Orthopedic Clinic Online — assessment of joints, muscles, and bones

Typical age

More common with increasing age.

Background

Degenerative joint disease, cartilage breakdown.

Symptoms

Pain and stiffness, especially after rest.

What the doctor looks for

Symptom pattern, previous imaging findings.

Investigations

Often clinical, sometimes X-ray.

Diagnosis

Clinical picture ± imaging findings.

Management

Physical activity, pain relief, surgery in some cases down the line.

Follow-up

Regular.

Prognosis

Chronic but manageable, varies with severity.

What you can do yourself

Regular strength training for the muscles around the joint is the single most effective measure — better than rest.

When should you book?

For joint pain lasting more than a few weeks, or affecting your sleep and daily life.

Typical age

Adults, most common 30–50 years.

Background

Disc tissue presses on a nerve root; the good news is that most cases improve with time and conservative treatment, without ever needing surgery.

Symptoms

Back pain radiating down the leg, possibly numbness.

What the doctor looks for

Radiation pattern, neurological symptoms.

Investigations

Clinical assessment, sometimes MRI.

Diagnosis

Clinical picture ± imaging findings.

Management

Pain relief, activity, surgery rarely — reserved for cases with significant neurological symptoms or ones that don't improve over time.

Follow-up

If no improvement.

Prognosis

Good, most improve without surgery.

What you can do yourself

Keep moving within the limits of pain. Bed rest makes it worse and prolongs recovery.

When should you book?

For radiating pain lasting more than two weeks. With leg weakness, altered sensation in the genital area or around the anus, or bladder or bowel involvement — emergency care.

Sudden leg weakness, altered sensation in the genital area or around the anus, or loss of bladder/bowel control with back pain is an emergency — see the safety box.

Typical age

All adult ages, more common with repetitive loading.

Background

Overuse of a tendon.

Symptoms

Pain with movement/loading of the tendon.

What the doctor looks for

Location and loading pattern.

Investigations

Clinical assessment.

Diagnosis

Clinical picture.

Management

Rest, gradual loading, physiotherapy.

Follow-up

Per progress.

Prognosis

Good but can take time.

What you can do yourself

Gradual, controlled loading heals tendons better than rest — but increase slowly; tendons respond more slowly than muscles.

When should you book?

For tendon problems that haven't improved within six weeks.

Typical age

Adults, more common in women.

Background

Pressure on the median nerve at the wrist.

Symptoms

Numbness and tingling in thumb, index, and middle finger, often at night.

What the doctor looks for

Symptom pattern.

Investigations

Clinical assessment, sometimes nerve conduction testing via specialist.

Diagnosis

Clinical picture.

Management

Wrist splint, surgery in pronounced cases.

Follow-up

Per progress.

Prognosis

Good, especially with early treatment.

What you can do yourself

A night wrist splint often gives a noticeable effect within a few weeks and is a good first step.

When should you book?

For numbness that wakes you at night, or if you've started dropping things.

Typical age

All ages, more common in active people.

Background

Acute or overuse injury from sports.

Symptoms

Pain, swelling, reduced function.

What the doctor looks for

Injury mechanism, functional impairment.

Investigations

Clinical assessment, sometimes imaging if a more serious injury is suspected.

Diagnosis

Clinical picture.

Management

Rest, gradual return, physiotherapy.

Follow-up

Per progress.

Prognosis

Good with proper rehabilitation.

What you can do yourself

For the first few days — relative rest, compression, elevation. After that, gradual return rather than complete rest.

When should you book?

If you can't bear weight, with marked swelling, or if there's no improvement after a week.

Typical age

All adult ages.

Background

Often muscular or posture-related.

Symptoms

Stiffness, pain with movement.

What the doctor looks for

Movement restriction, possible radiation.

Investigations

Clinical assessment.

Diagnosis

Clinical picture.

Management

Movement exercises, pain relief.

Follow-up

If symptoms persist.

Prognosis

Good.

What you can do yourself

Range-of-motion exercises and a review of your working posture usually work better than painkillers in the long run.

When should you book?

For neck pain beyond three weeks, or if it radiates into the arm with numbness.

Typical age

Adults, more common middle-aged.

Background

Pinching of tendon tissue in the shoulder joint.

Symptoms

Pain when lifting the arm, especially above shoulder height.

What the doctor looks for

Movement pattern that triggers pain.

Investigations

Clinical assessment, sometimes imaging.

Diagnosis

Clinical picture.

Management

Physiotherapy, pain relief.

Follow-up

Per progress.

Prognosis

Good with proper rehabilitation.

What you can do yourself

Avoid repeated movements above shoulder height during the acute phase, but keep moving the shoulder within the pain-free range.

When should you book?

For shoulder pain beyond four weeks, or if you can't lift your arm.

Typical age

All ages.

Background

Injury to the cartilage disc in the knee.

Symptoms at follow-up

Persistent knee pain or feeling of instability.

What the doctor looks for

Functional level, previous investigation findings.

Investigations

Review of previous imaging.

Diagnosis

Already established, this concerns follow-up.

Management

Physiotherapy, sometimes surgery.

Follow-up

Per individual plan.

Prognosis

Varies with injury type.

What you can do yourself

Strength training for the thigh muscles improves function and often reduces the need for surgery.

When should you book?

For a knee that locks, gives way, or stays swollen.

Typical age

Adults.

Background

Inflammation of a bursa near a joint.

Symptoms

Localized pain and swelling.

What the doctor looks for

Location, signs of infection.

Investigations

Clinical assessment.

Diagnosis

Clinical picture.

Management

Rest, pain relief.

Follow-up

If no improvement.

Prognosis

Good.

What you can do yourself

Avoid the pressure or movement that triggered it; cold can relieve symptoms in the acute phase.

When should you book?

If there's no improvement within two weeks. With fever and marked redness — emergency care.

Marked redness, warmth and fever around a joint can indicate infection — an emergency, see the safety box.

Typical age

Adults, most common 30–50 years.

Background

Irritation or pressure on the sciatic nerve; most people see meaningful improvement within a few weeks with conservative management.

Symptoms

Pain radiating from the lower back/buttock down the leg.

What the doctor looks for

Radiation pattern, neurological signs.

Investigations

Clinical assessment, sometimes MRI.

Diagnosis

Clinical picture ± imaging findings.

Management

Pain relief, activity, surgery rarely.

Follow-up

If no improvement.

Prognosis

Good, most improve within weeks.

What you can do yourself

Keep moving. Walking is better than bed rest, even when it hurts.

When should you book?

For radiating leg pain beyond two weeks. With weakness, altered sensation in the genital area or around the anus, or bladder or bowel involvement — emergency care.

Typical age

All adult ages.

Background

Night pain is a pattern that deserves particular attention in orthopaedics. Mechanical pain is normally relieved by rest — pain that instead wakes you, or is worst at night, follows a different pattern and may point to inflammation or, rarely, a more serious cause.

Common symptoms

Pain that wakes you, or that is markedly worse in bed than during the day.

What the doctor looks for

Whether the pain eases with movement (suggesting inflammation) or worsens (suggesting a mechanical cause), and whether other warning signs are present.

Investigations

Blood tests (inflammatory markers), often imaging for persistent night pain.

How the assessment is made

By mapping the daily pattern carefully — it is often more revealing than where the pain sits.

Management

Directed at the established cause.

Follow-up

Closer than for ordinary load-related pain.

Risk factors to know

Previous cancer, unintended weight loss, fever, night sweats — these combined with night-time bone pain require prompt investigation.

Common misconception

That night pain just means a bad mattress. Sometimes it does — but the pattern always deserves an assessment.

What you can do yourself

Note exactly when the pain wakes you and whether it eases when you move — that is decisive information.

When should you book?

For pain that repeatedly wakes you, particularly alongside weight loss, fever, or if you've had cancer before.

Prognosis

Depends entirely on the cause — but most cases have a benign explanation.

Typical age

All ages, most common in people who have recently increased their training load.

Background

Overload injuries occur when loading increases faster than the tissue can adapt. It is one of the most common causes of orthopaedic problems in active people — and one of the most preventable.

Common symptoms

Gradually increasing ache with a specific movement, often in a tendon, ligament or bone; worst at the start of activity or afterwards.

What the doctor looks for

The time relationship to a change in training volume or a new activity, and whether the pain is load-dependent.

Investigations

Clinical assessment; imaging where a stress fracture or more serious injury is suspected.

How the assessment is made

From the loading history and the pain pattern.

Management

Relative rest (reduce, don't stop), technique adjustment, gradual rebuilding to a structured plan.

Follow-up

According to the return-to-activity plan.

Risk factors to know

Rapid increase in training volume, insufficient recovery, lack of variation, old injuries, unsuitable equipment.

Common misconception

That you should rest completely until it doesn't hurt at all. Total rest weakens the tissue further — controlled, progressive loading is usually right.

What you can do yourself

Reduce the load by roughly half rather than stopping altogether, then increase by no more than ten per cent a week.

When should you book?

For pain persisting beyond three weeks despite reduced loading, or if you're limping.

Prognosis

Very good with the right loading progression.

Typical age

All adult ages.

Background

Numbness indicates nerve involvement, but the source can sit anywhere along the nerve pathway — from the neck or lower back to the wrist or ankle. Where the numbness sits often tells you exactly where the problem is, which makes careful mapping more valuable than early imaging.

Common symptoms

Numbness, tingling or a crawling sensation, sometimes with weakness at the same time.

What the doctor looks for

The exact distribution — which fingers, or which part of the foot — since each nerve has a characteristic territory.

Investigations

Clinical assessment; nerve conduction studies or MRI via in-person care for persistent problems.

How the assessment is made

By mapping the distribution pattern against known nerve territories.

Management

Directed at the cause — splinting, ergonomic adjustments, physiotherapy or, in some cases, surgery.

Follow-up

According to progress; sooner where weakness is present.

Risk factors to know

Diabetes (a common cause of neuropathy), repetitive work, previous neck or back problems, B12 deficiency, high alcohol intake.

Common misconception

That numbness always comes from the place where you feel it. Numbness in the hand often originates in the neck.

What you can do yourself

Draw exactly where the numbness sits on a diagram and bring it to the visit — it's the most valuable information you can give.

When should you book?

For numbness lasting more than two weeks. With sudden weakness or rapidly increasing numbness — emergency care.

Prognosis

Good, particularly with early treatment — nerve problems recover more slowly the longer they are left.

Typical age

All ages.

Background

Bone heals, but function does not return automatically. Many people are left with stiffness, weakness or uncertainty after the cast comes off — and the rehabilitation phase is often what determines the final result, rather than the fracture treatment itself.

Common symptoms

Stiffness, reduced strength, swelling, uncertainty when loading the limb.

What the doctor looks for

Range of motion, functional level, and whether recovery is following the expected course for the fracture type.

Investigations

Review of previous X-rays and the operation report; new imaging where healing is in doubt.

How the assessment is made

From the fracture type, the time since injury and current function.

Management

Structured rehabilitation; referral to a physiotherapist where needed.

Follow-up

Regular throughout the rehabilitation phase.

Risk factors to know

Smoking (markedly impairs fracture healing), diabetes, osteoporosis, older age, inadequate rehabilitation.

Common misconception

That you're finished when the cast comes off. For most fractures, the most important part starts there.

What you can do yourself

Start range-of-motion exercises as soon as you've been cleared — stiffness is harder to fix than to prevent.

When should you book?

For persistent stiffness or weakness a few weeks after the cast comes off, or if pain is increasing rather than easing.

Prognosis

Good with structured rehabilitation; worse if rehabilitation is skipped.

Typical age

More common from 60 onwards, and considerably more common in women after the menopause.

Background

Osteoporosis causes no symptoms at all until a fracture occurs — and the first fracture is often what reveals the diagnosis. Since the risk of further fractures rises sharply after the first, early identification is particularly valuable.

Common symptoms

None before a fracture; then pain and loss of function. Sometimes reduced height or a stooped posture.

What the doctor looks for

Previous low-energy fractures (a fracture after a fall from standing height), risk factors, and loss of height.

Investigations

Bone density scan (DXA) via in-person care; blood tests (calcium, vitamin D, kidney function).

How the assessment is made

Bone density measurement, or clinically after a low-energy fracture in an older person.

Management

Vitamin D and calcium, strength and balance training, plus bone-specific medication where risk is raised.

Follow-up

Regular, with repeat measurement to plan.

Risk factors to know

Early menopause, corticosteroid treatment, smoking, low body weight, family history of hip fracture, high alcohol intake, inactivity.

Common misconception

That osteoporosis only affects very old women. Men are affected too, and treatment can start long before any fracture occurs.

What you can do yourself

Weight-bearing exercise (walking, strength training) stimulates bone formation. Balance training reduces the risk of falling, which matters at least as much as bone density.

When should you book?

After a fracture from a fall at standing height, or with several risk factors even without a previous fracture.

Prognosis

Good risk reduction is possible — treatment markedly lowers fracture risk.