Understand your symptoms.
Stay active.

What matters most

Sleep is the body's most important recovery phase and a powerful factor shaping how pain is perceived. Poor sleep lowers your pain threshold and increases muscle tension. Seven to nine hours is the target.

What matters most

There's no single "correct" posture – the best posture is your next one. What matters is variety and a muscular balance between the front and back of the body. Prolonged sitting shortens the hip flexors and chest muscles while weakening the glutes and upper back.

What matters most

The right footwear takes load off the joints throughout the whole lower body chain – from the feet through the knees and hips to the spine. Insoles aren't a default for everyone; they're a targeted measure for a confirmed deformity or abnormal loading pattern.

What matters most

Movement can become medicine. Regular training is one of the most powerful measures there is for slowing the ageing process, reducing pain, and preserving independence well into old age. No medication has such broad-reaching effects as physical activity.

What matters most

Small adjustments to your workstation and everyday movements add up to a big effect on joint and spine health over the years. The goal isn't perfect posture, but avoiding sustained poor loading patterns.

What matters most

Body weight and diet directly influence joint load and inflammation. Every kilogram lost eases the load on the knees and hips several times over. This isn't about short-term diets, but about habits you can sustain for good.

What is it?

For most low back pain – roughly 85 out of 100 cases – no single, clearly identifiable cause such as a disc herniation or fracture can be found. This is called non-specific low back pain, or lumbar spine syndrome: the pain arises from a combination of muscle tension, poor loading patterns, reduced mobility, and sometimes psychosocial stress factors. Pain is considered chronic once it has lasted longer than twelve weeks. That's common – and very treatable, especially with active measures.

Typical symptoms & self-care

People typically describe a dull ache or stiffness in the lower back that's most pronounced in the morning and eases with brief movement. Tightness in the back-extensor muscles, reduced forward bending, and pain after prolonged sitting or standing are common.

What we do in clinic

The first step is a thorough examination: we check whether your back pain is genuinely non-specific or whether a treatable underlying cause is involved. Simply knowing that no dangerous finding is present has a proven pain-relieving effect.

Conservative treatment

Targeted physical therapy with an active exercise programme, short-term manual therapy for mobility work if needed, heat treatment, and brief medication support during pronounced flare-ups. If the small facet joints are the main pain source, targeted injections can help.

Surgical options

Surgery is generally not indicated for non-specific low back pain. If a specific finding emerges over time, we'll discuss it openly with you – without pressure and with clear information on benefits and risks.

Exercises to do at home

Perform within a pain-adapted range. A mild stretching sensation is normal – sharp pain is a stop signal.

Frequently asked questions

What is it?

Lumbago (a "locked back" or acute back spasm) refers to the sudden onset of sharp low back pain, often after an awkward movement or overexertion. When it also radiates down the leg along the sciatic nerve, it's called sciatica. Most acute episodes improve substantially within 1–4 weeks – staying active is the key factor.

Typical symptoms & self-care

Sudden, severe pain in the lower back, often after lifting or twisting. Pain may radiate into the buttock or leg. Marked restriction of movement.

What we do in clinic

We explain that the prognosis is generally favourable. Unnecessary imaging in the first few weeks is avoided when the pattern is typical.

Conservative treatment

Short-term medication support (NSAIDs), manual therapy, targeted injections for pronounced sciatica, and physical therapy with activation exercises.

Surgical options

Surgery isn't indicated for acute non-specific back pain.

Exercises to do at home

Perform within a pain-adapted range. A mild stretching sensation is normal – sharp pain is a stop signal.

Frequently asked questions

What is it?

In a disc herniation, the gel-like core of the disc pushes out through its outer fibrous ring and can compress a nerve root. The L4/5 and L5/S1 levels are most often affected. Importantly, most herniations shrink back with conservative treatment within 6–12 weeks, as the body gradually breaks down the herniated tissue.

Typical symptoms & self-care

Back pain combined with leg pain that follows the path of a nerve (for example, from the outer thigh down to the foot with an L5 nerve). Tingling or numbness. Pain worsens with sitting.

What we do in clinic

A clinical examination identifies which nerve root is affected. MRI is used if warning signs are present or a procedure is being planned.

Conservative treatment

Physical therapy (McKenzie method, core stabilisation), NSAIDs, and targeted nerve-root injections for pronounced nerve irritation (radiculopathy).

Surgical options

Considered for progressive weakness, cauda equina syndrome (pressure on the nerve bundle at the base of the spine), or after 6–12 weeks of unsuccessful conservative treatment.

Exercises to do at home

Perform within a pain-adapted range. A mild stretching sensation is normal – sharp pain is a stop signal.

Frequently asked questions

What is it?

A herniated disc in the neck compresses a nerve root that radiates into the arm and hand – most often at the C5/6 and C6/7 levels. The hallmark is arm pain that follows the path of a nerve, together with tingling or numbness in the hand. If the spinal cord itself is compressed (myelopathy), problems with walking can occur – this needs urgent assessment.

Typical symptoms & self-care

Neck pain with arm pain that follows the path of a nerve. Tingling or numbness in the fingers. Pain worsens when tilting the head back.

What we do in clinic

A clinical examination identifies which nerve root is affected. MRI is used for unclear findings or if a procedure is being planned.

Conservative treatment

Physical therapy (chin tucks, isometric strengthening), careful manual therapy, NSAIDs, and targeted nerve-root injections for severe radiating arm pain.

Surgical options

Considered for spinal cord compression (myelopathy) or progressive weakness. For pure nerve-root irritation (radiculopathy), considered after 6–12 weeks of unsuccessful treatment.

Exercises to do at home

Perform within a pain-adapted range. A mild stretching sensation is normal – sharp pain is a stop signal.

Frequently asked questions

What is it?

In spinal stenosis, the spinal canal narrows due to degenerative changes – thickened ligaments, bony overgrowth, and enlarged facet joints. Nerves become compressed under load. The hallmark is neurogenic claudication: leg pain when walking that improves with sitting or bending forward – cycling (a bent-forward posture) is usually much better tolerated.

Typical symptoms & self-care

Pain or heaviness in the legs when walking that eases with sitting. Reduced walking distance. Cycling is often better tolerated than walking.

What we do in clinic

A clinical examination and MRI determine the degree of stenosis, distinguishing it from vascular claudication (a circulation-related cause).

Conservative treatment

Physical therapy with flexion-based exercises, targeted injections (around the nerve root or into the spinal canal), and walking aids as needed.

Surgical options

Considered for significant limitation despite conservative treatment, or progressive weakness.

Exercises to do at home

Perform within a pain-adapted range. A mild stretching sensation is normal – sharp pain is a stop signal.

Frequently asked questions

What is it?

The small facet joints connecting the vertebrae are true joints – complete with lubricating joint fluid – and, like any joint, can develop arthritis. When irritation is pronounced, it's called facet syndrome, with pain especially on extension and rotation. Often combined with disc degeneration.

Typical symptoms & self-care

Back pain with twisting and bending backward. Morning stiffness that eases with movement. Pain with prolonged standing, relief when sitting.

What we do in clinic

A clinical examination and imaging are used. A diagnostic facet joint injection can help when findings are unclear.

Conservative treatment

Physical therapy, heat therapy, manual therapy, and facet joint injections. Radiofrequency denervation may follow if these respond well.

Exercises to do at home

Perform within a pain-adapted range. A mild stretching sensation is normal – sharp pain is a stop signal.

Frequently asked questions

What is it?

Neck pain syndrome covers neck pain with or without radiation into the shoulder and back of the head, caused by degenerative changes, muscle imbalance, or poor loading patterns. When pain radiates down the arm following a nerve's path (cervicobrachialgia), a nerve root is involved. With active treatment, the outlook is generally very good.

Typical symptoms & self-care

Neck pain and stiffness, pain with turning or tilting the head, headaches originating from the neck. With cervicobrachialgia: tingling or heaviness in the arm along the path of a nerve.

What we do in clinic

A clinical examination is performed, with imaging if needed. Manual therapy is used where appropriate.

Conservative treatment

Physical therapy (chin tucks, shoulder-girdle strengthening), manual therapy, heat, and targeted nerve-root injections for cervicobrachialgia.

Exercises to do at home

Perform within a pain-adapted range. A mild stretching sensation is normal – sharp pain is a stop signal.

Frequently asked questions

What is it?

Painful muscle tension in the neck and shoulders develops from sustained one-sided loading, poor posture, or stress. The hallmark is tender trigger points, which cause both local pain and referred pain elsewhere. This is common and usually responds well to consistent active treatment.

Typical symptoms & self-care

Diffuse, pressing pain in the shoulder and neck area. Tender muscle points (trigger points). Headaches originating from the neck. Stiffness after prolonged sitting.

What we do in clinic

A clinical examination rules out structural causes. Trigger point treatment and dry needling are used as needed.

Conservative treatment

Physical therapy, manual therapy, trigger-point-targeted injections, and heat therapy.

Exercises to do at home

Perform within a pain-adapted range. A mild stretching sensation is normal – sharp pain is a stop signal.

Frequently asked questions

What is it?

Scoliosis (sideways curvature), kyphosis (rounded upper back), and hyperlordosis (exaggerated lower-back curve) are structural deviations of the spine. Mild forms are common and often cause few symptoms. More pronounced forms can cause pain, muscular overload, and, rarely, restrictions affecting internal organs.

Typical symptoms & self-care

Usually few symptoms when mild. With more pronounced forms: back pain, muscle tension, and visibly uneven posture.

What we do in clinic

A clinical examination and X-ray (Cobb angle) are used. Children are followed with regular check-ups.

Conservative treatment

Physical therapy (the Schroth method for scoliosis), strengthening exercise, and bracing for certain indications.

Surgical options

Considered for a Cobb angle over 45–50°, or rapidly progressing scoliosis with symptoms.

Exercises to do at home

Perform within a pain-adapted range. A mild stretching sensation is normal – sharp pain is a stop signal.

Frequently asked questions

What is it?

The rotator cuff – a group of four muscles and their tendons – stabilises the shoulder joint and controls its movement. Tears occur either traumatically (a fall) or from gradual wear. The supraspinatus tendon at the top of the shoulder is most often affected. Partial tears cause pain; full-thickness tears often bring weakness as well.

Typical symptoms & self-care

Pain when raising the arm (a "painful arc" between roughly 60–120°), night pain when lying on the affected side, and reduced strength with outward rotation and lifting the arm.

What we do in clinic

A clinical examination (specific shoulder tests), ultrasound, and MRI if needed.

Conservative treatment

Physical therapy (scapular stabilisation, external rotation strengthening, pendulum exercises), targeted injections, and shockwave therapy.

Surgical options

Considered for a traumatic full-thickness tear with significant weakness, or after 3–6 months of unsuccessful conservative treatment.

Exercises to do at home

Perform within a pain-adapted range. A mild stretching sensation is normal – sharp pain is a stop signal.

Frequently asked questions

What is it?

In subacromial impingement, soft tissue – mainly the supraspinatus tendon and the bursa beneath the shoulder blade's bony roof – gets pinched in the narrow space under that roof as the arm is raised. Causes include poor posture, weak shoulder-girdle muscles, and a naturally tight space. Targeted training resolves most cases well.

Typical symptoms & self-care

A painful arc when raising the arm (60–120°), pain with overhead work, and night pain when lying on the affected shoulder.

What we do in clinic

A clinical examination (Neer and Hawkins tests) and ultrasound. A subacromial injection can serve both diagnostic and therapeutic purposes.

Conservative treatment

Physical therapy (scapular stabilisation, external rotation strengthening), targeted injections, and shockwave therapy.

Surgical options

Arthroscopic widening of the subacromial space is considered for a hooked acromion and persistent impingement after ≥6 months.

Exercises to do at home

Perform within a pain-adapted range. A mild stretching sensation is normal – sharp pain is a stop signal.

Frequently asked questions

What is it?

The subacromial bursa sits between the rotator cuff and the bony roof of the shoulder. Inflammation here often develops as part of impingement syndrome, after an injury, or on its own. In the acute stage the pain can be very intense – a prompt targeted injection is very effective in that case.

Typical symptoms & self-care

Acute, intense shoulder pain, especially when raising the arm or working overhead. Night pain. Often pain at rest too in the acute stage.

What we do in clinic

A clinical examination and ultrasound. A subacromial injection is very effective for acute bursitis.

Conservative treatment

A targeted injection (steroid is very effective), followed by physical therapy as for impingement.

Surgical options

Arthroscopic bursa removal is rarely needed – conservative treatment is usually enough.

Exercises to do at home

Perform within a pain-adapted range. A mild stretching sensation is normal – sharp pain is a stop signal.

Frequently asked questions

What is it?

Frozen shoulder is inflammation and tightening of the shoulder joint capsule, causing restricted movement in every direction. It typically follows three phases: freezing (3–9 months), frozen (4–12 months), and thawing (5–24 months). It resolves fully in most cases – treatment clearly speeds that process up. More common in women and in people with diabetes.

Typical symptoms & self-care

Significant pain and progressive stiffness. Every direction of movement is limited, especially outward rotation. Pain dominates during freezing, stiffness during the frozen phase, with gradual improvement during thawing.

What we do in clinic

Diagnosis is clinical (global restriction of movement in every plane). Imaging can rule out other causes.

Conservative treatment

Steroid injections (especially effective during the freezing phase), physical therapy, and manipulation under anaesthesia for severe restriction.

Surgical options

Arthroscopic capsular release is considered if there's no response after 12–18 months.

Exercises to do at home

Perform within a pain-adapted range. A mild stretching sensation is normal – sharp pain is a stop signal.

Frequently asked questions

What is it?

The acromioclavicular (AC) joint connects the collarbone to the shoulder blade. It can develop arthritis after a shoulder injury or through gradual wear on its own. Pain is well localised over the top of the shoulder and is typically triggered by pulling the arm horizontally across the body.

Typical symptoms & self-care

Pain over the top of the shoulder, with pulling the arm horizontally across the body and with overhead work. Tenderness directly over the AC joint.

What we do in clinic

X-ray and a clinical examination. An AC joint injection is very effective for significant pain.

Conservative treatment

AC joint injections, physical therapy, and shockwave therapy where appropriate.

Surgical options

Resection of the outer end of the collarbone (Mumford procedure) is considered for persistent symptoms.

Exercises to do at home

Perform within a pain-adapted range. A mild stretching sensation is normal – sharp pain is a stop signal.

Frequently asked questions

What is it?

Glenohumeral osteoarthritis refers to cartilage wear in the shoulder's main joint. It develops either primarily (age-related) or after trauma (fractures, dislocations, or rotator cuff tears). Typical features are worsening pain, restricted movement in every direction, and grinding or clicking sensations.

Typical symptoms & self-care

Pain and stiffness throughout the shoulder joint, grinding or clicking with movement, night pain, and reduced strength. Every direction of movement is limited.

What we do in clinic

X-ray (narrowed joint space, bony overgrowth) and targeted injections.

Conservative treatment

Physical therapy and targeted injections (steroid, hyaluronic acid), together with pain management.

Surgical options

Total shoulder replacement is considered for symptoms that don't respond to treatment.

Exercises to do at home

Perform within a pain-adapted range. A mild stretching sensation is normal – sharp pain is a stop signal.

Frequently asked questions

What is it?

Hip osteoarthritis is cartilage wear in the hip joint – one of the most common forms of arthritis and the leading reason for hip replacement surgery in Germany. Starting active treatment early significantly eases symptoms and can slow progression.

Typical symptoms & self-care

Groin pain, "start-up" pain in the morning, pain with inward rotation, and a limp as it progresses. Pain may radiate into the buttock or thigh.

What we do in clinic

X-ray (narrowed joint space, denser bone, bony overgrowth) and a targeted injection for pronounced pain.

Conservative treatment

Physical therapy (hip abductor strengthening, mobility work), targeted injections, shockwave therapy, and pain management.

Surgical options

Total hip replacement is considered for significant limitation despite conservative treatment.

Exercises to do at home

Perform within a pain-adapted range. A mild stretching sensation is normal – sharp pain is a stop signal.

Frequently asked questions

What is it?

In FAI, an irregular shape of the femoral head (cam type) or the socket rim (pincer type) causes the labrum or cartilage to get pinched during movement. It commonly affects young, active adults. Over the long term, FAI can lead to earlier-than-usual hip arthritis.

Typical symptoms & self-care

Groin pain with hip flexion and inward rotation (the "C-sign"). Pain with prolonged sitting, climbing stairs, and sport. Typically affects young, active people.

What we do in clinic

A clinical examination (FADIR test), X-ray, and MRI arthrography to assess the labrum and cartilage.

Conservative treatment

Physical therapy (hip mobility work, core strengthening), a targeted intra-articular injection, and activity modification.

Surgical options

Arthroscopic reshaping of the cam lesion and/or labral repair is considered where damage is confirmed.

Exercises to do at home

Perform within a pain-adapted range. A mild stretching sensation is normal – sharp pain is a stop signal.

Frequently asked questions

What is it?

Greater trochanteric pain syndrome causes pain over the bony point on the outer hip. It's usually driven by irritation at the gluteus medius tendon attachment and/or the nearby bursa – not always true bursitis. It's common in middle-aged women and in runners.

Typical symptoms & self-care

Pain on the outside of the hip, tender over the bony point. Pain when lying on that side, climbing stairs, or standing up from sitting.

What we do in clinic

A clinical examination and ultrasound. A targeted injection into the bursa is very effective.

Conservative treatment

Physical therapy (hip abductor strengthening), targeted injections, and shockwave therapy.

Exercises to do at home

Perform within a pain-adapted range. A mild stretching sensation is normal – sharp pain is a stop signal.

Frequently asked questions

What is it?

Reduced blood flow to the femoral head causes bone tissue to die off. Causes include steroid use, alcohol, sickle cell disease, decompression sickness, or no identifiable cause. Early diagnosis matters, because joint-preserving treatment is possible in the early stages.

Typical symptoms & self-care

Groin pain, initially with activity, later also at rest. Reduced inward rotation.

What we do in clinic

MRI (the gold standard for early detection) and X-ray. Regular orthopaedic follow-up.

Conservative treatment

Reduced weight-bearing, core decompression in stage I–II, and extracorporeal shockwave therapy.

Surgical options

Core decompression in stage I–II; total hip replacement in stage III–IV.

Exercises to do at home

Perform within a pain-adapted range. A mild stretching sensation is normal – sharp pain is a stop signal.

Frequently asked questions

What is it?

Knee osteoarthritis is cartilage wear in the knee joint – the most common form of joint arthritis overall. It more often affects the inner compartment. Risk factors include excess weight, previous knee injuries, and misalignment of the leg axis. A conservative programme can substantially reduce the symptom burden.

Typical symptoms & self-care

"Start-up" pain in the morning and after sitting, pain with activity, pain climbing stairs, swelling, grinding or clicking sensations, and reduced quadriceps strength.

What we do in clinic

A standing X-ray (narrowed joint space) and a clinical examination. A targeted injection where needed.

Conservative treatment

Physical therapy (quadriceps strengthening), weight loss, targeted injections (steroid, hyaluronic acid), and braces.

Surgical options

Total knee replacement or a corrective osteotomy is considered for significant limitation.

Exercises to do at home

Perform within a pain-adapted range. A mild stretching sensation is normal – sharp pain is a stop signal.

Frequently asked questions

What is it?

Meniscus tears occur either traumatically (a twisting injury, often in sport) or degeneratively (wear from middle age onward). Degenerative meniscus findings are seen in many people with no pain at all – the finding on its own doesn't justify surgery.

Typical symptoms & self-care

Pain along the joint line, swelling after activity, a locking or catching sensation, and pain with squatting and twisting.

What we do in clinic

A clinical examination (McMurray and Apley tests) and MRI to assess the tear.

Conservative treatment

Physical therapy (strengthening the front and back of the thigh, balance training) and targeted injections during a flare.

Surgical options

Arthroscopic repair (for a fresh tear in a younger patient) or partial removal. Degenerative tears: conservative treatment first, for at least 3 months.

Exercises to do at home

Perform within a pain-adapted range. A mild stretching sensation is normal – sharp pain is a stop signal.

Frequently asked questions

What is it?

Patellofemoral pain syndrome is a common source of kneecap pain, especially in young, sport-active people. Causes include kneecap misalignment, weakness of the inner thigh muscle, weak hip abductors, or overuse. It responds very well to targeted training.

Typical symptoms & self-care

Pain at the front of the knee with stairs (worse going down), prolonged sitting ("theatre sign"), squatting, and knee bends.

What we do in clinic

A clinical examination and assessment of kneecap tracking. MRI for unclear findings.

Conservative treatment

Physical therapy (inner quadriceps strengthening, hip abductor training), kneecap taping, and insoles.

Exercises to do at home

Perform within a pain-adapted range. A mild stretching sensation is normal – sharp pain is a stop signal.

Frequently asked questions

What is it?

Patellar tendinopathy is a degenerative-inflammatory change in the tendon just below the kneecap. It's a classic overuse injury in jumping and running athletes. Eccentric (slow, controlled lengthening) exercises are the best-evidenced treatment.

Typical symptoms & self-care

Pain just below the kneecap that depends on activity, with a "warm-up" pattern – better at the start of activity, worse again afterward.

What we do in clinic

A clinical examination and ultrasound to assess the tendon structure.

Conservative treatment

An eccentric training programme, shockwave therapy, and needling for persistent cases.

Exercises to do at home

Perform within a pain-adapted range. A mild stretching sensation is normal – sharp pain is a stop signal.

Frequently asked questions

What is it?

Pes anserine bursitis is inflammation of the bursa on the inner shin, just below where the sartorius, gracilis, and semitendinosus tendons attach. It's common in people with knee osteoarthritis and excess weight, and in runners.

Typical symptoms & self-care

Pain on the inner shin just below the knee joint line, with tenderness to touch. Often worse at night. Frequently occurs alongside knee osteoarthritis.

What we do in clinic

Diagnosis is clinical, supported by ultrasound. A targeted injection into the bursa is very effective.

Conservative treatment

A targeted injection (steroid), physical therapy, and insoles if needed.

Exercises to do at home

Perform within a pain-adapted range. A mild stretching sensation is normal – sharp pain is a stop signal.

Frequently asked questions

What is it?

Plantar fasciitis is a degenerative-inflammatory change where the plantar fascia – the tissue band under the sole – attaches to the heel bone. A heel spur (a bony outgrowth) is often visible on X-ray but isn't always symptomatic – irritation of the fascia itself is the real source of pain. It's very common and treats well.

Typical symptoms & self-care

Heel pain that's worst with the first steps in the morning ("start-up pain") and after prolonged sitting. It eases as you warm up, then worsens again by evening.

What we do in clinic

Diagnosis is clinical (tenderness on the inner heel) with ultrasound. X-ray may show a heel spur.

Conservative treatment

Stretching, insoles, shockwave therapy (very good evidence), and targeted injections if treatment-resistant.

Exercises to do at home

Perform within a pain-adapted range. A mild stretching sensation is normal – sharp pain is a stop signal.

Frequently asked questions

What is it?

Achilles tendinopathy is a degenerative change in the Achilles tendon, usually 2–6 cm above the heel attachment (mid-portion) or right at the heel itself (insertional). It's common in runners. The Alfredson eccentric strengthening protocol is the best-evidenced treatment.

Typical symptoms & self-care

Pain and stiffness in the Achilles tendon in the morning and after inactivity. A palpable thickening. Pain with running, uphill walking, and jumping.

What we do in clinic

A clinical examination and ultrasound to assess the tendon structure.

Conservative treatment

An eccentric training programme, shockwave therapy (good evidence), and high-volume injections for persistent cases.

Exercises to do at home

Perform within a pain-adapted range. A mild stretching sensation is normal – sharp pain is a stop signal.

Frequently asked questions

What is it?

Osteoarthritis of the ankle joint is often post-traumatic – following ankle fractures or repeated sprains. Primary forms are less common. The hallmark is restricted upward flexion of the foot.

Typical symptoms & self-care

Pain with activity in the ankle, swelling after activity, restricted movement (especially pulling the foot upward), and grinding or clicking sensations.

What we do in clinic

A standing X-ray, MRI for unclear findings, and a targeted intra-articular injection.

Conservative treatment

Physical therapy (mobility work, strengthening), insoles, targeted injections, and bracing.

Surgical options

Arthroscopic debridement, total ankle replacement, or fusion is considered for advanced arthritis.

Exercises to do at home

Perform within a pain-adapted range. A mild stretching sensation is normal – sharp pain is a stop signal.

Frequently asked questions

What is it?

A bunion is a misalignment of the big toe joint: the big toe drifts outward while the first metatarsal bone shifts inward, creating the visible "bump." Causes include genetic predisposition, tight footwear (pointed toes, high heels), and connective tissue laxity. Women are affected considerably more often.

Typical symptoms & self-care

Pain over the bunion, pressure sores, difficulty with footwear, and occasionally the second toe being pushed out of place.

What we do in clinic

A standing X-ray (hallux valgus angle, intermetatarsal angle) and a clinical examination.

Conservative treatment

Footwear adjustments, insoles, bunion protection, and splints. Full correction isn't possible without surgery.

Surgical options

A corrective osteotomy (for example, the Scarf or Chevron procedure) is considered for a symptomatic bunion.

Exercises to do at home

Perform within a pain-adapted range. A mild stretching sensation is normal – sharp pain is a stop signal.

Frequently asked questions

What is it?

Hallux rigidus is osteoarthritis of the big toe joint, with progressively restricted upward movement of the toe. It's the most common condition affecting the big toe in middle and older adulthood. That restricted upward movement significantly affects your push-off when walking.

Typical symptoms & self-care

Pain and stiffness in the big toe joint when pushing off (rising on toes, stairs, walking uphill). Pain when wearing high heels.

What we do in clinic

A clinical examination (measuring upward toe movement) and a standing X-ray.

Conservative treatment

A stiff-soled shoe, a Morton's extension, targeted injections, and pain-free range-of-motion exercise.

Surgical options

Cheilectomy (removal of the bony overgrowth) in stage II–III. Fusion of the big toe joint in stage IV.

Exercises to do at home

Perform within a pain-adapted range. A mild stretching sensation is normal – sharp pain is a stop signal.

Frequently asked questions

What is it?

Hammer toe (a bent middle joint) and claw toe (an upward-bent base joint with bent middle and end joints) are common deformities of the smaller toes. They develop from muscle imbalance, tight footwear, or neuromuscular conditions, and are often seen alongside a bunion.

Typical symptoms & self-care

Tenderness over the toe joints, corns on the tips and tops of the toes, difficulty with footwear, and occasionally pain when walking.

What we do in clinic

A clinical examination and X-ray. For a rigid, fixed deformity, an early surgical consultation is advised.

Conservative treatment

Footwear adjustments, padding, insoles, and physical therapy. A rigid deformity generally needs surgery.

Surgical options

Joint resurfacing or fusion of the middle toe joint is considered for a rigid deformity.

Exercises to do at home

Perform within a pain-adapted range. A mild stretching sensation is normal – sharp pain is a stop signal.

Frequently asked questions

What is it?

Morton's neuroma is a benign thickening of a nerve between the toes, most often in the space between the third and fourth metatarsal bones. It develops from chronic pressure and friction. The classic description is a feeling of a pebble or a fold in your sock inside the shoe, with burning pain in the ball of the foot.

Typical symptoms & self-care

Burning pain in the ball of the foot, tingling or numbness between the third and fourth toes. Eases when shoes come off and walking barefoot. Pain when the forefoot is squeezed (Mulder's sign).

What we do in clinic

A clinical examination (Mulder's sign) with ultrasound to confirm.

Conservative treatment

Footwear adjustments, insoles, steroid injections (quite effective), and alcohol sclerosing injections.

Surgical options

Removal of the affected nerve segment is considered for treatment-resistant cases.

Exercises to do at home

Perform within a pain-adapted range. A mild stretching sensation is normal – sharp pain is a stop signal.

Frequently asked questions

What is it?

Posterior tibial tendon dysfunction (PTTD) causes the arch to gradually flatten and the foot to roll inward. In the early stage, conservative treatment works very well – catching it early is key.

Typical symptoms & self-care

Pain on the inner side of the foot, a feeling of fatigue when walking, and a progressively flattening arch. The "too many toes" sign – more toes visible from behind than expected.

What we do in clinic

A clinical examination (single-leg heel raise, the "too many toes" sign) and MRI to assess the tendon.

Conservative treatment

Insoles, supportive footwear, physical therapy, and bracing where needed. Steroid injections are given around the tendon, never into it.

Surgical options

Tendon lengthening plus a heel-bone osteotomy plus tendon transfer. Fusion is considered for advanced arthritis.

Exercises to do at home

Perform within a pain-adapted range. A mild stretching sensation is normal – sharp pain is a stop signal.

Frequently asked questions

What is it?

Tarsometatarsal arthritis affects the Lisfranc joint complex or nearby midfoot joints. It's often post-traumatic (following a midfoot injury) or degenerative. It causes pain with push-off and weight-bearing.

Typical symptoms & self-care

Midfoot pain with walking and standing, swelling over the midfoot, pain with push-off, and pain putting shoes on.

What we do in clinic

A standing X-ray, CT for post-traumatic arthritis, and a clinical examination.

Conservative treatment

A stiffening shoe, insoles, and targeted injections.

Surgical options

Fusion of the affected midfoot joints is considered for severe arthritis.

Exercises to do at home

Perform within a pain-adapted range. A mild stretching sensation is normal – sharp pain is a stop signal.

Frequently asked questions

What is it?

Carpal tunnel syndrome (CTS) is the most common nerve compression syndrome in the body: the median nerve is compressed as it passes through the carpal tunnel at the wrist. It supplies the thumb, index, middle, and part of the ring finger. Risk factors include repetitive tasks, diabetes, pregnancy, and thyroid disorders.

Typical symptoms & self-care

Tingling and numbness in the thumb, index, middle, and part of the ring finger. Symptoms at night (waking up with a numb hand), relieved by shaking the hand out.

What we do in clinic

A clinical examination (Tinel and Phalen tests) and nerve conduction studies to confirm the diagnosis and assess severity.

Conservative treatment

A night splint, steroid injections (very effective, especially early on), and physical therapy (nerve gliding exercises).

Surgical options

Carpal tunnel release – a short outpatient procedure with very good results. Recommended early for moderate to severe CTS.

Exercises to do at home

Perform within a pain-adapted range. A mild stretching sensation is normal – sharp pain is a stop signal.

Frequently asked questions

What is it?

This is compression of the ulnar nerve as it passes through a groove at the elbow – the second most common nerve compression syndrome. This nerve supplies the ring and little finger, along with most of the small muscles of the hand.

Typical symptoms & self-care

Tingling and numbness in the ring and little finger. Pain on the inner elbow. Worse with the elbow bent. Weakness with writing.

What we do in clinic

A clinical examination (Tinel's sign at the elbow groove) and nerve conduction studies to confirm.

Conservative treatment

A night splint (elbow straight), nerve gliding exercises, padding, and ergonomic changes.

Surgical options

Nerve transposition or groove widening is considered for moderate to severe compression.

Exercises to do at home

Perform within a pain-adapted range. A mild stretching sensation is normal – sharp pain is a stop signal.

Frequently asked questions

What is it?

Dupuytren's contracture is a progressive thickening of the connective tissue in the palm, causing the fingers – typically the ring and little finger – to gradually bend and become harder to straighten. It runs in families, is more common in men and people of Northern European descent, and is linked to alcohol and tobacco use.

Typical symptoms & self-care

A nodular thickening in the palm, with progressively bent fingers that can no longer fully straighten. Usually painless.

What we do in clinic

Diagnosis is clinical (the "tabletop test"). The degree of contracture is measured in degrees.

Conservative treatment

Needle release or a collagenase injection for contractures of 30–60°. Stretching alone cannot fully reverse it.

Surgical options

Surgical removal of the thickened tissue is considered for a contracture over 30–45° at the base joint, or any contracture at the middle joint. Recurrence is known to be common.

Exercises to do at home

Perform within a pain-adapted range. A mild stretching sensation is normal – sharp pain is a stop signal.

Frequently asked questions

What is it?

In trigger finger, the A1 pulley – the guiding band for the flexor tendon – narrows at the base of the finger. The flexor tendon catches as it glides through, causing the finger to snap or lock. It's common in people with diabetes and after repetitive hand use. Conservative treatment is often very effective.

Typical symptoms & self-care

Snapping or catching of the finger when straightening it. Pain at the base of the finger. Often worse in the morning after sleep.

What we do in clinic

Diagnosis is clinical (a palpable triggering sensation). A targeted injection is very effective.

Conservative treatment

A steroid injection into the tendon sheath (success rate roughly 60–80%). A second injection if it recurs.

Surgical options

Percutaneous or open release of the pulley. Outpatient, with a short recovery.

Exercises to do at home

Perform within a pain-adapted range. A mild stretching sensation is normal – sharp pain is a stop signal.

Frequently asked questions

What is it?

Thumb base arthritis affects the carpometacarpal (CMC) joint at the base of the thumb – the most common form of hand arthritis. Women are affected considerably more often, especially after menopause. The thumb accounts for 40–50% of overall hand function.

Typical symptoms & self-care

Pain at the base of the thumb with gripping (key or pinch grip) and twisting (opening a jar). Weakness holding things.

What we do in clinic

A clinical examination (grind test) and a thumb-base X-ray (Eaton stage I–IV).

Conservative treatment

A splint, occupational therapy, and targeted injections (steroid, hyaluronic acid).

Surgical options

Trapeziectomy ± ligament reconstruction. Good long-term results.

Exercises to do at home

Perform within a pain-adapted range. A mild stretching sensation is normal – sharp pain is a stop signal.

Frequently asked questions

What is it?

Wrist arthritis affects the radiocarpal joint or the small wrist bones, and often develops after an injury (a distal radius fracture, or a scaphoid non-union) or without a clear cause. It leads to pain, stiffness, and reduced strength.

Typical symptoms & self-care

Activity-related wrist pain, stiffness, and reduced strength. Pain when pushing up, twisting, and lifting.

What we do in clinic

A standing X-ray, CT for post-traumatic arthritis, and a clinical examination.

Conservative treatment

A splint, occupational therapy, targeted injections, and pain management.

Surgical options

Partial wrist denervation, wrist replacement, or fusion is considered for severe arthritis.

Exercises to do at home

Perform within a pain-adapted range. A mild stretching sensation is normal – sharp pain is a stop signal.

Frequently asked questions

What is it?

Lateral epicondylitis is irritation at the tendon attachment of the forearm extensor muscles, on the outer side of the elbow. Despite the name, it's more common in people with repetitive gripping and wrist movements at work or in daily life than in tennis players. It responds well to conservative treatment in most cases.

Typical symptoms & self-care

Pain on the outer elbow radiating into the forearm. Pain with gripping, wrist extension, and outward forearm rotation. Reduced strength.

What we do in clinic

Diagnosis is clinical (Thomsen's test); ultrasound for longer-standing cases.

Conservative treatment

Eccentric training, shockwave therapy (good evidence for the chronic form), and targeted injections.

Surgical options

Rarely needed – after 6–12 months of unsuccessful conservative treatment, arthroscopic or open removal of damaged tissue is considered.

Exercises to do at home

Perform within a pain-adapted range. A mild stretching sensation is normal – sharp pain is a stop signal.

Frequently asked questions

What is it?

Medial epicondylitis is irritation at the tendon attachment of the forearm flexor muscles, on the inner side of the elbow. It's less common than tennis elbow but works through a similar mechanism. An important condition to distinguish it from is cubital tunnel syndrome, since the ulnar nerve runs right alongside.

Typical symptoms & self-care

Pain on the inner elbow radiating into the forearm. Pain with gripping and wrist flexion. Worse with inward forearm rotation.

What we do in clinic

Diagnosis is clinical, with nerve conduction studies to rule out cubital tunnel syndrome.

Conservative treatment

Eccentric training, shockwave therapy, and targeted injections.

Exercises to do at home

Perform within a pain-adapted range. A mild stretching sensation is normal – sharp pain is a stop signal.

Frequently asked questions

What is it?

A ganglion cyst is a fluid-filled sac arising from a joint capsule or tendon sheath. It's the most common benign soft-tissue growth in the hand, most often appearing on the back of the wrist. In roughly half of cases, it resolves on its own.

Typical symptoms & self-care

A visible, firm but springy swelling on the wrist. Tender to pressure. Can restrict wrist movement.

What we do in clinic

Diagnosis is clinical, with ultrasound. MRI for an atypical location.

Conservative treatment

Watchful waiting (spontaneous resolution in about 50% of cases), aspiration (high recurrence rate), and steroid injections.

Surgical options

Arthroscopic or open removal. Recurrence rate around 20%.

Exercises to do at home

Perform within a pain-adapted range. A mild stretching sensation is normal – sharp pain is a stop signal.

Frequently asked questions

What is it?

Muscle injuries range from a harmless strain (overstretching without a tear) through a partial tear (individual fibres torn) to a complete muscle tear. They usually happen with fast, forceful movements without enough warm-up, most often in the hamstrings and calf. A contusion, by contrast, results from a direct blow.

Typical symptoms & self-care

Sudden, sharp pain during activity, tenderness, swelling, and possibly bruising. Movement and tensing the affected muscle hurt. A strain tends to feel more like a cramping pull; a tear feels more sharply stabbing.

What we do in clinic

A clinical examination and ultrasound distinguish a strain, a partial tear, and a larger tear. This determines healing time and when you can return to sport.

Conservative treatment

The great majority of muscle injuries heal without surgery: RICE acutely, then a graded return to load with physical therapy, followed by eccentric strength training to prevent recurrence.

Surgical options

Surgery is only considered for complete muscle or tendon tears with loss of function, especially in athletes.

Exercises to do at home

Perform within a pain-adapted range. A mild stretching sensation is normal – sharp pain is a stop signal.

Frequently asked questions

What is it?

In a sprain, ligaments and the joint capsule are stretched beyond their normal range – from a simple overstretch to a partial or complete tear. The ankle is most often affected, from rolling outward, followed by the knee and fingers. Most ligament injuries heal very well without surgery.

Typical symptoms & self-care

Immediate pain when the joint rolls, swelling, bruising, and tenderness over the affected ligament. A feeling of instability or insecurity in the joint. Pain with weight-bearing and certain movements.

What we do in clinic

A clinical examination of ligament stability, X-ray to rule out a fracture (following established clinical rules), and ultrasound or MRI if needed to assess the ligament damage.

Conservative treatment

Most ligament injuries – including many complete ankle ligament tears – are treated without surgery: RICE acutely, a functional brace, early movement, then targeted strength and balance training.

Surgical options

Surgery may be considered for certain complete tears, ongoing instability despite training, or associated injuries (such as to a cruciate ligament or a bony ligament avulsion).

Exercises to do at home

Perform within a pain-adapted range. A mild stretching sensation is normal – sharp pain is a stop signal.

Frequently asked questions

What is it?

A stress fracture is a fine hairline crack in the bone caused by repeated overload – not a single injury. It's typical in runners and jumping athletes, often in the shin, a metatarsal bone, or the femoral neck. It develops gradually, when load increases faster than the bone can adapt.

Typical symptoms & self-care

Well-localised, activity-dependent pain that at first appears only with intense activity, later even with light activity. Often swelling over the affected spot. Pain eases with rest.

What we do in clinic

A clinical examination; X-ray often doesn't show a stress fracture early on. MRI is the most sensitive method for early detection. Distinguishing lower-risk from higher-risk locations matters.

Conservative treatment

Most stress fractures heal with a break from loading (often 6–8 weeks), sometimes with crutches or a boot/brace, followed by a gradual return to activity.

Surgical options

Higher-risk stress fractures (for example, certain femoral neck fractures, the front of the shin, or the fifth metatarsal) may need surgical stabilisation.

Exercises to do at home

Perform within a pain-adapted range. A mild stretching sensation is normal – sharp pain is a stop signal.

Frequently asked questions

What is it?

After a fracture or joint injury has healed, symptoms often remain: stiffness, loss of strength, a tendency to swell, weather-sensitive pain, or early arthritis in the injured joint. These after-effects usually improve substantially with targeted rehabilitation.

Typical symptoms & self-care

Stiffness and restricted movement in the affected joint, reduced strength, pain with activity, a tendency to swell, and weather sensitivity. Often uncertainty about fully loading the injured body part again.

What we do in clinic

A clinical examination of mobility, strength, and stability; X-ray to assess bone healing and any early arthritis. If CRPS is suspected, prompt specialist assessment.

Conservative treatment

Rehabilitation is the core of treatment: physical therapy to restore mobility and strength, lymphatic drainage for swelling, gait training, and a gradual return to full loading. For post-traumatic arthritis, the same principles apply as for arthritis generally.

Surgical options

Surgery may be considered for a fracture that healed out of alignment, hardware (plates or screws) causing problems, or advanced post-traumatic arthritis.

Exercises to do at home

Perform within a pain-adapted range. A mild stretching sensation is normal – sharp pain is a stop signal.

Frequently asked questions