Muscle pain of any type can be get difficult to handle. Sometimes the pain may be minor and can be worked through, while other times it can debilitating and hard to handle. One chronic condition that involves muscle pain that many of us may deal with is called the Myofascial Pain Syndrome.
This involves inflammation that is in the soft tissues of the body and cause pain in different areas (referred pain). It could involve one particular muscular area or a group of muscles causing pain.
Here are a few things you should know if you’re dealing with muscle pain or if you think you’re dealing with myofascial pain.
Causes and Symptoms of Myofascial Pain Symptoms
The causes of myofascial pain can be due to an injury or strain of a muscle in the body. It could be due to repetitive motions that injury the muscle groups being used, an excessive strain that is put on the muscle, tendon or even ligaments, or it can be due to inactivity in a group of muscles. This could be due to having an injury to your arm and not being able to move it due to the cast or sling you’re having to wear.
This type of muscle pain originates from what are known as “Trigger Points”. Trigger Points are sensitive areas in the muscle which may under undue pressure. These can cause pain in those specific areas, or it can also produce other problems such as depression, behavioral problems, or fatigue due to the pain the patient is in.
When examined for Myofascial Pain, you may have few types of Trigger Points
Active – is very tender can cause the muscle to twitch when manipulated and is the most common type
Latent – which do not cause any immediate pain when probed but can get activated where there’s stress or trauma. Basically, waiting to cause future problems
Primary – A central trigger point that was activated directly by acute or chronic overload, or repetitive overuse of the muscle in which it occurs.
Secondary – painful point in the muscle that becomes active when you stress another muscle.
Satellite – This Trigger Point that activates coz its located near to another Trigger Point
Treatment Options for Myofascial Pain
There are several options available to treat this type of muscle pain depending on what you’re dealing with at the time.
You can opt for massage therapy to help reduce the trigger points and work out the kinks in the muscles.
Physiotherapy to help you gain movement back in those muscles if you’ve dealt with an injury that restricted your movement.
You may also find that trigger point injection therapy works well for you. This is where the doctor will inject either anaesthetic, saline, or corticosteroids into the trigger point and make it dormant so that it doesn’t cause pain anymore.
One other method that may be used is the “spray and stretch” method. This is where the trigger point is sprayed with a cooling type spray and then it is slowly stretched out.
You can also take anti-inflammatory medications to assist with the pain as well
Myofascial Pain Relief in Singapore
Singapore Sports & Orthopaedic Clinic has been in service for the past 20 years in Singapore helping patients with pain relief and treatments. Our team of doctors (specialists & generalists) have treated Myofascial Pain Syndrome for many patients. Call us today for more info.
Feeling pain in any body part is never a desirable situation to be in. And when we do experience it the obvious reaction is treating that part of the body with remedies at our disposal. Perhaps followed by deliberating what could be the possible cause of it.
But sometimes pain in one area of the body can be a sign of an issue in another area. Human Body is strange. For example, you may have shoulder pain and at first think it’s something to do with your arm or shoulder, however it may not have anything to do with your shoulder at all! It could be something called referred shoulder pain instead.
What is Referred Shoulder Pain?
Referred shoulder pain is actually pain that shows up in the shoulder but could be an indication of gallstones, heart blood vessel problems, lung infection such as pneumonia, or a variety of other problems. Yes! the pain you’re feeling in your shoulder could be might as well be from another area instead of your actual shoulder. If you’re noticing pain in that area and it doesn’t change when you move your arm or neck, it could be what is known as Referred Shoulder Pain.
Signs of Referred Shoulder Pain
While in the case of local topical shoulder pain it can be from an injury to the shoulder such as a fall or sports injury but if its Referred Shoulder Pain then it can also be caused by something entirely different. Things to look out for include:
Pain that is felt not only in the shoulder but in your shoulder blade areas, neck, armpit, or even in the chest
Intense pain that comes on quickly
Swelling in the area
Inability to use your arm or move the shoulder joint
These are signs that you should be watching out for to make sure you seek medical attention when it’s needed. But if you’re having shoulder pain and you have shortness of breath or tightening of your chest, call for emergency medical help to assist you. It could be signs that something dangerous is on the horizon.
Causes of Referred Shoulder Pain
It is always best to have your doctor check you out when you’re feeling pain, whether it’s in your shoulder or in some other area. Pain is a sign that something is not quite as it should be and should not be ignored.
In the case of Referred Shoulder Pain, possible causes could be –
Abdominal related problems like Gallstones, Pancreatitis, etc
Result of Lung problems which result in pain in your upper torso
Left arm and shoulder pain could be because of serious problem such as inflammation around the heart or a heart attack
If you’ve had a procedure done recently it could be air pressure or gas that was used in the process causing the pain
If you know what your referred shoulder pain is from, such as a recent medical procedure or you’ve had a diagnosis, you can use some of these tips to help with the pain. Be sure to rest the shoulder and use ice to help relieve the inflammation. Over the counter pain relievers can also be a huge help to reduce the pain and swelling.
Of course, it’s always advisable to reach out to a clinic in your area for proper diagnosis and remedial treatment. We at Singapore Sports and Orthopaedic Clinic, conveniently located at the Gleneagles Medical Centre are always at your service.
Ankle Sprains & Foot injuries are a common occurrence that can result while playing your favourite sport or maybe from a fall you experienced climbing down a flight of steps. It may also result passively on account of inherent foot deformities.
Torn or injured ankle ligaments can cause a lot of discomfort and pain given that foot and ankle bear weight of our body.
In such situations, experienced Foot & Ankle Specialists are the best persons equipped to prescribe the right treatment. Sometimes one can get away with rest and change of habits, or with non-invasive therapies. And at times it may need Ankle Ligament Surgery to correct the issue.
So, in this post we’ll touch more upon Ankle Ligament Surgery, its Pros & Cons and the alternatives. Read on…
Ankle ligaments that are most commonly injured are the ones on the outside. They are Ateral calcaneofibular, anterior and posterior talofibular, and the anterior and posterior tibiofibular ligaments. Ankle ligament procedures may involve repair/reconstruction or by drilling small holes in the bones and rerouting the tendons to take the place of the ligaments. But the complexity of procedure really depends on the seriousness of the ligament tear
Common Ankle Ligament Surgeries
Lateral Ankle Ligament Reconstruction
Also known as the Brostrom procedure, this is where the physician will repair one or more of your ligaments in the ankle. It is because you’ve had multiple sprains in your ankle, your ankle has become weak over time due to injury, or there may be a defect in the ankle area that this can help to correct.
If you’ve dealt with problems such as hindfoot Varus, midfoot cavus, or a disease such as Ehlers-Danlos where your ligaments are very loose, this is the surgery that can help you to get some stability back in your ankles. There are some risks involved but you should consult with your physician on your personal risks.
The procedure will involve you being put under general anesthesia or just some local anesthesia depending on the severity of the surgery. The surgeon makes a small incision and uses instruments to carry out the procedure if the surgery is a minimally invasive one. In some situations, the doctor will need to make a longer incision for severe cases.
The Foot/Ankle Surgeon may either shorten your ligaments, remove them, and attach your ankle differently (re-route) to help give it stability, or do other constructive means to help give the ankle the strength it needs. Harvesting a tendon to replace your damaged ligament is generally involved in such procedures
Peroneus Brevis Tendon Rerouting / Loop / Split
In Rerouting procedure, the tendon is transected above the ankle, rerouted in a distal-to-proximal direction through a surgically created tunnel in the fibula, and then reattached at the initial transection site.
In Loop Procedure the tendon is transected above the ankle and rerouted through the fibula but is not reattached at the initial transection site
In Split Procedure the tendon is split longitudinally, with half of the tendon separated proximally from the intact peroneus brevis muscle-tendon unit followed by rerouting.
Surgeries & procedure such as ligament reconstruction, tendon rerouting or splitting can assist you in getting back on your feet. Once you’ve gone through the rest period of about six weeks after surgery, you can start to bear weight on your ankle and getting back to life.
The Foot and Ankle Specialists at the Singapore Sports & Orthopaedic Clinic supported by a qualified medical team have helped patients with treated and recovery from Ankle Ligament conditions. Book your appointment today and be on the path to good health and active life again.
Our hips and knees undergo a lot of stress throughout our lives. These joints absorb substantial force and weight when we walk, jump, and move. With wear and tear over time, the cartilage in our joints breakdown causing pain during weight-bearing activities.
Other than Cartilage wear out limb/joint misalignment, joint space narrowing, stiff joints, disease, or traumatic conditions may inflict pain and limit movement and mobility
Arthroplasty surgery can lead to restored function of these joints and an improved overall quality of life. The new joint can last up to 15-20 years. Trends in Singapore continue towards most individuals having at least one arthroplasty procedure in their lifetime
The most common Arthroplasty Surgeries in Singapore replace the hip or knee joint. It is one of the most effective and affordable surgeries in Singapore.
What Are the Benefits of an Arthroplasty?
With technological improvements, joint replacement surgery continually gets better, fast and cheaper. Undergoing an Arthroplasty surgery can benefit individuals by
Decreased risk of depression
An increased quality of life
The overall outcome of these procedures are high, with almost all experiencing decreased pain levels and improved functioning. However, as with any surgery, the procedure does not come without its risks. Risks include:
Loosening of replacement parts
These risks are often higher in those that suffer from pre-existing conditions beforehand.
Why Undergo an Arthroplasty?
Degenerative diseases, such as osteoarthritis, are the most common reasons for undergoing an Arthroplasty Surgery.
Osteoarthritis is the most common form of arthritis. Over time, wear and tear causes the protective cartilage in between bones to breakdown. This creates painful bone-on-bone grinding. Other reasons for undergoing an Arthroplasty procedure include injury or damage to the joint, necrosis, or rheumatoid arthritis.
While physiotherapy and chiropractic care methods may help ease the pain via strengthening of the surrounding muscles, pain may still persist. When the pain begins to interfere with one’s quality of life and daily activities, an Arthroplasty procedure is often recommended.
What Does a Arthroplasty Procedure Involve?
In short, the affected joint is either replaced or partially reconstructed. Since the 2 most common procedures involve the hip or knee, the following outlines hip and knee arthroplasty surgeries in a step-by-step process.
Hip Replacement Surgery:
A general anesthesia is administered. This will allow you to sleep during the surgery and allow your muscles to relax making the operation easier for the surgical team to perform. You will also feel no pain during the procedure.
An incision is made on the side of the hip.
The ball portion of the femur bone is removed and replaced with an artificial part.
Damaged portions of hip bone, such as cartilage, are removed.
The replaced ball portion of the femur bone is then inserted into the hip.
Tissue, such as muscle, is reattached, and the incision is, then, closed.
Knee Replacement Surgery:
A general anesthesia is administered. This will allow you to sleep during the surgery and allow your muscles to relax making the operation easier for the surgical team to perform. You will also feel no pain during the procedure.
An incision is made vertically in the front of the kneecap.
The kneecap is moved out of the way to make room to perform the surgery directly on the joint.
Damage to the femur bone is removed. It is, then, resurfaced to fit the artificial piece.
An artificial piece is attached to the end of the femur bone.
The top of the shin bone is treated in a similar fashion. Damaged portions are removed and the top of the shin bone is fitted with an artificial piece.
A plastic piece is snapped into the top of the shin bone’s new part to help the knee bend properly.
The patella is adjusted. A plastic piece may also be added to the patella to allow it to fit properly in the new knee joint.
The joint is moved to ensure each piece is functioning properly. Then, the incision is closed.
Before surgery, the appropriate examinations and tests are carried out to minimize risks. Your surgeon will fully explain the procedure and answer any questions you may have. You will also be advised not to consume any food for a set time before the procedure.
If you are on a waitlist for surgery or have months in advance to plan, it is recommended to begin strengthening around the area before undergoing the procedure. Strengthening these muscles beforehand will help with the recovery process. Discuss your options with your surgeon or your chiropractor and physiotherapist.
Following an Arthroplasty surgery in Singapore, your surgical team may require that you move your joint the right away. For hip replacement surgery, you may be required to walk right after surgery. This will ensure proper healing and mobility of the new joint. Your doctor will also prescribe pain medication to help you deal with the initial stages of recovery including how to take proper care of the incision while it heals.
It is also important to take extra care not to fall after surgery as this could cause damage to the newly replaced joint. Use handrails and supports when necessary. Often, a rehab program through a registered physiotherapist or chiropractor is recommended during the post-surgery stage.
Orthopaedic Care after Arthroplasty
Before joint replacement surgery, exercise may help decrease and manage your pain levels. Following an Arthroplasty Surgery, exercise in the rehabilitation process can help:
Improve range of motion and mobility
Improve gait and help retrain gait mechanics
Your physician will work with you to help you gain back your confidence and get you back to your regular activities. Initially, heat or ice application may be used to help reduce the swelling and pain. They will prescribe and help you perform stretches and strengthening exercises to help promote movement of the joint and provide support to the new joint.
Having a qualified healthcare professional guide you through the rehabilitation process can help determine the success of your Arthroplasty surgery. It also ensure you complete your exercises correctly which is essential to proper function of the new joint.
For the knee joint, post-surgery exercises focus on strengthening the quad and achieving full range of flexion. For the hip joint, post-surgery exercises will focus on the gluteal muscles, the major muscles of the leg, and core strengthening.
At the Singapore Sports and Orthopaedic Clinic, our team of doctors and surgeons can guide you through the entire process. Our experts provide the best treatment and care during the pre-surgery, surgery, and post-surgery stages. Our experienced team can help you get back to living your life, free of pain.
Ligament Tears are a common injury people experience, especially with those who are active in sports. Yet, many of us are quite clueless while trying to imagine which of portion of the body it is that actually gets affected.
And rightly so, coz Ligaments aren’t a prominent body organ nor is it something that visible externally to the human eye. So, ignorance on this subject can be quite rational.
In this post lets learn more about Ligaments, get a bit well-versed in appreciating its functions and gain some understanding of what happens on someone has torn ligament injury.
What are Ligaments
Ligaments are fibrous and flexible tissues that connect our bones to other bones. They help to support the joints and allow a normal range of motion for the joints. Ligaments have high tensile strength due to the high density of collagen present. Ligaments also provide proprioceptive inputs to the brain and allow the body to perform complex activities required in sports.
Common Ligament Injuries
Injuries to the ligament are common in high impact (such as Badminton), high speed sports (especially athletics) with the knee and ankle being the most vulnerable. A structural damage to the ligaments is known as ligament sprains. There are some ligament injuries that are much more common than others and let’s take a look at them.
Anterior Cruciate Ligament (ACL) injuries are common is high impact sports like football, soccer, rugby and basketball. The ACL is one of the 4 main ligaments in the knee which joins the femur to the tibia. Nearly 50% of patients who experience ACL injuries suffer it in combination with injuries to other parts of the knee such as the meniscus and medial collateral ligament.
ACL injuries occur most commonly from sudden twisting motion when the foot is still firmly planted on the ground while the knee is trying to change direction, causing the ACL to rupture. An ACL reconstruction will be the most viable option after injury as ligaments cannot heal by themselves.
The medial collateral ligament (MCL) is another main ligament of the knee which provides stability to the knee. The MCL is located from the end of the femur to the top of the tibia and it prevents the knee from opening up. Due to its preventive features, it is commonly injured when there is an impact on the outside of the knee joint which causes the knee to buckle and the knee to open up.
MCL injuries are also mostly in conjunction with ACL and meniscus injuries. If it is a standalone MCL injury, surgery is often not required and patients can get on with their lives pretty well with the help of a knee brace to provide stability.
The Glenohumeral joint ligaments (GHL) are located in the shoulders at the Glenohumeral joint which provides stability to the shoulder. The Glenohumeral joint connects the upper arm bone to the humerus and the shoulder blade. Injuries to the Glenohumeral joint occurs due to a fall and the patient landing on an outstretched arm, sudden twisting of the arm to beyond the normal motion range and a sudden impact on the shoulder, causing the ligaments to tear.
Above are 3 of the common ligament injuries that are experienced by many. Although ligaments are strong fibrous tissues, they can rupture if a sudden impact or twisting motion is applied on it. Ligaments are important in ensuring stability of the specific part of the body so extreme care should be taken to protect it.
Symptoms & Treatments for Knee Ligament Tear
Our knee is supported by 4 main ligaments – anterior cruciate ligament (ACL), medial collateral ligament (MCL), lateral collateral ligament (LCL) and the posterior cruciate ligament (PCL). Each of the ligament plays a different role in ensuring the stability of the knee.
However, due to various reasons, the ligaments can be torn. Rupture of the ligament can be a partial one or a full one and this will affect the treatment administered. A ligament tear will also bring about instability in the knee and the inability for it to bear weight, causing problems when walking. In this article, we will look at some of the symptoms and treatments for ligament tears.
As a general rule of thumb, a partially torn ligament will not bring about a pop sound while a fully ruptured one will produce a pop sound. A fully torn one can create instant instability and the knee may give way.
Swelling occurs and the injured knee may start to turn purple due to the lack of proper blood flow to the area. Swelling occurs due to a build-up of blood from the injured ligament.
The knee is unable to function properly, and you may feel that you are unable to control it.
Tenderness will onset when you touch the knee.
Quick Care Options (for minor injuries)
Protect the knee from further movements
Resting the knee immediately following injury for at least 48 hours. If you need to move around, consider using crutches or walkers to prevent bearing weight on the injured knee.
Ice will bring down swelling and reduce inflammation. Always try to ice the area every hour by using a cold compress or simply by wrapping knee in a towel and applying it locally.
Compress the knee with a bandage to reduce swelling and prevent excessive movements.
Elevate the knee to above your heart level to reduce swelling. This will cause excessive blood to flow away due to gravity towards your heart.
Treatment Options for Torn Ligaments
Here are the common treatment options for recovery from torn or ruptured Ligaments. The intensity of treatment needed and estimated knee sprain recovery time are dependent upon the severity of the injury.
Physical Therapy: Strengthening the knee and its surrounding muscles, tendons, and ligaments can help to repair ligament injuries. Specific knee ligament injury treatment exercises can help to repair ligament damage and restore full function to the knee.
Bracing: Wearing a knee brace or using crutches can help stabilize the knee and prevent sideways movements that may increase ligament damage and prevent healing and increase knee sprain recovery time.
Surgery: For serious injuries or tears associated with other injuries normal healing may not help, in such cases your doctor will most likely recommend a surgical solution.
Nutrition Tips for Ligament Tear Recovery
The ligament is a fibrous tissue and its main function is to connect bones to another bone and prevent abnormal joint motions. Injuries to ligaments will take a long time to heal. However, good nutrition can help to speed up the recovery process. The vitamins and minerals in food can help to facilitate healing.
Proteolytic Enzymes: The first step of any injury is to reduce inflammation in the region and foods that contain Proteolytic enzymes are especially useful due to its anti-inflammatory properties which help to eliminate protein from the injured region. Foods that are rich in proteolytic enzymes include pineapples and ginger roots.
Zinc: Zinc is another mineral that is excellent in combating inflammation. The way our body works is fascinating. When one part of the body is injured, it will divert all the zinc in the body to the injured part to counter inflammation. As such, other parts of the body will have a zinc deficiency. In order to prevent zinc deficiency, it is important to consume foods that are rich in zinc such as oysters, wheat germ and veal liver.
Vitamin C: Vitamin C has excellent anti-inflammatory properties as well and when worked together with Proteolytic enzymes, it provides an even better result. Vitamin C is not a vitamin that they body can self synthesize. As such, patients will need to consume it in order for the body to possess it. Vitamin C is also required to produce collagen in the body and this is important in ligament healing. Foods that are rich in Vitamin C include citrus fruits, broccoli and tomatoes.
Protein: Protein is the building block of our body and it is required by the body for any healing process. Protein can easily be obtained from foods such as tofu, meat, eggs and soy products. Protein deficiency will lead to various ailments in the body.
Calories: Although the body’s metabolism is low during injury, there is still a need to consume sufficient calories on a daily basis. Calories are required in the healing process and if patients decide to cut down severely on their calorie intake, this will slow down the recovery process.
Ligament injuries will require physical therapy, surgery and proper nutrition to ensure a speedy recovery. Proper nutrition is not difficult to achieve. Although your movements will be severely limited, you can always ask a dear one to help you out in ensuring you receive sufficient nutrition daily.
Torn Ligament Treatment in Singapore
At the Singapore Sports and Orthopaedic Clinic, our orthopaedic specialists are ready to help you get back to the activities you know and love. Call us today for an appointment @ +65 6653 2981 to get a professional assessment of your condition & start your journey toward a better life!
Bunions & Bunionettes are a common cause of painful toes. A bunion is a misalignment of the bones in the foot, occurring when something causes the big toe to turn inward or in case of bunionettes this is a bone growth on the outside of your foot near your pinky, or 5th, toe.
While these can result from heredity, arthritis, or misalignment of the foot; a common cause is wearing shoes that squeeze the toes into pointy or narrow toe boxes, forcing the toes to fold over one another to fit in.
So if you are experiencing this condition what are the options available to overcome this deformity, read on…
Medically it is known as hallux valgus deformity. The symptoms for Bunion conditions are quite visible and clear, common ones include –
a bony protrusion at base of big toe (for bunion) or fifth toe (for bunionette)
pain, especially when wearing shoes that press against the bump
While you may not even notice a bump or growth there to start with, over time as the bunion/bunionette continues to grow, it can become quite painful. It’s also called a Tailor’s bunion in some circles.
Yes prevention is better than cure. And in cases when its not hereditary…simply wearing shoes that provide sufficient room in the toe boxes is the best strategy for preventing bunions and bunionettes from developing. Look for shoes with blunt toes rather than pointy ones, and allow for about a quarter-inch to a half-inch of space between your longest toe and the front of the shoe. Selecting a functional shoes that are good to your feet over ones that are just aesthetically pleasing would be a wise choice.
Treatment for Bunions & Bunionettes
While some people can do well with the deformity by getting shoes that are roomier on their feet. For others treatment some of the treatment options would be –
Padding the affected area to protect it from rubbing on the shoes, and even custom inserts (Bunion Correctors) to help protect the area can be tried.
Another helpful aid is a shoe stretcher. A plastic fixture or plug that can be placed in the shoe to stretch the narrow area, which relieves pressure on the foot at that point. A shoe inserts (orthosis) can redistribute your weight so the bunion doesn’t constantly rub against your shoe.
While this may help some, it doesn’t always work and the next step would be a surgical procedure.
Orthopaedic Correction Surgery
First, those who may benefit from surgery are the patients who have not gained any relief from the other methods already tried. Surgery is not the first line of defense for this ailment but it can relieve pain in those who do not receive relief in any other form.
This is an outpatient procedure so unless there are other complications to deal with, you’re going to be in and out in the same day. The surgeon you work with will go into detail on their plans, but generally the bunionette surgery entails the tissue on your outside of the foot and sometimes an incision is made into the bone itself. There are several different methods to help rid the foot of the bony growth and straighten out the curve that may have developed. Once your surgeon has looked over you records, they will go over the best options.
People who have a cut on their foot, lost circulation in the foot area, or that have an infection in the foot will not be good candidates for the procedure. Your doctor will advise the best route of dealing with the deformity correction to help relieve your pain and get you walking again.
If you have the surgery you can expect recovery to vary depending on your specific case. Most people are in a boot or splint to help the foot stay in place for anywhere from three weeks up to twelve. Be sure to follow all of your doctor’s orders afterwards so that you can make sure it heals properly and you can get back to business as usual.
Bunion Correction in Singapore
For Orthopaedic help and surgeries reach out to Singapore Sports & Orthopaedic Clinic at the Gleneagles Medical Center. Our team of orthopaedic specialists and doctors will advise you on the best possible way to treat Bunion Deformity Conditions. Call us or fill in the appointment form and we’ll get in touch with you.
Surprisingly, gout (podagra) affects about 1 in 40 individuals. It is a form of arthritis that causes stiffness, tenderness, and pain in the joints. It can make movement difficult and very painful. Luckily, gout treatment can help you manage your symptoms. Orthopaedic care offers a holistic approach to treating gout.
At the Singapore Sports and Orthopaedic Clinic, our qualified experts can help find the best solution and gout treatment in Singapore, for you and your lifestyle.
What is Gout?
Gout (podagra) is a disease that results from an overload of uric acid in the body. This overload of uric acid leads to the formation of tiny crystals of urate that deposit in tissues of the body, especially the joints.
When crystals form in the joints, it causes recurring attacks of joint inflammation (arthritis). Gout is considered a chronic and progressive disease. Chronic gout can also lead to deposits of hard lumps of uric acid in the tissues, particularly in and around the joints and may cause joint destruction, decreased kidney function, and kidney stones (nephrolithiasis).
What Causes Gout?
Intake of alcholic beverages
Increase in level of uric acid
Starvation and dehydration
Thousands of years ago, gout was considered the ‘disease of kings.’ Why? Certain foods with a high purine content, such as shellfish and red meat, and alcohol trigger gout attacks. During this era, these foods and alcohol were limited to royalty and the extremely wealthy. Thus, middle and lower class civilians rarely experienced the disease.
Today, the prevalence and incidences of gout have steadily increased. Our diets have changed. And with technology, we can detect and diagnose gout much easier than ever before.
Gout is caused by a buildup of uric acid in the body. Usually, the kidneys filter and then excrete uric acid through the urine. In certain circumstances, the body may produce uric acid at a higher rate than it can expel it. When uric acid levels in the blood become too high, the body deposits monosodium urate crystals in the joints. These crystals irritate our joints, and cause the symptoms commonly associated with gout including:
The body may be unable to keep up with uric acid levels for a number of reasons. Our body breaks purine down into uric acid. Purine is found in alcohol beverages, various meats, and seafood. When we consume foods high in purine, our bodies may lack the ability to keep up with the production of uric acid. This results in hyperuricemia, or high uric acid levels, in the blood.
In other cases, kidney impairment may cause higher uric acid levels. If the kidneys are unable to excrete uric acid, it builds in the blood. Impaired kidney function may occur due to diabetes, cancer, high blood pressure, thyroid disorders, or kidney failure.
Genetics and certain medications are also thought to play a role in the development of gout. For example, diuretic medication used to treat high blood pressure can lead to gout. Diuretics increase your fluid output. Yet, the fluid left in the body may become highly concentrated with uric acid. Doctors advise drinking plenty of fluids when taking diuretics and avoiding foods high in purine to reduce the risk of gout.
How is Gout Diagnosed?
Prior to gout treatment in Singapore, a proper diagnosis must be made by a physician. Your doctor may take into account a number of factors. They may assess and ask questions relating to the following:
Are you overweight?
Do you consume a diet high in purine foods?
Do you regularly consume alcoholic beverages in high amounts?
Are you on certain medications, such as diuretics?
A joint fluid test and blood test will confirm a gout diagnosis.
In a joint fluid test, fluid is taken from the inflamed and painful joint via a needle. If crystals are present in the fluid, a gout diagnosis is made. Your doctor may further order an x-ray to ensure the pain is not caused by other problems.
Exploring the Relationship Between Gout & Joint Pain
Gout can cause sudden intense painful attacks at the joints, causing swelling and redness of the joint tissues. It usually attacks the joint of the big toe but this does not rule out the attacks on other joints. Gout usually affects men with 9 out of 10 patients being men. Once gout starts to attack other joints, it leads to inflammatory arthritis. Let’s look at the relationship between Gout and Joint pain here.
Gout happens due to an excessive accumulation of uric acid. Uric acid is formed when the body breaks down an aromatic organic compound called purines. Purines are found in foods such as livers, beans, mackerel and beer. Overconsumption of such foods will lead to a high level of purines, resulting in too much uric acid. The body’s natural mechanism of dealing with uric acid is by passing them out through urination but when this urination process is less efficient, hyperuricemia occurs, leading to gout.
Gout happens through 3 basic stages:
This is the onset of gout. In this first stage, the patient starts to have an excessive accumulation of uric acid in the body but no other symptoms or problems are present. It is also in this stage that the problem can easily be reversed by significantly reducing the amount of purine-rich foods.
Acute Gouty Arthritis
When no actions were performed to limit the consumption of purine-rich foods, the uric acid levels will increased and lead to the formation of uric crystals in the spaces between the joint. Due to the crystals and high acidity, sudden onset of intense pain will occur and this can lead to swelling in the joints. Attacks will be infrequent and can be spaced weeks or even months apart from each, but as time passes, the attacks will become more and more common.
Chronic Tophaceous Gout
This stage is the most serious and will only happen after 10 years. A patient will only reach this stage when he makes no attempt to seek treatment and gout has caused a permanent damage to the joints and kidneys.
There is an exponential relationship between gout and joint pain, leading to sudden onsets of pain attack and swelling. However, reaching from one stage to the other takes time and during the periods, it can be treated by medication and reduction in consumption of purine-rich foods. Gout will cause a lot of trauma and severely affect patients.
How is Gout Treated?
In some cases, gout is very dehabiliting. It can happen suddenly and be very painful. The most common spot for gout to occur is in the big toe. Although, it may spread to the ankles, feet, and knees.
Fortunately, gout is a very treatable condition. And we offer a variety of ways to treat the disease. When a gout attack occurs, it will often resolve on its own in about a week. Thus, many health professions focus on relieving the symptoms and preventing future incidents.
Medications are the most common go-to. NSAIDs, nonsteroidal anti-inflammatory drugs, may alleviate swelling and pain. Your doctor may also prescribe stronger pain medication if over-the-counter drugs aren’t helping. Medications that help lower uric acid levels may also be considered. These type of medications help to prevent attacks by reducing the production of uric acid.
However, long-term use of most of these drugs is not recommended. Surprisingly, NSAIDs can have fairly dangerous side effects. With chronic use, heart problems may arise. Prescription NSAIDs are particularly problematic for this. You may experience gastro-intestinal issues. These medications may cause bleeding and ulcers when used for long-periods or at high dosages. Such medication may also lead to further impaired kidney function, which not only doesn’t help the problem but can amplify gout occurrences and symptoms. When using any medication, make sure to follow the direction on the label and read the warnings prior to consumption.
Your healthcare provider may also consider the medication you are currently taking and make modifications where it is necessary.
If your diet is the main problem, your healthcare provider may discuss other dietary options that do not increase your risk of gout. They will advise you to avoid foods high in purine and to drink plenty of water throughout your day.
The treatment of an acute attack of gouty arthritis involves measures and medications that reduce inflammation. Preventing future acute gout attacks is equally as important as treating the acute arthritis. Prevention of acute gout involves maintaining adequate fluid intake, weight reduction, dietary changes, reduction in alcohol consumption, and medications to lower the uric acid level in the blood.
Maintaining adequate fluid intake helps prevent acute gout attacks. Adequate fluid intake also decreases the risk of kidney stone formation in patients with gout. Alcohol is known to have diuretic effects that can contribute to dehydration and precipitate acute gout attacks. Alcohol can also affect uric acid metabolism to cause hyperuricemia. Therefore, alcohol has two major effects that worsen gout by slowing down the excretion of uric acid from the kidneys as well as by causing dehydration, both of which contribute to the precipitation of uric acid crystals in the joints.
Orthopaedic Care & Gout Treatment in Singapore
At the Singapore Sports and Orthopaedic Clinic, our experts can diagnose, treat, and prevent joint, neuro, and muscular disorders, such as gout. They can provide exercise and nutritional advice to help treat gout.
Your doctor will address your nutritional and lifestyle choices, in combination with manual manipulation of the joints to eliminate your pain, improve mobility, reduce the incidences of gout attacks, and help increase your overall quality of life.
Your healthcare provider may recommend the following foods to replace high-purine content foods in your diet:
Low fat dairy products
Surgery is a rare option for treating gout. However, in cases where there is a lack of draining, the area has become infected, or movement is severely impacted, surgery may provide the best option.
Your healthcare provider may also recommend specific exercises to reduce joint pain and increase support to the commonly affected areas. Weaknesses in the body may lead to pain and conditions such as gout. Strengthening around these areas can lessen the pain symptoms associated with the condition. Weight management is also important to limit the stress placed on the joints that are prone to gout attacks. Your treatment will likely involve an exercise program tailored to your specific needs, including strengthening exercises and possible weight loss strategies.
Get the advice you need and the proper care and treatment for your condition. Frequent and painful gout attacks do not have to be your normal.
At the Singapore Sports and Orthopaedic Clinic, our qualified doctors will find the appropriate gout treatment in Singapore for you. Our team of doctors are experienced in treating orthopaedic problems, sport injuries, and degenerative changes. Start your life free of pain. Get back to the activities you know and love. Call and book your appointment, today.
Sprained ankles are one of the most common sports-related injuries obtained by people. Although a sprained ankle may not be a major injury, it could be quite a hindrance to daily activities and of course, sports or other physical activities would not be possible without further injuring the ankle.
Depending on the severity of the sprain, there are plenty of sprained ankle treatments in Singapore that can provide recovery from 6 weeks to up to 4 months. However, with adequate rest, proper treatment and rehabilitation, the healing process could be sped up significantly.
Sprained ankles typically occur when the ankle is turned at an unnatural angle and the ligaments connecting the bone and ankle tears.
Typically, an ankle sprain can be identified by the pain, swelling, stiffness and instability. A minor sprain involves a stretched ligament with slight tearing. The pain would not be too intense and it would still be possible to walk with a limp.
If the ligament is completely torn, the ankle joint would lose its function and stability. Intense pain would be felt initially but it would wear off after a while till no pain is felt and swelling would be extensive.
You can identify a sprained ankle by bruising around the affected area, a swollen or painful lump near the ankle, and a general instability of the area.
Depending on the severity of the sprain, a doctor may recommend several treatment programmes to suit your needs. Most of the time, sprains will go away with adequate rest without further pressure on the feet, but extreme cases may call for surgical solutions like arthroscopy.
As with many other kinds of leg and joint injuries, the R.I.C.E (Rest, Ice, Compression, Elevation) method is the first form of treatment to contain the injury and reduce pain and swelling.
Rest: Avoid weight bearing as much as possible to allow the ankle to heal and prevent further aggravation of the injury.
Ice: Using an ice pack or ice wrap, apply it on the injured area for 10-15 minutes several times a day. This would reduce the pain and swelling.
Compression: After icing, use bandage to wrap around the injured area snugly. Make sure that it is not too tight that it cuts off blood circulation.
Elevation: Raise your leg above the heart level to further reduce the swelling.
These four steps should be repeated at least three times a day or until the pain and swelling subside.
During this time, you should also restrict movement and involvement in physical activities. If you have difficulty walking, consider a crutch or an ankle brace to assist you in your daily routine.
Generally, no medication is required for a sprained ankle, but painkillers are sometime given out if necessary.
Nonsteroidal anti-inflammatory drugs (NSAID) can help to reduce the inflammation and reduce pain and swelling.
Other than that, over-the-counter painkillers are also prescribed to handle the pain. These can include ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve, others) or acetaminophen (Tylenol, others).
Keeping your ankle immobilized for too long can result in stiffness. Always wriggle your toes or move your ankle lightly whenever possible to keep it flexible. Once the injury has stabilized and is recovering, you can start rehabilitation exercises to restore its motion, strength and balance.
You can start off with sitting on a chair and moving your ankle up and down, followed by rolling your foot inward and outward. If these movements are bearable, proceed to stand with legs at hip width apart and lift up one foot at ankle level. Change to the other foot and repeat the reps.
Slowly lift your feet off the ground on a tiptoe and hold the position before lowering it back down. Use a support if necessary.
With a wall for support, lean forward with one leg bent and reach out for the wall with both hands at head level. The other leg should be kept straight and feeling the stretch along the calf. Do the same with the other leg.
If you often suffer from sprains, you can lower the chances of such occurrences by wearing proper shoes or going through physiotherapy and stretching exercises to improve your balance and footwork.
Other preventive measures can include ankle braces or sports tape which can hold and reinforce your ankle to prevent it from landing at susceptible angles.
One of the most common causes of ankle sprains is weak ankle muscles. You can train your ankles to be stronger with a simple exercise. Wrap a towel around your foot to create some resistance and roll it inward as a simple movement. Do not attempt to do this if your ankle already hurts!
60-90% of the population will experience back pain in Singapore. Chances are you or someone you know has suffered from back pain at some point in their life. It can catch you by surprise and drastically limit your mobility and function. 1 in 2 employees took 4-7 days off work for their back pain in the past year. It decreases productivity and one’s quality of life.
However, back pain doesn’t have to be the norm. At the Singapore Sports and Orthopaedic Clinic, our experts can help you bounce back from back pain and prevent future incidents.
What Causes Back Pain?
The back is a complicated structure, consisting of neural networks, the spine, and muscles.
However, everything in the body is connected. Back pain may be caused by a tight muscle, structural abnormalities, neurological issues such as nerve compression, and more.
The spine consists of small bones called vertebrae. In between each bone is a disc. These discs prevent bone-on-bone contact, as well as act as shock-absorbers. Within the spine is the spinal cord. The spinal cord contains the nerves that connect the central nervous system to the rest of the body, allowing your brain to communicate to your muscles and joints to perform certain movements.
Further, muscles connect to various points of the spine and pelvis. The condition of these muscles, such as strength and flexibility, can impact your posture and alignment. If these muscles aren’t functioning properly, back pain may occur.
There are a variety of causes of back pain. Some of the most common causes include a slipped disc, osteoarthritis, poor posture, and tight muscles.
A Slipped Disc
A slipped disc, or herniated disc, is the displacement of the shock absorbing disc in between the spinal vertebrae. It may occur due to twisting or moving incorrectly or due to wear and tear over time. Consequently, it may place pressure on nearby nerves.
‘Sciatica’ is the common term used in conjunction with a slipped disc condition. The disc may place pressure on the sciatic nerve, causing numbness, pain, tingling, and weakness to occur down the legs.
Osteoarthritis is the wearing down of the protective cartilage between bones. In the spine, it is often due to the wearing down of the protective discs. With age, these discs naturally become dehydrated. Some refer to this as ‘degenerative disc disease.’
It frequently occurs in the neck or low back, and may cause varying degrees of pain and functional limitations.
Your body is made to move a certain way. Further, your joints, muscles, and tissues are optimized for proper posture. Unfortunately, a lot of people lack proper posture.
Today, many people lead fairly sedentary lives. We sit at desks all day, jeopardizing our posture and causing certain muscles to shorten. Flexibility and strength decrease.
When we place our body in unnatural positions, dysfunctions occur. For example, if you are leaning forward all day with your head protruding toward your computer screen, you are placing stress on your neck and shoulder muscles, bones, and tissues.
Bad posture can also lead to added stress on the lower back. The body isn’t made to sit in such positions for prolonged periods. And as much as it tries to adapt, back pain is often inevitable without proper intervention or education.
Sitting for long periods may also contribute to tight muscles. The hamstrings, hip flexors, and piriformis muscles may become tense or shortened. Due to their attachment points and locations, these muscles can pull on the pelvis and spine causing pain.
Frequently called ‘Piriformis Syndrome,’ the piriformis muscle may spasm and compress the sciatic nerve creating radiating pain down the legs.
However, sports doctor can educate you and help you overcome these conditions. With proper treatment and care, you can decrease and eliminate your back pain issues.
How is Back Pain Treated in Singapore?
Back pain is treated in a number of ways. It frequently depends on the cause.
Pain relievers, such as over-the-counter NSAIDs, may help decrease initial pain and inflammation. However, it isn’t recommended to use these medications in the long-term. Negative side-effects, including gastrointestinal issues, may occur with chronic use.
Exercise, supervised and provided by a trained professional, can help decrease your risk of back pain and eliminate future injuries. Frequently, back pain in Singapore is caused by inactivity and muscle weakness.
The most common form of rehab exercise for back pain involves the strengthening of the neglected transverse abdominals, or TA. The TA muscles are the deep and lower core muscles. They help support and stabilize the spine and pelvis, acting as a girdle. When this muscle is weak, we try to compensate in other ways. However, this often results in injury and pain, specifically in the low back.
A back pain exercise program will focus on strengthening these abdominal muscles, as well as stretching out shortened or tight muscles. Doing so helps reduce pain and dysfunction of the spine. A basic TA exercise to get you started involves:
Lying face up, with your knees bent and your feet planted on the ground.
Imagine a tightrope pulling your hip bones together or stopping the flow of urine. You can feel with your fingers in between your hip bones to determine if you are tightening your TA muscle or not. Your stomach should not bulge upward, just tighten.
Your low back should remain on the ground or bed. Make sure to keep breathing throughout the exercise. A lot of people tend to hold their breath. However, this is incorrect.
Try holding the contraction for 5 seconds to start. Build up to 10 second holds. Perform the exercise 10-12 times and at least 2-3 times per day.
Common problematic muscles that may also lead to back pain, include the hamstrings, hip flexors, and piriformis. The hamstrings or hip flexors may become tight, which may pull on the pelvis. In turn, this creates alignment issues. Your lower back may become under stress in this unnatural position. Thus, pain may occur. To correct these issues, your sports doctor will prescribe exercises to stretch out and elongate these muscles. They may also use manual techniques to promote healing and to release muscular tension.
The piriformis, as aforementioned, can spasm and compress the sciatic nerve, causing back pain and radiating pain down the legs. Myofascial release techniques and stretches can help release this small muscle, reducing and preventing future incidences.
In combination with exercise, a manual therapist or sport doctor can perform joint manipulations, traction, myofascial release, and other techniques to help alleviate your pain levels. Each treatment protocol is suited to your particular needs.
In severe cases and where other treatment options fail to work, surgery may be used as a last resort. At the Singapore Sports and Orthopaedic Clinic, our sports doctor are qualified to perform such surgeries. They can prepare you before surgery and help guide recovery post-surgery.
Types of Back Surgery
There are many types of back surgery. Again, it depends on the cause of your back pain as to what kind of surgery you have. Also, surgery is only considered when other interventions have failed to work. The 3 most common surgeries include:
Discectomy: This surgery may be performed when an individual has a slipped disc. The doctors removes the damaged part of the disc.
Laminectomy: Spinal stenosis is the narrowing of the spinal column, which can cause neural issues to arise. In this type of surgery, the lamina portion of the spine is removed to relieve pressure on the spinal cord.
Spinal Fusion: 2 or more vertebrae are fused together in this type of surgery. It limits movement between the 2 vertebrae, reducing pain brought on by the motion of these 2 bones. This is often done in cases where the spine has been damaged or a deformity has occurred.
Your sports doctor will thoroughly explain the surgery prior to. Again, these surgeries are only performed when all other interventions and treatments have been unsuccessful. Frequently, surgery will improve one’s pain levels. However, in some cases, it may not fully fix the problem. Exercises and other treatment protocols can help manage the remaining pain post-surgery.
Orthopaedic Care & Treatment of Back Pain in Singapore
At the Singapore Sports and Orthopaedic Clinic, our injury experts can help you thwart back pain in Singapore and get you back to your regular activities.
Your sport doctor will conduct a thorough assessment. From their assessment, they will come up with an appropriate treatment plan, including exercise, manual techniques, and education. Call or visit our clinic today! Regain back control of your life and rid yourself of back pain for good.
A laminectomy procedure on the lower back is one of the most common procedures to treat spinal stenosis, a narrowing of space around the spinal cord. In a laminectomy, surgeons remove the lamina, a bony structure that protects the spinal cord, to relieve pressure causing neural issues and pain. Following a laminectomy surgery, orthopaedic care can aid in the recovery process and help you get back to feeling your best.
Reasons for Undergoing a Laminectomy
Essentially, a laminectomy is performed when other options to alleviate the problem fail to work – it is often a last resort.
The spine is a complex structure. It is made up of 33 vertebrae or bones. These bones of the spine protect the spinal cord. The spinal cord is home to an intricate network of neural bundles stemming from the brain. The brain and spinal cord are the structures that comprise the central nervous system. The central nervous system drives every movement, breath, and thought we make. It is the center of our being. Damage to the spinal cord can cause varying degrees of problems, including paralysis and regulatory functioning issues.
The lamina is the back arch of the vertebrae bone. It protects the spinal cord from outside impact or harm. When abnormalities or bony overgrowths develop on the spine, neural functioning may become significantly impaired and pain may occur. Spinal stenosis, a narrowing of the spinal canal, may create pressure on the nerves that run through the spine. Bony overgrowths due to age or arthritis may also compress these fragile neural networks.
Consequently, pain, numbness, and weakness may occur. In severe cases, the individual may struggle to walk and may lose control of their bladder and bowel movements. When the symptoms become severe enough that they impact day-to-day function and when other treatment options fail to work, a laminectomy is performed. In other words, the lamina portion of the vertebrae is removed.
What Does a Laminectomy Involve?
A laminectomy surgery in Singapore involves the use of general anesthesia. However, before surgery the appropriate tests and examinations are performed to ensure as little risk as possible. Your doctor will also ask you to avoid food and drinks for a set time before surgery. Your doctor will also ask that you avoid NSAID, nonsteroidal anti-inflammatory drugs, the week before your surgery.
Depending on the part of the spine that the laminectomy is performed on, it often lasts 1-2 hours. The medical team measures your heart rate, blood pressure, and oxygen levels throughout the procedure.
An incision is made at the affected vertebrae. The aggravating part of the lamina is removed, relieving pressure off of the spinal cord. Depending on the severity and type of condition you have, the surgery may also involve spinal fusion or the removal of a slipped disc. Your surgeon will discuss the plan with you beforehand.
Following a laminectomy surgery, the surgery team will take you to a recovery room. Some will be required to stay in the hospital of a few days, while others may undergo a same-day discharge. It entirely depends on the severity of your situation and how invasive the surgery was.
What Are the Risks of a Laminectomy Surgery in Singapore?
As with any surgery, there are varying risks involved. These risks include:
Damage to the spinal cord
Spinal fluid leak
No change in back pain
Frequently, individuals experience relief after surgery. However, surgery may not fully eliminate the cause and it will only remove the decompression in the part of the spine operated on. For example, arthritis or spinal stenosis may still progress after surgery.
The Immediate Recovery Process
The surgeon will likely require you to walk and perform movements right after the surgery. These tests will ensure no damage was done to the spinal cord. They may also prescribe pain relief medication during the initial recovery stage.
Take the advice of your surgeon, and slowly and gradually increase your activity levels. Follow-up appointments will help guide you through the recovery phases. Recovery is often 2-6 weeks. Again, it may depend on your condition and the exact type of surgery performed. For example, if a bone fusion was also performed your doctor may recommend a back brace as part of the recovery process, and your recovery may be slightly longer.
You will have to work to keep the incision clean and dry, particularly the first few days after surgery. If swelling or tenderness occurs at the incision site, seek out medical attention immediately. An infection could potentially develop. Your surgeon will outline how to avoid infection following the surgery.
General advice following a laminectomy surgery in Singapore includes:
Avoid sitting for long durations.
Avoid driving for 2-4 weeks right after surgery. Discuss your options and prognosis with your surgeon.
Avoid heavy lifting.
Do not bend or twist the torso. This could potentially open the incision and cause other problems.
Do not smoke. Smoking may interfere with your body’s ability to heal properly and quickly.
Avoid travelling. Car rides or plane rides may increase your risk of developing a blood clot.
Back surgery sounds scary. It is absolutely normal to experience worries or concerns regarding your surgery and recovery. Ask questions beforehand and after the procedure. Our team of surgeons and doctors would be more than happy to address any concerns you may have.
At the 6 week mark, regular activities can often gradually be resumed. Neural pain may subside in about 4-6 weeks. And pain and swelling will decrease over time and eventually, with use.
Following a laminectomy, chiropractic care and physiotherapy may be recommended to help guide the rehabilitation process. Chiropractic treatment can also coincide with physiotherapy treatment, and vice versa.
However, initial healing must take place before you seek out chiropractic or physiotherapy care. The body is fragile after surgery and a certain amount of rest and time must take place before any spinal manipulation is performed. Often, physiotherapy and chiropractic care can begin about 2 weeks post-surgery.
Most experience reduced back pain symptoms. A Laminectomy surgery improves pain in about 70% of patients.
If you follow proper guidelines and instructions, your quality of life may significantly improve post-surgery. A positive attitude and proper care following your surgery can go a long way and can drastically impact your results. However, you may not notice the results straight away. It may take up to 6 weeks to notice any notable difference.
Chiropractic care and physiotherapy can also help restore mobility and reduce incidences of pain during the later stages of your recovery. Your healthcare provider can recommend exercises throughout the recovery process to help you get back to your regular activities and improve your outcome.
Make sure to always follow the direct advice and instructions from your doctor.
For more information regarding laminectomy procedures and post-surgery care, contact us at +65 9734 3087. If you wish to have your back pain assessed, book an appointment. At the Singapore Sports and Orthopaedic Clinic, our orthopaedic specialists are ready to help you get back to the activities you know and love. Call us today. Start your journey toward a better life.