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Health and Fitness

Orthopaedic Treatments for Musculoskeletal Conditions in Singapore

The modern healthcare consumer is more informed, leading to increasing demands on their healthcare providers to provide evidence-based healthcare services, information, and ongoing research. Musculoskeletal problems in the orthopedic setting and the management of painful musculoskeletal conditions have grown into a subspecialty of parallel research and discovery. The orthopedic sector is now internationally committed to developing new knowledge with evidence from analogous orthopedic syndromes, diseases, or problems. It is part of their mission to advance medical knowledge, research, and science through which patient care is provided. With advances in technology and the development of sophisticated medical imaging, many musculoskeletal conditions, once managed solely by orthopedic surgeons, are now managed by physiotherapists, rheumatologists, sports physicians, and pain specialists.

The extensive array of musculoskeletal conditions often associated with both acute and chronic pain related to the spine, hips, knees, shoulders, wrists, hands, and elbows can represent a significant proportion of healthcare presentations and costs to the nation. A lot of Singapore citizens will suffer from back pain at some time in their lives, and treatment costs between $20-50 billion annually. It is now well recognized that prompt diagnosis and treatment of musculoskeletal injuries will decrease the potentially enormous financial and productivity impacts on the individual, society, and industry as a whole.

Understanding the Relationship Between HIV and Lower Back Pain

Lower back pain can be caused by congenital factors such as spondylolisthesis, osteoarthritis, discogenic factors, spondylosis, nerve root entrapment, facet joint dysfunction, posterior inflammation, and muscular spasm. The biopsychosocial model now provides the framework with which lower back pain complaints are analyzed. This includes taking into account work and leisure habits, psychosocial well-being, family history, and health and fitness levels. The healthcare provider has the expertise to provide information on physiotherapy, nursing, lifestyle, and psychological and social factors. Recommendations will also be made for imaging and specialist referral. Patient teaching is also a key factor in controlling low back pain, and it will likely be suggested that core muscle strengthening exercises be performed in combination with yoga, Pilates, or other forms of stretching. Moderate amounts of activity, even if pain is present, are generally advised to help facilitate recovery.

By the age of 30, at least 50% of the population will have experienced lower back pain to some extent. It is the most common musculoskeletal problem worldwide and the leading cause of absence from work. Generally, a benign and self-limiting condition, lower back pain results from problems with the spinal musculature, supporting ligaments, disc, or the spine itself. The lower back has a low threshold for pain and any slight irritation will result in the perception of pain. In common everyday tasks such as bending forward, sneezing, coughing, reaching, and other movements of the lower back, compression, rotation, or flexion forces are placed on the lower back. This stress may result in injury if the spine or supporting structures become compromised. Fortifying, restoring, and protecting these structures can help prevent lower back pain. HIV and lower back pain are often linked due to inflammation and side effects of antiretroviral therapy.

Exploring the Impact of Shingles on Lower Back Pain

Reduction of the severity of pain, its persistence, and the chance of recurrence are the three main goals that can be achieved with early intervention. The length and lasting nature of the lower back pain that afflicts a person are indicative of poor management of viral damage to the sensory nervous system. Sciatica may be another related effect of viral invasion and nerve damage due to the shingles outbreak. Pain management support can help resolve the issue. Patients should not seek out treatment centers that specialize in treating skin infections only. Mention that you have specific symptoms of pain and discomfort beneath the skin. This will alert the staff and the doctor that the viral infection is having an effect that requires their evaluation and support. Highly contagious, shingles patients should remain in home isolation 1-2 weeks after the rash has healed.

While the devastating impacts of shingles on bodily skin regions are well known, its links with lower back pain and sciatica are less explored. The release of varicella-zoster virus structurally damages the nerves that it infects, triggering the pain reaction in the body. The more extensive the neurological functional damage from the varicella-zoster virus, the more severe and lasting the lower back pain and sciatica issues. Hence, treatment protocols are designed to intervene early to reduce the chance of complications from affecting the individual. Both the response to therapy and the delaying of therapy have a significant impact on the overall reduction of chronic pain. Shingles and lower back pain frequently co-occur when the virus affects the nerves in the lower spine.

Treatments for Plantar Fasciitis Foot Pain

Treatment for plantar fasciitis foot pain typically involves rest, stretching exercises, orthotics, and anti-inflammatory medications. Patients with aching, stiff, and painful feet often find it difficult to wear shoes all day and to perform their daily routines. The consequences of affecting work performance or being bedridden for an indefinite period are a constant worry for these individuals. Hence, it is necessary to address and recommend alternative treatments for plantar fasciitis.

There are numerous minimally invasive procedures performed under ultrasound guidance using a fine needle. The rationale for performing ultrasound-guided minimally invasive procedures is to provide a safe and effective alternative treatment modality that requires no anesthesia. These procedures can be performed to aid the diagnosis of plantar fasciitis, release excessive tension in gastro-soleus fascia, treat joint capsule arthrofibrosis, remove asymptomatic bone spurs, and excise critical soft tissue pathologies. The duration of each ultrasound-guided procedure is between 15 to 30 minutes, and patients can, without restrictions, walk out of the clinic once the procedure is complete. By the next day, almost all patients experience immediate reduction in pain and discomfort for the first time in a long while. These ultrasound-guided minimally invasive procedures cause minimal adverse effects such as recovery time, tissue injury, and pain and have resulted in high success rates; 80% of patients with plantar fasciitis have a 4-year relapse-free happy period, and 65% become virtually pain-free. These amazing results can be explained by the ultrasound machine providing a precise 3D real-time visual and continuous imaging of the targets. The real-time visual capability of an ultrasound machine allows the clinicians to visualize the ultrasonic path of where each needle progresses as it pierces through various tissues and structures then withdraws back thereafter. Procuring the ultrasound-guided procedures takes at least 2 weeks since there are no waiting lists required. On the other hand, surgical intervention may require patients to wait for at least 3 months to commence their rehabilitation. There is no need for any inactivating injections following the ultrasound-guided procedures.

Treatment for plantar fasciitis is guided by the degree of changes in the plantar fascia, the long-term interruption in quality of life, and the desire to maintain an individual’s activity level. Conservative measures include modifying patients’ activities resulting in an immediate reduction in pain, changing the type of shoes that they usually wear to ones with better support. Regarding supportive shoes, recommendations include arch supports that elevate only the plantar arch. Patients should refrain from using orthotics that allow an elevated longitudinal arch aimed at reducing the gastroc-soleus junction since tightening this muscle group can result in the loss of normal posterior muscle support of the ankle and forefoot. Likewise, all stretching exercises need to focus on stretching and minimizing the tension on the gastroc-soleus muscle (solitary and gastrocnemius).

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