diseases

Orthopedic diseases – an overview

Musculoskeletal problems are common: back pain, shoulder pain, knee pain or hand and ankle problems are among the most frequently cited reasons for visiting a doctor. Many causes can be treated conservatively if they are recognized early. Not every abnormality in the imaging is relevant to the disease - the focus is on your symptoms, function and your everyday life.

Our job is to classify the cause of your symptoms, identify risk factors and work together to determine a realistic treatment strategy. The aim is to restore resilience and quality of life - without unnecessary procedures and without false expectations. Surgical measures are only considered if conservative options have been exhausted or there are clear medical reasons.

Body regions and typical complaints

For initial orientation, you will find the most common complaints by region here. Detailed information can be found on the respective subpages.

• Head: Temporomandibular joint problems (TMD), muscular-fascial headaches related to the neck, myofascial pain in the facial/temple area
• Spine: acute and chronic back pain, disc herniation/bulging, spinal canal stenosis, facet joint syndrome, SI joint dysfunction, postural and stress syndromes
• Shoulder: Impingement syndrome, calcific shoulder, rotator cuff tendinopathy or tear, biceps tendon irritation, frozen shoulder, instability
• Elbow: Tennis and golfer's elbow (epicondylitis), bursitis (olecranon bursitis), irritation of the ulnar nerve (cubital tunnel syndrome), ligament overload
• Hand/wrist: carpal tunnel syndrome, rhizarthrosis (saddle joint), tendovaginitis de Quervain, snapping finger, ganglion (above leg), ligament injuries
• Hip/pelvis: Hip osteoarthritis (coxarthrosis), hip impingement (FAI), trochanteric bursitis (lateral hip pain), musculotendinous groin pain, gluteal tendinopathy
• Knee: meniscus lesion, knee osteoarthritis (gonarthrosis), patellar tendinopathy, anterior knee pain/patellofemoral pain syndrome, runner's knee (ITB syndrome), ligament injuries
• Ankle / foot: sprain trauma with ligament injury, Achilles tendon problems, heel spurs/plantar fasciitis, ankle arthrosis, tendonitis

Important: Many diagnoses can be treated conservatively - often with very good results. What is crucial is a precise clarification and the right combination of exercise therapy, training and – if appropriate – additional procedures.

Typical symptoms and warning signs

Not every movement restriction is an emergency. However, the following warning signs should be checked by a doctor promptly:

• severe, persistent pain, especially at rest or at night
• new numbness, tingling or muscle weakness/signs of paralysis
• Fever, redness, overheating and swelling in the joint
• severe restriction of movement or mechanical blockage
• Fresh injury (e.g. twisting an ankle, fall) with suspected fracture or tendon rupture
• Newly occurring bladder or bowel emptying disorders in connection with back pain (immediate clarification required)

If your symptoms are unclear or worsening, please make an appointment as soon as possible. An early examination can prevent consequential damage and simplify therapy.

Diagnostics: careful and targeted

Good therapy begins with good diagnostics. We combine a structured anamnesis with a physical examination and use imaging responsibly – as much as necessary, as little as possible.

Not every structural change explains pain. That's why we always classify findings in the context of your symptoms and goals. This helps to avoid overdiagnosis and to focus on effective measures.

Conservative therapy first

Conservative treatment is the standard in orthopedics and has the best risk-benefit balance for many medical conditions. It aims to relieve pain, improve function and ensure a sustainable return to everyday life, work and sport.

• Advice and education: realistic goals, load management, return to activity plan
• Physiotherapy and manual therapy: mobilization, strengthening, coordination, neuro-muscular training
• Medical training: individually dosed exercises, home program, progression
• Aids: bandages/ortheses, insoles, kinesiotaping – targeted and limited in time
• Medication: local and systemic pain and anti-inflammatory drugs (e.g. NSAIDs) according to indication
• Targeted infiltrations: e.g. B. peritendinous/periarticular cortisone injections with a clear question and explanation
• Shock wave therapy (ESWT) for selected tendinopathies
• Acupuncture and pain-relieving procedures as a supplement depending on the symptoms

The measures will be combined gradually. We try to avoid immobilization; Movement within pain limits promotes healing and tissue adaptation. We regularly review progress and adjust the plan.

Regenerative procedures: careful indication

Regenerative or biologically oriented therapies such as PRP (platelet-rich plasma) or hyaluronic acid injections are being discussed in orthopedics. They can be helpful in selected cases - for example, in chronic tendon insertion problems or early to moderate stages of osteoarthritis. The study situation is differentiated; a certain benefit cannot be promised.

• Possible areas of application: gluteal or Achilles tendinopathy, patellar tendinopathy, early osteoarthritis in the knee/hip
• Requirement: exhausted basic therapy (training, load adjustment, physiotherapy) without sufficient effect
• Transparency: Information about opportunities, risks, alternatives and expected costs
• Reasons for exclusion: acute infection, unexplained inflammation, certain coagulation disorders

We will clarify individually whether regenerative treatment makes sense for you. The basis remains a solid conservative treatment plan and a realistic assessment of the expected effects.

Operate – if necessary and sensible

Operations are considered when conservative measures have been exhausted and significant limitations remain or when there are clear medical reasons (e.g. unstable fractures, certain tendon tears, severe mechanical blockages).

• Indications: persistent loss of function, progressive instability, therapy-resistant severe pain
• Decision: joint weighing of benefits, risks, alternatives and rehabilitation effort
• Cooperation: if operationally necessary, referral to specialized partners; Aftercare and rehabilitation management in our practice

Even after an operation, targeted rehabilitation remains crucial for the result. We support you with planning, coordination and progress checks.

This is how the appointment and treatment work

You can find us at Dorotheenstraße 48, 22301 Hamburg. Arrange your appointment easily online via Doctolib or by email. At the first appointment, the focus is on the conversation and the examination; Existing previous findings help to avoid double examinations.

• Bring with you: preliminary findings/images (X-rays, MRI), list of medications, surgical reports if necessary, exercise profiles
• First appointment: anamnesis, clinical examination, initial measures and training recommendations
• Planning: individual therapy plan with clear intermediate goals and control appointments

Our goal is to provide understandable, implementable treatment – ​​suitable for everyday use and tailored to your life situation.

Prevention and self-help

Many orthopedic complaints can be reduced through targeted prevention. Small, consistent steps are more effective than rare, very intensive measures.

• Regular exercise: 2-3 units of strength/coordination per week plus everyday activity
• Ergonomics: adjusting the workplace, micro-breaks, changing positions
• Load control: slowly increase the amount and intensity (10-15%/week), plan for recovery
• Technical training in sports: running technique, jumping/landing mechanics, core stability
• Weight management, balanced diet, enough sleep
• Warmth/cold depending on the phase: cold more for acute irritation, warm for tension
• React early: persistent pain > 2–3 weeks, seek medical advice

Common mistakes – briefly explained

• “Only imaging brings clarity.” – What is crucial is the connection between findings, symptoms and function.
• “Strict protection heals the fastest.” – Dosed exercise promotes healing and adaptation.
• “Arthrosis means standstill.” – Many affected people benefit significantly from training and weight loss.
• “An injection solves every problem.” – Injections can complement, but rarely replace, active therapy.
• “Surgery is the best and fastest solution.” – A conservative approach often leads to comparable or better results – with fewer risks.

Individual advice helps distinguish myths from evidence-based recommendations. Talk to us – together we will clarify what makes sense in your situation.