Pain caused by arthritis can be quite uncomfortable, especially when it affects your finger joints. The symptoms of arthritis in fingers can make normal hand activities like grabbing an object and typing on your computer keyboard, particularly difficult. Hence, it limits your ability to perform simple everyday tasks and leaves a negative impact on your productivity level. The aftereffect of arthritis also depends on which type of arthritis you are suffering from, as it might cause more serious symptoms and increased discomfort.
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
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.
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
- Whole grains
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.
Have you ever woke up to a stiff neck before? That uncomfortable and tight feeling that makes movement almost impossible and causing you a lot of discomfort throughout the entire day. Stiff neck are frequently experienced by many and it will usually go away by itself after a few days. You may rest assure that stiff neck is not an indication of any serious problems with your neck.
A stiff neck is typically characterized by difficulty moving the neck, especially when trying to turn the head to the side. It may also be accompanied by a headache, neck pain, shoulder pain or arm pain. In order to look sideways an individual may need to turn the entire body instead of the stiff neck. Most people are familiar with the pain of a stiff neck. In most cases, pain and stiffness go away naturally within a week.
If a stiff neck has not improved after a week, it should be checked by a doctor. Also, regardless of how long it has lasted, a stiff neck accompanied by fever, headache, nausea or unexplained sleepiness should be treated by a medical professional immediately.
Causes of Stiff Neck
Injuries are one of the most common reasons that one will experience stiff neck. A sudden jerking movement at the neck region can injure the muscles and ligaments, causing injury and subsequent pain and stiffness. Injuries can be caused by sports, accidental falls or even a car accident.
Our body response to stress is the natural tensing of our muscles. If you did not suffer any injuries recently and is experiencing stiff neck, it could be an indication that you are under tremendous stress. It’s time to take things easy and relax.
Muscle spasm are due to the signalling of certain messages from our nerves to the muscles which will result in them involuntary contracting, causing stiff neck.
Improper sleeping posture
Improper sleeping posture is probably the most common reason for stiff neck. Our body is in a relaxed state when we are asleep and an improper sleeping posture can cause the pulling of the neck muscles without us being aware of it. Only when we finally wake up do we realise it and it is often too late.
Rheumatoid arthritis is an autoimmune disorder that targets the joints, especially those in the neck. It will result in neck pain and stiffness.
Meningitis is a very serious inflection of the fluid that surrounds our brain and spinal cord and if you suffer from neck pain and stiffness and they are not caused by the factors listed above, you should consult a doctor immediately as a stiff neck is a common symptom of meningitis.
Diagnosis of Stiff Neck
Your doctor will take a medical history and do an exam. He or she will check for tenderness, numbness and muscle weakness, as well as see how far you can move your head forward, backward and side to side.
Your doctor might order imaging tests to get a better picture of the cause of your stiff neck. Examples include:
- X-rays can reveal areas in your neck where your nerves or spinal cord might be pinched by bone spurs or other degenerative changes.
- CT scans combine X-ray images taken from many different directions to produce detailed cross-sectional views of the internal structures of your neck.
- MRI uses radio waves and a strong magnetic field to create detailed images of bones and soft tissues, including the spinal cord and the nerves coming from the spinal cord.
It’s possible to have X-ray or MRI evidence of structural problems in your neck without having symptoms. Imaging studies are best used as an adjunct to a careful history and physical exam to determine the cause of your pain.
Treatment Regime for Stiff Neck
An individual can do several things to begin treating a stiff neck. Some common self-care strategies include:
- Rest. Taking it easy for one or two days gives injured tissues a chance to begin to heal, which in turn will help relieve stiffness and possible muscle spasm. For example, someone who swims may want to avoid certain swim strokes that involve lots of head twisting for a few days. However, it is recommended to limit rest to one or two days, as too much inactivity can lead to a weakening of the muscles, and weak muscles have to struggle to adequately support the neck and head.
- Cold and/or heat therapy. Cold therapy/ice packs help relieve most types of neck stiffness by reducing local inflammation. Applying ice during the first 24 to 48 hours of a painful flare-up usually has the most benefit in terms of reducing inflammation. Applying heat to the neck can spur blood flow, which fosters a better healing environment. Some patients prefer ice, whereas others prefer heat. Both may be used alternately.
- Over-the-counter medications. Nonsteroidal anti-inflammatory drugs (NSAIDs), which work by reducing inflammation, are typically a first line of treatment for neck stiffness and soreness. Even non prescription medications have risks, possible side effects, and drug interactions, so be sure to discuss any medications with a doctor.
- Gentle stretching. Stretching, as soon as tolerated, helps ease the stiffness and restore the neck to a more natural range of motion. For many, it is a good idea to learn appropriate stretches with the help of a physical therapist.
- Low-impact aerobic exercise. Stretching or any form of low-impact aerobic exercise, such as walking, is often helpful in relieving any type of stiffness. Even if walking does not directly involve the neck, it helps circulate oxygen to the soft tissues throughout the spine, which in turn promotes healing.
Stiff Neck Treatment in Singapore
You can contact us for counselling regarding stiff neck treatment. We are closely working with more than 35 Insurance companies for cashless payments. We are an Accredited Specialist Clinic. E-filing facility is also available at our clinic.
Osteoarthritis is a form of degenerative arthritis that causes pain and swelling in joints. Due to the wear and tear of cartilage in the joint, the bones become more prominent and as a result, rub against each other as they move. While the condition occurs gradually, it worsens over time if left untreated. The big toe is a common area to be affected by osteoarthritis.
Most cases of osteoarthritis come with age, starting from ages 30 to 60. As the body system slows down, the cartilage deteriorates faster than it can heal, resulting in osteoarthritis to develop.
Obesity also increases the risk of developing the condition. With additional pressure from the body weight, the bones of the feet are stressed and may accelerate the damage of cartilage in the big toe.
Some people are born with an overgrowth of the big toe bone, making the toe joint stiff and difficult to bend, thus more susceptible to developing osteoarthritis.
Some of the first signs of osteoarthritis of the big toe include stiffness, achiness, tenderness and pain in the affected toe, though may also be felt in the arch of the foot and other toes. The toe feels most achy and stiff in the morning and after sitting for a long period of time.
Gradually, you would start to notice swelling around the joint. It might be some time before the bone spur becomes visibly noticeable. However, you would feel the bones rubbing together and causing the area to swell as they get more prominent.
As the big toe gets stiffer, it gets harder to bend the toes. Walking and balancing becomes difficult and painful. The constant rubbing between the toes can cause corns and calluses to form, and even leading to other conditions such as hammer toes.
Conservative treatment for osteoarthritis may not cure the condition but can relief the symptoms. Your doctor might prescribe painkillers and anti-inflammatory medicine to ease the pain and bring down the swelling. There are also creams and gels to reduce the swelling. Orthoses can be inserted in your shoes to decrease the pressure while walking. It is best to avoid high heels and pointy-toed shoes as these shoes give puts stress on the feet and may aggravate the symptoms.
For very severe cases, your doctor might recommend a joint replacement surgery. The damaged cartilage is removed and the joint is held together in a fixed and immovable position so that the cartilage would not be affected again. However, the results of the surgery might cause a reduction in mobility. Thus, this procedure may only be suitable for elderly patients that do not require as much mobility in daily activities.
The shoulder joint is composed of three different types of bones: the shoulder blade, upper arm bone and collarbone. This type of joint is a ball and socket joint, allowing for extreme flexibility and wide range of motion. The upper arm bone acts like a ball and is securely inside the shoulder blade socket. For stabilization purposes, the upper arm bone is slightly larger than the socket, ensuring that the fit is tight. To further enhance the stability, there is a layer of soft tissue called the labrum. Injuries to the labrum is the cause of a shoulder joint tear. In this article, we will look at some of the symptoms and preventive measures.
Symptoms of Glenoid Labrum tears are difficult to be diagnosed. The pain is unable to be localized to the exact location and pain is severely increased when actions involving the injured shoulder is attempted. Such actions can include stretching the arm or raising a hand. As time passes, the shoulder will be weaker and instability will start to set in.
Shoulder joint tears are often caused by a sudden trauma to the shoulder blade. These can include falling on an outstretched arm or a direct blow to the shoulder. In order to prevent this, protective measures should be taken:
Warm-ups and stretching
Have you ever taken a rubber band and pulled it suddenly? The rubber band will end up breaking immediately. This is the same for our muscles and it is the reason why warm ups and stretching are extremely important. Warming up will loosen the muscles and enable the tendons and ligaments to stretch. This will allow them to function properly and hold the shoulder joint together.
Shoulder joint tears are also much more common in players engaging in high impact sports such as rugby and baseball. Players often wear protective paddings designed for the shoulder. These cushioning pads are able to cushion and absorb shocks to a certain extent. Some are even able to prevent fractures and dislocations.
Build strong muscles
Building up strength in the shoulders will increase the ability of tendons, ligaments and muscles to withstand the impact experienced by the shoulder. Strong muscles will hold the shoulder together and prevent any muscular tears during an impact.
Shoulder joint tears are extremely painful and affects our daily lifestyle. Players who participate in high impact or repetitive sports shoulder consider investing in good protective gears and ensure that proper warm ups are performed prior to the start of their activity.
Osteoarthritis is a degenerative disease that affects any joint in the body. One of the most common places is the hip due to the tremendous amount of stress and workload it faces day in day out. As we age, the cartilage in our joint will start to lessen due to wear and tear. You can simply imagine the cartilage to be a soft cushion located in between the joints and its main function is to absorb any shock experienced by that particular joint. Without this cushion, there will be a direct bone-to-bone interaction. When this occurs, pain and tenderness will kick in. There will be restricted mobility in that joint due to severe pain and simple daily activities can be difficult. Let’s look at some symptoms and treatments for hip osteoarthritis below.
The very first symptom one will experience is the discomfort at the hip joint. This pain is amplified after periods of inactivity such as sitting down for long periods or waking up from a sleep in the morning. When you start to work out the hip through activities such as walking or jogging, the pain is also increased tremendously. There may be also a cracking sound and feel experienced when you are using the hip.
The very first form of treatment a doctor will administer is medication to help manage the pain. It can come in either an oral or injection form. Some of the common oral medications are ibuprofen, naproxen and acetaminophen. These are usually strong enough to help control the pain adequately. However in serious cases, corticosteroid drugs may need to be injected directly into the hip for an immediate reduction in pain and swelling.
In serious cases where the pain persists despite medication treatment, a surgical treatment may be considered. The most common type is a total hip replacement surgery. The damaged bone and cartilage are removed entirely and replaced with man-made ones. The femoral head will be removed and a metallic stem will be placed into the hollow center of the femur. A ceramic ball will be placed at the upper stem and it acts as a replacement for the femoral head. Ceramics are preferred as they are much more biocompatible than metals. The worn out cartilage will also be removed and screws will be used to hold the socket in place. In order to provide a smooth surface, a ceramic spacer will be inserted to reduce coefficient of friction between the two surfaces.
Rheumatoid arthritis (RA) is not a selective disease. This indicates that RA can occur in any joint in the body, destroying it and causing pain and bringing disability to the patient. RA usually attack joints that are located in the upper groin region but is not limited to that only. In the initial stages, any form of strenuous activities such as jogging, running or even carrying a heavy object can aggravate the pain. As it slowly progresses, it will start to affect the quality of sleep and lead to patients being disorientated. Hip surgery is one of the most effective treatment methods of RA and we will look into it in this article.
Total hip replacement (THR) is the most common form of surgical treatment for RA with the other being hip resurfacing. In THR, there are three different components for the implant; the stem, ball and socket. The stem will fit itself into the femur while the ball will replace the spherical head of the femur and finally the cup will replace the worn out hip socket. The materials used for the implant have specifically been chosen for the biocompatibility properties. This means that they will not react with the body fluids and chemicals and ultimately causing an undesired immune response from the host body. The materials are also resistant to corrosion and are long-lasting in the region of a decade or more. The mechanical properties are as good as or even better than the natural components of the hip.
THR will be performed in a sterile operating theatre that is free of bacteria in order to prevent infection. Patients will be given a general anesthesia jab, which will cause them to fall asleep throughout the surgery. An incision will be made along the side of the hips and can be as long as 25cm. However, this incision will not be visible as the clothes will be able to cover it decently. The diseased joint will be removed with a surgical saw and the bone will be cleaned and prep for the arrival of the new prosthesis. There will be proper drainage systems to remove blood from the region and when everything is over, sutures will be used to close up the incision.
As with all forms of surgery, there are risks involved. There will always be a slight chance of the formation of a blood clot and infection despite sterilizing the operating theatre.
Total hip resurfacing arthroplasty is a surgical procedure with the intention of restoring the function of a hip for a patient suffering from degenerative joint diseases. Some of the common degenerative joint diseases include osteoarthritis, rheumatoid arthritis and traumatic arthritis to name a few. It is one of the few surgical techniques that can help patients lead an active lifestyle, with the next common one being hip replacement surgery. In recent years, there has been an increase in interest with regards to hip resurfacing. This is largely due to the fact that the bone will be preserved in this case unlike traditional hip replacement, which requires the removal of the hip joint and replaced with an artificial one. In this article, we will discuss about some of the possible benefits of total hip resurfacing arthroplasty over other techniques.
Unlike traditional hip replacement surgery, hip resurfacing is much more future proof. Both hip replacement and hip resurfacing uses a man-made component, which will eventually wear out over time. The implant is designed to last between 10 to 20 years before failure. Once failure occurs, a surgery will be performed to remove the failed component and replaced with a brand new one. In a hip replacement surgery, the bone is removed from the femur and revision surgery will be made more difficult. Instead, hip resurfacing does not remove the bone from the femur. Therefore, replacement of the implants is much more simpler, effectively future-proofing it.
Less risk of dislocation
The hip joint is essentially a ball and socket joint, which allows a wide range of motion. In a hip resurfacing surgery, the replacement ball is much bigger than the one used in hip replacement with dimensions closed to the original one. Since it provides a tighter fit, it is much more difficult to fall out of the joint. Thus, dislocation risks are restricted.
Increased range of motion
Patients who choose hip resurfacing over hip replacement tend to enjoy an increased range of motion. This is due to the fact that bone was not removed from the body and the ball and socket joint is fitted better.
Natural walking stance
Patients who had undergone hip resurfacing will be able to walk more naturally compared to patients who did hip replacement. There will be minimal limping and the hip is able to perform close to what it could previously.
Recovery from a total hip resurfacing surgery will take roughly 6 weeks. Throughout this period, physical therapy will be required to prevent scarring and regain the strength and range of motion.