Chronic Joint Pain: Finding Relief
Oct 30, 2026 10:00AM ● By Eric Winder
Photo credit to Monkey Business Images
It might be a knee, an elbow, an ankle, or a shoulder. Wherever the pain manifests, it still hurts long after an injury heals. Why does pain continue in a joint for months or even years? Sometimes the reasons are obvious, but sometimes they’re not what you think. Understanding the sources of pain makes it easier to successfully treat and achieve lasting relief.
Tissue Damage
The most obvious potential cause of chronic joint pain is permanent tissue damage. This can include changes like osteoarthritis, bone spurs, spinal disc degeneration, torn ligaments, or an altered postural alignment such as scoliosis.
All of these changes could be present in a chronically painful joint, but they are not necessarily the source of pain. In fact, research shows only a low correlation between how much spinal or shoulder arthritis someone has and how much pain they experience.
Many patients at our clinic feel tremendous pain relief despite having scar tissue and arthritis in or near previously painful joints—even when the scar tissue and arthritis are still present. In other words, those areas of tissue damage were not the main causes of pain. In our clinic, we see other factors are more likely to cause pain. Arthritis and scar tissue usually cause some stiffness or discomfort, but not more intense levels of pain.
Inflammation
Another likely suspect is inflammation—a normal occurrence in healing injuries. However, sometimes a joint is still inflamed long after recovery should be complete. This can mean swelling, tenderness, or soreness in the affected joint. Anti-inflammatory medications might offer temporary relief, but in many cases, symptoms return without the 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 or motions that it shouldn’t (even a small amount), this can cause anything from mild to severe pain. A joint is like the wheel on a car or a bicycle—it should rotate smoothly without even a small degree of shake or wobble. If a slight wobble occurs, it can impact a joint’s bearings and even cause damage to other parts of the body.
Fascia Restriction
The connective tissue called fascia can have restrictions, which lead to painful joints as well. Fascia is a network of fibrous sheets and web-like structures that runs throughout the body to cover muscles, bones, joints, and other tissues. This fascial network contains nerve endings that create position sense and allow for coordinated motion. This sense helps us maintain muscular balance, alignment, and joint stability. When the fascia has restrictions or distortions, position sense can malfunction and, in turn, cause faulty joint function.
Identifying the Root Cause
These four major causes of chronic joint pain can be intertwined. Structural damage—such as torn ligaments—can cause instability, which leads to inflammation or new fascia restriction. On the other hand, pain from inflammation could activate muscle tension, which causes instability, new fascia restriction, and possibly arthritis. In other words, any of these four factors can contribute to developing the others. Successful treatment often requires symptom management, but permanent relief requires finding the root cause wherever possible. Let’s look at each of these four factors again from a treatment point of view.
Fascia: Treating joint pain is an integral part of my practice. Due to fascia restriction’s ability to disrupt muscle and joint function, I find that treating fascia offers the most powerful results in relieving joint pain. Fascia restrictions can usually be treated with hands-on therapies that release stiffness and restriction from the tissue. Relieving fascial stiffness and restriction restores normal position sense input from the nerve endings in the tissue, which improves alignment and joint stability. I have seen hundreds of cases in which a joint that used to “give out” became more stable after releasing fascia restriction. Successful fascia treatment can also reduce or eliminate inflammation.
Structural damage: This can lead to chronic pain, and the structural changes are usually not reversible. However, research has found a low correlation between the severity of joint degeneration and severity of pain. Often, pain is due to fascia restrictions and the resulting instability or inflammation. If structural damage is serious enough, a person might need to wear a brace or undergo surgery, but many patients 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. Even patients whose arthritis has been worsening each year (as seen on X-ray or MRI) often see the progression stop after a thorough course of fascia therapy.
Instability: Sometimes joint instability is due to permanent ligament damage, and can only be treated with orthopedic braces, exercises to strengthen their muscles, or surgery in severe cases. However, 95 percent of the joint instability I see in my practice is a result of position sense distortions from abnormal fascia restriction. When these restrictions are released, muscular balance is restored, and the joint becomes stable.
Inflammation: For reasons poorly understood, it seems that inflammation can become stuck in its own feedback loop, continually maintaining itself without end, rather than resolving on its own after an injury heals. In these cases, a steroid injection is sometimes given to halt that feedback loop and resolve the inflammation. However, steroid injections usually do not offer permanent relief, and it is more common for underlying factors to cause the inflammation.
Oral anti-inflammatory medications, such as ibuprofen, can be helpful in relieving pain, but they do not resolve chronic pain and sometimes have troubling side-effects. Fascia therapy, on the other hand, can often remove the underlying stressors that activate chronic inflammation. In fact, I see long-term pain relief from treating fascia restrictions more often than I do from using steroids or other anti-inflammatory medications.
Because multiple factors contribute to chronic pain after a joint injury, each case is different. The most effective relief comes from treating the root causes. At times, surgery, orthopedic braces, or steroid injections might be required, but the less invasive option of fascia therapy is—in my experience—usually the most effective treatment.
Releasing fascia restriction frequently helps achieve relief, even in cases where surgery or orthopedic braces are also necessary. Of course, physical therapy to strengthen affected areas is also an effective adjunct to treating these root causes. In the end, each patient requires careful evaluation and a treatment method that fits their specific source of joint pain.
Eric Winder D.C. uses gentle soft tissue manual therapy and rehabilitation techniques to help patients with a wide range of chronic pain and injury problems. For more information, call 941-957-8390 or visit https://gentlebay.com/
