Symptoms — back, joint pain, numbness, stiffness

Choose your symptom

The same symptom may stem from a dozen causes — from harmless to life-threatening. Correct interpretation begins with precise localization of the pain, its character (dull/sharp/shooting), its relationship to activity, and accompanying signs (numbness, swelling, cracking). Below are the main symptoms patients bring to the orthopedic clinic, with a direct link to the detailed diagnostic breakdown.

Spine

Lower back pain

12 causes — from disc herniation to facet joint syndrome. When to see a doctor, what tests to run.

Knee pain

Osteoarthritis, meniscus, ligaments. Pain when walking, stairs, squatting. Diagnosis by location.

Read more about this symptom → Shoulder

Shoulder pain

Rotator cuff, frozen shoulder, impingement. Why it hurts at night and when raising the arm.

Neck pain

Cervical disc herniation, cervical osteoarthritis, cervicogenic headache. Hand numbness, dizziness.

Hip joint pain

Coxarthrosis, avascular necrosis, impingement. Groin pain, limping, restricted range of motion.

Foot and heel pain

Heel spur, plantar fasciitis, ankle arthrosis, Mortons neuroma, hallux valgus.

Wrist and hand pain

Carpal tunnel, rhizarthrosis, de Quervain, trigger finger, finger numbness.

Hand and foot numbness

Carpal tunnel, radiculopathy, polyneuropathy. Diagnosis by location of numbness.

Joint cracking

When cracking is harmless, and when it signals osteoarthritis. Physiological vs pathological.

Sciatica

Shooting pain from lower back down to the foot. Sciatic nerve compression, radicular syndrome.

Read more about this symptom → General

Morning stiffness

Differential diagnosis: arthritis vs osteoarthritis. Stiffness duration as the key marker.

"Red flags" — when to seek urgent care

Most back and joint pain resolves spontaneously or responds to conservative care. But certain symptoms require urgent diagnostic workup within hours or days — they may indicate cauda equina syndrome, infection, malignancy, or severe nerve compression.

Neurological

Progressive leg or arm weakness, inability to stand on toes/heels, "drop foot". Urinary or fecal incontinence. Saddle anesthesia (perineum). — Go to the ER immediately.

Systemic

Fever above 38°C combined with spinal pain. Night sweats. Unexplained weight loss above 5% over 3 months. Night pain that does not improve with rest. — See a doctor within 24–48 hours.

Traumatic

Pain after a fall or motor vehicle accident, particularly in patients over 50 or with osteoporosis — requires X-ray and MRI to rule out fracture. Inability to bear weight after a knee or ankle injury. — Within 24 hours.

Oncological

Personal history of breast, prostate, lung, kidney, or thyroid cancer + new spinal or bone pain. — Urgent contrast-enhanced MRI, oncology consultation.

Diagnostic workup: what and in what order

1. History and physical examination

Pain character, relationship to activity and time of day, irradiation, accompanying symptoms. Functional tests (Lasègue, Phalen, Tinel, McMurray depending on the area). In 70% of cases the preliminary diagnosis is established here.

2. X-ray

Baseline imaging for bony structures: osteophytes, joint space narrowing, fractures, osteoarthritis stage by Kellgren–Lawrence. Limitation: does not visualize soft tissues (cartilage, ligaments, discs).

3. Ultrasound

The "workhorse" for soft tissues: tendons, ligaments, muscles, synovitis, bursitis, cysts. Dynamic ultrasound shows structures in motion. MIBRAR® performs all injections under ultrasound guidance.

4. MRI

Gold standard for cartilage, discs, menisci, ligaments, bone marrow edema, early avascular necrosis. Optimal: 1.5 T with cortical and fat-suppressed sequences.

5. Laboratory tests

If inflammatory disease is suspected: ESR, CRP, complete blood count, rheumatoid factor, anti-CCP, uric acid, HLA-B27, ANA. For osteoporosis — DEXA scan, bone turnover markers.

6. Electromyography (EMG/NCS)

For numbness, weakness, suspected radiculopathy, tunnel syndromes. Objectively assesses nerve function and severity of injury.

From symptom to treatment method

Once diagnostics are complete, the cause of the pain becomes clear. Then comes method selection. Conservative approaches are effective in early stages, surgery is indicated for severe damage with neurological deficit. Between them — regenerative medicine, which in 70–85% of cases avoids surgery and halts disease progression.

Conservative

Physical therapy, ortheses, NSAIDs in short courses. Effective for acute non-specific pain but does not treat chronic degenerative processes. When sufficient →

MIBRAR® / PRP / CGF

Ultrasound-guided injection of autologous growth factors and stem cells. Stimulates regeneration of cartilage, tendons, discs. PRP → · Stem cells →

Surgery

For complete ligament tears, severe herniations with paresis, instability, stage IV osteoarthritis. MIBRAR® does not replace surgery in these cases but can delay it by 5–10 years. MIBRAR® vs joint replacement →

Frequently asked questions

When does back or joint pain require seeing a doctor?

If pain persists more than 10–14 days, worsens at night, or is accompanied by numbness, leg/arm weakness, fever, weight loss, or pelvic dysfunction — seek medical attention immediately. According to the German Society of Orthopaedics (DGOU), early consultation reduces chronicity risk by 60%.

What is the difference between inflammatory and mechanical pain?

Mechanical (osteoarthritic) pain worsens with load and improves with rest; morning stiffness lasts under 30 minutes. Inflammatory (arthritic) pain persists at rest, with morning stiffness over 60 minutes, often with swelling and local warmth. The distinction determines the entire treatment approach.

What tests are needed for chronic pain?

Minimum: X-ray in two projections plus ultrasound (for soft tissues). The gold standard is 1.5 T or 3 T MRI. If a systemic condition is suspected — blood tests: ESR, CRP, RF, anti-CCP, uric acid, HLA-B27. Prof. Babayan reviews MRI scans free of charge — just send the images.

Can I take painkillers long-term?

No. Long-term NSAIDs (ibuprofen, diclofenac) damage the GI mucosa, kidneys, and accelerate cartilage destruction. Corticosteroid injections are limited to 3 per year — each erodes cartilage. Regenerative methods (MIBRAR®, PRP, CGF) target the cause, not the symptom.

What are pain "red flags"?

Symptoms requiring urgent diagnostic workup: progressive limb weakness, urinary/fecal dysfunction, saddle anesthesia (perineum), pain after trauma, night pain with weight loss, fever above 38°C with spinal pain. With any of these — go to the emergency room or see a specialist immediately.

Can MIBRAR® help with chronic pain?

Yes, in 70–85% of cases of mechanical pain (osteoarthritis I–III, tendinopathies, protrusions, herniations up to 15 mm). The procedure involves ultrasound-guided injection of autologous growth factors and stem cells. The effect: pain reduction by 2–4 points on the VAS scale within 2–4 weeks, and tissue regeneration over 3–6 months.

Where to start if I dont know the cause of my pain?

Start by identifying the location (lower back, knee, shoulder, etc.) and select the matching symptom above. Each page contains a differential diagnosis table and a "when to see a doctor" checklist. For a personalized assessment, send your MRI scans through the booking form.

Did not find your symptom or unsure where to start?

Send your MRI images — Prof. Babayan personally reviews each case within 48 hours and proposes a non-surgical treatment plan. Free of charge.

Send MRI +49 1522 1828872