מכיוון שיש לי כאב מפרקים, הפיזיותרפיסט שינה את תוכנית הטיפול.

מכיוון means because / since in this sentence.

In מכיוון ש־..., the ש־ introduces the clause that explains the reason:

• מכיוון שיש לי כאב מפרקים = because I have joint pain

A few common alternatives are:

• כי = because
• מפני ש־ = because
• בגלל ש־ = because

מכיוון ש־ sounds a bit more formal or written than כי.

The ש־ is a connector meaning something like that or because depending on the structure.

Here, מכיוון ש־ works as a fixed expression meaning because:

• מכיוון ש... = because...

So in this sentence:

• מכיוון שיש לי כאב מפרקים = because I have joint pain

You will often see ש־ attached directly to the previous word, as in:

• חשבתי ש... = I thought that...
• אמרתי ש... = I said that...
• מכיוון ש... = because...

Hebrew usually expresses possession with יש ל־:

• יש לי = literally there is to me
• natural English translation: I have

So:

• יש לי כאב מפרקים = I have joint pain

This is one of the most important patterns in Hebrew:

• יש לי ספר = I have a book
• יש לה זמן = she has time
• יש להם ילדים = they have children

The opposite is:

• אין לי = I don’t have

לי is the preposition ל־ (to / for) plus the pronoun I / me attached to it.

So:

• ל־
  • אני does not stay separate
• it becomes לי = to me / for me

Some other forms:

• לי = to me
• לך = to you (m. / f. depending on pronunciation/context)
• לו = to him
• לה = to her
• לנו = to us

In יש לי, this attached form is standard Hebrew.

כאב מפרקים means joint pain.

This is a very common Hebrew structure called סמיכות (the construct state), where two nouns are linked:

• first noun: כאב = pain
• second noun: מפרקים = joints

Together:

• כאב מפרקים = pain of joints = joint pain

This pattern is extremely common:

• בית ספר = school
• חדר שינה = bedroom
• כוס מים = glass of water

So Hebrew often expresses ideas like English noun compounds by putting two nouns together.

Because joint pain refers to pain in the joints in general, not usually one specific joint.

• מפרק = joint
• מפרקים = joints

So:

• כאב מפרקים = joint pain / pain in the joints

Hebrew often uses the plural in this kind of medical or general expression, much like English can say joint pain while referring to joints generally.

In Hebrew, the phrase כאב מפרקים is indefinite as written:

• כאב = a pain / pain
• מפרקים = joints

So literally it is something like joint pain or pain in the joints, not the joint pain.

If Hebrew wanted to make the whole construct phrase definite, the definiteness usually appears on the second noun:

• כאב המפרקים = the pain of the joints / the joint pain

But in many contexts, especially with medical conditions or general symptoms, the indefinite form is natural:

• יש לי כאב מפרקים = I have joint pain

שינה is the past tense, 3rd person masculine singular form of the verb לשנות = to change.

So:

• שינה = he changed

Who changed it?

• הפיזיותרפיסט = the physiotherapist

Since פיזיותרפיסט is grammatically masculine singular here, the verb matches it:

• הפיזיותרפיסט שינה... = the physiotherapist changed...

If the subject were feminine, you would usually see:

• הפיזיותרפיסטית שינתה... = the female physiotherapist changed...

את marks a definite direct object in Hebrew.

The verb is שינה = changed, and the thing being changed is:

• תוכנית הטיפול = the treatment plan

Because that object is definite, Hebrew uses את:

• שינה את תוכנית הטיפול
• literally: changed [direct-object marker] the treatment plan

A very important point:

• את here does not mean you
• it is a grammar marker used before definite direct objects

Compare:

• קראתי ספר = I read a book
• קראתי את הספר = I read the book

תוכנית הטיפול is another construct phrase:

• תוכנית = plan/program
• הטיפול = the treatment

Together:

• תוכנית הטיפול = the treatment plan / plan of the treatment

In Hebrew construct phrases, definiteness is usually shown on the second noun, but it makes the whole phrase definite.

So:

• תוכנית טיפול = a treatment plan
• תוכנית הטיפול = the treatment plan

This is a very important rule in Hebrew grammar.

תוכנית means plan or program, and it is a feminine noun.

That is why it often behaves as a feminine word in grammar. For example, if you described it with an adjective, the adjective would usually be feminine too:

• תוכנית חדשה = a new plan

In this sentence, it appears in a construct phrase:

• תוכנית הטיפול = the treatment plan

The basic noun is still תוכנית.

Hebrew, like English, can put the reason clause first:

• מכיוון שיש לי כאב מפרקים, הפיזיותרפיסט שינה את תוכנית הטיפול.
• Because I have joint pain, the physiotherapist changed the treatment plan.

This word order emphasizes the reason first.

You could also reverse it:

• הפיזיותרפיסט שינה את תוכנית הטיפול מכיוון שיש לי כאב מפרקים.

Both are grammatical. The version with the reason first is often a bit more explanatory or formal.

The comma is natural and standard when the sentence begins with a subordinate clause like:

• מכיוון ש...

So:

• מכיוון שיש לי כאב מפרקים, הפיזיותרפיסט שינה את תוכנית הטיפול.

It helps separate the reason clause from the main clause.

In informal writing, people are not always perfectly consistent with commas, but in careful written Hebrew, this comma is appropriate.

A more everyday version might use כי instead of מכיוון ש־:

• כי יש לי כאב מפרקים, הפיזיותרפיסט שינה את תוכנית הטיפול.

But even more natural in conversation would often be:

• הפיזיותרפיסט שינה את תוכנית הטיפול כי יש לי כאב מפרקים.

That said, the original sentence is completely correct. It just sounds a bit more formal or written because of מכיוון ש־.

הפיזיותרפיסט means the physiotherapist.

It has ה־, the Hebrew definite article:

• פיזיותרפיסט = a physiotherapist
• הפיזיותרפיסט = the physiotherapist

The ה־ is like English the.

Pronunciation varies a bit by speaker, but roughly:

• ha-fiz-yo-te-ra-pist

Because the next word begins with פ, the ה is pronounced normally as ha-.

Yes. Depending on context, Hebrew might also say:

• כאבים במפרקים = pains in the joints / joint pains
• כאב במפרקים = pain in the joints

The original כאב מפרקים is compact and natural, especially in a medical-style expression. But in conversation, people may also use the ב־ form:

• יש לי כאב במפרקים
• יש לי כאבים במפרקים

All of these can be natural depending on nuance and context.