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Carpal tunnel syndrome: the median nerve in a passage that cannot expand

The median nerve serves four and a half fingers and no more. What the 934-person DISTRICTS trial found about starting with surgery versus an injection, what splinting actually filters, and the splint design that beat the standard one.

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Facet joint pain: the threshold that defines it was set in a workshop

Two small joints at the back of every spinal level, wearing like any other joint. Why no scan can diagnose this, what a diagnostic block actually proves, and the difference between the results measured against baseline and against a sham.

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Frozen shoulder: the movement that identifies it, the two phases, and what actually helps in each

Frozen shoulder is the capsule shrinking, not the muscles failing. The passive test that identifies it, why the treatment that works in the painful phase does little in the stiff one, and what the randomised evidence supports.

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Peripheral neuropathy: the longest nerves fail first, so it starts in both feet

The longest nerves fail first, which is why this starts in both feet evenly. The B12 deficiency that long-term metformin causes, the five-year data showing individuals recover, the annual screening that costs almost nothing, and what the drugs actually buy.

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Plantar fasciitis: the first step out of bed, and the scan that does not track how you feel

Sharp heel pain on the first stride of the morning has a mechanical explanation. Why the '-itis' is wrong, why the heel spur is a red herring, what actually predicts staying in pain, and how to choose between the injections.

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Retatrutide: the third receptor, and what the evidence now establishes

One molecule switching on GLP-1, GIP and glucagon receptors at once. Why adding glucagon to a weight-loss drug is not a mistake, the largest weight and blood-sugar effects measured in the class, the body composition answer, and the four things the trials still do not tell you.

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Rotator cuff tears: four tendons holding a shallow joint, and what a scan can tell you

Nearly every shoulder over a certain age shows an abnormality on MRI, whether it hurts or not. What the scan can and cannot tell you, why conservative care works while the muscle degenerates anyway, and the two numbers that actually predict outcomes.

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Sacroiliac joint pain: point with one finger, because the buttock is crowded

Two joints that transfer your whole upper body weight into your legs. Why no scan settles this, why one positive provocation test means little, what pregnancy changes, and a specialty guideline candid enough to call its own evidence low quality.

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Sciatica: what is actually pressing on the nerve, and what each cause does over a year

Sciatica is a description of where the pain is, not a diagnosis. Four different causes, what each does if left alone, what the randomised evidence supports, and what it costs to try the things it does not.

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Spinal stenosis: the canal narrows, and posture decides how far you can walk

Leaning forward opens the canal a few millimetres — that is the mechanism and the diagnostic test. What happened to people who went untreated for a year, why the scan and the walking distance disagree, and why the simpler operation is usually the better one.

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Tendinopathy: why the injection that helps this month leaves you worse next year

Tendinopathy is not inflammation, which is why the intuitive treatment has the worst long-term record. What 41 randomised trials found about steroid injections, what loading actually does, and the twelve-week protocol people quit at week four.

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