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What's Causing Your Pain?

One of the main causes of pain in the arm and elbow is overuse from repetitive movements, known as tennis elbow or golfer’s elbow. Both osteoarthritis and rheumatoid arthritis can also affect the elbow.

Sprains and strains of muscles and tendons generally heal with rest, but persistent pain may require ongoing pain management.

Most Common Causes Of Arm And Elbow Pain

Arthritis: Osteoarthritis and rheumatoid arthritis are both common culprits for chronic elbow joint pain, as is posttraumatic arthritis—which occurs due to a previous injury to the joint.

Tendinitis: Tendons are thick cords that attach muscle to bone. Repetitive movements and minor impacts are the most common causes of the irritation and inflammation known as tendinitis.

Tennis Elbow/Golfer’s Elbow: Also known as lateral epicondylitis, tennis/golf elbow is brought on by repetitive arm and wrist movements.

Repetitive Strain Injury: Pain caused by overuse and repetitive movement impacts not just muscles, but also nerves, ligaments and tendons. Usually, this term is used to describe injuries other than tennis/golfers elbow.

Bursitis: Bursitis of the elbow is an inflammation of the bursa, the fluid-filled sack that provides cushioning between the elbow bone and connecting tendons. It is commonly caused by overuse of the elbow, pressure on the elbow, an infection or an injury.

Pinched Nerve: Also known as nerve entrapment, a pinched nerve in the elbow usually causes pain, a tingling sensation or numbness in the arm, wrist or hand. The nerve most commonly pinched is the ulnar nerve (the nerve you feel when you accidentally bang your elbow against a sharp object).

Risk Factors

  • Athletic activity
  • Trauma

There are over 100 different types of arthritis, and the causes vary depending on the exact type or form. Osteoarthritis (OA) and rheumatoid arthritis (RA) are two of the most common types. In both cases, the loss of cartilage can be severe enough to cause bones in joints to grind against one another.

Osteoarthritis is caused by normal wear and tear on the cartilage in joints, while rheumatoid arthritis is an autoimmune disorder in which the immune system attacks tissues in the body—ultimately causing the destruction of bone and cartilage inside joints. Each is capable of causing chronic pain throughout the body. There are many options for treatment, including prolotherapy.

Most Common Causes Of Arthritis

Immune system dysfunction: Rheumatoid arthritis and Systemic Lupus Erythematosus are common immune system disorders that cause arthritis.

Injuries: A previous injury, such as a bone fracture, is often a trigger for osteoarthritis.

Obesity: Extra weight on your body puts greater stress on joints. The knees, hips and spine are particularly susceptible to the development of arthritis.

Genetics: Some people are just more prone to developing arthritis because it runs in the family.

Metabolism abnormalities: Conditions brought on by problems with metabolism can cause gout and pseudogout, which often lead to arthritis.

Risk Factors

  • Family history
  • Gender
  • Age
  • Additional health issues like obesity
Chronic back pain afflicts millions of people. There are many causes for it—ranging from poor posture to serious injuries and degenerative diseases. Although strained muscles and ligaments may cause back pain, other cases involve problems with the spinal cord.

Back pain is so common, it is the leading cause of disability in Americans under 45. While surgery is necessary in extreme cases, many types of back pain can be managed with pain control therapies like prolotherapy.

Back Pain Causes

Spinal problems

Herniated or Bulging Discs. When the soft tissue between vertebrae bulges out or becomes too compressed to cushion the vertebrae, it can cause excruciating pain in the spine. Other disc issues include pressure on the nerves and the bones of the vertebrae rubbing together.

Degenerative Disc Disease. The discs in your vertebrae provide a cushion between the bones. As we age, these tend to shrink and often tear. The bones of the vertebrae rubbing together causes pain and may limit mobility.

Spinal Stenosis. This is a narrowing of the spinal canal, fairly common with people over 60. It causes increased pressure on the spine and the nerves in the spinal cord, causing numbness in the legs and shoulders.

Wear on the Sacroiliac Joint. The sacroiliac joint is located at the junction of the spine and pelvis. It’s function is to move the load of the upper body in relation to the lower body. Swelling due to inflammation or wearing away of the cartilage can cause persistent pain to the lower back.

Spondylolisthesis and Arthritis. Spondylolisthesis is when a bone in the spine slips out of place, usually in the lower back. Arthritis is the degenerative version of this condition, in which a discs moves forward over a vertebra due to a weakening of the joints and ligaments that maintain alignment of the spine.

Scoliosis. Curvature of the spine is a congenital condition that often causes chronic pain.


Fractures of the Spine or Vertebrae. Typically caused by falls, auto accidents and sports, spinal fractures can also occur due to weakened bone structure caused by osteoporosis.

Strains and Sprains. Injury to muscles and ligaments are usually caused by lifting something and twisting at the same time, but can also be caused by car accidents and sports injuries.

Spasms. When muscles or tendons are torn in the lower back, there will often be spasms where the muscle contracts uncontrollably. Weightlifting and sports are common causes for the tears that cause spasms.

Other Causes

Lifestyle. Obesity, slouching, lack of exercise, wearing high heels are all things we do in daily life which can trigger back pain. Even stress can bring on back pain due to tensed up muscles in the back.

Medical Conditions. Fibromyalgia, tumors, kidney stones and other health problems can all contribute to or cause back pain.

Risk Factors

  • Family history
  • Gender
  • Age
  • Poor posture
  • Pregnancy
  • Additional health issues like obesity and smoking

Pain in the facial area usually afflicts adults and is more common for women. The pain can be a sharp, stabbing, aching, or similar to an electrical shock. Single parts or the entire face may be affected by periodic or constant pain.

Causes of facial pain range from physical trauma inflicted by violence, sports injuries and car accidents to a wide range of medical conditions and even allergic reactions and infections. While some physical injuries heal, other conditions are chronic and require pain management. Prolotherapy is a natural effective treatment for ongoing facial pain.

Most Common Causes Of Facial Pain

Sinusitis (Sinus Infections): An infection of the sinus occurs when excess mucus and bacteria fill the sinuses, causing congestion and inflammation of nasal passages, cheeks, eyes and even forehead. The inflamed areas often become painful.

Deviated Septum: A cause of chronic sinusitis, a deviated septum is a nasal septum (the wall dividing the nasal cavity into halves) that doesn’t separate the cavity into two passageways of equal size. Approximately 80% of all septums are off center, a common cause of ongoing sinus infections.

Temporomandibular Joint Disorders (TMJ): The temporomandibular joint is a hinge-like joint connecting the jaw to the skull. The causes of TMJ disorders are notoriously difficult to determine, but are often attributed to arthritis, teeth clenching or grinding, jaw injury and even a genetic predisposition.

Salivary Gland Infections: Known as sialadenitis, a bacterial infection of the salivary gland usually occurs when the passageway into the mouth is blocked, resulting in a painful lump in the gland and the secretion of an awful tasting pus. If not treated, an infection causes severe pain.

Trigeminal Neuralgia: A chronic pain likened to the pain of an electric shock, this condition affects the cranial nerves that control sensations for different parts of the face. These trigeminal nerves are divided into three groups: the ophthalmic branch (eye, eyelid, forehead); maxillary branch (lower eyelid, cheek, nostril, upper lip and gum); and mandibular branch (lower lip and gum, jaw and some muscles used for chewing).

Temporal Arteritis: Also known as cranial arteritis, this is an inflammation of the temporal arteries—the ones that carry blood to the head and the brain. The cause is unknown, but it has been linked to severe infections and heavy doses of antibiotics.

Fibromyalgia: A disorder causing pain throughout the body and fatigue, as well as problems with sleep and mood. It is believed fibromyalgia affects the brain in a way that amplifies the sensation of pain. This is one of the most common causes of pain treated by Dr. Pollack at Neurology & Pain Treatment.

Multiple Sclerosis: This disease causes the immune system to attack the protective cover (myelin) over nerve fibers. Symptom can range from a tingling sensation and numbness to painful muscle spasms and difficulty thinking, speaking and walking.

Risk Factors for Pain

  • Family history
  • Gender
  • Age
  • Trauma
  • Additional health issues like multiple sclerosis

Fibromyalgia causes pain throughout the body, in addition to problems with sleep and a general sense of fatigue. Research indicates the condition amplifies the sensation of pain. There is no consensus on what causes it, but in many cases it appears to be precipitated by physical trauma, surgery or a highly stressful event. Women are far more likely to have fibromyalgia than men.

The pain reported is a persistent, dull ache throughout the body. With no known cure, most patients are prescribed a pain management regime, which can include medication to reduce deep muscle pain as well as anticonvulsants and antidepressants. Prolotherapy is a treatment option that strengthens connective tissue and allows muscles to release. Physical therapy and exercise are also commonly prescribed.

Most Likely Causes Of Fibromyalgia

Physical or Emotional Trauma: The onset of fibromyalgia is often triggered by traumatic physical injury, invasive surgery, a viral infection or some profoundly stressful event in one’s life.

Genetics: Some research points to genetics having a role in the onset of fibromyalgia, although there is no conclusive evidence for this.

Hormone Imbalance: People with fibromyalgia tend to have noticeably lower levels of the hormones that regulate mood, sleep, appetite, and behavior—particularly in stressful situations. In women, pregnancy and menopause may lead to hormonal changes resulting in fibromyalgia.

Sleep Disorders: Sleep is a time of natural refreshment for the body. Insomnia and sleep disorders rob the body of the chance to heal. Less sleep means less serotonin being released, a potential cause of the pain associated with fibromyalgia.

Disease: Certain conditions like lupus and arthritis may cause fibromyalgia.

Combination of Stress, Anxiety, and Other Factors: A mixture of stressors ranging from changes in hormones to family medical history can lead to fibromyalgia. A seemingly minor injury being unable to heal can exacerbate stress.

Risk Factors of Fibromyalgia

  • Family history of fibromyalgia
  • Gender
  • Age
  • Going through menopause
  • Experiencing high stress
  • Inability to focus (“fibro fog”)
  • Additional health issues like insomnia, depression, or long-lasting disease

There are 28 bones and over 30 joints in the human foot, each susceptible to injury and disease. From Achilles tendonitis to osteoarthritis, foot and ankle pain can range from numbness and tingling to searing pain and an inability to even put weight on the foot.

While overuse or injury can cause inflammation to ligaments and tendons, and nerve damage can cause burning or tingling, osteoarthritis is by far the most common persistent source of pain in the foot. Prolotherapy is the most effective treatment to produce tissue regeneration, reduce pain and avoid surgery.

Most Common Causes Of Foot And Ankle Pain

Arthritis: Characterized by chronic inflammation (and pain!) caused by the loss of cartilage, arthritis in all its forms (osteoarthritis, rheumatoid arthritis and posttraumatic arthritis) make it difficult to walk or even put pressure on your feet.

Tendinitis: Tendons connect muscles to bones. Irritation and inflammation of the tendons, which run throughout the foot, can cause excruciating pain.

Neuroma: Usually occurring on the ball of the foot, a neuroma is a nerve that has become irritated and swollen.

Plantar Fasciitis: Heel or arch pain caused by an inflammation of the tissue that connects your heel bone to your toes.

Gout: A form of arthritis, gout causes pain and swelling of the toes due to crystals forming in the joints.

Risk Factors

  • Family history
  • Athletic activity
  • Trauma
  • Gender
  • Age
  • Additional health issues like obesity

The ball-and-socket joint of the hip is the largest joint in the human body. Although exceptionally strong, it’s not impervious to fractures or wear and tear. There are numerous conditions and afflictions which can cause hip pain. In many cases the pain is temporary (as in the case of a fracture), in others the pain is chronic and requires ongoing pain management like prolotherapy.

Most Common Causes Of Hip Pain

Arthritis: Of the hundreds of types of arthritis, the two most prevalent are osteoarthritis (OA) and rheumatoid Arthritis (RA). Osteoarthritis, the more common, is the wearing down of cartilage to the point the bones grind against each other. Rheumatoid arthritis, an autoimmune disorder, causes the immune system to attack tissues in the body—including the one that creates lubricating fluid for joints.

Injuries: Fractures from falls are the most common cause of hip pain, followed closely by sports injuries. According to the American Academy of Orthopaedic Surgeons, your chances of developing arthritis increase sevenfold if you’ve damaged a joint at some time.

Pinched Nerves: Numbness, tingling or burning sensations in the hip are often caused by something putting pressure against a nerve. The most common cause is an accident that pushes a bone or piece of cartilage against a nerve. Sciatica and sacroiliitis, an inflammation of the sacroiliac joint, can also cause pinched nerves.

Obesity: Excess weight puts a lot of strain on all the joints, but especially on the hip, knees and ankles. The pressure exerted on the hip joint socket can cause premature wear of the protective cartilage inside, resulting in pain from bone on bone grinding.

Cancer: Bone cancer and leukemia are the cancers that can cause pain in the hip, but any advanced stage cancer that has spread to the hip area can also cause pain.

Knee pain is a common problem afflicting millions. The usual culprits are an injury, a mechanical problem, or arthritis. In some cases, the underlying problem must be corrected with surgery. More often than not, though, the practical solution is pain management therapy like prolotherapy.

Most Common Causes Of Knee Pain

Injuries: The most common conditions causing knee pain are: ACL injury (a tearing of anterior cruciate ligament); fractures; torn meniscus (the rubbery cartilage between the shinbone and thighbone); bursitis of the knee (inflammation of the small sacs of fluid that cushion the outside of the knee joint); and patellar tendinitis (inflammation of the tendon that connects the quadriceps muscle to the shinbone).

Mechanical Problems: These can range from a broken off piece of bone or cartilage interfering with the knee joint to a dislocated knee cap, an altered gait due to hip or foot pain that causes you to put more stress on a knee joint, and tightness of the iliotibial band tissue.

Arthritis: There are hundreds of types of arthritis, but the two most common are osteoarthritis (degenerative arthritis) and rheumatoid arthritis (an autoimmune system disorder that causes the body to attack tissue critical to the joints).

A migraine is a severe headache, often accompanied by nausea, hyper-sensitivity to light, and vomiting. Migraines can last anywhere from hours to days. It’s not known what causes migraines, but theories range from changes in the brain brought on by external factors like bright lights, the weather, and certain foods.

Migraines may be an inherited problem, with children having a 50% chance of getting them if one parent suffers from them.
Treatment ranges from over the counter medications to prescription drugs (triptans) designed to stop a migraine and drugs designed to prevent migraines (including high blood pressure meds, antidepressants and anti-seizure medications). Prolotherapy is also a rising treatment option for migraine sufferers.

Most Likely Causes Of Migraines

Imbalance in brain chemicals: Certain hormones and chemicals in the body that regulate pain (including serotonin) are thought to have a role in the onset of migraines.

Changes in the brain: Changes in the way the brainstem interacts with the trigeminal nerve (a primary pain pathway) may have a role in the occurrence of migraines.

Hormonal changes: Changes in estrogen levels in women, particularly during pregnancy and menopause, may be a trigger for migraines.

Diet: Salty foods, highly processed foods and aged cheeses seem to be triggers for those susceptible to migraines. Wine and caffeinated drinks can also bring on migraines. The additives aspartame and monosodium glutamate are also known triggers.

Environmental changes: For many, changes in the weather or barometric pressure are triggers for migraines.

External stimuli: Exposure to bright lights, loud noises and strong smells are all documented triggers for migraine headaches.

Myofascial pain syndrome is a persistent condition characterized by deep, persistent pain in a muscle. It usually occurs when muscles have been repeatedly contracted, as often happens with the movements used at work or in recreational activities.

What differentiates myofascial pain from other muscle pain is that it persists, and often worsens, over time. Also, pressure put on sensitive points in muscles results in pain in other parts of the body—a phenomenon known as referred pain.

Most Likely Causes Of Myofascial Pain

Muscle Injury/Overuse. Repetitive muscle use (or overuse) causes clusters of tight muscle fibers to form in the muscle. These trigger points cause pain and spasms throughout the muscle.

Previous Injury. In some cases, there is reason to believe a previous injury may have a role in the development of myofascial pain syndrome.

Stress/Poor Sleep. Stressful events, a lack of sleep and depression are often situational factors present before the onset of myofascial pain. Some researchers believe they may actually trigger the condition.

The human head weighs, on average, 11 lbs. This may not sound like a lot of weight, but it’s enough to create a lot of strain on the neck. Aside from muscle fatigue and deterioration of the cartilage over time, injuries and disease can also contribute to chronic neck pain.

A common cause of neck pain is whiplash, usually sustained when someone’s car is rear-ended. Sports accidents are also a frequent cause of whiplash. In most cases, patients make a full recovery within a few months of treatment. Others may continue to experience chronic neck pain, which requires additional pain management options like prolotherapy.

Neck Pain Causes

Nerve compression: When nerves in the neck vertebrae are compressed by herniated discs or bone spurs pressing against spinal cord nerves, the pain can be intense. Often, there is an accompanying tingling or numbness in limbs.

Wear on joints: Over time, the cartilage in our bodies wears down. Osteoarthritis is the deterioration of the cartilage between the vertebrae. As this happens, bone spurs develop—causing pain and limiting range of motion to the neck and back.

Strained muscles: Spending hours in a hunched over or contorted position can put intense strain on neck muscles. If you grind your teeth while you sleep, this repetitive motion can also cause neck pain when you’re awake.

The sacroiliac joint is located near the bottom of the spine and connects the sacrum (a triangular bone at the base of the spine) to the pelvis. Its function is to cushion the forces of the upper body on the hips and legs. Problems with this joint can cause sharp or dull pain in the back and/or the legs.

The cause of sacroiliac pain isn’t entirely clear, but it is thought to be the result of a change in the normal joint motion. The most common diagnosis tool is an anesthetic injection into the sacroiliac joint. Treatment ranges from physical therapy to supporting braces and prolotherapy.

Most Common Causes Of Sacroiliac Pain

Sacroiliac Joint Dysfunction: Abnormal motion in the sacroiliac joint, either too much or too little, can cause a painful inflammation of the sacroiliac joint (known as sacroiliitis).

Physical Trauma: A fall, an auto accident or a sports injury involving the lower back, hip or buttocks—these can call cause sacroiliac pain.

Osteoarthritis: Caused by wear and tear on the joint, osteoarthritis results in loss of cartilage in the sacroiliac joint. The result is chronic inflammation and pain.

Ankylosing Spondylitis: This arthritis attacks the spine, causing inflammation of the vertebrae and new bone growth that can ultimately fuse joints together.

Uneven Strides: If one leg is shorter than the other or you limp due to a leg injury, you are more susceptible to pain in the sacroiliac joint.

Chronic shoulder pain not only makes it difficult, if not impossible, for many to work, it also makes it hard to enjoy recreational activities. While time will heal injuries such as broken or dislocated shoulders, surgery is needed for a complete rotator cuff injury recovery. There are also many chronic conditions which can only treated with prolotherapy.

Causes Of Shoulder Pain


Brachial plexus injury: Often caused by auto accidents and sports injuries, a brachial plexus injury is the stretching/compressing or tearing of nerves that send signals from the spine to your shoulder, arm and hand.

Broken collarbone: While most collarbone breaks heal without lasting problems, sometimes the sections of bone overlap and cause chronic pain which lasts for years.

Rotator Cuff Injury: The muscles and tendons surrounding the shoulder joint keep the ball of the upper arm bone in the socket of the shoulder. Repetitive motions like swinging a tennis racket or golf club with force are common triggers for a rotator cuff injury.

Tendinitis: Tendons are thick, fibrous cords which connect muscle to bone. Irritation or inflammation, known as tendinitis, can cause pain. Classic shoulder tendinitis occurs in swimmers and from pitching the ball in baseball.  Severe tendinitis can result in a ruptured tendon.

Separated Shoulder: An injury of this type can range from stretching to tearing the ligaments of the collarbone and shoulder blade.

Thoracic Outlet Syndrome: Commonly caused by auto accidents and repetitive motion injuries, thoracic outlet syndrome is the compression of nerves or blood vessels in between the collarbone and the first rib. Pain in the shoulders and neck are typical symptoms, as well as numb fingers.

Risk Factors of Medical Shoulder Conditions

  • Overuse
  • Arthritis
  • Activities like tennis, swimming, and baseball

Medical Conditions

Arthritis: Osteoarthritis and rheumatoid arthritis both cause chronic shoulder pain. A previous shoulder blade or collarbone fracture can increase the likelihood of osteoarthritis (degenerative arthritis), while a family history of rheumatoid arthritis is a risk factor for this autoimmune disorder.

Bursitis: Bursitis is an inflammation of the bursae (small fluid-filled sacks that provide cushioning to bones and tendons near joints).

Avascular Necrosis: Also known as osteonecrosis, this is bone tissue death due to poor blood supply which can cause small breaks in the bone and, in worse case scenarios, complete collapse of the bone. It can occur if a bone is broken or a joint dislocated. It also occurs among alcoholics and those who take high-dose steroid medications.

Risk Factors of Medical Shoulder Conditions

  • Gender
  • Age
  • Additional health issues like diabetes

The temporomandibular joint connects the jaw to the temporal muscles in the skull. Since these joints involve muscles, tendons and bones, an injury to any one of them (or a disorder) can trigger chronic pain in the jaw area, ears, neck and shoulders. Chronic headaches and lockjaw are also possible.

Although ice packs and over-the-counter anti-inflammatory drugs help many patients, there are several options for those with more serious TMJ pain. These treatments can include prolotherapy, prescription medications, dental splints, Botox injections and even corrective surgery.

Common Causes Of TMJ

Misalignment of teeth or jaws: Although a traumatic injury can cause alignment problems, more TMJ problems are the result of problems with tooth structure causing displacement of the lower jaw.

Gum chewing: Most dentists agree excessive gum chewing overworks the muscles of the temporomandibular joint and can lead to TMJ.

Teeth grinding: Grinding and clenching of the teeth causes wear that can result in improper closure of the jaw and problems with the bite.

Poor posture: The connection between posture and TMJ is very real. Slouching or hunching over, for instance, causes the lower jaw to protrude forward. This results in a poor bite—one of the primary causes of TMJ syndrome.

Arthritis: Because bones are involved, several forms of arthritis can cause TMJ. In addition to osteoarthritis and rheumatoid arthritis, traumatic arthritis and infectious arthritis can also cause TMJ.

Genetic predisposition: There is evidence to suggest that TMJ may be an genetic problem inherited from parents with TMJ.

Besides the sprains and fractures caused by falls and other injuries, wrist pain is often caused by chronic problems like arthritis, carpal tunnel syndrome and pain caused by repetitive stress on a muscle, tendon or joint.

Treatment can range from avoiding whatever activity triggered the wrist pain to medications, physical therapy and even surgery in cases of severe carpal tunnel syndrome, torn ligaments or broken bones. Pain management is recommended for chronic pain, including prolotherapy.

Causes Of Wrist Pain

Impact Injuries: Falling with a hand outstretched is the most common injury, with a fracture being the most severe outcome.

Repetitive Stress Injuries: Anything that requires repeatedly moving the wrist for extended periods of time (like playing tennis) can cause a repetitive stress injury.

Arthritis: Both osteoarthritis and rheumatoid arthritis cause deterioration of cartilage that cushions joints in the wrist bones. There is no cure for either, but steroidal injections and prolotherapy can lessen the discomfort.

Carpal Tunnel Syndrome: Caused by pressure on the median nerve where it runs through a tunnel in the palm side of the wrist, carpal tunnel syndrome is a common ailment among those who spend long hours working on computers.

Kienbock’s Disease: Caused by an inadequate supply of blood to the lunate bone (a small bone in the wrist). Pain and swelling are typical symptoms. Left untreated, the bone dies and nearby bones shift out of position. Usually, the wrist becomes arthritic.

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Neurology & Pain Treatment
2600 N. Mayfair Road Suite 1120
Milwaukee, WI, 53226 USA
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