Heel Pain Treatment: What You Need to Know

If you are a fitness buff, then you may have heard of the “10,000-step goal.” This is actually promoted by Fitbit as a way to get an individual to achieve the150 minutes minimum of weekly moderate exercise recommended by the Centre of Disease Control of the US to keep a healthy body.

Whether you are able to successfully accomplish this on a daily basis or not, the part of the body that does most of the hard work often gets the littlest care. Unlike the other parts of the body, our feet do not always get some sweet loving and pampering as much as they need. Probably, the only time they get attention is when they get injured or suddenly feel discomfort.

One of the common complaints that patients have is heel pain. If you have tried whatever home remedies recommended online to ease your heel pain and are looking for a more effective alternative, then you have stepped into the right place. This article by PhysioActive will tackle things you need to know about heel pain treatment.

Causes of Heel Pain

Heel pain can be caused by different factors. It is important to know what the root cause is exactly in order for treatment to be planned out accordingly. Your heel pain may be due to the following:

  • Achilles tendonitis
  • Ankylosing spondylitis
  • Bursitis
  • Fracture
  • Osteochondroses
  • Plantar fasciitis
  • Reactive arthritis
  • Sprains and strains

Among the causes listed above, the most common causes of heel pain are Achilles Tendonitis and Plantar Fasciitis.

In this article, we will focus more on the heel treatment for Plantar Fasciitis.

What is Plantar Fasciitis?

Plantar Fasciitis

Plantar Fasciitis is a condition that affects the plantar fascia causing it to become inflamed and feel pain. The plantar fascia is a part of your foot that is composed of a thick band of fibrous ligament that connects the front of the foot to the heel. It serves as a shock absorber whenever activities that require weight to be put on the foot are done, such as jumping, walking, and running.

What is the cause of heel pain in the plantar fascia?

The real cause is yet to be determined, although a study done in 2003 and published in the National Centre for Biotechnology Information of the US National Library of Medicine proposed that the cause of heel pain to the plantar fascia may be linked to chronic degeneration rather than inflammation.

What are the factors that can lead to the degeneration of the plantar fascia causing heel pain?

Some of the factors that can lead to the plantar fascia’s degeneration are:

  • Biomechanical irregularities
  • Conditions affecting the muscle, such as weakening or tightening of tissues
  • Flat feet or overpronation
  • Inappropriate or poor choice of footwear
  • Obesity or recent weight gain

What are the symptoms of heel pain?

Patients who complain of plantar fasciitis or heel pain often mention the following symptoms:

  • Burning pain in the heel that reaches the bottom of the foot
  • Dull or sharp in the heel’s bottom
  • Dull or sharp in the mid-foot area

Who are most likely to be at risk of experiencing heel pain?

Anyone can experience heel pain, but those who are at high risk of developing this condition are the following:

  • Adults that are within the age of 40 and 70 involved in active lifestyles
  • Individuals that have flat foot or feet
  • Individuals with foot that have high arches
  • Individuals with jobs that require standing for long hours
  • Individuals that are overweight or obese
  • Individuals that have tight Achilles tendons
  • Pregnant women

Also, heel pain or plantar fasciitis is observed more in women than men.

What heel pain treatment can be considered to address this condition?

Heel pain treatment

Chronic heel pain can be a hassle. Aside from the discomfort it brings, it also affects a person’s daily productivity and overall wellness. It is vital that heel pain is addressed during its early stages as this brings more chances of a successful recovery.

There are two effective ways used by PhysioActive for heel pain treatment. These are:

  • Orthotics
  • Shockwave Therapy

Orthotics remains to be the first option for heel pain treatment. Orthotics is a form of medical device prescribed by doctors that is designed to be worn inside the shoes in order to improve any biomechanical issues or pain affecting the foot. This is usually used together with treatments, such as muscle exercises and stretches to be even more effective.

Shockwave Therapy, on the other hand, makes use of clear high-energy sound waves that are produced by a shockwave generator. When applied to the foot, the sound waves bring rapid extreme pressure to the treatment area, which is then followed by negative pressure. Throughout the treatment, a patient will feel a pulsating sensation on the areas where the shockwave device is administered to. This can be uncomfortable for some, but the discomfort is rather mild and tolerable.

Conclusion

Heel pain or plantar fasciitis is curable. Most feel pain resolve on their own within two days. If your case does not go away after a 48 hours and is already causing you too much pain and discomfort, then it is strongly recommended that you see a doctor immediately as chronic heel pain that is not addressed immediately can lead to long term injury.

 

PhysioActive
Camden Medical Centre #11-05
Singapore 248649
+65 6235 2647

Pap Smear Singapore: How much does it cost?

Among women, cervical cancer is the 4th most frequent cancer globally, with almost 600,000 new cases each year. That’s approximately 7% of all cancers in women, and cervical cancer is responsible for almost 300,000 deaths every year. In Singapore alone, 400 women are diagnosed with the disease with 200 deaths each year. This is very problematic but if detected early, the cancer is preventable and curable.

One of the most effective ways to detect early-stage cervical cancer is the Papanicolaou test, more commonly known by its shortened name, the Pap test or Pap smear. It was developed by Georgios Papanicolaou, a Greek physician who was one of the pioneers in early cancer detection.

The Pap smear is a widely accessible and affordable test and is crucial in the detection and prevention of early-stage cervical cancer. According to research, women whose cervical cancers were detected by a Pap smear had a cure rate of 92% – compare that with the 66% cure rate among women who were diagnosed through symptoms alone. It is undeniable that a Pap smear is an essential medical test that every woman should undergo.

For the benefit of Singaporean women, I have discussed the procedure and costs of a Pap smear in Singapore. I hope that this article will, in one way or another, help save the lives of women who are unaware that they may have cervical cancer.

Pap smear – what is it?

Gynecologist taking womans cervix sample

A Pap smear, also called a Pap test, is a medical procedure that detects cervical cancer in women. The procedure involves the collection of cells from a woman’s cervix, which is the opening of the uterus nearest the vagina.

During the test, some of your cervical cells will be carefully scraped which are then examined if they exhibit any growth abnormalities. This is usually done at in-office and I can guarantee that it is a quick and safe test. Besides cervical cancer, a Pap smear can also help detect infection, inflammation and specific sexually transmitted diseases (STDs).

Should you get a Pap Smear?

I usually recommend to my patients that they should get a Pap smear at least once every three years beginning at age 21. When it comes to risk factors, the most at risk of having cervical cancer are:

  • women who have a human papillomavirus (HPV) infection
  • women who have a weakened immune system, such as those with the human immunodeficiency virus (HIV)
  • women who have genital herpes
  • women who smoke regularly
  • women aged 21 and above
  • women who have regular sexual intercourse and/or with multiple partners

If you belong to any of the groups above, then I suggest you undergo a Pap smear as early as possible.

On the other hand, if you have had a hysterectomy, which is the surgical removal of the uterus for noncancerous reasons, then you most likely no longer need to get a Pap smear. Also, if you are 65 years old or above, then you no longer need to get a Pap smear as cervical cancer rarely develops around this age.

How do you prepare for a Pap smear? And what can you expect from the procedure?

Woman holding menstruation calendar

For a Pap smear to be highly effective, I suggest my patients do the following preparations:

  1. Schedule the Pap smear on a day where you don’t have your menstrual period. Menstruation can muddle the results so it’s best to avoid these days for the test.
  2. Avoid sexual intercourse and/or the use of any vaginal medicines or spermicidal creams at least two days before having a Pap smear. These activities can wash away abnormal cells and the test may give you a false negative result.
  3. If you are pregnant, then it is safe to have a Pap smear up to 5 or 6 months in your pregnancy. Any later, and it may become painful for you.
  4. If you have just given birth, you should wait at least 3 months before getting a Pap smear.
  5. Relax and stay calm before and during the procedure.

When it comes to the procedure itself, it may be a bit uncomfortable, but it usually doesn’t take long and will be over in just 5 minutes. First, you will be asked you to lie down on an exam table with your knees bent. Then, a small device called a vaginal speculum will be inserted into your vagina, which will give a better view of your cervix. After this, cells from your cervix will be carefully scrapped using a special Pap smear brush and then the test is over. Easy and quickly as that. There may be some discomfort after the test but should disappear within a few hours.

The cell samples will be sent to our laboratory for analysis and you’ll be advised you to return to the clinic when the results are ready.

How much does a Pap smear cost in Singapore?

  • Pap smears are free if you can arrange an appointment by calling the Singapore Cancer Society.
  • As an alternative, if you are a CHAS (Community Health Assist) cardholder you can get a Pap smear done for just $2. Also, thanks to the Health Promotion Board, women can get the test for only $5 for citizens and $12.25 for permanent residents if you qualify.
  • You can also get a Pap smear from almost any health clinic and hospital in Singapore from $15 to $100.

There are also speciality clinics like DB Clinic where you can get a Pap smear. Here, our services are geared to improve not only women’s health but of men and the whole family as well. If you have already decided to get one, contact us at DB Clinic to arrange an appointment. We’ll be happy to give you a quotation and assist you in every way we can.

Conclusion

I would like to reiterate that a Pap smear is very important because early-stage cervical cancer usually does not display any symptoms. Thus, if you have early-stage cervical cancer but don’t get a Pap smear, then most likely you will only detect the disease once it displays symptoms and has advanced to a stage where it is harder to treat. Remember that early detection is key to the success of your treatment.

 

DB Medical: Women’s & Men’s Health Clinic
290 Orchard Rd, #14-10 Paragon Medical Centre,
Singapore 238859
+65 6733 7122

Treatments for Age Related Macular Degeneration

Age-related macular eye degeneration (AMD) is an eye condition that occurs in people that are over 50 years old. This eye condition affects the eye’s sharp, central vision as the damage is done to the macula, which is found in the retina’s centre. The macula is responsible for seeing fine details of images. If allowed to persist, AMD can bring challenges in doing daily activities as the eye’s vision may become blurry or distorted. If the condition is overlooked for a long time, it may result in complete loss of vision.

Causes of Age-Related Macular Degeneration

According to ophthalmologists from Singapore Eye care centre AsiaRetina Age-related macular degeneration can be caused by several factors:

  • Age (50 years and above)
  • Genetics
  • Hypertension
  • High levels of cholesterol
  • Poor nutrition
  • Smoking
  • Unprotected and prolonged exposure of the eyes to sunlight

Types of Age-Related Macular Degeneration

Types Age Related Macular Degeneration

There are two types of age-related macular degeneration:

  1. Dry AMD – this type of AMD happens when the macula’s light-sensitive cell gets damage and destroyed, causing yellow fatty particles (drusen) to pile up in the retina.
  2. Wet AMD – this type of AMD is more critical as compared to dry AMD. Wet AMD occurs when tiny abnormal blood vessels grow beneath the retina. Blood, fluid, and proteins can seep out from these abnormal blood vessels and cause damage to the retina. Wet AMD progresses fast. If it is not treated at an earlier time, prolonging the eye’s ability to see may be too late.

Both dry and wet AMD can exist at the same time. Usually, wet AMD develops from dry AMD that is already in existence.

Signs and Symptoms of Age-Related Macular Degeneration

In general, age-related macular degeneration does not affect the vision greatly during its earlier stages. AMD can be asymptomatic. The onset of AMD can be felt when there are already changes in your eyesight. When these symptoms are already present, it means that the disease is already advancing to a much serious condition. These are the symptoms that you should look out for:

  • Blurred central vision
  • Central vision loss
  • Dark or shadow spots in the vision
  • Distorted lines or images
  • Inability to distinguish colours of similar tones

Testing for Age-Related Macular Degeneration

Age-related macular degeneration may or may not exhibit symptoms. The best way to determine its existence is to have your eyes checked by the doctor. A couple of tests may be done to confirm if your eye is suffering from this condition. These are the tests that your doctor may ask you to take:

  1. Amsler Grid – The Amsler Grid is a screening tool used to check if there are slight changes affecting the eye’s normal function to see. This can also be done at home every day, so patients can monitor the condition of their eyes. In this test, a patient is asked to look at an Amsler grid chart. The chart is held at a level below the eye, similar to reading a book. To check for vision changes, cover one eye and focus on the dot located at the centre of the grid. Any changes in vision, such as wavy lines, blurry or dark spots, may indicate signs that AMD is present.
  2. Fundus Fluorescein and Indocyanine Angiogram (FFA and ICG) – These tests are done similarly. First, a fluorescent dye is injected into the patient’s arm. The dye then flows through the blood vessels and reaches the eye. Photo images of the eye are taken as the dye in the blood vessels passes through. The picture is then assessed to see if there are leaking blood vessels in the eye, which indicates the existence of wet AMD.
  3. Optical Coherence Tomography (OCT) – this test can be likened to the ultrasound as both uses “waves” to get photos of tissues in the body. The difference is that OCT uses light waves while ultrasound uses sound waves. To do the test, the eyes are dilated first. Then, the patient is asked to put their head on a chin rest and stay immobile while the light waves pass through and images of the eyes are taken. Once done, the images are examined to check whether AMD is present or not.

Treating Age-Related Macular Degeneration

Laser eye surgery

There are several age-related macular degeneration treatments available. However, it is important to note that these treatments do not cure this eye condition. Despite advancements in medical technology and treatments, there is still no known cure for AMD. These treatments work to delay the continuous development of AMD, which results in vision loss. The response of the eye to the treatment will also depend on the severity of the AMD.

There is no available treatment for dry AMD, especially during its early stages. In general, doctors can only do as much as track its progression. A change in lifestyle will also be recommended for patients with dry AMD. Smokers will need to give up smoking as this is one of the factors that cause AMD. Patients will also be asked to eat healthy and nutritious foods. These recommendations neither cure nor prevent AMD, but they help in delaying its advancement to a much worse state.

Wet AMD has several treatments available:

  • Laser therapy – Also known as laser photocoagulation, this treatment uses laser beams to destroy abnormal blood vessels that are present inside the retina. This treatment is risky as it also destroys healthy tissues around the abnormal blood vessels, resulting in further problems with vision.
  • Drug therapy – This is the most common treatment used for wet AMD. Drug medications, such as anti-angiogenesis drugs and steroids, are injected into the eye and work to obstruct further growth of abnormal blood vessels into the retina. The eyes are numbed with anaesthesia before injecting the drug. Repeated administration of the drug is recommended over a period of 2 years to keep AMD under control.
  • Photodynamic Therapy – A light-sensitive drug, verteporfin, is injected into the arm and travels throughout the body in the blood vessels. As verteporfin passes through the abnormal vessels beneath the macula, a light is probed into the eye to activate the drug and destroy these blood vessels that cause AMD.

Conclusion

Vision loss as a result of age-related macular degeneration can only be delayed with treatments and changes in a patient’s diet and lifestyle. The key to be able to prolong a patient’s vision is early detection and treatment of AMD. Do not wait for your AMD to reach an advanced state before getting tested for AMD. At the first sign of AMD, visit your eye doctor to discuss your condition and opportunity for treatment.

A Quick Rundown on Jaw Surgery in Singapore

Overview

Orthognathic surgery, or corrective jaw surgery, is a procedure whose aim is to correct dental, jaw and facial abnormalities. These abnormalities are often caused by genetics or facial trauma. Besides the obvious effects on one’s physical appearance, these abnormalities can also affect a person’s ability to speak, chew or bite. Because of the presence of these abnormalities, orthognathic surgery was developed to help correct and fix these deformities.

A lot of people experience dental problems such as crooked teeth, and these problems are usually fixed by braces or some other dental solution. There are times, however, that a dental problem might actually be caused by jaw structure, such as differing jaw sizes or imperfect jaw positions, which in turn affects your dental health. This is because the alignment of your teeth is based as well on the position and sizes of your upper and lower jaws. Due to this problem being quite common, orthognathic surgery was developed and has since been a relatively popular procedure undertaken by many people in Singapore.

When is it necessary to undergo jaw surgery?

It varies case by case, which is why it is important that a patient undergo a preliminary check-up by a trusted so that his/her condition is assessed and whether or not jaw surgery is necessary. If the specific abnormality makes it difficult for the patient to function and carry out daily tasks, then jaw surgery is most likely needed to fix it.

What causes jaw abnormalities and deformities?

Jaw abnormalities and deformities are usually attributed to physical facial trauma or genetics.

What abnormalities and deformities can be fixed by jaw surgery?

Orthognathic surgery can be undergone to fix a slew of different deformities, such as:

  • an open bite
  • a protruding jaw
  • a receding jaw
  • facial asymmetry
  • facial elongation
  • a severe crossbite
  • post-traumatic facial injury
  • recurring jaw pain

If you have any of the given problems above, then it’s high time to consult with a trusted oral and maxillofacial surgeon (OMFS) and determine if jaw surgery is needed or not.

What results can I expect from jaw surgery?

TES Clinic says that successful jaw surgery can result in many positive changes, such as:

  • making the biting or chewing easier and improve overall the action of chewing
  • slowing down the process of wear and tear of the teeth
  • fixing problems in swallowing and speech
  • correcting issues in closing the jaw and bite fit
  • correcting facial asymmetries, such as small chins or overbites and crossbites
  • lessening the strain in closing the lips
  • relieving pain caused by TMJ disorder and other jaw problems
  • repairing facial injury
  • repairing birth defects
  • providing relief for someone who has sleep apnea

facial assymetry jaw surgery

Is jaw surgery a safe procedure?

Jaw surgery is a relatively safe procedure when done by an experienced oral and maxillofacial surgeon. However, there are a few risks in undergoing jaw surgery, such as:

  • Infection
  • Loss of blood
  • Nerve injury
  • Jaw fracture
  • Jaw relapsing to its original position
  • Need for a follow-up surgery

Also, after the surgery, there might be some lingering pain or swelling. Other possible complications include eating problems and the inevitable adjustment period with your new appearance.

What are the preparations needed before jaw surgery in Singapore?

In a lot of cases, braces must be placed on teeth for about 12 to 18 months before surgery to ensure that your teeth are aligned and levelled in preparation for the procedure.

The orthodontist and oral and maxillofacial surgeon will develop a treatment plan for the patient, which includes x-rays, photos, and models of your teeth and jaw. All of these data are then examined and studies to fully prepare both the surgeon and the doctor for the jaw surgery. Some of the details that are observed and recorded include the shape of the teeth, and how your teeth fit together.

What happens during jaw surgery?

Before the surgery itself, general anaesthesia is injected into the patient to ensure that he/she will have little to no discomfort or pain during the long ordeal.

For the surgery, the incision is usually made inside the mouth so that there are no facial scars on the patient’s jaw, chin or mouth. There are cases, however, that some small incisions are made around the mouth.

After the incision, the surgeon will then make some cuts in the jawbone to move them to the intended position. Screws and wires are then used to keep and secure the bones in this position. Sometimes, the surgeon will transfer some bone from your hip, leg, or rib and added to the jaw. This is then secured with plates or screws. The bone may also be reshaped depending on the treatment plan.

What are the important things that need to be considered after jaw surgery?

Right after the procedure, the doctor will instruct you regarding the recovery. It is a good idea to avoid any demanding activity to give your body the energy to heal. The doctor will also give you some advice regarding what to eat, and which medicine to take to manage the pain and discomfort while the bone is still in the process of healing.

Patients will have to miss a bit of work or school as the first two to three weeks after the surgery is a delicate time when it comes to recovery. Six weeks after the surgery, the orthodontist will realign your braces. Expect a long but satisfying recovery as your teeth and jaw will start to look better compared to before.

How a Sleep Specialist Can Help You Have a Restful Sleep?

Sleep is an essential part of life. Without sleep, humans cannot function normally and can cause serious damage to our overall health, well-being and quality of life. This is why our parents and doctors never fail to constantly remind us to get enough sleep when we were growing up. This fact remains true even today that we are adults and lead our own lives. However, as we grow older, we can develop sleep disorders that rob us of our precious sleeping time. When sleep disorders affect the way you live, maybe it is time to get some help from sleep specialists.

What is a sleep specialist?

A sleep specialist is a doctor that has speciality training in sleep medicine and is well-trained to perform treatments for sleep disorders. Sleep specialists can come from different backgrounds such as:

  • ENT surgeons
  • Respiratory therapists
  • Neurologists
  • Psychologists
  • Psychiatrists

These doctors can work together depending on a patient’s condition and treatment plan. Sleep specialists are skilled in the latest techniques to properly diagnose, treat and prevent a wide range of sleep disorders.

What conditions does a sleep specialist treat?

The two most common sleep disorders that medical sleep specialists treat are sleep apnoea and snoring.

Sleep apnoea

This is a serious sleep disorder that is characterized by a sudden stop in breathing and then restarts over and over again while a person is asleep. This sudden stop and start of breathing can be caused by different factors such as:

  • Relaxation of throat muscles (Obstructive sleep apnoea)
  • Improper transmission of brain signals to breathing muscles (central sleep apnoea)
  • Both obstructive sleep apnoea and central sleep apnoea manifested in one patient (Complex sleep apnoea syndrome)

Snoring

Snoring can occur when your airflows cause the throat and nasal tissues to flutter as you breathe. This condition can be exhibited by anyone at any age, although it can be worse with men and overweight people. Snoring can be caused by various factors such as:

  • Obstruction or blockage of nasal airways (can be caused by allergies, sinus infection, a deviated nasal septum or long soft palate tissue)
  • Weak throat and tongue muscles
  • Large throat tissue, tonsils and soft tissues behind the nasal cavity (adenoids)

More often than not, sleep apnoea and snoring can have similar symptoms and can be hard to be distinguished from one another. In fact, snoring can also be an indication of sleep apnoea. This is where the expertise of a sleep specialist comes in. With proper assessment, a sleep specialist can provide an accurate diagnosis for sleep apnoea and snoring and can draw out treatment and management plans for each condition.

Other more serious sleep disorders like insomnia (difficulty in falling asleep), parasomnia (night terrors), sleep paralysis, hypersomnia (daytime sleepiness), narcolepsy (loss of control of sleep and wakefulness) and many more sleep conditions that affect the normal sleep cycle and body rhythm, requires psychotherapy, medications and neurological treatments.

sleep specialisti for healthy sleep

What treatments can a sleep specialist perform to treat sleep apnoea and snoring?

 

Management of sleep apnoea and snoring can be similar as well as the available treatment options. Depending on the severity of your condition, a sleep specialist can recommend the following management and treatment plans:

Lifestyle Changes

For people with mild sleep apnoea or snoring, usually, no medical interventions are required. However, your doctor may advise you to practice a healthy lifestyle to lessen the occurrence of sleep apnoea and snoring. These lifestyle changes can include losing weight and developing a better sleeping pattern.

Continuous positive airway pressure (CPAP)

Depending on your doctor’s recommendation, CPAP can be used to help manage sleep apnoea and snoring. A CPAP is a medical apparatus that looks like a mask that has to worn over the nose and mouth during sleep. The mask is attached to a machine that delivers continuous airflow to the airways creating a pressure that frees the airways (hence the name) and restores normal breathing patterns.

Surgery

For advanced cases that require correction of a physical problem such a deviated septum, large throat muscles, tonsils or adenoids, long soft tissue palate and other physical features that block the airways, surgery may be required. According to Dr. Dennis Chua from ENT Specialist Singapore, ENT surgeons are the ones who perform these corrective surgical procedures.

What qualities should you look for when choosing a sleep specialist in Singapore?

Experience and Track Record

The best indication of a reliable sleep specialist is by looking at his/her track record in treating sleep disorders. Search for patient reviews online and assess if the sleep specialist achieved great results and if patients had good experience under his/her guidance.

Consultation and Treatment Costs

Determine if the prices for consultation and treatments are reasonable and cost-effective. Also, make sure that there are no hidden costs and the costs related to your treatment are discussed.

Good Communication Skills

It is important that your sleep specialist is able to listen to your needs and does everything he can to accommodate them for you. Good communication builds trust in the long run.