Dr Željko Kojadinović — NEUROHIRURGIJA I LEČENJE BOLA
Dr Zeljko Kojadinovic — Pain Treatment & Neurosurgery
Author: Dr. Zeljko Kojadinovic, MD, PhD – Neurosurgeon and Pain Management Specialist
Last medically reviewed: June 7, 2026
This short hub points to patient-friendly guides on hip, knee, foot, and shoulder pain. It is written especially for patients whose joint-region pain persists despite treatment, whose MRI or X-ray findings do not fully explain symptoms, who are unsure whether the pain is coming from the joint or from a nerve, or who need to decide whether a joint procedure or surgery is truly the right next step.
This hub focuses on five practical questions:
- Why does joint-region pain persist despite treatment?
- Is the pain coming from the joint or from a nerve?
- Is the painful structure really the one seen on MRI or X-ray?
- Is joint surgery necessary, avoidable, or unlikely to solve the main pain problem?
- What should be reassessed if pain persists after joint surgery?
Pain felt “in the joint” does not always come from the joint itself. Arthritis, meniscus tears, labral tears, tendon changes, bursitis, or degeneration may appear on imaging, but the visible finding is not always the active pain generator. Pain may also come from nerves, tendons, bursae, fascia, muscles, the spine, or several generators acting together.
Joint-region pain often persists despite treatment when the wrong pain generator is being treated, when imaging findings are only incidental or partial, when a nerve or referred spinal source is missed, or when several pain sources overlap. In that situation, repeated injections, rehabilitation, or surgery may give only partial or temporary relief because the dominant source of pain has not been confirmed.
This distinction matters because injections, procedures, or surgery may fail if the treated structure is not the true source of pain. Focused history, pain mapping, examination, ultrasound assessment, and small diagnostic blocks can help clarify whether the dominant source is joint-related, nerve-related, extra-articular, referred from the spine, mixed, or post-surgical.
Hip Pain — Causes, Diagnosis, Treatment
Hip-region pain may persist despite treatment when the real source is not the hip joint itself, but a nerve, gluteal tendon, bursa, iliopsoas, sacroiliac region, lumbar spine referral, or mixed pain generator. This guide explains how to check whether labral tears, arthritis, or FAI seen on imaging truly match the symptoms, how to distinguish hip-joint pain from nerve or spine-related pain, when hip surgery is reasonable or avoidable, and what to reassess if pain persists after hip treatment or surgery.
Knee Pain — Causes, Diagnosis, Treatment
Knee pain may persist despite treatment when the painful source is not the meniscus tear or arthritis seen on MRI, but a tendon, pes anserine region, fat pad irritation, nerve, hip referral, spine referral, or mixed mechanism. This guide explains how to decide whether pain truly comes from the knee joint or from another source, when knee surgery is necessary or avoidable, and what to consider if pain continues after arthroscopy, injections, rehabilitation, or other knee treatment.
Foot Pain — Causes, Diagnosis, Treatment
Foot pain may persist despite treatment when the dominant source is not the visible joint, tendon, heel, or forefoot finding, but a peripheral nerve, Morton’s neuroma, tarsal tunnel, plantar fascia, lumbar referral, or mixed pain generator. This guide explains how nerve pain can mimic joint or tendon pain, why imaging may be non-specific, when foot surgery should be avoided or considered, and what to check if foot pain continues after treatment or surgery.
Shoulder Pain — Causes, Diagnosis, Treatment
Shoulder pain may persist despite treatment when the main source is not the MRI finding, but the biceps tendon, subacromial bursa, AC joint, cervical spine, nerves, myofascial structures, or mixed pain generators. This guide explains how to distinguish shoulder-joint pain from referred neck or nerve pain, why rotator cuff tears or degeneration may not always be the true pain source, when shoulder surgery is reasonable or avoidable, and what to reassess if pain continues after surgery.
Seek urgent care if any of the following appear:
- joint redness with fever, severe swelling, or inability to bear weight or use the arm
- visible deformity or acute trauma with suspected fracture or dislocation
- rapidly worsening night pain or unexplained weight loss
- new neurological deficits, such as foot drop, loss of grip strength, or spreading numbness
Still in pain despite joint treatment?
A focused telehealth pain consultation can help clarify why pain persists, whether pain is coming from the joint, from a nerve, from structures around the joint, from the spine, or from several generators acting together. If joint surgery or a procedure was suggested, request an online second opinion to check whether the imaging finding truly explains the symptoms, whether surgery is necessary or avoidable, and what should be reassessed if pain persists after surgery.
A focused telehealth pain consultation can help clarify why pain persists, whether pain is coming from the joint, from a nerve, from structures around the joint, from the spine, or from several generators acting together. If joint surgery or a procedure was suggested, request an online second opinion to check whether the imaging finding truly explains the symptoms, whether surgery is necessary or avoidable, and what should be reassessed if pain persists after surgery.