Frequently Asked Questions
What is the cause of my back ache?
Backache is caused by a large number of causes, most of them originating from the spine. Some examples include a “slipped” or prolapsed intervertebral disc, musculoskeletal back pain, spinal stenosis, spondylolithesis etc. These can be broadly classified as degenerative in one way or the other. Sometimes backache can be caused by more serious conditions, like an osteoporotic fracture, spinal infections and spinal tumours. Occasionally extra-spinal causes (i.e. outside the spine) can also give rise to backache
The diagnosis of the cause of backache is achieved through a careful evaluation of the patient through taking a clinical history and physical examination. The severity of the pain and the unremitting constant nature of pain are 2 examples of how backache could be evaluated. Further information could be obtained by radiological imaging, which includes X-rays. Sometimes more sophisticated imaging techniques are required, e.g. magnetic resonance imaging (MRI), computerized tomography (CT) scans and myelography. Sometimes blood tests may also be required.
I have this pain in my buttock going down my leg; what is it caused by?
Pain radiating down the leg is most often a sign of a pinched nerve in the spine, though not always. Sometimes this is caused by “sciatica”, which is a sharp, current-like or burning sensation radiating down a particular dermatome. It could also be due to “claudication”, which is often described as tiredness, weakness or numbness in the leg(s) after walking a particular distance. Occasionally pain radiating in the leg could also be secondary to hip or knee pathology.
Symptoms of this nature need to carefully evaluated especially to exclude injury to spinal nerves.
What is degenerative disc disease of the spine?
In a young individual the inter-vertebral disc in the back or neck serves as cushion-like supports for the spine. With degeneration (which usually follows aging) their ability to act as supporting cushions decrease, often resulting in pain. Other causes of degenerative disc disease include previous injury or infection of the disc. There is also a likely hereditary component.
What causes neckache / neck pain?
There is a wide variety of causes for neck pain. A common cause is that of cervical spondylosis, and/or with a slipped disc in the neck. These are largely degenerative in nature. This combined with poor habitual or postural care can result in recurrent neck issues. Other more serious but rarer conditions include tumours and infections of the neck.
Neck symptoms can be broadly classified into axial neck pain, cervical radiculopathy, cervical myelopathy or a combination of the above 3.
What is a torn meniscus (in the knee)?
The medial and lateral menisci are 2 crescent shaped fibrocartilage in the knee that are essential for the normal functioning of the knee. When a meniscus get injured, it might get caught in the knee joint, causing pain and affecting the normal motion of the joint.
What is arthritis?
Arthritis (or the most common form “osteoarthritis”) occurs when the cartilage normally covering the involved joint is damaged, exposing the underlying bone of the joint. The most commonly affected joints include the knee, hip and hands, although any joint can be involved. This commonly will lead to pain, especially on weight bearing. Osteoarthritis can be subdivided into primary or secondary osteoarthritis. Primary osteoarthritis refers to a condition where there is no obvious cause, for which a degenerative cause is most likely. Secondary osteoarthritis occurs when there is a known cause which contributes to the damage of the knee joint. Some examples include gout, rheumatoid arthritis, previous trauma or previous infection of the knee.
Following a strain or sprain, should one apply heat or ice/cold to the injured area?
Both heat and cold serve different purposes in the course of such injuries. Ice and cold in the acute/early stage serves to decrease the amount of swelling that is likely to develop. The common acronym “RICE”: rest, ice, compression and elevation would be useful in the acute setting to help reduce pain.
Heat has a general soothing effect and serves to increase the blood flow to a region, thereby increasing the healing potential. It is therefore more likely useful when the acute injury situation has subsided.
What is a frozen shoulder?
Frozen shoulder, or adhesive capsulitis, is a condition which results in stiffening of the shoulder joint and scar formation. The shoulder becomes painful and the range of motion is affected. It is common associated with other shoulder conditions, e.g. traumatic injury to the shoulder, shoulder impingement syndrome. There is also an increased incidence of frozen shoulder in patients with diabetes.
What is tendinitis?
A tendon is a band of tissue that connects muscle to bone. Tendinitis is the inflammation of a tendon, resulting in pin and decreased function. It is commonly the result of overuse of the tendon (e.g. during sports). In particular, excessive repetitive motions can cause irritation and inflammation of the tendon.
Chronic (long-term) tendinitis might increase the possibility of the tendon to tear.
What is bursitis?
A bursa is a fluid-filled space found around our joints. Bursitis is therefore the inflammation of a bursa. It can occur as a result of excessive physical activity or an infection of the fluid in the bursa. General inflammatory conditions like gout and rheumatoid arthritis can also cause a bursa to swell and be inflamed.
Bursitis is common in the shoulder, elbow, hip, knee and ankle.
What is a trigger finger?
Tenosynovitis refers to a group of conditions where tendons in the hand passing through an enclosed space become painful. Some examples include:
a) Stenosing tenosynovitis, or trigger finger
b) DeQuervain tenosynovitis
This commonly occurs when inflammation narrows or irritates the tendons passing through the common tendon sheaths, leading to a limitation of the normal smooth gliding of the tendon.
What is carpal tunnel syndrome?
Carpal tunnel syndrome is a hand condition that causes pain, numbness and tingling sensation in the hand. It is caused by a pinched nerve in the wrist. A number of factors can contribute to carpal tunnel syndrome, including the anatomy of your wrist, certain underlying health problems and possibly patterns of hand use.
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