What's Causing My Pain?

Pain is your body’s way of telling you something needs attention. While only a thorough evaluation can provide a definitive diagnosis, understanding common pain patterns can help you communicate your symptoms more effectively and give you confidence that physical therapy is the right next step.

Pain can present in many different ways, and the characteristics of your pain often provide important clues about the underlying cause:

• Sharp or shooting pain — often indicates nerve involvement, such as a pinched nerve or herniated disc
• Dull, aching pain — frequently associated with muscle strain, joint dysfunction, or degenerative changes
• Burning or tingling — commonly linked to nerve irritation or compression
• Stiffness that eases with movement — typical of arthritis or joint-related conditions
• Pain that worsens with specific positions or activities — suggests a mechanical cause that can often be addressed with targeted treatment
• Pain that came on gradually without a specific injury — often related to overuse, postural habits, or degenerative changes

Below are some of the most common pain patterns we see and what they often indicate. Remember — this is general information, not a substitute for a professional evaluation.

Sharp pain in the low back that radiates into the leg: This often suggests nerve involvement — possibly a herniated disc or sciatica. Physical therapy is a first-line treatment recommended by clinical guidelines and is highly effective for these conditions, often eliminating the need for surgery.

Stiffness and aching that is worse in the morning: This pattern is common with arthritis and degenerative joint conditions. A combination of exercise, manual therapy, and joint mobilization can significantly reduce stiffness and improve your ability to move comfortably throughout the day.

Pain with reaching overhead or sleeping on your side: This likely indicates a shoulder condition such as rotator cuff pain, impingement, or bursitis. These conditions respond very well to targeted strengthening and hands-on treatment.

Headaches starting at the base of the skull: These are often cervicogenic headaches that originate from the joints and muscles of the upper neck. They respond very well to physical therapy, and many patients experience significant relief within just a few sessions.

Numbness or tingling in the hand: This could be carpal tunnel syndrome, a pinched nerve in the neck, or thoracic outlet syndrome. A thorough evaluation can differentiate the source and determine the most effective treatment approach.

Dizziness with head movements or position changes: This may indicate BPPV (benign paroxysmal positional vertigo) or another vestibular condition. These are often highly treatable — BPPV can frequently be resolved in one to two visits.

Knee pain going up or down stairs: This pattern often points to patellofemoral syndrome, meniscus issues, or early arthritis. Physical therapy addresses the underlying muscle weakness and movement patterns that contribute to knee pain with activity.

Pain that developed gradually without a specific injury: Many conditions — from tendinopathies to degenerative disc disease to postural pain — develop over time due to repetitive stress, muscle imbalances, or age-related changes. These respond well to the targeted assessment and treatment that physical therapy provides.

If any of these patterns sound familiar — or if you have a completely different type of pain that is not listed here — the best next step is a professional evaluation. Our physical therapists are trained to identify the source of your pain through detailed movement testing, orthopedic assessment, and clinical reasoning. We will determine whether physical therapy, medical referral, or diagnostic imaging is the most appropriate path forward.

You do not need to know your diagnosis before scheduling. That is exactly what the evaluation is for. Many patients come to us simply knowing that something hurts — and we take it from there.

You do not need a referral to schedule an evaluation in Delaware. Most insurance plans, including Medicare, cover physical therapy. Call (302) 529-1900 or schedule online to get started.