Orthopedic pain may involve joints, tendons, ligaments, muscles, bones, spine structures, nerves, inflammation, hypermobility, or injury-related pain.
This video explains how orthopedic pain may involve joints, tendons, ligaments, nerves, spine referral patterns, and coordinated care.
Our team organizes conditions and treatments into related zones of expertise to make it easier to explore the care paths most relevant to your symptoms and goals.
Use the zone tags above to browse dedicated pages for each focus area, including services, providers, and what to expect during treatment.
Orthopedic conditions can include a wide range of problems involving the joints, tendons, ligaments, and connective tissues of the body.
Some of the most common issues we see are shoulder pain, knee injuries, tendon problems, joint instability, and chronic musculoskeletal pain.
In many cases, people are told to simply rest, take medication, or consider surgery. But there are often additional options that focus on supporting the body’s ability to repair damaged tissues.
In my practice, I focus heavily on diagnostic ultrasound, which allows us to look closely at the soft tissues that control movement. This helps us identify problems that may not appear clearly on other types of imaging.
I also work with patients who have hypermobility or joint instability, including conditions like hypermobility spectrum disorder and hypermobile Ehlers–Danlos syndrome. These conditions require a careful approach that focuses on stabilizing tissues and improving function over time.
At Manhattan Pain Medicine, we take a comprehensive approach to orthopedic conditions. That means combining accurate diagnosis, regenerative treatments, and collaboration with other specialists when needed.
Our goal is to help patients reduce pain, improve stability, and return to normal movement.
Orthopedic conditions affect the musculoskeletal system, including bones, joints, muscles, tendons, ligaments, cartilage, spine structures, and nearby nerves. Pain may begin after an injury, overuse, arthritis, tendinopathy, ligament strain, joint instability, surgery, or inflammation.
Some patients have pain that clearly matches imaging findings. Others have ongoing symptoms even when an MRI, X-ray, or prior evaluation does not fully explain the pain. Orthopedic pain can be mechanical, inflammatory, nerve-related, hypermobility-related, referred from the spine, post-surgical, or part of a complex chronic pain pattern.
Care should begin by identifying the specific pain generator before selecting treatment.
At Manhattan Pain Medicine, evaluation begins by identifying whether orthopedic pain is coming from a joint, tendon, ligament, muscle, nerve, spine structure, inflammatory process, hypermobility pattern, pelvic or sacroiliac mechanics, or chronic pain pathway.
For patients looking for orthopedic pain treatment in Manhattan, MPM uses a diagnosis-first approach that may include history, physical examination, movement assessment, imaging review, diagnostic ultrasound, and diagnostic injections when appropriate.
Care may include medication management, physical restoration, ultrasound-guided injections, peripheral joint injections, steroid injections, PRP, prolotherapy, hyaluronic acid, regenerative options, nerve hydrodissection, acupuncture, Feldenkrais, weight support, biofeedback, or pain psychology depending on the diagnosis.
Orthopedic pain is not always explained by one structure or one imaging finding. A tendon tear, arthritic joint, disc change, or ligament injury may be visible on imaging, but that does not always prove it is the main pain generator. Some patients have significant pain with mild imaging changes, while others have advanced findings and little pain.
MPM evaluates orthopedic pain by looking beyond the image alone. The assessment considers movement, joint stability, tendon and ligament loading, nerve irritation, spine referral patterns, autoimmune or inflammatory clues, hypermobility, pelvic mechanics, prior surgery, scar tissue, prior injections, and chronic pain sensitization. This helps determine whether the patient needs nonsurgical pain care, physical therapy coordination, rheumatology input, orthopedic surgical evaluation, regenerative options, or a broader complex pain plan.
Orthopedic conditions fit most directly within MPM’s Musculoskeletal issues Zone of Expertise, with important overlap across Complex Chronic Pain, Hypermobility, Autoimmune and Inflammatory concerns, and Pelvic Pain. This matters because joint, tendon, ligament, muscle, spine, and nerve pain may have more than one contributor.
MPM uses the Zones of Expertise framework to evaluate whether symptoms appear mechanical, inflammatory, instability-related, nerve-related, referred from the spine, pelvic or sacroiliac-related, post-surgical, or centralized. A patient with shoulder pain may have frozen shoulder, tendinopathy, nerve irritation, or inflammatory disease. A patient with hip or pelvic pain may have joint pathology, pelvic floor dysfunction, sacroiliac joint dysfunction, sports hernia, or referred spine pain. The care pathway should reflect the full pattern.
I cannot say enough good things about Manhattan Pain Medicine. From the moment I walked in, I felt truly cared for and taken seriously. Dr. Nino Mikaberidze, Director of Rheumatology, is exceptional — knowledgeable, compassionate, and incredibly thorough. She takes the time to listen, explains every...
The best care I've received as a chronic pain patient. I traveled from out of state to visit Manhattan Pain Medicine because I could not find knowledgeable doctors in my hometown for my hypermobility, and Ehlers-Danlos syndrome symptoms and comorbidities. Let me tell you, it was worth every travel e...
I was injured in a bicycle accident over 8 years ago. I’ve suffered throughout the years since my accident with nothing seeming to work. PT, Yoga, lifestyle changes, NOTHNG! I finally made an appointment with Dr Kane and I’m feeling an improvement in my life. I no longer stay up all night in pain, a...
One of the best experiences, if not the best, I have ever had at the doctor’s office. From the front desk to the nurses to the PA assisting the doctor this was a great experience. Dr.Nino actually listened to me and came up with a game plan. Would recommend this practice to as many people as I could...
I have very unique & severe nerve pain from CRPS which has no known specific cure. Dr. Siefferman has a huge tool box, far greater than the other 23 Drs. I have seen. He saved me from jumping off a bridge and continues to help me with both treatments and advice. Dr. S. is in a different league!
After two years of searching and feeling lost and let down, I finally found real help at Manhattan Pain Medicine. With Dr. Siefferman, Adam Rosenberg, Dr. Mikaberidze, and the whole team, I feel heard, supported and understood. Every symptom is being considered and I’m finally getting answers with m...
Why is Dr Dr. Tayyaba Ahmed one of the top pevic Floor specialists - 1- She wants to know a full history of what led the patient to get to this point. 2 - She listens intensley to the patient 3- She does not rush you 4- Extremely skilled at giving pelvic floor injections 5- I thank my luck stars she...
The staff was friendly and helpful. Dr. Siefferman was thoughtful, listened, asked questions and proposed simple safe ways to come to further conclusions regarding my pain and discomfort. The office staff including Dr. Siefferman is responsive even after the initial in-person visit. Very pleased.
Dr. Siefferman is a brilliant provider. While my pain is still a work in progress, Dr Siefferman always gives me options and explains his reasoning behind things. He listens to my feedback and concerns. I never feel rushed; and am grateful he works to meet me where I am. I highly recommend him.
What a great find! They listen to me, I listen to them and the diagnosis is made and a plan developed to develop an approach to treat all of my chronic pain. I wish I could have discovered this type of treatment sooner. This doctor and group give me hope.
Orthopedic conditions affect the musculoskeletal system, including bones, joints, muscles, tendons, ligaments, cartilage, spine structures, and nearby nerves. They may include arthritis, tendinopathy, ligament injury, muscle strain, joint instability, spine-related pain, frozen shoulder, sacroiliac joint dysfunction, TMJ disorders, sports injuries, and pain after surgery or injury. Some orthopedic pain is mechanical, meaning it relates to movement, loading, structure, or instability. Other pain may be inflammatory, nerve-related, hypermobility-related, referred from the spine, or part of a complex chronic pain pattern.
Orthopedic pain should be evaluated when it persists, worsens, limits function, returns repeatedly, or follows an injury that does not improve as expected. Evaluation is especially important when pain occurs with swelling, weakness, instability, loss of motion, numbness, tingling, redness, warmth, fever, inability to bear weight, or worsening function. Pain after surgery, pain that does not match imaging, or pain that does not improve with physical therapy may also benefit from a diagnosis-first evaluation. Urgent evaluation is needed after major trauma, suspected fracture, progressive neurologic symptoms, or severe instability.
Chronic orthopedic pain may be caused by injury, arthritis, tendinopathy, ligament injury, joint instability, frozen shoulder, spine referral, scar tissue, nerve irritation, overuse, inflammatory disease, hypermobility, pelvic or sacroiliac mechanics, or chronic pain sensitization. Sometimes the original injury heals, but pain persists because the tendon, joint, nerve, movement pattern, or nervous system remains sensitized. In other cases, the underlying problem is still active, such as ongoing inflammation, mechanical overload, instability, or nerve compression. Identifying the driver matters because treatment varies significantly by cause.
MPM begins with a detailed history, physical examination, movement assessment, and review of prior imaging, testing, procedures, and treatments. Diagnostic ultrasound may be used when appropriate to evaluate tendons, ligaments, joints, soft tissue, or procedural targets. Imaging such as X-ray, MRI, or CT may be reviewed or coordinated when needed. In selected cases, diagnostic injections may help clarify whether a specific joint, tendon sheath, bursa, nerve, facet joint, sacroiliac joint, or other structure is contributing to pain. The goal is to identify the pain generator before selecting treatment.
Nonsurgical care may include medication management, physical restoration, movement-based therapy, acupuncture, Feldenkrais, weight support when relevant, biofeedback, pain psychology, ultrasound-guided injections, steroid injections, peripheral joint injections, trigger-point injections, hyaluronic acid viscosupplementation, PRP, prolotherapy, nerve hydrodissection, peripheral nerve stimulation, spine injections, facet joint injections, or sacroiliac joint injections. The right treatment depends on the diagnosis, anatomy, severity, imaging findings, prior response, and patient goals. Not every patient needs injections, and not every orthopedic condition can be managed without surgical input.
Regenerative medicine options such as PRP, prolotherapy, or bone marrow aspirate concentrate may be considered for selected orthopedic pain patterns after the diagnosis, anatomy, goals, risks, and available evidence are reviewed. These options may be discussed for certain tendon, ligament, joint, or soft tissue conditions, but they are not universal treatments. They should not be described as reversing arthritis, healing all tendon injuries, or replacing surgery when surgery is medically indicated. MPM evaluates whether regenerative options are appropriate as part of a broader stepwise care plan.
Yes. Hypermobility and Ehlers-Danlos syndrome can contribute to orthopedic pain when joint laxity or instability places extra stress on muscles, tendons, ligaments, joints, nerves, and surrounding tissues. Patients may develop recurrent sprains, tendon irritation, joint subluxation, muscle guarding, neck and back pain, TMJ symptoms, pelvic pain, or sacroiliac joint dysfunction. Treatment often requires a stability-focused plan rather than a simple pain-relief approach. MPM evaluates hypermobility-related pain in context, including movement patterns, tissue sensitivity, nerve symptoms, autonomic symptoms, and chronic pain contributors.
An orthopedic surgeon may be needed when there is a fracture, major tendon or ligament tear, severe instability, advanced joint destruction, progressive neurologic deficit, structural deformity, loss of function, or symptoms that have not improved with appropriate nonsurgical care. Surgery may also be appropriate when imaging and examination show a problem that is unlikely to respond to conservative treatment. MPM can help evaluate nonsurgical options and coordinate with orthopedic surgery when the condition requires surgical assessment. The goal is not to avoid surgery at all costs, but to match care to the diagnosis.
Before care begins, our team helps patients understand the practical side of treatment, including insurance verification, out-of-network benefits, cost-share estimates, self-pay options, and billing questions. We believe patients should have as much clarity as possible before moving forward.
Jason W. Siefferman, MD
Jason W. Siefferman, MD
MPM
Orthopedic conditions affect the musculoskeletal system, including bones, joints, muscles, tendons, ligaments, cartilage, spine structures, and nerves. Pain may develop after an injury, sports activity, repetitive strain, arthritis, tendon overload, ligament injury, surgery, joint instability, inflammatory disease, or no obvious event. Some patients recover with time and basic care. Others continue to have pain despite physical therapy, imaging, injections, surgery, or rest.
At MPM, orthopedic pain is not treated as one diagnosis. The first question is: what is generating the pain? A painful knee, hip, shoulder, spine, jaw, tendon, or joint may involve the joint itself, surrounding soft tissue, a nerve, the spine, the sacroiliac joint, pelvic mechanics, hypermobility, inflammation, or central pain sensitization.
Imaging can be helpful, but it does not always tell the whole story. An MRI may show arthritis, a disc change, tendinopathy, or a partial tear, but those findings may or may not be the main pain source. Some people have significant imaging changes with little pain. Others have severe symptoms with mild findings. Pain is influenced by structure, movement, inflammation, nerves, load, tissue sensitivity, sleep, stress, and the nervous system.
This is why MPM combines imaging review with physical examination, movement assessment, diagnostic ultrasound when appropriate, and clinical reasoning. The goal is not simply to find an abnormality. The goal is to identify which finding matters for the patient’s pain and function.
Orthopedic pain may come from arthritis, joint inflammation, tendinopathy, ligament strain, muscle injury, bursitis, enthesitis, gout, frozen shoulder, TMJ disorders, sacroiliac joint dysfunction, spine pain, peripheral neuropathy, or referred pain from the neck or back. Pain may also occur after surgery, trauma, repetitive loading, sports injury, or prolonged compensation.
Inflammatory and autoimmune conditions can create orthopedic symptoms as well. Rheumatoid arthritis, lupus, Sjogren’s syndrome, vasculitis, undifferentiated connective tissue disease, gout, and enthesitis may cause joint, tendon, ligament, or muscle pain. In those cases, pain care may need to coordinate with rheumatology or other specialists.
Hypermobility can make orthopedic pain more complex. When joints move beyond their typical range or feel unstable, surrounding muscles, tendons, ligaments, and nerves may work harder to protect the body. This can lead to muscle guarding, tendon irritation, recurrent sprains, joint pain, TMJ symptoms, neck and back pain, pelvic pain, sacroiliac dysfunction, and fatigue.
Patients with Ehlers-Danlos syndrome or hypermobility spectrum disorder may need a care plan focused on stability, pacing, movement quality, strength, and pain control. Injections or procedures may have a role in selected cases, but they should not replace a broader plan that addresses mechanics and function.
MPM begins with a detailed history and examination. This may include review of injury history, work demands, sports activity, prior surgeries, imaging, physical therapy, medications, prior injections, autoimmune history, hypermobility, nerve symptoms, and daily function. The examination may assess range of motion, strength, tenderness, joint loading, instability, nerve sensitivity, spine referral patterns, and movement mechanics.
Diagnostic ultrasound may be used to evaluate tendons, ligaments, joints, soft tissue, or procedural targets. Diagnostic injections may sometimes help determine whether a specific joint, tendon sheath, bursa, facet joint, sacroiliac joint, or nerve is contributing to pain. When surgery, rheumatology, spine care, pelvic care, or rehabilitation is needed, MPM helps coordinate the next step.
Treatment depends on the diagnosis. Medication management may help with inflammation, nerve pain, muscle spasm, or flare control when appropriate. Physical restoration may focus on movement quality, graded strengthening, stability, mobility, and return to activity. Acupuncture, Feldenkrais, biofeedback, and pain psychology may support pain regulation, movement confidence, and function, especially when pain has become chronic.
Image-guided procedures may be considered when the pain generator is clear. Options may include ultrasound-guided injections, peripheral joint injections, steroid injections, trigger-point injections, facet joint injections, epidural injections, sacroiliac joint injections, pelvic floor trigger point injections, superficial cervical plexus block, nerve hydrodissection, or peripheral nerve stimulation in selected cases.
Some patients may be candidates for hyaluronic acid viscosupplementation, PRP, prolotherapy, regenerative medicine, or bone marrow aspirate concentrate. These options require careful patient selection. The decision depends on the tissue involved, severity of degeneration, imaging findings, functional goals, medical risks, and evidence for the specific condition.
Regenerative medicine should not be framed as reversing arthritis, rebuilding all damaged tissue, or avoiding surgery in every case. It may be considered as one tool within a broader plan when the diagnosis and goals support it.
Nonsurgical care is not always the right answer. Surgical evaluation may be needed for fracture, major tear, severe instability, progressive neurologic deficit, advanced joint destruction, deformity, or persistent loss of function despite appropriate care. MPM’s role is to help patients understand nonsurgical options while recognizing when orthopedic surgery or another specialty should be involved.
MPM approaches orthopedic conditions through a diagnosis-first, coordinated model. The evaluation considers joints, tendons, ligaments, muscles, nerves, spine structures, sacroiliac mechanics, pelvic mechanics, inflammation, hypermobility, post-surgical changes, and chronic pain sensitization.
For patients looking for orthopedic pain treatment in Manhattan, MPM offers a careful, nonsurgical pain medicine perspective that works alongside orthopedics, rheumatology, physical therapy, spine care, pelvic pain specialists, and rehabilitation. The goal is to identify the pain generator, match treatment to the diagnosis, support function, and build a plan that is specific to the patient’s anatomy, symptoms, risks, and goals.
