@suz55 You said "I know I will need my knee replaced in the future and wonder if that is not exasperating my hip, shoulder and back issues." I will answer from experience - Absolutely! I had bilateral hip replacements at 55 and revisions 6 years later. The change in my overall pain level was amazing after I stopped limping. For two reasons - first, pain in a joint causes you to change gait, the way you hold your body, and the amount you move. Second, pain activates the pain receptors in your brain, which then become highly sensitized, causing more pain (in my family we call them "pain buddies.")

If your PA is only familiar with what I call "old-style" pain management specialists, whose primary tools were injections and opioids, that may color her opinion. What you need is a new-style one, whose goal is to find and interrupt the signals, and if possible treat the underlying cause. Ask your ortho or rheumatologist to refer you to a doc whose goal is improved function in spite of issues.

Good luck!
Sue