Nonsurgical Orthopaedic Treatments

Conservative Options for Treating Joint and Muscle Pain

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When joint, muscle, neck, or back pain interfere in your daily life, it’s time to see an orthopaedic specialist. Many strains, sprains, pulls, and fractures can be treated without surgery. Physical and occupational therapy; injections; and braces, boots, and casts can provide pain relief and restore range of motion. Our goal is to help you return to the activities you love with minimal downtime.

Duke orthopaedic specialists work with you to identify the cause of your pain and understand the impact on your daily life. We keep your goals in mind and recommend treatment options that will help you find relief. We begin with conservative methods for treating your pain and injuries and recommend surgery only if these options fail to improve your condition.

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Physical and Occupational Therapy

Whether you suffer from ongoing pain, mobility challenges, or a sports injury, physical and occupational therapy may help. Our physical and occupational therapists use a variety of techniques to reduce pain, restore range of motion, and help you comfortably return to daily activities. Therapies may include stretching and strengthening exercises, postural restoration, dry needling, and more. Our sports physical therapists specialize in age-specific and activity-specific concerns, such as knee pain in a young soccer athlete.

Schedule a New Appointment Online

You can schedule a new appointment with some of our providers online. Use this link to find available times and clinic locations.


Injections of steroids or medications that block pain can help reduce inflammation and discomfort. They may be performed with fluoroscopic guidance -- using an ultrasound machine or a low-grade X-ray to help position the needle -- especially around joints like the hip. Our orthopaedic specialists perform a full range of injections including the following.

Epidural Injections

They help treat pain that starts in the spine and radiates to the arms or legs. Medications, usually steroids, are injected either into the epidural space in the back of your spinal canal or around the spinal nerves that are the source of your pain.

Facet Joint Injections

These injections pinpoint neck, middle back, or low back pain that originates in the facet joints -- the joints between the vertebrae on the back of the spine. These injections are often used when pain is caused by injury to the joints or degenerative conditions like arthritis.

Sacroiliac (SI) Joint Injections

The SI joint connects the spine to the pelvis. Injections in this joint can help relieve pain in the low back, buttocks, groin, or thighs.

Steroid Injections into Other Joints

Steroid injections into joints can reduce inflammation and pain caused by arthritis, injury, or degeneration. They may also help identify the source of your pain. In this procedure, a steroid medication and a numbing drug are injected into your knee, hip, ankle, or other joint. The steroid helps relieve inflammation and pain over time, and the numbing drug provides more immediate pain relief.


Hyaluronic acid is injected into the knee joint to help reduce pain and swelling related to arthritis and to lubricate and cushion the joint. It is a thick fluid similar to a substance that naturally occurs in your joints.

Nerve Blocks

Numbing medication is injected into the nerves that are causing your pain or are sending pain signals to your brain. Nerve blocks numb the nerves and block pain signals.

Radiofrequency Ablation (RFA)

Your doctor will insert a small needle into the area where you are experiencing pain. A microelectrode is inserted through the needle, and radiofrequency energy is sent through the electrode to damage your nerve so that it no longer sends pain signals to your brain. RFA can help relieve pain related to arthritis, as well as low-back and neck pain.

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Joint Aspiration

When moving your joints is painful due to fluid buildup, joint aspiration may be recommended. In this procedure, your doctor uses a needle to remove fluid in a joint to decrease pressure, relieve pain, and improve range of motion. If necessary, the fluid can be tested to help diagnose arthritis, gout, joint infection, and other inflammatory conditions. Joint aspiration is most often done on the knee but can be performed on other joints such as the shoulder, elbow, wrist, hip, or ankle.

Immobilization for Fractures and Sprains

Casting and Splinting

Casts and splints (also called half casts) support broken or injured bones and joints. They limit movement and help keep the bone in place until it fully heals. Splints provide less support than casts, but they are adjustable to accommodate swelling and allow for a greater range of motion. Depending on your injury, you may start out with a splint for several days, and then be placed in a cast when swelling decreases.

Bracing and Booting

Braces and boots can provide an alternative to casts for some ankle, foot, and lower-leg injuries, including sports injuries. They are also used in the treatment of arthritis and after surgery. Braces and boots are lighter than casts and can be easily adjusted and removed. Our orthopaedic specialists offer a variety of orthopaedic braces and boots that can be custom fitted to meet your needs.

Our Locations

Duke Health offers locations throughout the Triangle. Find one near you.

Why Choose Duke

A Comprehensive Approach

Duke orthopaedic specialists treat the whole person -- not just your medial condition. We help you achieve your functional goals -- whether they are to grocery shop without assistance or to return to a sport. Your treatment preferences are the top priority; we will never pressure you to have surgery and will respect your wishes to avoid certain medications or procedures.

Quick, Convenient Care

Orthopaedic urgent care clinics provide fast service for orthopaedic injuries that are not life-threatening such as sprains, closed fractures (in which the bone does not break the skin), or sports injuries.

Direct Access to Orthopaedic Surgeons

If a non-surgical approach does not improve your condition, we can refer you to Duke orthopaedic surgeons who focus on a particular joint or area of the body such as the spine, hip, knee or, shoulder. They can assess your condition, and together you can decide if surgery is right for you.

Best Orthopaedic Hospital in North Carolina

Where you receive your care matters. Duke University Hospital is proud of our team and the exceptional care they provide. They are why our orthopaedics program is nationally ranked, and the highest-ranked program in North Carolina, according to U.S. News & World Report for 2023–2024.

This page was medically reviewed on 04/03/2023 by