General & whole-body health

Bone, tendon and joint problems are rarely confined to the joint itself — whole-body factors shape who develops them, how severe they become, and how well treatment works. Hormonal change is the clearest example: the loss of oestrogen through perimenopause and menopause drives a recognised cluster of musculoskeletal problems — joint and tendon pain, loss of muscle mass, accelerating bone loss, and a sharp rise in conditions seen in the upper-limb clinic, including frozen shoulder, carpal tunnel syndrome and thumb-base arthritis. Bone density, smoking, diabetes, nutrition and activity levels similarly influence fracture risk, tendon healing and recovery after surgery. The guides below explain these whole-body connections in plain language: what is happening, what the evidence supports, and what patients can do about it — alongside, not instead of, treatment for the specific condition. They are written from an upper-limb surgical practice, where these patterns are seen every week.