General Orthopaedic Archives - Orthopaedic Spine Surgery 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.

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.

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 to protect our joints against osteoarthritis?

December 14, 2021 by Tony Setiobudi

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

What is Osteoarthritis?

Osteoarthritis refers to damage or breakdown of the joint cartilage (the soft tissue that covers the joint’s surface) between bones. When it wears out, bones rub against each other, causing pain, redness, swelling, and stiffness. It occurs most often in the hands, knees, hips, and spine. Osteoarthritis occurs most often in older people, although it may occur in adults of any age. Osteoarthritis is the most common joint disorder.

Causes

Osteoarthritis is caused by joint cartilage damage. Repetitive stress accumulates on the joints as you grow older and hence the elderly are the ones who are most likely to suffer from it.

Other causes of joint damage are past injuries such as torn cartilage, dislocated joints, or ligament injuries. Obesity and poor posture also can cause osteoarthritis.

Risk factors

50% of adults ages 65 and older suffer from osteoarthritis.
Being overweight or obese increases the risk for osteoarthritis as the extra weight puts stress on joints causing more wear and tear.
It tends to run in families
Injury or overuse. Severe injury to a joint can lead to osteoarthritis. Injury may also result from overuse or misuse over time.

Treatment

There are ways to slow the progression:

There’s no cure for osteoarthritis, but the condition does not necessarily get any worse over time. There are several ways to slow the progression of osteoarthritis.

Exercise

Exercise is the best medicine to strengthen the muscles around your joints and help to relieve stiffness. For example, you can switch from running to cycling or swimming.

Weight maintenance

Maintaining weight is also another key to slowing arthritis. Being overweight can put a strain on your joints and cause pain. Carrying less weight usually means feeling less pain because it helps relieve the pressure.

Medications

These may include pain relievers and anti-inflammatory medicines. May be taken by mouth as a pill or rubbed on the skin as a cream.

Injections

Your doctor may offer steroid injections when conventional treatments are ineffective. The injection will be made directly into the affected area. Steroid injections work quickly and can ease the pain for several weeks or months.

Joint surgery

Surgery for osteoarthritis is only needed in a small number of cases if other treatments as mentioned above have not been effective or when one of your joints is severely damaged. Joint replacement surgery is very effective to reduce the pain and restore the functions of the joint.

It is important to know your health check early so your osteoarthritis can be treated as early as possible. You may check if you have a risk of osteoporosis here.

Foods to ease arthritis pain

December 14, 2021 by Tony Setiobudi

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

“Is there a special arthritis diet?”. We often hear this question from people with arthritis. An anti-inflammatory diet may help to fight inflammation and improve joint pain and other symptoms.

What is an anti-inflammatory diet? It is essentially a diet that reduces inflammation by eating anti-inflammatory foods and avoiding the ones that do. Before we continue, we should have a basic idea of what inflammation is. When you hear the word inflammation, you might picture a swollen knee, a bruised ankle or scraped elbow. Those are the signs of inflammation or trauma to the body, but there’s more to it. The long term chronic inflammation, such as like rheumatoid osteoarthritis or cancer, occur within our bodies over a long period of time, often without visible symptoms,

The good news is that one of the most powerful ways to combat inflammation is found within your fridge and not within pills. The food that you are eating effects inflammation and hence your health. Following an anti-inflammatory diet is of the easiest ways to improve our health.

Research shows that what you eat can affect the levels of C-reactive protein (CRP) – a marker for inflammation in your blood. Choosing the right anti-inflammatory foods allows you to relieve pain and reduce inflammation. The diet will not cure arthritis, however is an effective way of controlling symptoms, maintaining a healthy weight and reducing the risk of developing other health problems.

Foods to Eat

This is a list of foods that can reduce the risk for inflammation:

Fruits.

Eat fruits that are rich in antioxidants. They are fruits that are dark blue, purple or red in colors such as cherries and plums.
Eating fibrous fruits such as apples and pears are great as well

Vegetables.

Eat more dark-coloured leafy greens, like spinach, collards and kale

Whole grains.

Whole grains such as oatmeal, quinoa are packed with fiber.

Nuts, seeds and healthy fats.

Natural peanut butter, olive oil, almonds, chia seeds, and flax seeds are staples in this healthy eating plan.

Fish.

Fish especially salmon, are some of the best anti-inflammatory foods due to their healthy unsaturated fats and omega 3 fatty acid content.

Legumes

Examples are beans and lentils, which are high in fibre and protein, so they help keep you full plus regulate your digestive system

Keep in mind that each body is different. For example, nuts are considered anti-inflammatory, but if you are allergic do not eat them.

Foods to avoid

You can also reduce your arthritis by avoiding foods and drinks that trigger inflammation in the body such as.

Processed meats. They are high in saturated fat, which causes inflammation such as sausages, ham, salami include one processed meat.
Refined sugars such as soft drinks, cookies, candies, ice cream
Trans fats. They are mostly found in deep-fried foods, fast foods and commercially baked goods
Refined carbs. They are primarily white flour products including gluten, white rice, white bread and pasta.
Alcohol

Diet is not the only factor in causing inflammation, but it can help reduce or prevent the problem from worsening. It should not be viewed as a miracle cure but rather as a lifestyle choice that can improve your health and should be a part of your plan of care.

Natural ways to build strong bones for life

December 14, 2021 by Tony Setiobudi

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

Our bones are very important because they support, stay upright, and allow us to move. They protect our brain, heart, and other delicate internal organs from injury. They provide support for your muscles and supply key minerals like calcium and phosphorus when the body needs them.

However, the older you get, the harder it is to maintain bone strength because the bone loses its density. Bone density loss can lead to a range of issues, including osteoporosis, fractures, and even life-threatening falls. How to keep our bones strong? Fortunately, many ways can help you build strong bones through what you eat and lifestyle habits. It’s never too late to start!

Here are natural ways to build strong bones for life:

Eat high Calcium Foods

Calcium is the most important mineral to maintain strong bones. The bones act as a storage bank for calcium. The average calcium needed for all children ages 9-18 needs high calcium;1300mg, all adults under age 50 average is 1000mg, while adults aged 51 and older need 1,200 mg of calcium per day. The most common people known are milk as a source of calcium. Other dairy products such as yoghurt, cottage cheese, and fish are great for adding calcium.

Get Plenty of Vitamin D and Vitamin K

Vitamin D is a key nutrient that helps bones absorb calcium, magnesium, and phosphate. The most important compounds in this group are vitamin D3 and vitamin D2. There are 2 natural ways to get vitamin D; natural sunlight and food. Your body produces vitamin D naturally when it’s directly exposed to sunlight. You also can get it through certain foods such as mackerel, salmon and tuna, egg yolks.

Increase your intake of vegetables- specifically leafy greens like kale, collards, spinach, and bok choy. These vegetables also contain magnesium, potassium, and vitamin K that contribute to overall health. Prunes and plums are also known to increase bone density.

Include Foods High in Magnesium and Phosphorus.

Magnesium helps you absorb and retain calcium in the bones. Meanwhile, phosphorus is a key component of bones- roughly 85 per cent of the phosphorus in your body can be found in your bones and teeth. Fruits, vegetables and grains provide other minerals crucial to bone health such as magnesium and phosphorus. You can take walnuts, peanuts and pecans, especially almonds are a good source of magnesium and phosphorus too. Avocados, edamame, oatmeal are also good for your diet mixed food.

Perform Strength Training and Weight-Bearing Exercise

Maintaining an active lifestyle that includes regular exercise may be the most important thing that you can do to keep bones healthy and strong. Specifically, activities that require muscle strength such as lifting weight can improve muscle mass and support bone health. Other regular weight-bearing exercises like walking, jogging, dancing or step aerobics can protect your bones. Any activities that go against gravity are also helpful. Just like stomping and jumping, the force of hitting the ground during these weight-bearing exercises stimulates the bones, resulting in increased density. As we get older, balance training is also important to prevent falls.

Maintaining a healthy weight

People should keep a healthy weight. People who are underweight have a higher risk of developing bone disease, while excess body weight puts additional stress on the bones. One research study found repeatedly losing and regaining weight may lead to significant bone loss over a person’s lifetime. Maintaining a stable healthy weight is your best when it comes to protecting your bone health.

Bone health is important at all stages of life. Fortunately, there are many nutrition and lifestyle habits that can help build and maintain strong bones. If you are concerned about your bone health, or your risk factors for osteoporosis, consult with us.

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 tumour & infection, spinal cord injury, osteoporosis fracture, spinal stenosis and slipped disc.

Osteoporosis Risk Check

October 14, 2021 by Tony Setiobudi

Could you be at risk of osteoporosis and fractures?

[Read more…]

Could Long Run Lead to Osteoarthritis?

November 30, 2017 by Tony Setiobudi

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

Could Long Run Lead to Osteoarthritis?

Many people believe that running is bad for the knee and hip joints. In contrast to what many people believe, running is not only good for our hearts and lungs, it is great for our muscles, bones, and brains as well. In fact, people who run regularly are less likely to develop knee osteoarthritis compared to people with sedentary lifestyle.

Here are some of the benefits of running.

People who run regularly have more ideal body weight. Over weight puts a lot of pressure to the joint and muscles thus they wear out faster.
People who run regularly have stronger muscles. Quadriceps muscles are the stabiliser of the knee joint. The knee joint is more stable and has less wear and tear when the quadriceps muscles are strong.
Exercise helps to release the body anti-inflammatory substances. Osteoarthritis is caused by inflammation in the joint. Thus, exercise can slow down osteoarthritis by reducing the inflammation in the joint.
Exercises helps to produce greater supply of joint fluid (synovial fluid). It acts like a lubricant to the joint reducing the rate of osteoarthritis.

It does not mean that people who run regularly don’t get osteoarthritis. However, they are at a lower risk of getting one.

What can you do to reduce that chance of osteoarthritis if you like running?

Have adequate warm up before exercise so that you don’t strain your muscles
Have proper shoe wear appropriate for running
Run in even surface to reduce the risk of injury

How Vitamin D Keeps Your Bones Healthy

How does vitamin D deficiency happen?

Sources of Vitamin D

What is Osteoarthritis?

Causes

Risk factors

Treatment

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

Could you be at risk of osteoporosis and fractures?

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

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