Regarding other orthopedic symptoms
The orthopedic field encompasses a wide range of conditions affecting the musculoskeletal system, including bones, joints, muscles, tendons, and nerves. In addition to common symptoms like fractures, sprains, joint pain, back pain, stiff shoulders, and numbness, there are many frequently encountered conditions such as tenosynovitis, trigger finger, Heberden's nodes, Osgood-Schlatter disease, tennis elbow, and plantar fasciitis.
As a clinic with internal medicine and dermatology departments, we provide initial evaluation and conservative treatment for orthopedic conditions. If surgery, MRI, or specialized rehabilitation is required, we will promptly refer you to a trusted orthopedic medical institution.
Our Scope of Practice
Mild contusions, muscle pain, tenosynovitis, and early-stage joint pain can be managed at our clinic with NSAIDs, poultices, and guidance on supports. On the other hand, we will refer patients requiring MRI, fracture reduction, cast immobilization, intra-articular injections, surgery, or specialized rehabilitation to an orthopedic specialist.
Hand and Wrist Conditions
| Condition | Characteristics | Main Treatment |
|---|---|---|
| Tenosynovitis | Overuse of the hand, localized tenderness | Rest, NSAIDs, orthotics; steroid injection for intractable cases |
| De Quervain's tenosynovitis | Tenosynovitis at the base of the thumb | Thumb immobilization orthosis, NSAIDs |
| Trigger Finger (Flexor Tenosynovitis) | Finger catches when bending | Rest, steroid injection; surgery for intractable cases |
| Carpal Tunnel Syndrome | Numbness in thumb to middle finger, worsens at night | Orthosis, Vitamin B12, surgery |
| Ganglion Cyst | Benign sac-like tumor in the wrist joint or tendon sheath | Observation, aspiration (orthopedics) |
| Mallet Finger | Fingertip is bent and cannot straighten, after trauma | Splint immobilization for 6 weeks |
| Sprained Finger | Sprain or fracture of a finger joint | X-ray, immobilization, rest |
| Heberden's Nodes | Osteoarthritis of the finger DIP joints (common in middle-aged women) | Topical NSAIDs, orthotics, guidance |
| Bouchard's Nodes | Osteoarthritis of the finger PIP joints | Same as above |
| Thumb CMC Osteoarthritis | Pain and deformity at the base of the thumb | Orthotics, medication; surgery for intractable cases |
Elbow Conditions
| Condition | Characteristics | Main Treatment |
|---|---|---|
| Lateral Epicondylitis (Tennis Elbow) | Pain on the outer side of the elbow, worsens when extending the wrist | Elbow band, NSAIDs, stretching |
| Medial Epicondylitis (Golfer's Elbow) | Pain on the inner side of the elbow | Same as above |
| Cubital Tunnel Syndrome | Numbness in the little and ring fingers, worsens with elbow flexion | Orthotics, neuropathic pain medication; surgery for intractable cases |
| Little League Elbow | Elbow pain in growing athletes (throwing) | Stop throwing, orthopedic evaluation |
Knee Conditions
| Condition | Characteristics | Main Treatment |
|---|---|---|
| Knee Osteoarthritis | Pain with aging, standing up, or climbing stairs | Weight loss, muscle strengthening, NSAIDs, hyaluronic acid injection |
| Meniscus Tear | Sports injury, middle-aged to elderly, catching, locking | MRI, conservative or surgical treatment (orthopedics) |
| ACL Tear | Sports injury, instability | Surgery + rehabilitation (orthopedics) |
| Patellar Dislocation/Subluxation | Injury or congenital factors | Reduction, immobilization, surgery |
| Jumper's Knee (Patellar Tendinopathy) | Sports, pain below the patella | Rest, stretching |
| Osgood-Schlatter Disease | Pain at the tibial tuberosity during growth spurts | Rest, stretching (resolves naturally) |
| Baker's Cyst | Lump behind the knee | Treatment of underlying joint condition + observation |
Foot and Ankle Conditions
| Condition | Characteristics | Main Treatment |
|---|---|---|
| Plantar Fasciitis | Heel pain with the first step in the morning | Stretching, insoles, NSAIDs |
| Achilles Tendinopathy/Insertional Tendinopathy | Exercise, aging, pain above the heel | Rest, stretching, NSAIDs |
| Achilles Tendon Rupture | Feeling a "snap" during a sprint | Surgery or conservative treatment (orthopedics) |
| Hallux Valgus | Big toe deforms outwards, pain | Orthotics, insoles, shoe modifications; surgery for severe cases |
| Morton's Neuroma | Nerve compression between toes, numbness | Insoles, steroid injection |
| Flatfoot | Decreased arch of the foot | Insoles, exercise therapy |
| Ankle Sprain | Most common sprain, inversion injury | RICE, brace immobilization |
| Shin Splints | Inner tibial pain in runners | Reduce training volume, stretching, stretching |
| Stress Fracture | Bone pain after repetitive exercise | Stop exercise, cast, surgery |
Spine and Lower Back Conditions
| Condition | Characteristics |
|---|---|
| Scoliosis | Lateral curvature of the spine, common in adolescence |
| Spinal Stenosis | Middle-aged to elderly, intermittent claudication |
| Herniated Disc | Sciatic nerve pain, leg numbness |
| Vertebral Compression Fracture | Elderly patients with osteoporosis |
| Ankylosing Spondylitis | Young males, morning stiffness |
| Spondylolysis/Spondylolisthesis | Lower back pain, leg symptoms |
Sports Injuries
| Condition | Common in |
|---|---|
| Shin Splints | Runners, track and field athletes |
| Jumper's Knee | Volleyball, basketball players |
| Little League Elbow | Growing pitchers |
| Tennis Elbow/Golfer's Elbow | General enthusiasts |
| Stress Fracture | Long-distance runners, dancers |
| Iliotibial Band Syndrome (Runner's Knee) | Long-distance runners |
| Muscle Strain | Sports involving sprints and quick dashes |
Osteoporosis
Osteoporosis is a decrease in bone density common in the elderly and postmenopausal women, leading to fractures from falls or minor trauma. Common fracture sites include the vertebrae, femoral neck, wrist (distal radius), and proximal humerus.
Risk Factors for Osteoporosis
- Female, elderly
- Postmenopausal estrogen decline
- Underweight (BMI < 18.5)
- Smoking, excessive alcohol
- Long-term steroid use
- Calcium and Vitamin D deficiency
- Lack of exercise
- Family history
- Early menopause, malnutrition
Diagnosis and Treatment
- Bone density measurement (DXA method)
- Blood tests (Ca, P, Vitamin D, bone metabolic markers)
- Calcium and Vitamin D supplementation
- Bisphosphonates (e.g., Alendronate)
- Denosumab (Prolia) subcutaneous injection
- Teriparatide (bone formation stimulant)
- Romosozumab (Evenity)
- Lifestyle guidance (exercise, smoking cessation, nutrition)
Bone Density Testing by Orthopedic Referral
While we do not have a bone density measurement device at our clinic, we perform blood tests and risk assessments. We will refer you to an orthopedic specialist for bone density measurement and initiation of medication. After starting oral medication, ongoing management can be continued at our clinic.
Consult Us for These Symptoms
- Recurring pain in the same area
- Pain occurring with specific movements
- Hand or finger pain/deformity
- Elbow pain from overuse (e.g., tennis elbow)
- Knee pain when standing up or climbing stairs
- Morning heel pain (suspected plantar fasciitis)
- Progressing bunion (hallux valgus)
- Shin pain after long-distance running
- Sudden back/loin pain in the elderly (suspected compression fracture)
- Knee/elbow pain in children (suspected growth-related disorder)
Examination and Testing
What We Can Do
- Evaluation by medical interview, visual inspection, and palpation
- Initial evaluation for differential diagnosis
- Prescription of NSAIDs, topical medications, poultices, and supports
- Simple bandaging and taping
- Osteoporosis risk assessment and blood tests
- Lifestyle guidance for osteoarthritis
- Guidance on timing for return to sports
Cases Where Orthopedic Referral is Appropriate
- Detailed examination with MRI/CT is necessary
- Fracture/dislocation reduction and cast immobilization
- Evaluation for surgical indication
- Intra-articular injections, nerve blocks
- Specialized rehabilitation
- Bone density measurement
- Sports medicine evaluation
General Principles of Treatment
Acute Phase
- RICE treatment (Rest, Ice, Compression, Elevation)
- Pain management with NSAIDs/Acetaminophen
- Protection with orthotics/supports
- Activity restriction (avoiding causative movements)
Subacute to Chronic Phase
- Heat therapy
- Stretching, strength training
- Posture and form improvement
- Maintenance of appropriate weight
- Reassessment of causative movements/activities
Lifestyle Guidance
- Appropriate exercise habits
- Correct posture
- Balanced diet (protein, calcium, vitamin D)
- Smoking cessation
- Appropriate weight
- Fall prevention (elderly)
Our Clinic's Features
- Provides initial evaluation and conservative treatment for orthopedic conditions
- Prescribes NSAIDs, topical medications, poultices, and supports
- As an internal medicine clinic, we evaluate the involvement of systemic diseases (rheumatism, thyroid, diabetes)
- Osteoporosis risk assessment, blood tests, and ongoing treatment management
- If specialized treatment is required, we refer to a trusted orthopedic specialist
- Guidance on timing and staged return-to-sport protocols
- Fall prevention and frailty assessment for the elderly
- No appointment necessary, same-day consultation OK / Open daily 9:00-21:00 / 1-minute walk from Jujo Station
For those who "don't know where to go"
There are many types of orthopedic conditions, and it can be confusing to know which department to consult. We can perform an initial evaluation and refer you to the appropriate medical institution. Please feel free to consult us if you have any concerning symptoms.
