What to Expect at Your First Joint Pain Consultation

What Happens at Your First Visit

Your first joint pain consultation is critical—it’s where you’ll be evaluated, receive a diagnosis, learn about treatment options, and decide whether this provider is right for you. Understanding what to expect helps you prepare, recognize quality care, and identify potential red flags.

A comprehensive first visit typically lasts 45-60 minutes and includes medical history review, physical examination, imaging assessment, diagnosis discussion, treatment planning, and financial review.

This guide walks you through each phase of a quality first consultation, how to prepare, and what warning signs to watch for.

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Before Your Appointment: How to Prepare

Gather Your Medical Records

What to bring:

• List of current medications (including supplements)
• Previous imaging reports and CDs/files:
  • X-rays of affected joints
  • MRI reports and images
  • CT scans if applicable
• Records from previous providers who treated your joint pain
• List of treatments you’ve already tried
• Surgical history (especially previous joint surgeries)

Why it matters: Saves time, prevents duplicate testing, and gives your provider complete information for accurate diagnosis.

How to get records:

• Request from previous providers (allow 1-2 weeks)
• Most facilities provide CDs of imaging
• Some have patient portals for download

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Document Your Symptoms

Create a symptom timeline:

• When did pain start?
• What makes it better or worse?
• How has it progressed?
• Impact on daily activities
• Pain level (0-10 scale) at rest and with activity

Track patterns:

• Time of day pain is worst
• Weather effects (if any)
• Activities that trigger pain
• How long pain lasts after activity

Why it matters: Helps your provider understand severity and pattern of your condition.

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List Your Questions

Write down questions you want answered:

• About your specific condition
• About treatment options
• About provider credentials
• About costs and insurance
• About realistic expectations

Why it matters: Easy to forget questions during the appointment. A written list ensures you get the information you need.

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Verify Insurance Coverage

Before your appointment:

• Call your insurance to verify the provider is in-network
• Ask about copay for consultation
• Check if referral is required
• Understand your deductible status

Why it matters: Prevents surprise bills and ensures you’re maximizing insurance benefits.

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Prepare Logistically

Plan for:

• Arriving 15-20 minutes early for paperwork
• 1-2 hours total appointment time (including waiting)
• Comfortable, loose clothing for examination
• Bringing a companion to take notes and ask questions

Why it matters: Reduces stress and ensures you’re ready for the appointment.

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What to Expect: The Consultation Process

Phase 1: Check-In and Paperwork (15-20 minutes)

What happens:

• Complete patient registration forms
• Medical history questionnaire
• Insurance verification
• HIPAA privacy notices
• Payment of copay (if applicable)

Quality indicators:

• Professional, friendly front desk staff
• Clean, organized waiting area
• Efficient check-in process
• Clear explanation of copay/costs

Red flag: Disorganized check-in, pressure to pay large deposits, or unclear about costs.

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Phase 2: Vital Signs and Intake (5-10 minutes)

What happens:

• Medical assistant or nurse takes:
  • Blood pressure
  • Height and weight
  • General health screening
• Brief review of chief complaint
• Verification of medications
• May be taken to exam room

Quality indicators:

• Professional clinical staff
• Clean exam rooms
• Questions asked attentively
• Privacy respected

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Phase 3: Medical History Review (10-15 minutes)

What the provider will discuss:

About your joint pain:

• Location and severity
• Duration and progression
• Quality of pain (sharp, dull, aching, burning)
• Timing (constant or intermittent)
• Triggers and relieving factors
• Impact on function and quality of life

About your general health:

• Other medical conditions (diabetes, heart disease, etc.)
• Medications and allergies
• Previous surgeries
• Family history
• Smoking, alcohol use
• Activity level and occupation

About previous treatments:

• Physical therapy
• Medications tried
• Previous injections or procedures
• What worked and what didn’t
• Why you’re seeking care now

Quality indicators:

• Provider listens attentively
• Takes detailed notes or reviews EMR
• Asks clarifying questions
• Doesn’t interrupt excessively
• Spends at least 10 minutes on history

Red flag: Rushed history-taking, provider seems distracted, doesn’t ask about previous treatments, or interrupts frequently.

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Phase 4: Physical Examination (10-15 minutes)

What happens during examination:

Observation:

• Gait (how you walk)
• Joint alignment
• Swelling or deformity
• Muscle atrophy

Palpation:

• Feeling joints for warmth, swelling, tenderness
• Identifying specific tender points
• Checking for joint effusion (fluid)

Range of Motion:

• Active (you move joint yourself)
• Passive (provider moves joint for you)
• Measuring degrees of motion
• Noting pain with movement

Strength Testing:

• Muscle strength around joint
• Comparing to other side
• Identifying weakness

Special Tests:

• Specific maneuvers to test joint stability
• Ligament integrity
• Rotator cuff tests (shoulder)
• McMurray test (knee meniscus)
• Hip impingement tests

Quality indicators:

• Hands-on examination performed
• Both affected and unaffected sides examined for comparison
• Gentle technique
• Provider explains what they’re doing
• Takes 10-15 minutes minimum

Red flag (Major): No physical examination performed, or only cursory examination lasting under 5 minutes.

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Phase 5: Imaging Review or Ordering (5-10 minutes)

If you brought imaging:

• Provider reviews X-rays or MRI
• Explains findings in plain language
• Points out areas of concern
• Discusses severity

If you don’t have recent imaging:

• Provider explains what imaging is needed
• Orders appropriate tests:
  • X-rays (for bone and joint space assessment)
  • MRI (for soft tissue, cartilage, ligaments)
  • CT scan (rarely needed)
• Discusses when imaging will be done
• May schedule follow-up to review results

Quality indicators:

• Provider personally reviews imaging (not just radiology report)
• Explains findings clearly
• Uses images or models to help you understand
• Orders appropriate imaging if needed
• Doesn’t order unnecessary tests

Red flag: Ordering extensive imaging that seems unnecessary, or recommending treatment without any imaging.

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Phase 6: Diagnosis Discussion (5-10 minutes)

What the provider should explain:

• Diagnosis: What condition you have
• Severity: How advanced it is
• Prognosis: Expected progression without treatment
• Causative factors: Why this happened
• Natural history: What typically happens with this condition

Common diagnoses:

• Osteoarthritis (knee, hip, shoulder, etc.)
• Rotator cuff tear or tendinopathy
• Meniscus tear
• Inflammatory arthritis
• Labral tears
• Bursitis or tendinitis

Quality indicators:

• Clear, understandable explanation
• Uses diagrams, models, or images
• Explains grading/severity
• Answers questions about diagnosis
• Acknowledges any uncertainty

Red flag: Vague diagnosis, reluctance to explain findings, or immediate jump to treatment without clear diagnosis.

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Phase 7: Treatment Planning (15-20 minutes)

A quality provider discusses multiple options:

Conservative (First-Line) Treatments:

• Physical therapy
• Home exercise programs
• Weight management (if applicable)
• Activity modification
• Oral medications (NSAIDs, acetaminophen)
• Topical treatments
• Bracing or orthotics
• Ice, heat, other modalities

Intermediate (Injection) Treatments:

• Corticosteroid injections
  • How they work
  • Expected duration
  • Risks and benefits
• Hyaluronic acid injections
  • Different brands available
  • Injection schedule
  • Expected outcomes
• Other injections (PRP, etc.)
  • Evidence level
  • Cost considerations

Advanced (Surgical) Options:

• When surgery becomes appropriate
• Types of surgery for your condition
• Recovery expectations
• Referral to surgeon if needed

What the provider should cover for each option:

• How it works
• Evidence supporting it
• Success rates
• Duration of benefit
• Risks and side effects
• Cost and insurance coverage
• Time commitment
• Recovery time

Quality indicators:

• Multiple options presented
• Evidence-based recommendations
• Pros and cons discussed
• Your preferences considered
• Questions welcomed
• No pressure to decide immediately
• Written information provided

Red flag: Only one treatment option presented, dismissal of conservative care, pressure to commit to treatment immediately, or heavy promotion of expensive unproven treatments.

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Phase 8: Recommended Treatment Plan (5-10 minutes)

What the provider should explain:

Their specific recommendation:

• What treatment they recommend for you
• Why this treatment is appropriate
• Why they think it will help
• Realistic expectations for outcomes

Treatment details:

• Procedure specifics (for injections)
• Use of imaging guidance
• Medication that will be used
• Number of treatments needed
• Timeline for benefits

Alternative pathways:

• What to try if first treatment doesn’t work
• Long-term management plan
• When to consider next steps

Quality indicators:

• Recommendation tailored to your specific situation
• Based on examination findings and imaging
• Explained clearly with rationale
• Realistic expectations set
• Acknowledges success is not guaranteed
• Discusses plan if treatment doesn’t work

Red flag: Same treatment for all patients, guaranteed results claimed, or no discussion of alternatives if treatment fails.

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Phase 9: Cost and Insurance Discussion (5-10 minutes)

What should be covered:

Cost information:

• Total cost of recommended treatment
• Breakdown of costs:
  • Physician fee
  • Facility fee
  • Medication cost
  • Imaging guidance fee
• Self-pay cost if relevant

Insurance coverage:

• Whether treatment is typically covered
• In-network or out-of-network status
• Expected copay/coinsurance
• Need for prior authorization
• Offer to verify benefits before treatment

Payment expectations:

• When payment is due
• Payment plan options if needed
• What happens if insurance denies coverage

Quality indicators:

• Clear, upfront cost discussion
• Written estimate provided
• Offer to verify insurance before procedure
• Transparent about all fees
• No surprise costs
• Reasonable pricing

Red flag: Evasive about costs, requiring large upfront payment, pressure to pay before insurance verification, or pricing far above market rates.

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Phase 10: Questions and Next Steps (5-10 minutes)

Your opportunity to ask:

• Any remaining questions
• Clarification on anything unclear
• Second opinion considerations
• Timeline for decision

Next steps discussion:

• If you want to proceed:
  • Scheduling treatment
  • Any preparation needed
  • Insurance authorization process
  • Timeline to treatment
• If you want to think about it:
  • Time frame for decision
  • How to contact office with questions
  • Scheduling follow-up if needed

Quality indicators:

• Provider welcomes questions
• Answers thoroughly
• No pressure to decide immediately
• Supportive of second opinions
• Clear instructions for next steps
• Contact information for questions

Red flag: Pressure to schedule treatment immediately, discouragement of second opinions, or limited time for questions.

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Phase 11: Checkout (5 minutes)

What happens:

• Schedule future appointments if applicable
• Receive written materials
• Follow-up instructions
• Prescription if needed
• Referrals if applicable

Quality indicators:

• Helpful front desk staff
• Clear scheduling
• Written summary of visit
• Easy to schedule follow-up

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Timeline: A Quality First Visit

Total time: 45-60 minutes with provider

• Check-in and paperwork: 15-20 minutes
• Intake and vitals: 5-10 minutes
• Medical history: 10-15 minutes
• Physical examination: 10-15 minutes
• Imaging review: 5-10 minutes
• Diagnosis discussion: 5-10 minutes
• Treatment options: 15-20 minutes
• Cost discussion: 5-10 minutes
• Questions and next steps: 5-10 minutes

Red flag: Provider spends less than 30 minutes total with you, or appointment feels extremely rushed.

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Red Flags During Your First Visit

Watch for these warning signs:

Critical Red Flags (Consider finding another provider)

• No physical examination before recommending treatment
• High-pressure sales tactics to commit immediately
• Guaranteed results or cure promises
• No imaging guidance offered for joint injections
• Dismissive of questions or concerns
• Vague about credentials or training
• Only discusses one treatment option
• Evasive about costs or insurance

Concerning Red Flags (Proceed with caution)

• Very rushed appointment (under 30 minutes)
• Sales staff involved in medical discussions
• Same treatment recommended to everyone
• Ordering excessive or unnecessary tests
• Promoting unproven or experimental treatments heavily
• Discouraging second opinions
• Poor communication or unclear explanations

Minor Red Flags (Consider in context)

• Long wait times beyond scheduled appointment
• Disorganized office
• Staff not particularly friendly
• Provider running behind (occasional is normal)

If you observe multiple red flags, especially critical ones, consider seeking care elsewhere.

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Questions to Ask During Your Visit

About the Provider

• “Are you board certified, and in what specialty?”
• “How many of these procedures do you perform each year?”
• “What is your specific training in joint injections?”

About Your Diagnosis

• “What exactly is my diagnosis?”
• “How severe is my condition?”
• “What happens if I don’t treat it?”

About Treatment

• “What are all my treatment options?”
• “What do you recommend and why?”
• “Do you use imaging guidance for injections?”
• “What are realistic expectations for outcomes?”
• “What are the risks and side effects?”

About Costs

• “How much will this cost?”
• “Is this covered by my insurance?”
• “Are you in-network with my insurance?”
• “Can you verify my coverage before treatment?”

About Next Steps

• “Do I need to decide today?”
• “What happens if treatment doesn’t work?”
• “When would I follow up?”
• “Can I get a second opinion?”

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After Your Visit: Reflection Questions

Evaluate the quality of care:

About the provider:

• Did they listen to my concerns?
• Did I feel respected?
• Were my questions answered satisfactorily?
• Did they explain things clearly?
• Do I trust their judgment?

About the examination:

• Was I examined thoroughly?
• Did they review my imaging?
• Did I understand my diagnosis?

About the treatment plan:

• Were multiple options discussed?
• Do I understand the recommended treatment?
• Are expectations realistic?
• Do I feel comfortable with the plan?

About the practice:

• Was the staff professional?
• Was the facility clean and organized?
• Were costs explained clearly?
• Do I feel pressured or comfortable?

Overall:

• Would I feel confident moving forward with this provider?
• Were any red flags present?
• Should I get a second opinion?

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When to Seek a Second Opinion

Consider seeing another provider if:

• Multiple red flags were present
• You felt rushed or dismissed
• Treatment recommended seems aggressive or unusual
• Costs are very high compared to what you expected
• You don’t trust the provider’s judgment
• Gut feeling that something isn’t right
• Major procedure is recommended (surgery, expensive treatment)
• You’re uncertain about the diagnosis or plan

Quality providers welcome second opinions. If your provider discourages you from seeking another perspective, that itself is a red flag.

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Special Considerations

If It’s a Telehealth Visit

Limitations:

• No physical examination possible
• Can’t assess range of motion or strength
• Relies on your description and imaging review

Acceptable for:

• Initial consultation to discuss symptoms
• Imaging review
• Treatment planning discussion
• Follow-up after in-person evaluation

Not appropriate for:

• Complete diagnosis without any in-person evaluation
• Recommending injections without ever examining you
• Replacing necessary in-person assessment

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If Imaging Must Be Done First

Some practices:

• Require imaging before consultation
• Order imaging, then schedule follow-up to discuss
• Have imaging done same day before consultation

This is acceptable as long as:

• Explained clearly when scheduling
• Costs are transparent
• You agree to the approach

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If Treatment Is Offered Same Day

Occasionally appropriate:

• Simple injection if you’ve decided to proceed
• Conservative treatments (prescription, brace, etc.)
• You’ve had time to review options beforehand

Red flag if:

• Pressured to do treatment immediately
• Haven’t had time to consider options
• Haven’t discussed costs or insurance
• Feels rushed or pushy

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Making Your Decision

After your consultation, take time to:

Review information:

• Go over any materials provided
• Research treatment options discussed
• Verify claims about success rates

Verify credentials:

• Check board certification
• Look up provider reviews
• Check for disciplinary actions

Consider costs:

• Contact insurance to verify coverage
• Compare costs to typical rates
• Ensure you understand financial responsibility

Reflect on the experience:

• Quality of communication
• Thoroughness of evaluation
• Comfort level with provider
• Presence or absence of red flags

Seek second opinion if:

• Uncertainty about diagnosis or treatment
• Red flags were present
• Major cost or procedure involved
• Gut feeling says to

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Your Rights as a Patient

Remember, you have the right to:

• Thorough evaluation before treatment recommendations
• Clear explanations in language you understand
• All treatment options discussed, not just one
• Time to consider options without pressure
• Second opinions without penalty
• Ask questions and have them answered
• Know costs before committing to treatment
• Decline treatment without having to justify your decision
• Respectful, professional care

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Summary: First Visit Checklist

A quality first consultation includes:

• Comprehensive medical history review (10-15 min)
• Thorough physical examination (10-15 min)
• Review of imaging or ordering if needed
• Clear diagnosis explanation
• Discussion of multiple treatment options
• Evidence-based recommendations
• Realistic expectations set
• Cost and insurance discussion
• Time for questions without pressure
• Written materials to take home
• Clear next steps

Total provider time: 45-60 minutes

Red flags to watch for:

• No physical examination
• Rushed appointment (under 30 min)
• High-pressure sales tactics
• Guaranteed results promised
• Only one treatment option discussed
• Dismissive of questions or concerns
• Vague about costs or credentials
• Discourages second opinions

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Related Resources

• How to Choose a Quality Joint Pain Specialist
• 25 Questions to Ask Before Getting Joint Injections
• Red Flags: Warning Signs of Questionable Providers
• How to Identify a High-Quality Joint Pain Clinic
• Understanding Insurance Coverage for Joint Treatments