Dr Mathew Tung Neurosurgeon

Dr Mathew Tung, Neurosurgeon

MBBS (Singapore), FRCS (Surgical Neurology UK), FAMS

Dr. Mathew Tung is a specialist in the management of acute and chronic neck pain.

Dr. Mathew Tung’s neck pain clinic in Singapore specialises in the diagnosis and treatment of acute and chronic neck pain. He provides non-invasive and effective treatment to patients throughout Singapore.

What Causes Neck Pain?

Many people suffer with acute or chronic neck pain. A modern lifestyle where too much time is spent in poor posture, using tablet, or smartphone is one of the most common causes of neck pain. This poor posture leads to misalignment and subluxation throughout the spine, which causes not only neck pain but often radiant pain throughout the body including the shoulders and arms.

Whiplash and other injuries sustained in car accidents are another major cause to the development of neck pain.

Osteoarthritis, degenerative diseases, and abnormalities in the bones and joints can also contribute to neck pain. 

Patients should seek immediate medical attention if their neck pain is accompanied by shooting pain, numbness, or loss of strength in arms or hands.

How is neck pain diagnosed?

Dr. Tung performs comprehensive manual examinations of the neck and spine. He takes a holistic approach to health and wellbeing so will also ask questions about the patient’s lifestyle, general health, and any possible accidents or activities that could contribute to the neck pain. 

In many cases, Dr. Tung finds that the patient is suffering from “text neck” which is an unnatural forward positioning of the cervical spine. This forward position leads to misalignment and nerve compression. 

If a patient has been in an accident, he or she should seek assessment and care as soon as possible, even if there are no symptoms. Often the adrenaline surge following an accident masks any painful symptoms for several days. Dr. Tung will be able to diagnose any issues even if there isn’t any pain.

How does Dr. Mathew Tung treats neck pain?

Dr. Tung provides his patients with expert pain control methods:

  • Physical Methods: Physiotherapy.
  • Oral Medication: To reduce inflammation to the neck area.
  • Steroid injection that helps with reducing the inflammation.

When you have osteoarthritis, there may not be enough natural hyaluron in the joint, and the quality of that hyaluron may be poorer than normal. Cingal is used to supplement hyaluron to the knee joint. Cingal also contains a steroid which provides fast-acting pain relief by reducing inflammation, while the hyaluronic acid provides long-lasting pain relief. Cingal is given in a single shot directly into the knee joint.

Cinga Injection

 

How can Cingal Provide Relief From Osteoarthritis Knee Pain?

Cingal is the first single-injection treatment that quickly relieves your osteoarthritis knee pain while providing sustained pain reduction. It is used for patients who do not get adequate pain relief from simple pain relievers or from physical therapy.

Cingal combines the benefits of a trusted anti-inflammatory to relieve osteoarthritis knee pain. The anti-inflammatory component offers fast pain relief generally beginning 24 hours after administration and the hyaluronic acid offers effective osteoarthritis pain relief for 6 months or more.

Knee pain due to osteoarthritis (OA) can impact your lifestyle and daily activities. The most widespread form of arthritis, osteoarthritis, affects more that 1 in 10 Singapore citizens, with increasing trends of premature osteoarthritis from sporting injuries.

Is hyaluronic acid joint injections right for me?

If knee pain is keeping you from doing what you love and you have tried other treatments (pain relievers, exercise, physiotherapy, cortisone injections) and nothing seems to work or is no longer effective. hyaluronic acid joint injection may be right for you.

Are there any special treatment instructions?

You will be able to go home immediately after your injections. You should have no problems walking or driving. However, for the first 48 hours after treatment, it is recommended that you avoid strenuous activities such as jogging, tennis and heavy lifting.

Are there any side effects?

The most commonly reported adverse events include temporary pain at the injection site. Cold compresses and painkillers should alleviate this temporary discomfort post injection. Hyaluronic acid joint injection should not be given to patients with infections or skin diseases in the are of the injection site.

Why hyaluronic acid joint injections?

Many unknowingly take painkillers for extended periods of time to provide temporary pain relief, without realising the side effects. Most doctors limit steroid injections to three of four in a lifetime as the effects of multiple doses can damage cartilage and connective tissue.

Is hyaluronic acid joint injection painful?

The procedure usually only takes a few minutes and most patients experience little or no discomfort. The doctor will usually begin by cleaning the injection site with alcohol or iodine. A local anaesthetic may also be administered to numb the knee and make the injection as comfortable as possible.

A total tear in the Achilles tendon can happen in any part of its length. It is a sudden, traumatic injury. When the tendon snaps, it leaves two broken ends which may stay close together or spring apart, leaving a visible dent. There may also be bruising.

Achilles Tendon Rupture

Rupture is very rare in children, uncommon in teenagers, and happens most often to people in early and later middle age.

What you Feel When you Have Achilles Tendon Rupture

You feel as if something has hit you hard in the back of the leg. If you try to walk, you stumble or fall over. Your foot feel floppy: you can draw the foot upwards into dorsiflexion, but while toes can still move downwards into flexion, you cannot point the foot down at the ankle. If you lie on your stomach, the foot falls to a right angle. If the gastrocnemius muscle is squeezed, the foot does not move as it normally would: this is a standard test for Achilles tendon rupture, and does not cause pain.

Causes for Achilles Tendon Rupture

Although the rupture can be caused by a direct blow to the back of the leg when the calf is under tension, more often it is intrinsic, with no obvious cause. It usually happens late in an exercise session or competition, and is associated with fatigue and circulatory problems rather than being cold or not warmed up properly. You may have had previous warning signs, such as tightness, cramping or involuntary twitching in the calf. You may have been stressed, overtired or suffering from an infection. The tendon may have been weakened by previous injury or injection, or overworked by compensating for a previous thigh or foot injury.

Treatment for Achilles Tendon Rupture

The foot must be supported immediately with bandaging or taping in the plantarflexed position, pointing down from the ankle. Avoid putting weight through it: hop using crutches. If you have to put the foot down, keep the leg away from your body turned out sideways, and try to keep your weight on the heel.

Seek specialist advice as quickly as possible. You have the choice of an operation or non-intervention. Surgery can be done through a scar as open surgery.

Non-intervention is a choice between either immobilisation in a plaster cast for several weeks, or support in a removable walking boot which allows weight-bearing, remedial therapies, exercises and alternative training to commence immediately. You should decide with your doctor which approach you want to use, and then follow all instructions to the letter.

Read more about Achilles Tendon Injury: Should I go for Surgery?.

Rehabilitation Phases

In all cases the foot is held pointing downwards in plantarflexion for the first phase, as the tendon has to be prevented from lengthening as it heals. If it is not in plaster, the leg can be taped to hold the position. Crutches are used as directed by the specialist. In the case of the walking boot they may not be needed for long, but should be used when exercises are done without boot on.

Rehabilitation starts with calf strengthening holding the Achilles tendon in a shortened position. Progression through the rehabilitation phases should generally be pain-free. However, sometimes following open surgery there is a moment when some movement causes a tearing sensation around the scar, almost as if the injury has happened again. This is usually due to adhesions round the scar breaking, and does not interfere with your progress to fitness. If in doubt, refer back to your doctor.

The tendon can become sore, thickened and tender to touch at the back of the ankle or just above, on one or both legs. The condition is called Achilles tendinitis, meaning inflammation in the paratenon. It is an overuse problem which happens mainly to teenagers and adults, but can happen to very young children.

Achilles Tendinitis

What you Feel When you Have Achilles Tendon Injury

Symptoms may appear gradually or suddenly. vFirst thing in the morning there is stiffness in the tendon, which wears off as you move around. There is no pain at rest. The tendon might hurt if you go up and down on your toes barefoot, but in the early stages this pain eases with repetitions. Going up and down on your toes wearing shoes usually causes pain. In the later stages, the tendon hurts when you walk and when there is any kind of pressure against it, for instance if you sit with your ankles crossed.

What are the Causes for Achilles Tendon Injury

If you feel the pain when you wear certain shoes, but not barefoot, the cause is friction from the back of the shoe. Most sports shoes have raised backs, known as heel tabs, as do many normal shoes. It may look low, but if the tab is any higher than the level of the ankle it puts pressure on the Achilles tendon. Boots with stiff seams do the same. Once the problem starts, any shoes which touch the Achilles tendon make it worse.

Other causes or aggravating factors of this type of pain include overtraining; faulty foot mechanics, especially overpronation; pain referred from the hip; poor circulation caused by sitting too long in tight clothing or with your ankles crossed; and hormonal changes in females.

Treatment for Achilles tendon Injury

Any faulty shoes must be discarded or modified by cutting the heel tabs back to the right level. In some cases this solves the problem immediately.

Some specialists offer injections into the painful tendon: if you choose this option, make sure your specialist is an expert, otherwise there is a strong risk of tendon rupture a few weeks later. A more drastic option in chronic cases is surgery to strip the tendon clean of inflammatory material.