Current Lower-Limb and Right Upper-Limb Symptoms for MSK
Date: Thursday 3 September 2026
Type: Letter
Summary
This document records two groups of musculoskeletal symptoms for clinical assessment:
- continuing lower-limb symptoms;
- newer right upper-limb symptoms.
The document records the current symptoms only.
Background
The lower-limb problem developed first and is already known to Musculoskeletal Services.
The right upper-limb symptoms developed later.
The purpose of this document is to provide a concise record of the current symptoms and functional changes for clinical assessment.
Details
1. Lower-Limb Symptoms
The lower-limb symptoms remain present, although some aspects have improved.
Current features include:
- intermittent pain affecting the front of both knees, including areas above and below the kneecaps;
- the right side remains more affected overall;
- bilateral calf heaviness;
- altered sensation affecting the top of the right foot during some activities;
- continuing outward appearance or alignment of the right lower limb;
- continued caution with some movements and activities.
A previous FCP assessment recorded bilateral anterior mechanical knee pain, right greater than left, together with mild quadriceps weakness.
One noticeable improvement occurred after the prescribed physiotherapy exercises. A previously painful area around the knee stopped producing the same pain after the exercise programme.
The patient cannot determine whether this improvement resulted from the exercise itself or from another factor.
Although pain has improved in that area, the lower limbs still do not feel normal in strength or function.
The impression that muscle strength remains reduced is the patient's own observation rather than a new clinical finding.
2. Right Upper-Limb Symptoms
The newer right upper-limb problem includes:
- marked reduction in right-hand strength;
- continuing difficulty lifting heavier everyday objects with the right hand;
- continued inability to lift the same frying pan with the right hand alone as before;
- some improvement in opening food packaging, although function remains substantially worse than previously;
- intermittent numbness or altered sensation around the right shoulder-blade area, which has reduced but has not resolved;
- intermittent pain or pulling around the right shoulder-blade / shoulder area;
- neck stiffness that varies in severity;
- noticeable differences between the right and left shoulder-blade areas during some movements.
The reduction in right-hand strength remains.
The numbness or altered sensation around the right shoulder-blade area has become less noticeable, but has not disappeared.
Recently, an additional difference was noticed while trying a familiar warm-up movement that had been performed regularly in the past.
When standing relaxed and moving both arms in forward circles at the same time:
- the movement remains smooth and does not cause pain;
- the right and left shoulder-blade areas feel different from each other;
- there is a mild pulling sensation on the right that feels stronger than it did previously;
- a sound can repeatedly be heard around the right shoulder-blade area that was not noticed when performing the same type of warm-up movement in the past.
This has been noticed on approximately three to four occasions over the past week, with the right-sided sound occurring each time.
The movement has been performed cautiously and not through the maximum range previously used during exercise. It is therefore unclear whether the range of movement itself has changed.
The patient is unsure whether the right-hand weakness, shoulder-blade symptoms, and neck stiffness are related.