MRI, X-ray and ultrasound showed extensive abnormalities in this patient’s painful knee, including meniscal damage, cartilage loss and osteoarthritis. Yet his symptoms and clinical examination told a more complicated story. Dr Win Huang reflects on an important question: when treating chronic knee pain, what are we actually trying to change?
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Shoulder pain is a symptom, not a diagnosis. Although the problem may come from the shoulder itself, pain can also originate from the neck, nerves, muscles around the shoulder blade or, less commonly, other medical conditions. Teresa Shen shares how she approaches the question: where is the pain actually coming from?
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When pain disappears after one treatment, the result may be genuine—but what does it actually prove? Dr Win Huang reflects on immediate treatment responses, clinical reasoning and why doctors must distinguish real outcomes from explanations that go beyond the evidence.
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Many patients ask me whether their painful, stiff shoulder is caused by frozen shoulder or a rotator cuff injury. Although both conditions can make lifting the arm difficult, they develop differently and require different treatment approaches. In this Clinical Reflection, I explain how I distinguish between these conditions using clinical history, physical examination, imaging when appropriate, and Traditional Chinese Medicine
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Many patients tell me that their shoulder is manageable during the day but becomes much more painful at night. Night pain is not a diagnosis—it is an important clinical clue. In this reflection, I share how I approach persistent night shoulder pain from both modern medicine and Traditional Chinese Medicine, and why understanding the cause always comes before treatment.
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Pain below the kneecap may immediately suggest the patellar tendon. In this patient, however, the pain was worst in the morning, eased with movement and disturbed his sleep. The history and examination gradually shifted my attention towards the
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Many people assume persistent shoulder pain simply needs another treatment. In this clinical reflection, Teresa Shen shares why long-lasting shoulder pain often has a deeper story, and why understanding what is preventing recovery is the first step towards choosing the most appropriate treatment.
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A diagnosis is rarely found by chance. Experienced clinicians follow clues, develop diagnostic hypotheses, test them through history taking and examination, and gradually narrow down the possibilities. Dr Huang shares the clinical thinking developed over more than forty years in practice.
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Not every painful knee is caused by arthritis. In this clinical reflection, Teresa Shen shares how one patient with medial knee pain reminded her that careful observation, thoughtful assessment, and treating the individual—not just the symptoms—are the foundation of effective acupuncture care.
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Pain throughout the shoulder does not necessarily mean that every painful area is a primary injury. By comparing the injury mechanism, neurological findings, rotator cuff tests, weakness and local tenderness, I gradually focused on the long head of the biceps tendon.
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