Arthritis and joint pain can come from inflammation, joint wear, injury, autoimmune disease, hypermobility, nerve irritation, or referred pain.
Learn how Dr. Nino approaches arthritis and joint pain, from identifying the underlying cause to creating personalized treatment plans that reduce pain and improve mobility.
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.
Hi, I鈥檓 Dr. Nino Mikaberidze, and I鈥檓 a rheumatologist at 91视频. I鈥檇 like to talk a bit about arthritis and joint pain, because it鈥檚 something I see very often, and it can affect people in very different ways.
At a basic level, arthritis refers to inflammation in the joints, which can lead to pain, stiffness, and reduced mobility. There are actually over 100 different types of arthritis, but the most common are osteoarthritis, which is related to wear and tear over time, and rheumatoid arthritis, which is an autoimmune condition.
Joint pain doesn鈥檛 always mean arthritis, though. It can also come from injury, overuse, instability, or other underlying conditions. That鈥檚 why it鈥檚 so important to really understand what鈥檚 driving the symptoms. Patients often tell me they feel stiff in the morning, or notice swelling, tenderness, or difficulty moving certain joints. Sometimes there鈥檚 also fatigue or a general sense of inflammation, especially with autoimmune forms of arthritis.
There are many possible causes. Some are related to aging or prior injuries, while others involve the immune system, genetics, or lifestyle factors like activity level, posture, or weight. The most important step is getting a clear diagnosis. That usually involves a detailed history, a physical exam, and sometimes imaging or lab work to understand what type of arthritis or joint condition we鈥檙e dealing with.
From there, treatment is very individualized. It may include medications to control inflammation, physical therapy to improve strength and mobility, injections, or other supportive therapies. In more complex cases, we also coordinate care across specialties to make sure everything is addressed in a cohesive way.
I always remind patients that while arthritis can be chronic, it is often very manageable when we understand it properly and treat it early. Our goal is to help reduce pain, improve function, and support you in getting back to your normal activities with more comfort and confidence. If you鈥檙e experiencing ongoing joint pain or stiffness, it鈥檚 worth getting it evaluated so we can understand what鈥檚 going on and create a plan that works for you.
Arthritis is not one single diagnosis. It is a broad term for conditions that affect joints, tissues around joints, and connective tissues. Joint pain may come from osteoarthritis, rheumatoid arthritis, autoimmune inflammation, gout, enthesitis, tendon or ligament irritation, hypermobility, prior injury, spine-related referred pain, or chronic pain mechanisms.
Symptoms may include pain, stiffness, swelling, warmth, redness, tenderness, reduced motion, instability, or difficulty using the joint.
Because treatment depends on the cause, careful evaluation is important before deciding whether medication, rehabilitation, injections, regenerative options, or surgical referral may be appropriate.
At 91视频, evaluation begins by identifying the actual pain generator.
For patients looking for arthritis joint pain treatment in Manhattan, MPM evaluates the joint, surrounding tendons and ligaments, spine referral patterns, nerve involvement, inflammatory signs, autoimmune clues, hypermobility, prior injury, and chronic pain contributors.
Care may include medication management, diagnostic ultrasound, ultrasound-guided injections, peripheral joint injections, steroid injections, hyaluronic acid viscosupplementation, PRP, regenerative options, weight-loss support, pain psychology, rehabilitation planning, and coordinated referral when rheumatology or orthopedic surgery input is needed.
Joint pain can feel straightforward, but the cause is not always obvious. Knee pain may come from osteoarthritis, meniscus injury, tendon irritation, inflammatory arthritis, referred spine pain, or altered movement patterns. Hand pain may reflect rheumatoid arthritis, osteoarthritis, gout, nerve compression, or hypermobility. Hip, shoulder, jaw, spine, and sacroiliac joint pain can also have overlapping causes.
A diagnosis-first approach helps avoid treating 鈥渁rthritis鈥� as if it means the same thing for every patient. Some joint pain is inflammatory and may require rheumatology care. Some is mechanical and may respond to rehabilitation, weight management, or image-guided injections.
Some is neuropathic or part of a chronic pain pattern. MPM evaluates these possibilities before recommending a care plan, so treatment is matched to the joint, diagnosis, severity, goals, and overall health.
Arthritis and joint pain fit across several MPM Zones of Expertise, including Musculoskeletal issues, Autoimmune and Inflammatory Disorders, and Hypermobility. This matters because joint pain may come from the joint surface, surrounding tendons or ligaments, immune inflammation, connective tissue laxity, nerve irritation, or referred pain from the spine.
MPM uses the Zones of Expertise framework to evaluate whether symptoms appear mechanical, inflammatory, autoimmune, hypermobility-related, neuropathic, or part of a broader chronic pain pattern. For some patients, the priority is identifying arthritis type. For others, the priority is determining whether pain is actually coming from a tendon, ligament, nerve, spine segment, sacroiliac joint, or chronic pain process that requires a different care pathway.
I cannot say enough good things about 91视频. From the moment I walked in, I felt truly cared for and taken seriously. Dr. Nino Mikaberidze, Director of Rheumatology, is exceptional 鈥� 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 91视频 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鈥檝e 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鈥檓 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鈥檚 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 91视频. With Dr. Siefferman, Adam Rosenberg, Dr. Mikaberidze, and the whole team, I feel heard, supported and understood. Every symptom is being considered and I鈥檓 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.
Arthritis and joint pain can have many causes. Pain may come from osteoarthritis, autoimmune inflammation, rheumatoid arthritis, gout, enthesitis, tendon irritation, ligament injury, hypermobility, prior trauma, joint instability, nerve irritation, or referred pain from the spine. Some patients have more than one contributor. For example, a person may have knee arthritis along with hip weakness, spine-related nerve irritation, or chronic pain sensitization. Because 鈥渁rthritis鈥� is a broad term, evaluation should focus on identifying the specific pain generator and whether symptoms are inflammatory, mechanical, autoimmune, neuropathic, or multifactorial.
Joint pain may be related to arthritis when it is persistent, recurrent, associated with stiffness, swelling, warmth, redness, tenderness, reduced range of motion, or difficulty using the joint. Morning stiffness, visible swelling, or pain in multiple joints can suggest inflammatory or autoimmune arthritis, especially when symptoms last more than a few weeks. Pain that worsens with activity and improves with rest may be more consistent with osteoarthritis or mechanical joint strain. The only way to know the cause is through a clinical evaluation, which may include exam, imaging, bloodwork, or diagnostic ultrasound.
Osteoarthritis is usually related to degenerative joint changes, cartilage wear, aging, prior injury, joint mechanics, or repetitive load. It often affects specific joints such as the knees, hips, hands, spine, or shoulders. Rheumatoid arthritis is an autoimmune inflammatory disease in which the immune system attacks joint tissue, often causing prolonged morning stiffness, swelling, warmth, and symptoms on both sides of the body. Rheumatoid arthritis may also affect other organs and usually requires rheumatology-directed care. Distinguishing between the two matters because treatment options and long-term monitoring are different.
You should consider evaluation if joint pain persists, worsens, limits function, or is associated with swelling, warmth, redness, instability, prolonged morning stiffness, fever, rash, unexplained weight loss, numbness, weakness, or loss of motion. Prompt evaluation is also important after injury, when pain is severe, when you cannot bear weight, or when symptoms are rapidly worsening. Joint pain can come from arthritis, autoimmune disease, gout, infection, tendon injury, ligament injury, nerve involvement, or referred spine pain. A specialist can help determine the cause and whether nonsurgical care, injections, rheumatology care, or surgical referral may be appropriate.
Diagnosis may include a detailed history, physical examination, X-rays, ultrasound, MRI, bloodwork, inflammatory markers, autoimmune labs, uric acid testing, or diagnostic injections when appropriate. Diagnostic ultrasound may help evaluate certain joints, tendons, ligaments, effusions, inflammation, or injection targets. Bloodwork may be useful when rheumatoid arthritis, lupus, gout, infection, or another inflammatory condition is suspected. Imaging can help identify joint narrowing, bone changes, tendon problems, soft tissue injury, or structural concerns. The right tests depend on the joint involved, symptom pattern, exam findings, and suspected cause.
Treatment depends on the type and cause of joint pain. Options may include medication management, activity modification, physical rehabilitation, weight-loss support, diagnostic ultrasound, ultrasound-guided injections, peripheral joint injections, steroid injections, hyaluronic acid viscosupplementation, PRP, prolotherapy, regenerative medicine, BMAC, trigger-point injections, peripheral nerve blocks, nerve hydrodissection, acupuncture, Feldenkrais, biofeedback, and pain psychology. Some patients may need rheumatology care for inflammatory or autoimmune arthritis. Others may need orthopedic surgery evaluation when joint damage is advanced or function is severely limited. Not every treatment is appropriate for every patient.
Joint injections may help selected patients with arthritis or joint pain, but the right injection depends on the diagnosis, joint, severity, imaging findings, symptoms, and goals. Steroid injections may help reduce inflammation in certain situations. Hyaluronic acid may be considered for some patients, especially with knee osteoarthritis. PRP, prolotherapy, BMAC, and other regenerative options may be considered in selected cases, but evidence and appropriateness vary. Injections should not be presented as reversing arthritis or preventing surgery. They are one tool within a broader plan that may include rehabilitation, medication, weight management, and coordinated care.
Many patients begin with nonsurgical care for arthritis joint pain. Depending on the diagnosis, this may include medication management, physical therapy or movement retraining, weight-loss support, image-guided injections, bracing, activity modification, pain psychology, or selected regenerative options. Nonsurgical care may help reduce symptoms, improve function, or delay the need for more invasive treatment in some patients. However, surgery may be appropriate when joint damage is advanced, pain remains severe, or function is significantly limited despite appropriate conservative care. MPM can help evaluate nonsurgical options and coordinate referral when surgical evaluation is needed.
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
Arthritis is a broad term, not a complete diagnosis. It includes more than 100 conditions that can affect joints, tissues around joints, and other connective tissues. Some forms are degenerative, such as osteoarthritis. Others are inflammatory or autoimmune, such as rheumatoid arthritis, lupus-related arthritis, or other autoimmune joint conditions. Joint pain may also come from gout, enthesitis, tendon irritation, ligament injury, hypermobility, prior trauma, nerve involvement, spine referral, or chronic pain sensitization.
This is why MPM approaches arthritis and joint pain through a diagnosis-first model. Before recommending treatment, the goal is to understand what structure or process is generating pain. A swollen, warm joint with prolonged morning stiffness may require a different pathway than a painful joint after activity. A hypermobile joint may need stability-focused care. A joint that hurts because of referred spine pain may not improve with a joint injection. The right treatment starts with the right diagnosis.
Arthritis symptoms can include pain, stiffness, swelling, warmth, redness, tenderness, reduced range of motion, clicking, grinding, instability, weakness, or difficulty using the joint. Pain may affect the hands, knees, hips, shoulders, spine, jaw, feet, ankles, wrists, elbows, or sacroiliac joints. Some patients feel stiff in the morning. Others notice pain after walking, climbing stairs, typing, lifting, chewing, sitting, or exercising.
The timing of symptoms can offer important clues. Prolonged morning stiffness may suggest inflammatory arthritis. Pain that worsens with use may suggest osteoarthritis, tendon irritation, or mechanical overload. Sudden severe pain and swelling may raise concern for gout, infection, or injury. Joint pain with rash, fever, fatigue, dry eyes, dry mouth, numbness, or other systemic symptoms may suggest autoimmune or inflammatory disease.
Osteoarthritis is one of the most common causes of joint pain. It is often related to cartilage changes, joint mechanics, prior injury, aging, or repetitive stress. It can affect the knees, hips, hands, spine, shoulders, and other joints. Symptoms often include pain with activity, stiffness after rest, swelling after use, and reduced function.
Inflammatory arthritis involves immune or inflammatory activity in the joint. Rheumatoid arthritis, lupus, Sjogren鈥檚 syndrome, vasculitis, undifferentiated connective tissue disease, and other autoimmune-related conditions can cause joint pain, swelling, stiffness, and fatigue. Gout can cause sudden episodes of intense joint inflammation from crystal deposition. Enthesitis involves inflammation where tendons or ligaments attach to bone and may feel like deep joint or tendon pain.
Hypermobility can also contribute to arthritis-like pain. Patients with Ehlers-Danlos syndrome or hypermobility spectrum disorder may experience joint instability, muscle guarding, tendon overload, or early joint irritation. Spine pain can refer into hips, shoulders, legs, or arms and may be mistaken for joint arthritis. Peripheral neuropathy or nerve irritation can also create burning, tingling, or deep aching around a joint.
Evaluation begins with a detailed history and physical exam. MPM reviews where pain occurs, when it started, what movements worsen it, whether the joint swells, how long stiffness lasts, whether symptoms are symmetrical, whether there was an injury, and whether systemic symptoms are present. Prior imaging, bloodwork, medication response, injections, physical therapy history, and surgical history are also reviewed.
Diagnostic ultrasound may be useful for selected patients. It can help evaluate certain joints, tendons, ligaments, fluid collections, inflammation, and soft tissue structures. It may also help guide injections more precisely when an injection is appropriate. X-rays, MRI, bloodwork, inflammatory markers, autoimmune labs, and other testing may also be considered depending on the suspected cause.
MPM also evaluates whether joint pain may be part of a broader pain pattern. A patient with knee pain may also have hip weakness, sacroiliac joint dysfunction, spine pain, or nerve irritation. A patient with hand pain may have arthritis, tendon irritation, nerve compression, or autoimmune disease. A patient with jaw pain may have TMJ dysfunction, hypermobility, muscle pain, or inflammatory arthritis. Looking beyond the painful joint can help prevent incomplete treatment.
Treatment depends on the diagnosis, joint involved, severity, imaging findings, function, goals, and overall health. Medication management may include topical or oral anti-inflammatory medications, other pain medications, or coordination of systemic treatment when autoimmune or inflammatory arthritis is present. Autoimmune or inflammatory arthritis may require rheumatology-directed medications such as DMARDs, biologics, or immunosuppressants.
Rehabilitation and movement support are often important. Physical therapy, strengthening, mobility work, gait changes, bracing, activity modification, Feldenkrais, acupuncture, biofeedback, and weight-loss support may help reduce load on painful joints and improve function. Pain psychology may help when arthritis pain becomes chronic, affects sleep, increases stress, or leads to fear of movement.
Image-guided injections may be considered when clinically appropriate. Options may include peripheral joint injections, steroid injections, hyaluronic acid viscosupplementation, PRP, prolotherapy, BMAC, trigger-point injections, peripheral nerve blocks, nerve hydrodissection, or sacroiliac joint injection. The goal of injection treatment is not to apply the same procedure to every patient. The goal is to match the treatment to the diagnosis and the pain generator.
Some patients ask about regenerative medicine options such as PRP, prolotherapy, or bone marrow aspirate concentrate. These may be considered for selected patients, depending on the joint, diagnosis, severity, goals, and medical history. They should not be described as reversing arthritis or guaranteeing long-term relief. Evidence and appropriateness vary, and a careful discussion is needed before choosing these treatments.
Surgery may be appropriate when joint damage is advanced, function is severely limited, or nonsurgical care no longer provides enough benefit. MPM can help patients evaluate nonsurgical options and coordinate orthopedic referral when needed. The goal is not to avoid surgery at all costs. The goal is to make sure each step is appropriate, informed, and aligned with the patient鈥檚 condition.
Patients should seek evaluation for persistent joint pain, swelling, warmth, redness, prolonged morning stiffness, instability, reduced motion, worsening function, fever, rash, unexplained weight loss, numbness, weakness, severe pain after injury, inability to bear weight, or rapidly worsening symptoms. Joint pain should not be self-diagnosed as arthritis, especially when systemic, neurologic, or inflammatory symptoms are present.
MPM approaches arthritis joint pain through a diagnosis-first, coordinated model. The evaluation looks at the joint, surrounding soft tissue, inflammatory signs, autoimmune clues, hypermobility, nerve involvement, spine referral, movement patterns, prior injuries, and chronic pain contributors. Care may involve coordination with rheumatology, orthopedics, physical therapy, psychology, or other specialists when needed.
For patients looking for arthritis joint pain treatment in Manhattan, MPM offers a careful, patient-centered approach to understanding the cause of joint pain and building a treatment plan that may include nonsurgical care, image-guided procedures, rehabilitation, lifestyle support, and coordinated referral when appropriate.
