Physicians' Back Institute
Joint Pain Doctors & Specialist Care
San Francisco
Healthy Joints Depend on Healthy Function
Shoulder, hip, knee, foot, and ankle pain are common—but pain in a joint does not necessarily mean that the joint itself is the source of the problem.
At Physicians’ Back Institute, we look beyond the painful area to understand why the joint is hurting and how it is functioning as part of the entire musculoskeletal system.
Robert Minkowsky, MD, and Irène Minkowsky, MD, are board-certified medical doctors with extensive postgraduate training in osteopathy. Our approach combines medical evaluation with careful hands-on examination to identify the factors contributing to pain and loss of function.
A Joint Does Not Function in Isolation
Every joint is affected by the structures around it—and by the way the rest of the body moves.
Knee pain may be influenced by the hip, ankle, foot, or pelvis. Shoulder symptoms may be related to the neck, ribs, or upper back. Hip pain may reflect problems involving the spine, pelvis, surrounding muscles, or the hip joint itself.
When one region is not moving normally, another may compensate. Over time, the area doing the compensating can become painful.
Where you hurt is not always where the problem begins.
Imaging Is Only Part of the Picture
X-rays and MRI scans can be extremely useful, but findings such as arthritis, cartilage wear, tendon abnormalities, or degenerative changes do not always explain why a patient is experiencing pain.
Imaging shows us anatomy. The physical examination helps us understand function.
We evaluate joint mobility, muscle strength and balance, posture, gait, neurologic function, soft tissues, and the relationship between the painful joint and other regions of the body.
Our osteopathic training adds hands-on evaluation of restrictions and mechanical dysfunction that may not be apparent on imaging alone.
Joint Conditions We Evaluate
Shoulder
Shoulder pain can arise from the joint itself, tendons and muscles surrounding it, or mechanical problems involving the neck, upper back, ribs, and shoulder blade.
Hip
Hip and groin pain may originate within the hip joint, but symptoms around the hip and buttock can also be influenced by the lumbar spine, pelvis, sacroiliac region, muscles, and nerves.
Knee
The knee functions between the hip and the foot. Changes in hip strength, pelvic mechanics, foot position, or ankle mobility can alter the forces passing through the knee.
Foot & Ankle
The feet are the body’s foundation during standing and walking. Problems with foot and ankle mechanics can cause local symptoms and can also affect the knees, hips, pelvis, and spine.
Sacroiliac Joint
The sacroiliac joints connect the pelvis to the spine. Dysfunction or instability in this region may contribute to low back, pelvic, buttock, or leg symptoms.
Treatment Is Individualized
The diagnosis determines the treatment.
Depending on what we find, treatment may include osteopathic manual treatment, therapeutic exercise, strengthening and stretching, rehabilitation, correction of posture or body mechanics, activity modification, or selected injection procedures.
The objective is not simply to make the painful joint feel better temporarily. We want to address the factors contributing to the problem and improve the way the region functions.
Our goal is to restore function using the least invasive approach appropriate for your condition.
Finding the Cause.
Restoring Function.
If joint pain is limiting your ability to walk, exercise, work, sleep, or participate in the activities you enjoy, a comprehensive evaluation can help determine what is contributing to the problem.
At Physicians’ Back Institute, we take the time to listen, examine the entire musculoskeletal system, explain what we find, and develop an individualized treatment plan.