Spine Archives - Orthopaedic Spine Surgery Singapore

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.

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.

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.

Chronic Back Pain and Neuropathic Pain

June 1, 2021 by Tony Setiobudi

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

Back pain is a very common problem in our society. Most of them are self-limited. Some become chronic back pain which is disturbing and difficult to treat. I am going to explain how neuropathy contributes to the development of chronic back pain.

Neuropathic pain is distinct from other types of pain. If a person breaks a bone or got a cut, pain signals are carried via nerves from the site of the trauma to the brain. That is how we can feel pain when we have an injury. With neuropathic pain, however, pain signals originate in the nerves themselves.

How Neuropathic Pain Develops

In many cases, the nerves become damaged or dysfunctional after responding to an injury or trauma, causing hypersensitivity to pain. The nerves then send faulty signals of pain even when the injury has healed. Neuropathic pain or neuropathy, is a chronic condition, meaning it does not go away. Instead, the pain becomes the disease process. An estimated 7 to 10% of people have neuropathic pain. Chronic back pain is a common example of neuropathic pain.

When Back Pain Causes Neuropathy

Neuropathy can result from any type of pain that compresses or impinges on a nerve. A slipped disc, for example, could press against a nearby nerve, causing pain. Neuropathic pain originating from the back or spine may include:

Chronic pain radiating down the leg (sciatica) or the arm (cervical radiculoapthy)
Chronic back pain

Why Early Treatment is Crucial

Early treatment is important, since more aggressive treatment may be needed if symptoms are not addressed soon. Over time, exposure to significant pain can cause changes to the central nervous system that make the body become more sensitive to even a slight touch. This phenomenon is known as central sensitization.

As with other types of chronic pain, delays in treatment may also make other health problems more likely. Depression, anxiety, difficulty sleeping, and an inability to work and take part in other activities are some health issues associated with untreated neuropathy.

Managing Chronic Pain

Chronic back pain does not go away completely even with the right treatment. The treatment aims to manage the pain so that the person can be functional. The first step is to get a thorough medical evaluation to determine the cause of the pain. It can be muscle strain, arthritis, slipped disc, or other things.

The medical treatment depends on the cause of the pain. Whatever the problem is, there are a number of effective strategies for coping with chronic back pain.

Reduce the stresses in your life. It may be your job or problems in the family. You have to try your best to sort out this problem
Have enough sleep. Our body carries out repair work when we are asleep.
Avoid activities that worsen your pain. E.g. bending down, prolonged sitting, and carrying heavy things.

I hope this information is useful to all of you.

Problem in Your Buttock Can Cause Low Back Pain

June 4, 2018 by Tony Setiobudi

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

80% of the population suffer from low back pain at least once in their life time. Sometimes, low back pain is caused by injury to the muscles, joints or the discs in the lumbar region. Other time, it is related to subtle wear and tear changes that cause gradual wearing down of the cartilage or the disc.

When there is significant pain in the buttock, it may be originating from the sacroiliac joint which is a joint that connects the spine and the hip bones. Sacroiliac joint is a common cause of low back pain. However, the diagnosis may not be obvious and often requires thorough physical examination.

There are two sacroiliac joints, one on each side of the spine. These joints transfer the weight of the upper body to the lower limbs. This joint operates under tremendous strain during activities like running, jumping and sitting. Unlike the knee joint which wide range of motions, sacroiliac joint has a very little movement.

Problem in Your Buttock Can Cause Low Back Pain

Anatomy of sacroiliac joint

Problems related to the sacroiliac joint is called Sacroiliac Joint Dysfunction (SIJ dysfunction). It affects both men and women but women tend to get it more. The ligaments stabilising the sacroiliac joint become lax during childbirth causing it to be prone to injury.

Apart from injury, weak muscles surrounding the joint are often the cause of SIJ dysfunction. If this is not addressed, the pain persists and becomes chronic. The nerves supplying the joint constantly send pain signal to the brain causing discomfort. Sometimes, the pain signal process continues independently of the original issue. This means after all identifiable problems are addressed, the pain can still persist.

People with SIJ dysfunction complain of low back pain very close to the buttock. It can affect one side or both sides of sacroiliac joints. The pain may radiate to the hips, thighs and calves especially when the nerves crossing in front of the sacroiliac joint are irritated. Initially, the pain comes on after prolonged sitting. When it gets worse, other activities like walking, climbing and running can trigger the pain.

SIJ dysfunction can be treated with medications and physical therapy. Strengthening the surrounding muscles and the core muscles helps to stabilise the sacroiliac joint. More severe form of SIJ dysfunction may require more invasive procedures like steroid injections or radiofrequency ablation. Radiofrequency ablation is done by passing heat in the form of electric current to desensitise the nerves supplying the sacroiliac joint. It can provide an excellent pain-relief. Operation to fuse the sacroiliac joint is rarely required. It is reserved for severe debilitating problems in the sacroiliac joint that do not respond well to less invasive forms of treatment.

Tumor Tulang Belakang – Salah Satu Penyebab Sakit Pinggang

November 1, 2017 by Tony Setiobudi

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

Pernahkan anda mengalami sakit pinggang?

Kebanyakan kita menyepelekan sakit pinggang yang sebagian besar akan sembuh sendiri jika beristirahat. Padahal, bisa jadi itu bukan sakit pinggang biasa. Untuk sakit pinggang yang berhubungan dengan masalah otot dan degenerative memang tidak serius. Tapi, sakit pinggang ini bisa menjadi masalah serius jika disebabkan oleh tumor.

Berikut ini adalah contoh kasus tumor tulang belakang.

Ibu Maria (bukan nama sebenarnya), 42 tahun, mengeluh sakit pinggang selama 3 bulan. Berat badan turun 5 kg. Dua hari sebelum ke dokter, secara tiba-tiba beliau tidak bisa jalan karena kaki merasa sangat lemah. Hasil pemeriksaan lengkap menunjukkan ibu Maria menderita tumor tulang belakang yang menjepit saraf. Tumor ini menyebar dari usus besar (tumor primari). Saraf yang terjepit menyebabkan kelemahan di otot kaki sampai pasien tidak kuat berjalan. Beliau menjalani operasi untuk mengambil tumor, membebaskan saraf dan menstabilkan tulang belakang. Setelah operasi ibu Maria bisa berjalan kembali dengan normal. Pasien menjalani chemotherapy dan radiotherapy untuk membasmi tumor lebih lanjut.

Tumor di tulang belakang adalah penyebab sakit pinggang yang berbahaya yang memerlukan penanganan segera. Tumor ini dapat membesar secara cepat dan tiba-tiba. Jika menjepit saraf, pasien bisa mengalami kelumpuhan secara tiba-tiba. Sering kali tumor di tulang belakang terjadi karena penyebaran sel tumor dari tempat lain seperti di usus, prostat, payudara dan lain-lain. Banyak sekali pasien yang mengeluh sakit pinggang tanpa keluhan lain seperti kasus Ibu Maria. Dengan pemeriksaan lengkap, tumor di tulang belakang dan asal tumor (tumor primari) bisa ditemukan dan ditangani secara keseluruhan. Jika pasien mengabaikan keluhan sakit pinggang, tumor ini tidak akan terdeteksi atau mungkin akan terdeteksi dalam kondisi yang lebih parah.

Jenis sakit pinggang seperti apa yang tidak boleh diabaikan?

Sebagian besar sakit pinggang tidak berbahaya. Jika sakit pinggang disertai berat badan menurun secara drastis, sakit pinggang lebih parah saat beristirahat, atau sakit pinggang yang terus menerus dan tidak pulih lebih dari satu bulan, pasien perlu segera periksa ke dokter untuk menegakkan diagnosa apakah hal ini berhubungan dengan tumor.

Mengapa tumor tulang belakang mengakibatkan sakit pinggang?

Tumor tulang belakang dapat menyebabkan sakit pinggang karena beberapa hal.

Tumor membuat tulang belakang menjadi tidak stabil.
Tumor membuat tulang belakang rapuh dan gampang patah. Sakit pinggang meningkat secara tiba-tiba jika ada patah tulang di punggung.
Tumor bisa menjepit saraf. Hal ini menyebabkan sakit pinggang terkadang menjalar ke kaki atau ke perut dan dada.

Apakah pentingnya untuk mendeteksi tumor tulang belakang secara dini?

Dengan berjalan waktu tumor bisa makin membesar, jika masih berukuran kecil tentu saja lebih gampang dioperasi dari pada sudah berukuran besar. Lebih baik lagi dioperasi sebelum tumor menjepit saraf dan mengakibatkan kelumpuhan.

Jadi jangan menyepelekan sakit pinggang yang tidak kunjung membaik apalagi jika berat badan menurun dan sakit pinggang memburuk saat istirahat. Segera periksalah ke dokter untuk mencari penyebabnya.

Dr Tony Setiobudi adalah spesialis bedah tulang dan super-spesialis bedah tulang belakang di Mount Elizabeth Hospital (Orchard), Singapore. Dr Tony menangani masalah tulang, sendi, saraf, otot dan ligamen pada orang dewasa dan anak. Dr Tony mempunyai keahlian khusus dalam penanganan saraf terjepit (HNP & spinal stenosis) & masalah tulang belakang seperti nyeri punggung & leher, scoliosis, postur bungkuk (kyphosis), tumor & infeksi tulang belakang, cedera saraf besar (spinal cord) & patah tulang osteoporosis.

Operasi Postur Bungkuk Dapat Menambah Tinggi Badan

August 18, 2017 by Tony Setiobudi

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

Postur bungkuk adalah masalah medis dan masalah estetika. Orang dengan postur bungkuk sering jatuh karena pandangan ke depan terganggu.

Postur bungkuk bisa disebabkan oleh bermacam-macam masalah medis:

Ankylosing spondylitis
Scheuermann’s disease
Proses penuaan (ageing)
Patah tulang belakang
TBC tulang belakang.

Postur bungkuk yang disebabakan oleh ankylosing spondylitis, Scheuermann’s disease dan TBC tulang belakang sering kali parah. Karena terlalu parah, sering kali pasien tidak dapat beraktifitas dengan baik. Operasi untuk menegakkan postur bungkuk ini perlu dilakukan. Dengan teknologi modern, operasi tulang belakang untuk menegakkan postur bungkuk menjadi jauh lebih aman.

Postur bungkuk ini memerlukan pemeriksaan yang menyeluruh. Ada beberapa kriteria untuk operasi terutama untuk postur bungkuk yang parah. Operasi dilakukan dengan bius total. Tulang belakang ditegakkan dengan menggunakan rods dan screws. Selain pandangan ke depan lebih normal, setelah postur lebih tegak pasien juga akan lebih tinggi. Secara estetika, pasien juga terlihat lebih tegap dan percaya diri.

Operasi menegakkan postur bungkuk ini lebih baik dilakukan secara dini semasa pasien masih muda dan sehat. Terkadang untuk pasien manula, operasi ini tidak mungkin untuk dilakukan terutama jika pasien menderita banyak penyakit kronis lain seperti diabetes, tekanan darah tinggi, sakit jantung dan lain-lain yang membuat resiko operasi lebih tinggi.

Pasien perlu tinggal di rumah sakit selama 5-7 hari. Setelah operasi pasien dirawat di ICU atau high dependency unit selama 1 malam. 2 hari setelah operasi pasien melakukan fisioterapi untuk berjalan. Setelah operasi, rasa nyeri dihilangkan dengan obat analgesik sehingga pasien tetap merasa nyaman.

Osteoporotic Spine Fracture

February 21, 2017 by Tony Setiobudi

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

When the bone is soft or osteoporotic, it can fracture with trivial injury or even without injury. Spine bone is one of the most commonly affected bones in osteoporotic fracture. It can be debilitating. But it doesn’t need to affect you. You can prevent osteoporosis by having regular screening and early treatment.

Mild fracture can heal by itself. The pain may not be too bad.

In severe fracture, the back pain can be very excruciating to the extent that the patient is unable to sit, stand and walk for a period of time. If the pain prevents the patient from getting out of bed, surgical treatment is required. The surgery depends on the stability of the spinal column. If the spine is stable, the patient needs cement injection (vertebroplasty) to strengthen the bone. If the spine is not stable, bigger surgery is required with the use of spinal implants. Surgical treatment for severe fracture has a high success rate. Immediate stability of the spinal column after surgery will result in significant reduction of pain.

Osteoporotic treatment to strengthen the bone is important regardless whether surgery is required. This is to reduce the risk of having another osteoporotic fracture.

The Danger of Excessive Mobile Use

February 20, 2017 by Tony Setiobudi

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

People of all ages are glued to their mobile phones. Other than the social impact, this phenomenon causes serious health issue to the neck.

Neck posture is bending forward for many hours a day, everyday, for many months and years. Can you imagine our teenage children are having this habit from such a young age? The damage to the neck is accumulative and irreversible to some extent.

Excessive mobile use causes upper cross syndrome

The more forward is the neck posture, the harder the neck muscles need to work to maintain the head up. This cause muscle imbalance and neck pain. This condition is called “Upper Cross Syndrome”. The neck pain does not get better unless the cause is identified and avoided.

Overtime, this causes chronic pain which is even more difficult to treat.

Excessive mobile use causes premature degeneration on the discs in the neck

Forward neck posture exerts excessive amount of pressure to the discs in the neck. This causes premature degeneration on the discs. The discs become thin and bulging. Sometimes, it causes narrowing of the spinal canal and nerve compression.

The symptoms do not appear immediately. It may take years to manifest. But sure it will. Thus, it is important to limit mobile use.

There are some tips that you can do to reduce the damage to the neck when you need to use your mobile excessively

Read your mobile at the eye level so that you neck posture is still upright.
Do regular exercises
Do strengthening of the inner neck muscles to balance up

The Danger of Spinal Cord Compression

February 19, 2017 by Tony Setiobudi

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

Spinal cord is a big nerve that connection the brain with the arms and legs. External compression to the spinal cord can interfere with the normal function of the nerves. People with spinal cord compression do not necessarily complain of neck pain or back pain. Spinal cord compression can occur in a few situations:

Slowly because of wear and tear or degenerative process.
Rapidly because of tumor or infection.
Suddenly due to fracture

Whatever the cause is, the treatment of spinal cord compression is surgery to free up the spinal cord. Spinal cord compression from slow process results in difficulty walking and difficulty using the hands. Patients with this condition rarely becomes paralysed. The surgery does not need to be done urgently. However, when the spinal cord compression occurs rapidly or suddenly, the patient may become paralysed. This requires urgent surgery to free up the spinal cord.

Spinal cord compression should not be left untreated.

How to Prevent Back and Neck Pain when Working from Home

Move your body

Practice good posture

Adjust the level of your equipment

Find a doctor

Solutions to Sleep with Back Pain

Back Pain Risk Factors You Can Change