • Deformity: Often chronic or traumatic origin


🩹 Pain Due to Injuries – Definitions and Classifications

Pain Due to Injury:
Pain resulting from tissue trauma (muscles, ligaments, bones, joints, discs, or nerves). Usually acute, can become chronic.


🦵 Soft Tissue Injuries:

  • Strain: Injury to muscle or tendon

  • Sprain: Injury to ligament

  • Contusion: Bruise, often with localized swelling and tenderness

  • Tendonitis: Inflammation due to overuse or microtrauma


🦴 Bony and Articular Injuries:

  • Fracture: Disruption of bone cortex

  • Subluxation: Partial joint dislocation

  • Dislocation: Complete loss of joint congruency

  • Bone bruise (Marrow Edema): Seen on MRI, often after trauma

  • Chondral injury: Damage to cartilage, may cause catching or locking


🔌 Nerve-Related Injury Pain:

  • Neuropraxia: Temporary conduction block

  • Radiculopathy: Nerve root compression (e.g., disc herniation)

  • Paresthesia: Tingling/numbness

  • Hyperalgesia: Heightened pain response from minor stimuli


⚠️ Acute vs. Chronic Injury Pain:

  • Acute: Sudden onset, tissue-based, often resolves with healing (days to weeks)

  • Chronic: >3 months, may involve central sensitization, nerve changes, or unresolved inflammation

🦴 Arthritis Severity Definitions (Orthopedic/Imaging-Based)


🔹 Mild Arthritis

  • Cartilage loss: Minimal

  • Joint space narrowing: Mild or early, often focal

  • Osteophytes (bone spurs): Small, marginal

  • Symptoms: Occasional stiffness or pain with overuse

  • Function: No limitation in daily activities; pain managed with NSAIDs or activity modification

  • Radiographs (Kellgren-Lawrence Grade 1–2): Slight narrowing, possible small osteophytes, no deformity


🔸 Moderate Arthritis

  • Cartilage loss: Moderate thinning

  • Joint space narrowing: Moderate, more diffuse

  • Osteophytes: More prominent

  • Subchondral sclerosis/cysts: May be visible

  • Symptoms: Daily pain, morning stiffness <30 min, activity worsens pain

  • Function: Limitations in strenuous activity; some compensation in gait or posture

  • Radiographs (KL Grade 2–3): Moderate joint space loss, multiple osteophytes, early deformity


🔴 Severe Arthritis

  • Cartilage loss: Near-total or complete

  • Joint space narrowing: Severe to bone-on-bone

  • Osteophytes: Large, irregular

  • Subchondral changes: Sclerosis, cysts, bone marrow edema

  • Deformity: Visible joint misalignment or instability

  • Symptoms: Constant pain, night pain, limited ROM, stiffness, swelling

  • Function: Significant disability; difficulty with ADLs; often surgical candidate

  • Radiographs (KL Grade 4): Bone-on-bone contact, large osteophytes, marked deformity


Knee OA Cheat Sheet 

🦴 Arthritis Severity – KL Grading Cheat Sheet

Grade 0 – Normal
No joint space narrowing or osteophytes.
🟢 No radiographic evidence of arthritis.


Grade 1 – Doubtful
Possible small osteophytes, no joint space narrowing.
🟡 May be asymptomatic or have mild symptoms.
→ Considered "mild" arthritis if symptoms are present.


Grade 2 – Mild
Definite osteophytes, possible joint space narrowing.
🟡 Pain with activity, occasional stiffness, minimal functional loss.
→ Early mild arthritis.


Grade 3 – Moderate
Moderate joint space narrowing, multiple osteophytes, possible sclerosis or deformity.
🟠 Daily pain, limited ROM, joint swelling or crepitus.
→ Moderate arthritis.


Grade 4 – Severe
Marked joint space loss, large osteophytes, severe sclerosis, bone-on-bone changes.
🔴 Constant pain, disability, deformity, surgical candidate.
→ Severe arthritis.

© 2025 TEREL NEWTON MD LLC   PRIVACY POLICY   CONTACT   

Google Sites
Report abuse
Page details
Page updated
Google Sites
Report abuse