dr. Chang Kok Chun asked 3 years ago
- General Orthopaedics
- Trauma Orthopaedics
- Spine
- Sport Injuries
- Joint replacement
- Pain intervention
- General and Trauma Orthopaedic Surgeries
- Spine Surgeries ( Open, Minimal Invasive, Endoscopic )
- Arthroscopy & related surgeries
- Arthroplasty Joint replacement surgeries
- Percutaneous pain intervention procedures
- Master Degree in Orthopaedic Surgery ( University Malaya )
- CMIA ( NIOSH certified disability independent assessor )
- AO Trauma Fellowship ( Austria )
- Fellowship in Spine Surgery ( Hong Kong )
- Medical School, University Malaya, Malaysia
Sami Mawijan answered 3 years ago
dr. Chang Kok Chun
replied 3 years ago Hi, good day.
You are having shoulder pain.
Though the pain radiate to the neck, the origin of the problem is likely to be at the shoulder joint itself as the pain is aggravated by shoulder movement. ( not a cervical spine problem )
Shoulder joint is common site of degenerative problem ranging from impingement to rotator cuff tear.
Early disease can be treated by simple subacromial shoulder injection. Advanced disease need MRI scan assessment and probably surgical treatment. Most shoulder surgeries nowadays can be done arthroscopically ( key holes ).
It is important to keep moving your shoulder despite pain, otherwise complication of frozen shoulder with progressive stiffness ensued. Physiotherapy is beneficial.
Teniawinarsih answered 3 years ago
dr. Chang Kok Chun
replied 3 years ago If this is something that happens occasionally, the likelihood of having severe or advanced disease is low.
You may do regular physical exercise to improve your joint flexibility.
If the attack become frequent or persistent, you need to see an Orthopaedic doctor for check up in particular of your lumbar spine.
Narsiti K answered 3 years ago
dr. Chang Kok Chun
replied 3 years ago Pain at the back of knees.
In young people with history of sport injury, this might be symptoms of meniscus injury, which is a supporting structure inside the knee. MRI scan will confirm the diagnosis, and treatment is by arthroscopic surgery.
In middle age people without history of injury, this might be early sign of degenerative osteoathritis of the knee. You may have an X-ray done to assess the condition. If the pain is not severe, you may take short course of pain killer ie one week. Long term improvement might be achieved with oral supplement glucosamine or lubricant injection into knee joint ( Hyaluronic acid ). In resistant case, arthroscopic debridement and repair of cartilage defect can be done.
If there is swelling at the back of knee ( compared to opposite site ) , you might be having Baker's cyst, which is a protrusion of fluid filled sac from the knee. The diagnosis can be confirmed by ultrasound or MRI scan. Surgical removal or arthroscopic decompression is recommended.
Krisna answered 3 years ago
dr. Chang Kok Chun
replied 3 years ago Good day.
You are young, and having a common problem of office workers ie sitting intolerance.
The most common cause of this condition is lumbar disc degeneration with or without annular tear ( wear and tear of disc between 2 segments of spine ).
Your spinal cord and spinal nerve are not affected since you have no leg symptoms.
The diagnosis can be confirmed by MRI scan of lumbar spine, which in T2 image, the affected disc became black color as compare to white color in normal disc.
What you can do is – not to sit too long ie less than 1 hour , sit with good posture, better use ergonomic office chair, do regular back exercise.
If the pain is not getting better, or recur frequently, then a minimal invasive procedure using Radio-frequency needles to treat the painful disc is an option ( percutaneous RF annuloplasty ).
Eka Sila answered 3 years ago
dr. Chang Kok Chun
replied 3 years ago Good morning. Your symptoms is consistent with severe osteoarthritis of the knee. If confirmed by X-ray, the best solution might be surgery ie Total Knee Replacement, especially if you need regular pain killer for relief. Methyprednisolone is a steroid medicine, give fast but short lasting relief. It has a lot of side effects, and is best avoided. In severe osteoarthritis, oral supplement eg glucosamine and knee injection of hyaluronic acid ( lubricant ) probably wouldn't work.
Ellis answered 3 years ago
dr. Chang Kok Chun
replied 3 years ago Hi, good morning. I am not sure what do you mean by ' calcification ' of the knee ? Is it osteophyte ( spur ), loose bodies, pseudogout with calcification of meniscus or gout with uric acid deposit on the joint surface observed during arthroscopy?
Osteophyte mean osteoarthritis of the knee. You may take short term pain killer for exacerbation of pain, Oral supplement eg glucosamine, knee injection of Hyaluronic acid ( lubricant ) or in severe case for knee replacement surgery. Loose bodies need arthroscopic surgery for removal of free floating bone pieces in the knee joint. Pseudogout attack can be treated by knee injection with steroid. Gout arthritis need long term treatment of diet control ( low purine diet ) and regular oral uric acid lowering drug ( allopurinol ).
Yulista answered 3 years ago
dr. Chang Kok Chun
replied 3 years ago Looks like you are having degenerative disc disease of the lumbar spine L4/5. Your condition can be improved with good posture ( ergonomic way of sitting, standing & heavy lifting ) and regular exercise of your spine. If the pain is not getting better or having frequent attacks, then you may go for another round of pain intervention treatment ie the injection at pelvis ( i presumed that is some epidural injection or radio-frequency treatment ). If the relief is not lasting, the last resort would be to have surgery ie spinal fusion. Proper MRI re-assessment must be done to look out for changes over time.
Bagus Nurdin answered 3 years ago
dr. Chang Kok Chun
replied 3 years ago Good day.
You might be having ' Tennis Elbow " , which is a common tendinitis problem (inflammation at the forearm muscle attachment to elbow).
Simple solution is having steroid direct injection to the painful region.
In resistant case, minor surgery is performed to clean up the abnormal / degenerated tissue.
Husein answered 3 years ago
dr. Chang Kok Chun
replied 3 years ago It is probably not related to the previous impact since you had no pain immediately after the impact.
Pain at the back of shoulder is often related to cervical spine disease C5/6 or C6/7 level ( neck ). This is especially so if you are spending long time with computer. Typically the pain is not aggravated by shoulder motion.
However, the cause of pain needed to be confirmed. You are advised to see Orthopaedic Surgeon for diagnosis.
If the pain is indeed related to cervical spine, and you are spending long hour with computer, the pain would improved if you reduced your screen time.
Thank you.
Soeparmi answered 3 years ago
dr. Chang Kok Chun
replied 3 years ago You are probably having Osteoarthritis of the knee, which is due to wear & tear of the knee joint with age.
If pain & swelling have not subsided after one month, you should see an Orthopaedic surgeon to assess the severity of your arthritis ( usually by X-ray ), and hence what is the appropriate treatment.
Pain killer like Voltaren is effective in relief, but not good for long term use because of side effect of kidney damage and gastritis.
Oral supplement for joint health eg Glucosamine is a slow acting remedy, which you need to take at least 2 months to get relief. But if the pain persisted after more than 2 months consumption, then oral supplement probably wouldn't work for you as the arthritis is too severe.
Another option is knee joint injection by Hyaluronic acid with or without PRP blood product.
If you are not responding to the above treatment, joint replacement surgery is indicated. The surgery is suitable for your age, as you are still strong enough for undergoing such surgery and get the maximal benefit as you are still active.