Tony Setiobudi, Author at Orthopaedic Spine Surgery Singapore

You may have troublesome chronic back pain for a long time. You may have tried many things including Pain-killers, Physiotherapy, Chiropractic, Yoga, Pilates, Traditional Chinese Medicine, Acupuncture or other Alternative Medicines. If you don’t get better you need to see a specialist who have experience in this area.

Now the most important thing is to exclude any serious conditions such as spine tumor, infection or fracture. This requires a thorough examination and investigations.

After serious conditions are excluded, we can relax a little bit. Many times, the causes are related to your activities and life-style such as sitting or driving too long and lack of exercises. Often with proper education and understanding and a change of life-style, chronic back pain can get significantly better. Sometimes, simple measures such as standing every 20-30 minutes when you need to sit for a long time can improve your back pain significantly.

Chronic back pain requires a more regular follow-up. The treatment often requires multidisciplinary approach. The treatment modalities that you have tried may be appropriate but need to be coordinated appropriately together with medications. The treatment aims to reduce the pain so that you can carry on with your regular activities comfortably with minimal or no medication.

Sometimes, the back pain is associated with mechanical problems such as spinal instability or nerve compression. Strengthening the core muscle is the key to this problem. In severe cases, surgical intervention is required. Fortunately, when the problem is clearly associated with spinal instability or nerve compression, surgical treatment has high chance to solve the problem. But don’t worry because surgical treatment is reserved only as the last resort and most patients don’t need it.

In summary, if your back pain don’t get better after your maximum efforts to treat it, you should consult specialist that has adequate experience in this area.

Author: Dr Tony Setiobudi BMedSci, MBBS, MRCS, MMed (Ortho), FRCS (Ortho), Orthopaedic and Spine Surgeon, Mount Elizabeth Hospital, Singapore

How to take Bisphosphonates? | Osteoporosis Treatment

Osteoporosis Treatment Singapore | Bisphosphonate Medication

Osteoporosis Treatment Singapore and proper Bisphosphonate Medication

Fosamax and Actonel (bisphosphonate) are taken once a week (on the same day).
To be taken first thing in the morning with empty stomach 2 hours before eating or drinking anything other than plain water. If you take it with food or drink other than water, only a small amount of the medicine is absorbed.
You need to swallow the tablet with a full glass of water and sit upright for 30 minutes so that it does not irritate the esophagus.
Bisphosphonate is to be taken three to five years continuously after that it can be stopped for two years and the patients can continue to benefit from its use.

Calcium and vitamin D

You need to have adequate calcium and vitamin D in the blood when you take bisphosphonate.
Calcium and vitamin D are normally taken every day at a different time to the bisphosphonate.

What are the possible side-effects?

The most common side-effects (nausea, indigestion, tummy pain, diarrhoea or constipation) usually happen in the first month of treatment but usually go away after this.
Other common side-effects (joint and muscle pain) can happen a few days or a few months after you first start treatment and normally goes away after you stop taking a bisphosphonate.
Less commonly but more serious side-effects – inflammation or ulcers of the oesophagus or a narrowing of the oesophagus. If you have difficulty or painful swallowing, worsening heartburn or chest pain, you should stop the tablets and see your doctor.

You cannot take a bisphosphonate if:

You have low calcium levels in your blood
You have untreated vitamin D deficiency
You are pregnant or breast-feeding
Your kidneys do not work very well
You cannot sit upright or stand for 30 minutes after you have taken the tablet
You have problems with your oesophagus including narrowing of the oesophagus or Barrett’s oesophagus.

How do I keep my bones strong?

Regular weight-bearing exercise e.g. jogging, skipping, brisk walking, dancing
Stopping smoking
Limit alcohol intake
Eating adiet rich in calcium e.g. cow milk, cheese, green vegetables, broccoli, green beans, fish
Adequate sun exposure improves your vitamin D levels

Bone Mass Density & Bisphosphonate

The purpose of bisphosphonate therapy is to maintain the bone density.
Bone density scan (BMD) is the standard investigation to detect osteoporosis and monitor osteoporosis treatment.
BMD should be repeated yearly for monitoring.

Author: Dr Tony Setiobudi BMedSci, MBBS, MRCS, MMed (Ortho), FRCS (Ortho), Orthopaedic and Spine Surgeon, Mount Elizabeth Hospital, Singapore

If Your Back Pain does not Get Better with any Treatment ….

How to take Bisphosphonates? | Osteoporosis Treatment

Osteoporosis Treatment Singapore and proper Bisphosphonate Medication

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