Ask a Pain Specialist and Anaesthetist: Dr Thor Timothy Anuntapon Chutatape from Mount Elizabeth Novena Hospital Singapore

Ask a Doctor ForumCategory: Anaesthesiology & Critical CareAsk a Pain Specialist and Anaesthetist: Dr Thor Timothy Anuntapon Chutatape from Mount Elizabeth Novena Hospital Singapore
I am Dr Thor Timothy, Anuntapon Chutatape, Pain Specialist and Anaesthetist based in Mount Elizabeth Novena Hospital and Farrer Park Hospital. Ask Me Anything! I am accredited as a Fellow of the Faculty of Pain Medicine Australian and New Zealand College of Anaesthetist (FFPMANZCA), as well as a Fellow of Interventional Pain Practice (USA). I am also Fellow of the Academy of Medicine in Singapore (FAMS) and one of the founding members of its Pain Chapter. I specialise in non-surgical management of chronic pain conditions involving but not limited to : -Headache such as trigeminal neuralgia, tension type headache, migraine. -Shoulder pain such as frozen shoulder. -Back pain which is caused by hernia nucleus pulposus, annular tear, spine degeneration. -Knee pain which is caused by osteoarthritis, ligament & meniscus problem. -Leg pain such as plantar fasciitis -And many more I do this using evidence-based treatment that synergizes therapeutic medications with specialized minimally-invasive pain procedures (radiofrequency, annuloplasty, nucleoplasty, etc) that can be done as an outpatient basis. I was the previous Director of Acute Pain Services in Singapore General Hospital. I am consulted on cases and do procedures in the Parkway Hospitals, Mt Alvernia, Farrer Park Hospital and at major day surgery centres. Learn more about me here: I am excited to be here to share/discuss pain management with everyone. I will be actively answering questions. Whether you've got questions about how to deal with and manage pain in the following areas: back, face, foot, head, knee, neck, shoulder, ask me anything! === Want to ask a question? Submit your question at the bottom of this page. Don’t forget to include your name and email address to get notified when the doctor answers your question.
37 Answers
Marwianti answered 3 years ago
Doctor, I have been feeling pain in my back for the past 7 months. I've seeked treatment everywhere but there is always no improvement. I had an x-ray done but the results didn’t bring any changes to my condition. Please give me a solution, what treatment should I do?

The human back composition is a complex structure built from nerves, muscles, discs, and bones. The problems with any of these components can lead to back pain.

Roentgen data alone may not be sufficient to see the detailed image required from the spines structures. Advance analysis of the spines structures will require an MRI scan.

Mulyadi answered 3 years ago
Doctor, what is likely the cause of pain in the back of the head, near the ears?

The common pain on the back of the head:

•Occipital neuralgia
Occipital neuralgia is characterized by piercing, throbbing pain in the upper neck, back of the head, and behind the ears, usually only on one side of the head.
Occipital neuralgia can be the result of nerves impingement or muscle tightness. It can also be caused by a head or neck injury.

•Cervicogenic headache
Cervicogenic headache is characterized by a dull, non-throbbing pain that radiates from the neck to back of the head. The pain may spread along the scalp and affect the forehead, temple, and area around eye or ear.
The cause is often related to excessive stress to the neck, cervical osteoarthritis (spondylosis), a damaged disc, or whiplash-type movement that irritates or compresses a cervical nerve.

•Tension type headache
Tension type headache is quite common and often described as a feeling like tightness on the back of the head. It is related to muscle tightness which can be a response to stress, depression, head injury, or anxiety.

Ricky Fardiansyah answered 3 years ago
The soles of my feet hurt when I walk, like as though there is something stabbing me, although I only walk inside the house. Why is this so, Doc? I don’t have uric acid problems.

Some possible stabbing foot causes:
1. Plantar fasciitis
Plantar fasciitis is an inflammation of the fibrous tissue (plantar fascia) along the bottom of your foot that connects your heel bone to your toes. (Please refer to the first picture)
The pain is usually worse in the morning when you take your first steps out of bed, or after you have been sitting for a while.

2. Diabetic foot pain
High blood sugar can damages the nerves that send signals from your feet. Diabetic neuropathy can cause numbness or tingling in your toes and feet. Another symptom is a burning, sharp, or aching pain.

3. Metatarsalgia
When the head of one metatarsal bone presses against another, the small nerve is caught between them and starts to become inflamed. This causes metatarsalgia.

Anna answered 3 years ago
Doctor, my left ankle has been swollen for the last 2 months. I have seen a doctor several times, but to no improvement. It hurts to walk. My feet are the flat feet type. What is the solution? I have been wearing sandals with bulges, the one that is for plantar feet.

For some people, flat feet may causes foot pain, particularly in the heel or arch area. Pain may worsen with activity. Ankle swelling can also occur.

What you can do:

•Rest, try to know your feet limit. Avoid activities that aggravate your condition such as : jogging, running, jumping and long walk. You may walk inside the swimming pool or swim.

•Continue to use your arch supports.

•Daily stretching. Some people with flatfeet also have a shortened Achilles tendon. Exercises to stretch this tendon may help. You may want to follow this video:

•Medications. Over-the-counter pain relievers might help to reduce pain and swelling.

•Weight loss. Losing weight can reduce stress on your feet.

Mustika answered 3 years ago
Hello doctor. Why do I feel throbbing pain in between my toes? It makes me limp.

The possible causes include:

• Freiberg disease. A form of avascular necrosis in the metatarsal bone of the foot.
•Damage to the nerves in the foot (Morton neuroma)
•Metatarsal joint pain
•Sesamoiditis. Inflammation of the sesamoid bones and the surrounding tissues
•Age-related thinning of the fat pad cushion in the ball of the foot

You may need further check up to know the cause.

Ratnasari Pertiwi answered 3 years ago
Doctor, can acupuncture cure the pain in the shoulder? My shoulder aches. A friend of mine asked me to see an acupuncturist, but I am afraid.

Whether acupuncture will help or not it depends on the cause of your shoulder pain. It may help to relieve your pain but may not help in repairing the anatomy issue.

Png G L answered 2 years ago

I have consistent monthly migraines that occur on the right side of my head - the pain spreads to the right side of my back. To relieve the pain, I sometimes have to lay down on my left side. What condition do I have?

Pain in the head can be due to migraines, tension headaches, as well as other causes. Sometimes if it runs down the back of neck or back, it may be due to pain from the facet joints which are the small joints of the neck or back. It is important to make sure that the pain is not from more dangerous causes such as infection, bleeding, cancer or some form of vessel disease. Do see a doctor who may ask some more questions and do a physical examination and order some investigations like an MRI to ascertain what the problem is.

Kston Ng answered 2 years ago

I feel pain in a certain spot on my spine every morning when I wake up. I have to have it be massaged with some ointment before the pain is relieved. The pain appears to be getting worse though with time. How do I treat it? What examination should I undergo?

Which part of your spine is painful?
The spinal column is made up of:
-7 cervical vertebrae are located in the neck
-12 thoracic vertebrae are located in the upper back
-5 lumbar vertebrae are located in the lower back
-The sacrum and coccyx
Cervical and lumbar spine are the 2 most common parts that have issues.

If you have any symptoms below, please seek medical attention immediately:
-Severe limitation during neck active range of motion in all directions.
-Hand or leg numbness or segmental sensory changes
-Hand or leg weakness
-Unsteady gait
-Bowel and bladder disturbances
-Radiating pain down to one or both leg
-History of malignancy
If the pain has persisted for more than 2 weeks, don’t let it become chronic pain. Consult with your Doctor, you may need to get a scan or blood test for further examination.

Ryan answered 2 years ago

What is the cause of pain right below the chest? I feel the pain when I twist my upper body to my right or left. When I press the area, it doesn’t hurt. The pain only comes with movement.

Several disorders can cause chest wall discomfort. These include: diseases of the skin, ribs, its surrounding muscles, as well as the internal organs such as heart and lungs can all cause pain that may be referred over the chest.

Based on your description, the pain is unlikely due to cardiac chest pain. Some possible causes :
– Costochondritis
Pain usually in the area along the sides of the breastbone.
– Lower rib pain syndrome / slipping rib syndrome
Pain in the lower part of the chest or in the abdomen.
– Intercostal muscle strain
Usually the pain occurs due to contact sports, trauma, excess twisting, or twisting while lifting.

Tan B L answered 2 years ago

Last year, I went for chiropractic treatment to treat the pain in my hip. There was a painful knot there. However after multiple sessions, the pain still persists. What should I do?

Hip pain is can be from various causes. Pain on the front of the hip and groin is commonly associated with hip joint, such as osteoarthritis and hip labral tears.
Pain on the back of the hip is associated with piriformis syndrome, sacroiliac joint dysfunction, lumbar radiculopathy, and less commonly ischiofemoral impingement. It may also be due to pain from the lumbar facet joints that are affected by the wear and tear of ageing.

Pain over the outer side of the hip may be due to greater trochanteric pain syndrome.

There are some conditions which need additional treatments other than chirotherapy . Please consult your medical doctor to find out the cause of the pain so you can receive a suitable treatment.

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