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Bone Metastasis Disguised as Back Pain: A Renal Cell Carcinoma Case Study Doctors acquire knowledge through textbooks and research papers, but the true depth of medicine is often revealed by the patients we treat in the clinic. Knowing medical theory and sharply detecting critical issues in a real clinical setting are entirely different realms. Recently, the case of a patient in their late sixties undergoing long-term dialysis brought a renewed sense of clinical vigilance and learning. 1. Presentation and Initial Evaluation The patient visited our clinic suffering from lower back pain, having been referred by a closely acquainted Korean medicine doctor to rule out any potential spinal fractures and evaluate their precise condition. Upon arrival, the patient was walking with the aid of a cane. Immediate and meticulous palpation of the spine was performed to check for localized tenderness or typical signs of fracture. Fortunately, no acute fracture signs were observed during the physical...
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Hallux Valgus: Why Does It Initiate Lower Extremity Malalignment? 1. Collapse of the Windlass Mechanism: The First Misstep in Gait During the late stance phase of walking, the big toe (first metatarsophalangeal joint) dorsiflexes, tightening the plantar fascia and elevating the medial arch—a process known as the Windlass Mechanism . This transforms the foot into a rigid lever to propel the body forward. Biomechanical Problem: As hallux valgus progresses, the first metatarsal head deviates medially while the big toe rotates laterally. Consequently, the first ray loses its ability to bear weight and effectively push off the ground . Compensation: Without this primary lever, the body resorts to inefficient compensatory gait patterns, placing excessive strain on the ankle and calf muscles. 2. Compensatory Chain Reactions: The Breakdown of the Kinetic Chain Instability at the base of the foot does not stay isolated; it propagates upward. Over-pronation: Hallux Valgus is typically accompa...
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Persistent Leg Pain That Wouldn't Heal with Lumbar Injections: Turned Out to Be Hip Osteoarthritis Have you ever experienced a shooting pain extending from your lower back/glutes all the way down your leg? When these symptoms occur, most people naturally suspect a lumbar herniated disc or spinal stenosis . In fact, many patients undergo intensive treatments focused solely on their lower back, only to find no relief—leaving them frustrated and anxious. Today, we would like to share a case of a male patient in his late 60s who visited Sohn's Physical Medicine & Rehabilitation Clinic . He had previously been diagnosed with a lumbar disc herniation and spinal stenosis at other clinics and received multiple nerve block injections, but experienced zero improvement. 1. Patient Profile & Previous Treatment History Age/Gender: Male in his late 60s Chief Complaint: Persistent pain starting from the left buttock extending down below the thigh, lasting for several months. Prior...
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Why Prolotherapy Helps Patients with Spinal Stenosis: A Root-Cause Approach Welcome to Son Rehabilitation Medicine& Chiropractic Clinic . As we age, many of us experience leg numbness, heaviness, or the need to sit down after walking just a short distance. These are classic symptoms of Spinal Stenosis . When patients are diagnosed with stenosis, they often think, "The nerve pathway is physically narrowed by overgrown bone or ligaments. How can an injection therapy like Prolotherapy (Ligament Proliferation Therapy) actually help?" It is completely natural to wonder how a non-surgical injection can resolve what seems like a purely mechanical, bony issue. Today, we will break down the clear medical evidence and reasons why Prolotherapy is a powerful, foundational treatment for spinal stenosis. 1. The True Culprit of Stenosis: Spinal Instability Spinal stenosis does not happen overnight, nor does it begin with bones suddenly overgrowing. The true starting point is the degen...
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Unexplained Abdominal Pain for 3 Months: How a Thorough Medical History Led to a T9 Vertebral Compression Fracture Diagnosis Hello, this is Son Rehabilitation Medicine & Chiropractic Clinic . Occasionally, patients visit our clinic and anxiously explain, "I’ve had a dull, band-like pain wrapped around my stomach and flank for months, but my internal medicine check-up showed absolutely nothing wrong." Experiencing persistent pain without a clear answer is incredibly frustrating and exhausting for both the patients and their families. Recently, an 80-year-old male patient came to our clinic under these exact circumstances. Today, we would like to share his clinical story and explain how we finally uncovered the root cause of his three-month-long suffering. 1. Wandering Between Orthopedics and Internal Medicine for 3 Months Starting this past March, the 80-year-old patient began experiencing a restrictive, band-like pain around his upper abdomen . Naturally assuming it was ...
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Right-Sided Disc Herniation and Left-Sided Sciatica? The Secret of "Contralateral Radiculopathy" Hello, this is Dr. Chul-ho Son, Director of Son Rehabilitation Medicine & Chiropractic Clinic . When consulting with herniated disc patients in my clinic, I occasionally encounter those who look confused while reviewing their MRI or CT results. "Dr. Son, my scan shows that the disc herniated on my right side. Then why do I feel pain and numbness down my left leg? Is it possible the scan is wrong?" It is a completely reasonable and natural question. Since the pain is on the left, it feels counterintuitive that the root cause is on the right. In general, disc symptoms align with the direction of the herniation. However, in clinical practice, we sometimes see a fascinating phenomenon where the cause and the symptomatic expression occur on opposite sides. In the medical community, this condition is known as "Contralateral Radiculopathy" or counter-balance pain...
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Calf Muscle Atrophy After a Medial Gastrocnemius Partial Tear: Is Surgery Necessary? (Step-by-Step Rehabilitation Protocol) Hello, this is Son Rehabilitation Medicine & Chiropractic Clinic .  A sudden, sharp "popping" sensation in the back of the lower leg accompanied by excruciating pain during sports activities or daily life is a classic indicator of a gastrocnemius (calf muscle) tear , commonly known as "Tennis Leg." Today, we would like to share the case of a patient who recently visited our clinic. Approximately one month ago (on May 8th), the patient suffered a partial tear of the medial gastrocnemius. Since the injury, they had received a variety of conservative treatments at another clinic, including three triamcinolone (steroid) injections, nerve blocks, and extracorporeal shockwave therapy (ESWT). However, the patient recently noticed visible muscle atrophy —the affected calf had become noticeably thinner than the healthy side. Filled with anxiety, the...
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