One of the most common things I heard in my clinic over the years was some version of this:
“I guess this is just part of getting older.”
The sentence usually came from someone with knee pain, hip pain, shoulder pain, or stiff hands. Often, they brought a specialist’s report with X-rays or an MRI mentioning “arthritis,” “degeneration,” or “wear and tear.” The conclusion seemed obvious: “Something is wrong with my joint.”
Joint pain is one of the most common reasons people seek treatment—and one of the most misunderstood.
The “wear and tear” story
The dominant explanation for joint pain is that joints wear out like mechanical parts. Use them long enough, and they break down.
It sounds logical—but clinically, it doesn’t hold up well.
Many patients with terrible-looking X-rays have little or no pain. Others with mild findings are in significant pain and disability. Studies confirm this pattern repeatedly.
The reason is simple: joints are living tissue, not door hinges. They respond to movement, circulation, and nervous system input. Pain is not a direct readout of tissue damage—it’s more complex than we thought.
When the joint isn’t the problem
Over time, I noticed patterns that didn’t fit a purely structural explanation:
Joint pain that moves from side to side. Pain that flares during stress. Pain that persists long after an injury healed. Pain that improves unexpectedly without any structural change.
These patterns suggest the joint itself often isn’t the primary driver of ongoing pain.
This doesn’t mean the pain isn’t real—it means the source may not be what we assume.
Arthritis: A label, not a life sentence
“Arthritis” is one of the scariest words patients hear. But at its most basic level, it simply means inflammation or age-related changes in a joint.
Here’s the crucial point: imaging studies show most adults have some degree of arthritis, especially as they age—including many people with no joint pain at all.
Arthritis on an X-ray doesn’t automatically predict pain or disability. It’s a descriptive finding, not always an explanation for why pain persists.
When medical treatment is necessary
To be clear, some situations do require medical or surgical treatment: acute fractures, major tears, progressive neurological symptoms, advanced inflammatory disease, or severe loss of function.
I referred many patients for orthopedic evaluation when it was the right choice. But these cases represent a much smaller percentage of the chronic joint pain people live with every day.
The nervous system’s role
Pain is processed by the nervous system. When pain becomes chronic, the system can become overly protective—continuing to send danger signals even when the joint is relatively stable.
Fear, repeated imaging, constant symptom-monitoring, and movement avoidance all reinforce this cycle. The pain is real, but the reason for this is that nervous system has become overly sensitive.
What You Can Do
So if your joint pain isn’t purely structural, what should you do about it?
Here are the steps I recommended to patients:
- Understand neuroplastic pain. When pain persists long after tissues have healed, or doesn’t match structural findings, it’s often what’s called neuroplastic pain—pain driven by an overprotective nervous system rather than ongoing tissue damage.
The good news? Neuroplastic pain can be reversed. I highly recommend the book The Way Out by Alan Gordon. It’s a practical, compassionate guide to retraining your nervous system and reducing chronic pain. Many of my patients found it life-changing.
2. Keep moving. Gentle, regular movement is medicine for joints. Walking, swimming, tai chi, or simple range-of-motion exercises all work. Start easy and build confidence. The goal isn’t to push through pain, but to show your nervous system the joint is safe to use.
3. Address inflammation and weight issues through diet. As I discussed in my article on diet, whole foods reduce systemic inflammation. Cut out processed foods, excess sugar, and unhealthy oils. Many of my joint pain patients noticed significant improvement just from dietary changes. And of course, weight loss, when needed, takes significant pressure off weight-bearing joints like knees, hips, and ankles. Even losing 10-15 pounds can make a noticeable difference in joint comfort
4. Reduce stress. Remember, pain flares during stressful periods. The practices I discussed in “F is for Feelings”—exercise, talking with friends, working with your thoughts—all help calm an overprotective nervous system.
5. Consider acupuncture. Acupuncture increases blood flow to the area, helps muscles relax, and calms the nervous system. Many patients who thought they needed surgery found relief through acupuncture treatments.
6. Change your story about your joints. Instead of “my knee is deteriorating,” try “my knee is being protected right now, and I can help it feel safer.” This isn’t positive thinking—it’s understanding how your nervous system actually works.
If you’ve tried these approaches for a few months without improvement, or if you have the serious symptoms I mentioned earlier, then it’s time to see a specialist.
But for most people with chronic joint pain, these steps can make a significant difference.
The Good News
Joint pain is common, but it’s not destiny.
Many people improve significantly when they stop viewing their joints as broken parts and start supporting them as living, adaptable tissue.
Healthy joints aren’t about having the perfect joints of a ten year old. Rather, they’re about restoring trust in the amazing—and resilient—body you have now.
Until next time, stay well—and keep moving forward with confidence. You can do it!