An injury may appear healed on an X-ray or MRI, yet pain can continue for weeks or months. The swelling may be gone, damaged tissue may have repaired, and the original treatment may be complete. Still, everyday activities such as working, walking, driving, sleeping, or exercising may remain difficult.

Persistent pain does not always mean the original injury failed to heal. It may indicate that another part of the body has not fully recovered or that the nervous system, muscles, joints, and movement patterns are no longer working together correctly.

A physical medicine and rehabilitation evaluation looks beyond the original diagnosis. Michael Jaffe, MD works to identify the physical, neurological, and functional factors that may be keeping pain active after the expected healing period.

Why Pain Can Continue After an Injury Has Healed

Healing is not always the same as complete recovery. A bone may heal, a surgical incision may close, or inflammation may decrease without restoring normal strength, flexibility, balance, or nerve function.

For example, a person may protect an injured knee by placing more weight on the opposite side. Over time, that compensation may place additional stress on the hip, lower back, or other knee. The initial injury may be stable, but the altered movement pattern can create a new source of discomfort.

Persistent pain may also be related to:

• Muscle weakness after inactivity
• Joint stiffness or limited range of motion
• Scar tissue affecting movement
• Nerve irritation or nerve compression
• Poor posture or body mechanics
• Myofascial pain and muscle trigger points
• Repetitive strain during work or exercise
• Reduced core stability
• An undiagnosed spine condition
• Changes in how the nervous system processes pain
• Finding the cause requires more than looking at the body part that was originally injured.

Looking Beyond the Location of the Pain

Pain is not always felt where the problem begins. A compressed nerve in the neck may cause shoulder, arm, or hand symptoms. A lumbar spine condition may produce pain in the buttock, thigh, calf, or foot. Hip problems can sometimes cause thigh or leg pain, and lower back pain, while certain shoulder conditions may create discomfort towards the elbow.

A physical medicine and rehabilitation specialist evaluates the relationships between the spine, joints, muscles, nerves, and movement patterns. This whole-person approach can help determine whether persistent symptoms are coming from the original injury, a related condition, or a previously overlooked source.

How a Physical Medicine Evaluation Finds the Missing Cause

The evaluation begins with a detailed review of the patient’s symptoms and medical history. Dr. Michael Jaffe may ask how the injury occurred, which treatments have already been attempted, where the pain travels, and which activities increase or reduce the symptoms.

The physical examination may assess:

• Muscle strength
• Reflexes and sensation
• Joint mobility
• Spinal movement
• Posture and alignment
• Walking patterns
• Balance and coordination
• Areas of muscle tenderness

The ability to perform work or daily activities

These findings can reveal functional problems that may not appear clearly on diagnostic imaging.

The Role of Imaging and Diagnostic Testing

An MRI, X-ray, or CT scan can provide valuable information, but imaging findings must be compared with the patient’s symptoms and physical examination. Many adults have disc degeneration, arthritis, or other structural changes without experiencing significant pain.

Additional testing may be considered when the source of the symptoms remains unclear. Electromyography and nerve conduction studies can help evaluate nerve and muscle function. These tests may assist in distinguishing a spinal nerve problem from carpal tunnel syndrome, peripheral neuropathy, or another nerve injury.

Diagnostic injections may also be used in selected situations to help determine whether a particular joint, nerve, or spinal structure is contributing to the pain.

Persistent Pain May Involve More Than One Problem

Some patients do not have a single missing diagnosis. Their symptoms may be caused by several related factors.

A person recovering from a lower back injury may have lingering nerve irritation, weak core muscles, restricted hip mobility, and fear of certain movements. Treating only one of these issues may provide limited improvement.

Physical medicine and rehabilitation focuses on building a coordinated treatment plan. Depending on the findings, care may involve physical therapy, therapeutic exercise, activity modification, medication management, image-guided procedures, ergonomic changes, or referral to another appropriate specialist.

The goal is not simply to cover up pain. It is to improve movement, reduce physical limitations, and help the patient return to meaningful daily activities whenever possible.

When Persistent Pain Should Be Reevaluated

Pain should be reevaluated when it continues beyond the expected healing period, interferes with sleep, or prevents a return to work and normal activities. A new assessment may also be appropriate when symptoms change or when previous treatment has stopped producing progress.

Prompt medical attention is particularly important for progressive weakness, increasing numbness, loss of coordination, difficulty walking, or changes in bowel or bladder control. These symptoms may indicate a significant neurological problem that requires timely evaluation.

A Function-Focused Approach to Long-Term Pain

Dr. Michael Jaffe is board-certified in Physical Medicine and Rehabilitation and Pain Medicine. His approach considers how the spine, nerves, joints, muscles, and daily activities interact.

Instead of focusing only on an imaging result or the site of pain, the evaluation is designed to identify the factors affecting the patient’s overall function. Patients receive clear information about their condition, available treatment options, and reasonable next steps based on their individual findings.

Find the Reason Your Pain Has Not Improved

Persistent pain can be frustrating, especially when you have been told that an injury has already healed. Continuing symptoms deserve a careful evaluation rather than assumptions that the pain has no identifiable cause.

Michael Jaffe MD evaluates ongoing back pain, neck pain, nerve symptoms, musculoskeletal injuries, and functional limitations. Call 801-262-7246 or contact the office online to schedule an appointment and take the next step toward understanding what may be keeping your pain active.

This content is provided for general educational purposes and does not replace an individual medical evaluation. Diagnosis and treatment recommendations depend on each patient’s symptoms, examination findings, medical history, and diagnostic results.