Orthopaedic Mount Elizabeth Singapore

Vitamin D for Bones

December 15, 2021 by Tony Setiobudi

By Dr Tony Setiobudi BMedSci, MBBS, MRCS, MMed (Ortho), FRCS (Ortho)

How Vitamin D Keeps Your Bones Healthy

Vitamin D is a vitamin for bones. Vitamin D, also known as the “sunshine vitamin” is one of important player when it comes to bone health. The general functions of vitamin D include promoting strong bones, properly functioning muscles, and an encouraging an effective immune system.

Bones are made up of many minerals, calcium is the most important. Calcium makes bones strong and prevents them from breaking. Vitamin D is necessary for the proper absorption of calcium. If you don’t have adequate levels of vitamin D in your blood, it may not absorb enough calcium to keep the bones healthy. It shown to reduce risk of osteoporosis, assist in the healing bone fractures and decrease risk of future bone breaks.

Our body is able to produce its own vitamin D, while with other kinds of vitamins, we need to get it from food. This vitamin D is being activated in the skin with exposure to ultraviolet-B (UVB) radiation from sunlight.

How does vitamin D deficiency happen?

Kidney Problem. Kidney condition affects vitamin D production.
Lack of sunshine. Asians usually avoid sunbathing to avoid freckles and wrinkles. When is the ideal time for sunbathing? 30 minutes under direct morning sun is enough for vitamin D production.
30-40% Asians genetically have vitamin D deficiency. Even though people who live at the tropical region most probably have enough sun exposure, nevertheless, a lot of them still suffer from vitamin D deficiency. In this case, it will useless to get more sun exposure. Food and supplementation are another ways to increase the vitamin D level.

Sources of Vitamin D

There are three ways you can get vitamin D:

1.Sun Exposure.

Sunlight exposure is essential. Your skin makes vitamin D from the ultraviolet-B (UVB). Your body then stores the vitamin and uses it when it’s needed.

2. Diet

Vitamin D is available in a number of food items. Foods rich in vitamin D are:

Fatty fish such as tuna, salmon, and cod
Dairy products such as milk, cheese, yogurt
Eggs

Some people find it difficult to get the recommended amounts of vitamin D through diet alone.

3. Supplement

When exposure to UVB radiation and your diet is insufficient, adequate intake of Vitamin D is essential for optimal health. It is hard to measure how much amount of vitamin D we take from food, therefore vitamin D supplement is more comfortable and easier to monitor daily dosage. The dosage depends on your blood levels and other health concerns.

Vitamin D deficiency is a silent disease. It does not show any symptoms and is usually detected after screening. Talk with us to check your vitamin D levels, especially if you have osteoporosis or broken/fracture bone.

Dr Tony Setiobudi is an Orthopaedic & Spine Surgeon at Mount Elizabeth Hospital (Orchard), Singapore. He treats bone, joint, muscle and ligament problems in adults and children. He has a special interest in nerve compression and spine problems such as back & neck pain, scoliosis, kyphosis, spine tumor & infection, spinal cord injury, osteoporosis fracture, spinal stenosis and slipped disc.

Top 3 Food for Bone Health

December 15, 2021 by Tony Setiobudi

By Dr Tony Setiobudi BMedSci, MBBS, MRCS, MMed (Ortho), FRCS (Ortho)

Osteporosis is a disease in which the density and quality of bone are reduced. As bones become more fragile and porous, the risk of fracture is increased. Human bones reach optimum density at age thirties. After this period, bone density will slowly decreased. People lose bone mass or density as they age, especially women after menopause. The speed of bone lose vary individually. Therefore, it is important to get enough vitamin D and calcium for bone strength. Top 3 food for bone health:

Dairy products. Such as milk, cheese and yogurt, are high in calcium.
Vegetables such as broccoli, long bean, and pak choy, etc contain high calcium. For those who dislike vegetables, it is advisable to try and learn to take veggies. Parents also should train their children to consume vegetables since young.
Fish. especially fatty fish such as Cod, Salmon, and Tuna are high in vitamin D. Soft bones fish such as anchovies, ikan bilis, or sardines are rich in calcium.

Take Control of Your Knee Pain

December 15, 2021 by Tony Setiobudi

By Dr Tony Setiobudi BMedSci, MBBS, MRCS, MMed (Ortho), FRCS (Ortho)

The knee is the joint connecting the bones of the upper and lower leg. The knee plays an important role in supporting various motions such as walking, running, etc. However, all the parts of the knee; bones, cartilage, muscles, ligaments, and tendons are susceptible to disease and injury, thus leading to severe knee pain. Knee pain is often caused by problems occurring from hip. Weak hip muscles may cause more strain on the knee lead to knee pain. Strengthening the muscles around the hip joint can help relieve it. The risk of knee pain can be minimised through some simple home exercise.

However, not to worry as knee pain can be avoided through some simple home exercises. Strengthening your hip and knee through the right combination of hip and knee stretches and exercise can greatly reduce the chances of knee pain.

When you first experience knee pain, especially from a minor injury or arthritis flare up is to carry out the “RICE” protocol — Rest, Ice, Compression and Elevation. This means that you should Rest your knees, apply Ice indirectly on the skin to reduce swelling, wear a Compression bandage, and keep your knee Elevated.

In addition, you still can take steps to reduce knee pain, after the first instance of knee pain, with strengthening and stretching exercises to improve joint mobility. The right combination of strengthening and stretching exercises can relieve pain by helping to improve joint moves and functions. To ease knee pain, you’ll want to perform exercises that work several different muscles. Here are some exercises to help relieve your knee pain:
1. Hamstrings Exercise

Hamstring Stretching Exercise

2. Quadriceps Strengthening Exercise

Quadriceps Strengthening Exercises

It’s important to do these stretches regularly and do them to the best of your ability for maximum benefit. You should increase the reps when the pain gets better. However, you should stop exercising if you feel unwell and pain persists or worsens and consult with us.

High Heels High Risk

December 15, 2021 by Tony Setiobudi

By Dr Tony Setiobudi BMedSci, MBBS, MRCS, MMed (Ortho), FRCS (Ortho)

For many women, wearing a pair of high heels is the perfect complement to an already perfect outfit. Research has shown that high heels can negatively affect your long-term spinal health, hips, and knees. However, this does not stop women from wearing them. Why is this such a serious problem?

Try standing barefoot, you can feel your weight being evenly distributed among your sole. Notice the subtle, subconscious adjustments being made at the feet, ankles, knees, hips, and lower back to maintain your upright position. However, this is not the case when wearing heels, where your weight is pressing down towards your toes.

When wearing high heels, the body must adjust its center of gravity. High heels change your walking patterns. After years of wearing high heels, the body will readjust to be used to walking on your tiptoes. Hence you may experience discomfort when wearing flat shoes or walking barefoot.

Research shows that wearing high heels, especially for long periods, alters balance and stability, reduces the range of movement in the lower body muscles and joints. With the habitual wearing of heels, the Achilles tendon and calf muscles is under more pressure. The tendon may shorten, and the muscles can stiffen and reshape, in medical terms, we called it plantar fasciitis and Achilles tendonitis.

If you feel that you are experiencing back pain or leg pain due to high heels then it may be time to see us about your condition. Contact us to get treatment as early as possible.

Muscle sore after exercise, should I stop?

December 15, 2021 by Tony Setiobudi

By Dr Tony Setiobudi BMedSci, MBBS, MRCS, MMed (Ortho), FRCS (Ortho)

The pandemic has made people more aware of the importance of a healthy lifestyle. Exercise is one of the key factors to stay healthy and boost your immune system.

The first workout goes great, and you are proud and confident of yourself. When you wake up the next morning, all your body feels sore, and you can barely get out of bed. What happened? Did I do something wrong? Did I do too much? Is it normal?

Some muscle soreness after a workout is perfectly normal. Don’t let muscle soreness after a workout get you down!

So why exactly do you feel sore the next day instead of right away? Muscle soreness is a side effect of the stress put on muscles when you exercise. It is commonly called ‘Delayed Onset Muscle Soreness (DOMS)’. DOMS is the stiffness and pain felt in muscles, usually begins within 6-8 hours after your workout and can last up to 24-72 hours after the exercise. Muscle soreness is especially common after taking time off, doing a new workout, or making a big change to your routine. The muscle pain is due to inflammation within the muscle, which is one of the main triggers for this muscle soreness.

The good news is muscle soreness is a good thing as it means that your muscles are repairing and strengthening themselves. Sore muscle pain can improve quickly or last several days. Normal muscle soreness is a sign that your muscles are getting stronger and denser than they were before. There is nothing to be alarmed about.

Performing gentle stretching, massaging the muscles, and resting can help relieve muscle soreness. You can put ice to help reduce inflammation. While a heating pad or warm bath helps increase blood flow to your muscles to aid muscle recovery. There are few things you can do that will certainly ease the pain, and help you recover quicker.

Warm up. It wakes up your muscles by increasing blood flow to the muscles before every session.
Drink water. Water helps control your body temperature, loosen your joints, and transport nutrients to create energy.
Limited rest. Wait about 48 hours before working for the same muscle group in the same intensity.
Use proper technique. While exercising, having the correct technique helps protect you from muscle strain and injury.
Cool down. It is important to stretch after you work out. Stretching also circulates blood away from your muscles and back to your heart to aid in recovery.
Stay within your limits. You need to start slow, steady, and progress gradually. If you try to increase too soon, you may injure yourself.

Just make sure what you are suffering from is DOMS and not an injury. Mild to moderate muscle soreness is common and generally harmless. On the other hand, severe muscle soreness could be a bad sign. It’s important to know the difference between reasonable muscle soreness caused by exercise, and pain due to overuse or muscle injury.

When should you worry about sore muscles?

It sounds like muscle soreness is a positive thing, but here’s where it can get a little complicated. If the pain begins during or immediately after the exercise, it is not normal. Pain that occurs during an exercise is a sign that is not quite right, that’s a signal from your body to stop the activity before serious joint or muscle damage occurs.

Contact your doctor or seek care if;

The pain you’re experiencing prevents you from carrying out daily activities, most probably the exercise was too intense
The discomfort lasts for more than a week
Severe unbearable pain
Visible redness, swelling in the sore muscles
You feel pain in the joint, over the bones, or in tendons
The RICE (Rest, Ice, Compression, and Elevation) treatment doesn’t work

A severe case of DOMS could be the condition rhabdomyolysis, a rare but serious and potentially fatal condition if not treated right away. It is the breaking down of muscle tissues that release myoglobin and creatine kinase into the bloodstream, which can lead to kidney damage and even, in some cases total kidney failure. Signs of the condition often referred to as ‘rhabdo’, include nauseous, urine turned a dark shade of brown color, and significant muscle pain after an intense workout.

The important thing to remember is that while exercise is important, don’t let muscle soreness discourage you from it. Start a new exercise routine slowly and allow your body to adjust over time. Your body will thank you later.

How to Prevent Back and Neck Pain when Working from Home

December 15, 2021 by Tony Setiobudi

By Dr Tony Setiobudi BMedSci, MBBS, MRCS, MMed (Ortho), FRCS (Ortho)

The Covid-19 pandemic has forever changed how business is conducted. More people than ever are working from home (WFH), either temporarily due to social distancing, or permanently as a remote professional. This scheduling flexibility may be nice but working from home can present its own unique challenges for your neck and spine for a variety of reasons.

WFH dramatically increases inactivity leading to an increase in musculoskeletal pain, such as the neck, shoulder, and low back pain. Psychological stress is a contributing factor to back and neck pain. With most people, experiencing higher levels of persistent stress and anxiety due to the pandemic, the risk of you getting it is increased. Coupled with non-ergonomic desks, WFH has caused people to develop musculoskeletal pain.

Luckily, preventing back and neck pain when WFH need not be as difficult as you might think. There are a few preventive measures you can take to ensure you are not feeling any discomfort when WFH.

Move your body

Don’t stay in one position for more than 45 minutes. Take a break in the middle of the day to do some exercise. There are a lot of simple exercises you can do at home to strengthen your neck muscle, core muscle, and support your lower back and spine. Do some stretches, walk around, bend over, roll your shoulders to help your body, they will also help your concentration. Even 30 second breaks to change your posture briefly by standing up or arching your back a few times while seated can help take pressure off.

Practice good posture

It would be best if you can invest in an ergonomic chair and table for your working area at your home. However, most people don’t have that luxury. However, you should try to keep your posture right. These are some tips to help position yourself properly when sitting:

Sitting up straight, do not slouch. Sit all the way back in your chair to take full advantage of the lumbar support.
Your upper arms must sit loosely next to you, with elbow height at a 90 to 100-degree edge.
Support your back using a pillow or towel roll, place it near the lower back for lumbar support
The knees should be bent at a 90-degree angle with the flat feet should be flat on a surface. If your feet don’t reach the ground, use a footrest, stack of books, or even stacks of paper to support them.

Adjust the level of your equipment

Adjust seat height level. Look for a chair that can be easily adjusted so you can change its height and backrest position. The most important is to adjust your seat height so your eyes are lined up 3 inches below the top of your screen. Adjust your chair height so you can use the keyboard and mouse with your wrist and lower arm straight and level with the floor.
Adjust monitor height level. The ideal laptop height and angle let you view the screen easily without bending or rotating your neck. Your eyes should naturally hit the top third of your screen when you look straight ahead.

Find a doctor

Finally, if you are starting to develop some neck or back pain, don’t let the problem get worse before you get help! With the proper treatment and a bit of discipline when it comes to correcting your posture, you can live a pain-free life. Contact us for an appointment today.

Dr Tony Setiobudi is an Orthopaedic & Spine Surgeon at Mount Elizabeth Hospital (Orchard), Singapore.

Solutions to Sleep with Back Pain

December 15, 2021 by Tony Setiobudi

By Dr Tony Setiobudi BMedSci, MBBS, MRCS, MMed (Ortho), FRCS (Ortho)

There’s nothing in this world that beats a good night’s sleep. One that leaves you refreshed and ready to start a new day. However, having a good sleep for those suffering from back pain may not be easy.

Pain and sleep are intertwined in a vicious cycle, meaning they can be mutually reinforcing. Pain can disrupt sleep, but at the same time, poor sleep can make it more likely that a person will experience having pain or pain get worse.

It is possible to get a good night’s rest and help relieve back pain with proper sleeping strategies. Here are some tips below that can help you to sleep better.

Fix your sleeping position

A sleeping position affects spinal alignment. Wrong sleeping positions can put pressure on the lumbar spine, which can cause pain and stiffness. It is important to maintain the natural curve of the spine when lying in bed, thus helping ease your back pain. To do this make sure that the head, shoulders, and hips are aligned and properly supported. Put a pillow underneath your legs for extra support. If you sleep on your side, put a pillow between your knees and another one behind your back. Avoid sleeping on your stomach because it puts a lot of strain on your back.

Get a good mattress

Mattress choice can influence and alleviate nighttime back pain. A mattress that doesn’t support the lumbar spine can induce or exacerbate lower back pain. Soft mattresses make you sink in too deep, twisting your joints, causing back pain. Research has shown that a very hard mattress is also not good. In general, a medium-firm mattress is probably better for people with back pain. However, there is no right answer, because every person has different preferences and needs that are important to consider. You should try which type of mattress is the most comfortable for you.

Exercise

Building strength and flexibility in the core muscles can help ease back pain. It also lowers the chances of you straining your back and experiencing muscle spasms during the night. Exercise also helps reduce your stress and make you sleep better.

Heating pad

The heating pad is effective as it can improve circulation. Hence, a heating pad can help ease aches and pains as well as reduce stiffness in the muscles and joints. Taking hot baths may ease your back pain as well.

Self-massage

A self-massage can be effective in reducing lower back pain. It can give immediate relief from pain, aches, and reduce tension in your muscles. It helps improve blood circulation in the muscles and helps relax them, which altogether results in a reduction of stress-related pains.

Quality sleep is essential to your health and overall well-being. Having a good night’s sleep can help prevent or reduce back pain. While knowing how to sleep when you have back problems can help cope with pain and contribute to healing and recovery.

Consult with your doctor if back pain is interfering with your sleep quality. For more details about your back pain condition, Spring Hope Orthopaedic Spine and Surgery can give you solutions. Schedule an appointment with us.

Back Pain Risk Factors You Can Change

December 15, 2021 by Tony Setiobudi

Back pain is one of the most common health problems among all the population of the world. People can suffer from different forms of back pain which in turn can lead to chronic backpain, lower back pain or spinal pain. It is important to get your chronic backpain taken care of before it gets worse. Preventing chronic back pain before it begins starts with doing all that you can to reduce your risk for a future back injury.

There are several key factors that could significantly increase the risk for developing back pain over time. Some factors are unavoidable such as age, genes, or sex. However, knowing the different risk factors to change your lifestyle that may lessen back pain or help you to cope with it better.

OCCUPATIONAL RISK

Having a job that requires activities increase the likelihood of future back problems, such as lifting, pulling, pushing, bending, repetitive motion patterns and heavy physical exertion, can lead to injury and back pain. Long distance driver who always sitting behind the steer for prolong of time with vibration

Certain jobs and activities put a greater strain on your back. Working at desk all day which involves prolonged periods of sitting can contribute to pain, especially poor posture or sitting in a chair with not enough back support.

SMOKING

Smoking may not directly cause back pain, but it increases your risk of developing low back pain. Smoking accelerates degeneration of the lower spine. Nicotine restricts blood flow to vertebrae and disks, so they may age and break down more quickly. Smoking may also interfere with the body’s ability to absorb and use calcium, leading to osteoporosis- related bone and back problems. Smoking also slows healing and prolongs pain. Smokers are also much more likely than nonsmokers to develop chronic, disabling back pain.

WEIGHT

Body weight alone (along with your height and general build) appears to have little to do with your likelihood of developing back pain in the first place. However, being overweight, obese can put stress on the joints and pressure on the vertebrae and discs and lead to low back pain. Individuals who have extra weight also showcase signs of a lack of physical activity.

POSTURE

Despite your parents’ admonition to “sit up straight,” experts now agree that, in most cases, posture alone, whether bad or good, will neither predispose you to back pain nor shield you from it. Slouching doesn’t seem to have much effect on the basic health of your spine. But before you slump down in your chair, note that poor posture can worsen existing pain. Improving your body mechanics can help relieve your symptoms and prevent flare-ups Being physically out of condition is an important reason people have recurring bouts of the “sprain and strain” type of back pain.

PSYCHOLOGICAL STRESS

A study published in Arthritis Care and Research suggest that people who suffer from depression have a 60% greater chance of developing back pain in their lifetime than those who don’t. Stress, anxiety, and negative emotions can influence how closely one focuses on their pain as well as their perception of its severity.

Part of the answer may lie in the fact that chronic pain and depression share some of the same biochemical features. Imbalances in the neurotransmitters serotonin and norepinephrine, for example, play a role in mood disorders such as depression and also are involved in producing the sensation of pain. This could explain why people suffering from depression tend to experience more severe and long-lasting pain than other people.

Anxiety and depression can also sensitize you to pain, making you feel worse. So can the disturbed sleep that often accompanies depression and anxiety. Fortunately, you can often address psychological influences on back pain with cognitive behavioral therapy, where a counselor helps you recognize negative thoughts, behaviors, and feelings and respond in a more positive way.

Dr Tony Setiobudi is an Orthopaedic & Spine Surgeon at Mount Elizabeth Hospital (Orchard), Singapore.

SURGERY, DON’T PANIC!!!

December 15, 2021 by Tony Setiobudi

By Dr Tony Setiobudi BMedSci, MBBS, MRCS, MMed (Ortho), FRCS (Ortho)

Suffering from chronic back pain for many years, I have tried everything that I could to alleviate the pain, from exercising to physiotherapy to taking medication. However, nothing works and the pain has gotten so bad that it affects my daily life, preventing me from carrying out basic tasks such as walking. I went to the doctor to seek help.

The doctor has recommended that I go for back surgery.

I was shocked. I am not ready to go for surgery. Worry, stress, panic-filled my mind, and I could not get a good night’s sleep.

This is what many people face when presented with the option of surgery, however, you are not alone! It is completely normal to feel anxious. But how can you deal with this situation? Here are some tips to help you better prepare for surgery.

First, Educate yourself.

An important step in dealing with surgical anxiety is to be as well informed as possible regarding your illness. Having a complete understanding of the procedure and why you need it and how it’s performed can alleviate some of your worries. Asking the doctor about the procedure and sharing with them your concerns and worries can be one way of becoming more well-informed.

Talking to and asking people who experienced surgery before can also increase your knowledge. Asking how they feel and some ways to cope with surgical stress may help you in your journey to feeling less anxious.

When you are well informed and educated about the situation, you may feel more calm and able to face the operating table.

Secondly, Plan in advance.

You will need to plan what you need to do before and after surgery. Make a list of what needs to be taken care of during surgery and the recovery period, such as familial and job obligations. Allocate your responsibilities to those you can trust and rely on. This will allow you to focus all your energy on getting better and healing, speeding up the recovery process.

Thirdly, Follow the instructions provided by us.

We would have provided you with a lot of information regarding the surgery, e.g what to expect and what to do before and after the surgery. When the detail of the surgery is finalised, we would help in the planning process and support you during the recovery period.

Spring Hope Orthopaedic Spine Surgery clinic would always try other treatment methods such as exercise, physiotherapy and medication to treat your condition. Surgery is always a last resort option, only recommending surgery to 10% of our patients. However not to worry as our surgery has a success rate of 95%(?). We take great care in explaining what the surgery entails and the risks involved.

Please keep in mind that we always want to provide the best possible treatment for our patients. We not only aim to provide excellent medical care but also take care of our patient’s emotional well-being.

Dr Tony Setiobudi is an Orthopaedic & Spine Surgeon at Mount Elizabeth Hospital (Orchard), Singapore.

Can exercise help with arthritis?

December 14, 2021 by Tony Setiobudi

By Dr Tony Setiobudi BMedSci, MBBS, MRCS, MMed (Ortho), FRCS (Ortho)

Almost everyone will experience some form of arthritis as they get older. It occurs when one or more joints become inflamed, causing stiffness and pain that worsen over time. If you suffer from arthritis, moving your body may be the last thing you want to think about.

However, exercising regularly is one of the healthiest ways to reduce arthritis symptoms since exercise increases muscle and bone strength to naturally reduce joint pain.

If you have arthritis, you should understand doing an exercise routine will give you lots of benefits such as:

Aiding joint lubrication and nourishment thus easing joint pain and stiffness
A better range of motion. Improved joint mobility and flexibility
Stronger muscles.
Better endurance.
Better balance.
Improved posture
Improve or maintain the density of your bones
Lower stress levels
Improve your mood
Maintain a healthy and body weight

Did you know that there are different types of arthritis and that they all have different causes and symptoms? Going to the doctor can help you get diagnosed and get started on your treatment plan. The doctor would prescribe any necessary anti-inflammatory medications to help manage the pain. Once joint pain and inflammation are under control, your doctor can help you to choose the right exercise for you, which helps to build the muscles around your joints but doesn’t damage the joints themselves.

Here are exercises for arthritis that can help improve your symptoms while also enhancing your overall quality of life.

Low impact aerobics

Low impact aerobic exercises such as walking, swimming, and bicycling, strengthens your heart and lungs and thereby increases endurance and overall health.

Yoga or tai chi

Both yoga and tai chi combine deep breathing, flowing movements, gentle poses, and meditation. They increase flexibility, balance, and range of motion and reducing stress as well.

Stretching

The ideal stretching routine will be different for each person and depend on which joints are affected and what symptoms occur. However, stretches often involve moving joints of knees, hands, and elbows.

Strength training

Strengthening the muscles around the affected joints can help increase strength while reducing pain and other symptoms.

Even though exercise gives you lots of benefits, not all exercises are suitable for people who experience arthritis. People with arthritis should avoid strenuous exercise including high-impact exercises that put excessive strain on the joints. However, each person is different, an activity may cause pain for one person but may not have the same effect on another person. The thing that you should remember is to know your own limits. You should exercise until you feel tired and not push past your limits. The pain that you feel is your body signaling to you that something is wrong and that you should stop.

Request an appointment with us today to learn more about our treatments for rheumatoid arthritis, osteoarthritis, and many other health conditions. Get further information about the types of exercise most ideal for your arthritis symptoms and overall health.

How Vitamin D Keeps Your Bones Healthy

How does vitamin D deficiency happen?

Sources of Vitamin D

By Dr Tony Setiobudi BMedSci, MBBS, MRCS, MMed (Ortho), FRCS (Ortho)

Move your body

Practice good posture

Adjust the level of your equipment

Find a doctor

Spring Hope Orthopaedic Spine Surgery

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