Constantly suffering from headaches and chronic pain and want to know how to manage it? Dr Tan Kian Hian, Senior Consultant from the Department of Anaesthesiology at Singapore General Hospital, gives detailed answers to your questions.
Do you suffer from constant headaches or pain that never seems to go away? Chronic pain may be caused by injury or an underlying medical condition. As pain can take an emotional toll on you, whether it’s continuous or sporadic, it needs to be properly managed.
Dr Tan Kian Hian, Senior Consultant from the Department of Anaesthesiology at Singapore General Hospital, gives detailed answers to your questions.
Question by anggielow
Are there any treatment/procedure available for chronic pelvic pain? I've tried all painkillers & nothing helps exsept addictive painkillers.
Besides that a few years back I had surgery done around my spine area due to infection. Things were getting better but about 6 to 8 months ago I started experiencing lower back pain which is worst especially when changing position of sudden jerk (when cough or sneeze). Are there any treatment to cure this back pain?
Answered by Dr. Tan Kian Hian Consultant & Director, Pain Management Centre Dept of Anaesthesiology Singapore General Hospital
There are many causes of Chronic Pelvic Pain. My advise is to make sure there isn’t any serious underlying pathology. Some nerve pain medications may be helpful in such pains. Back Pain can be also due to multiple causes.
The first thing is to ensure that the infection has not recurred. After this is excluded, I would advise back strengthening exercises and appropriate pain medications.
Question by oki70
Hi Dr. Tan,
I have experiencing neck pain for few months and it cause a lot of discomfort. I have gone for neck massage and went to GP but it relief a while after taking muscle relaxation. Fyi, I'm a coffee lover. Is it partly due to coffee? Also at times I do feel giddiness and vomits.
Answered by Dr. Tan Kian Hian Consultant & Director, Pain Management Centre Dept of Anaesthesiology Singapore General Hospital
We do not know of any link between coffee and neck pain. Neck pain can be very disturbing. Let your GP know that the pain is not better and seek his advise. Massages are usually provides only short term relief.
Please consult a doctor for your giddiness vomiting.
Question by suzannesoon
I have throbbing pain in my left arm occasionally which will last for a few days. It gets worse if I sleep on my left side. Taking pain killers does not lessen the pain. What other treatment options should I consider?
Answered by Dr. Tan Kian Hian Consultant & Director, Pain Management Centre Dept of Anaesthesiology Singapore General Hospital
There are many causes for left arm pain. They may be pain arising from the arm itself or it can be a pain radiating from the neck. Please see a doctor for a physical examination and appropriate investigations may help pin point the problem before treatment options can be determined.
Question by teemisty
Hi Dr Tan,
I have been suffering from migraine for years, with it getting more frequent recently. I have been on preventive medication for about 1.5 years. And as advised by my doctor, i have tried not to take my painkillers for more than thrice per week; so as to prevent rebound headache. But as my migraine is getting more frequent, I really wonder how can I better manage it. When should I take my painkiller? Is it at the very start when i sense my migraine coming? Please advise.
Thanks and Regards,
Tammy
Answered by Dr. Tan Kian Hian Consultant & Director, Pain Management Centre Dept of Anaesthesiology Singapore General Hospital
You may need to see your doctor again and see if the dosage of the preventive medication needs to be adjusted. There are cognitive behavioral programs which can help in pain including headaches. This is available in most restructured hospitals.
Question by guethui
Dear Doc, I experience heel pain after prolonged walking (heel cup does not seem to work well for me). Is there any other ways to relieve heel pain? Is it true that the massage slippers/ acupressure shoes (i.e. those with raised nodules in the insole) can help to improve blood circulation and relieve chronic pains?
Answered by Dr. Tan Kian Hian Consultant & Director, Pain Management Centre Dept of Anaesthesiology Singapore General Hospital
What you are experiencing may be plantar fasciitis. Please see a doctor to confirm if this is the case. If indeed so, you may need shoes with better support and also stretch your achilles tendon frequently.
Question by kwk18778
Dear Dr Tan
My name is Wai Kheng, female aged 34. I'm having neck pain since Oct 2011. I feel the pain when i turn my head and tilt my head sideways.
Besides neck pain, i also have lower back pain for the past 2 years. Sometimes my right thigh will feel a bit numb which will go away after a few days.
I have seen GP and took Cervical and Lumbosacral spine Xray in Jan 12. Result was mild lower cervical scoliosis with no significant bond/disc lession seen. GP prescibed Mobic and Lyrica for a week. I have also seen several TMC doctors but the pain will come back after a week or so.
Kindly give me some advice. Thank you very much!
Regards
Wai Kheng
Answered by Dr. Tan Kian Hian Consultant & Director, Pain Management Centre Dept of Anaesthesiology Singapore General Hospital
This may be due to degeneration of the neck and lower back spine. I would advise you to see a doctor for a closer examination. The numbness may be due to nerve impingement. A MRI maybe necessary.
Various treatments may be helpful including adjusting the dose of your lyrica. If indicated an epidural steroid injection may also help. Surgery may be necessary in some cases.
Question by dotkoh
Dear Dr Tan, Many people, especially athletes and sportsmen, have trouble with joint pain. I have heard that chondroitin supplements may be useful for joint pain. However it seems that most healthcare professionals will recommend glucosamine for the joints as it seems to have more evidence. In your experience, how useful do you think chondroitin is in helping with joint pain, and would you recommend it to your patients? Thank you.
Answered by Dr. Tan Kian Hian Consultant & Director, Pain Management Centre Dept of Anaesthesiology Singapore General Hospital
There is some evidence that glucosamine may be helpful in arthritis of the knee and hip. But even this is not conclusive. My advise is to try it and if it is not helpful, stop.
Question by mosmos
I am now in my 30's. I have no history of injury on my legs before. But whenever I am walking up a slope, there will be a painful stiff joint on my right knee that prevented me from walking further up. I do not feel any pain on the knees while walking up the stairs or down slope. I have not seen a doctor about this problem yet. Do I need a surgery on my knee to correct this problem?
Answered by Dr. Tan Kian Hian Consultant & Director, Pain Management Centre Dept of Anaesthesiology Singapore General Hospital
You need to see a doctor and find out what’s wrong with the knee. You are very young, and therefore unlikely to have arthritis. You may have other ligament or meniscus injury which may need further treatment and evaluation. Surgery may be necessary in some cases.
Question by [email protected]
Hi Dr Tan, Recently I had lower back pain whenever I sweep or mop the floor and cannot sleep lying on my back. Went for nerve conduction test and confimed CTS with the right hand more severe and had gone for 4 sessions of therapy already. Now the pain had gone up to my neck. Are these pains any relation to my knees' problems? Had right knee replacement 5 months ago and due to go for left knee replacement soon. Posted by Sue Chan
Answered by Dr. Tan Kian Hian Consultant & Director, Pain Management Centre Dept of Anaesthesiology Singapore General Hospital
CTS will not affect your lower back. They are not related to the knee as well.
Question by fachoy1898
Dear Dr Tan Recently I have pain on my left upper arm. I was told that I am having 'frozen shoulder'. What is 'frozen shoulder' and how to deal with it? Thank you. Anthony
Answered by Dr. Tan Kian Hian Consultant & Director, Pain Management Centre Dept of Anaesthesiology Singapore General Hospital
Frozen shoulder happens when the tissues surrounding the shoulder joint is inflamed and becomes stiff. Physical therapy is important and pain medications may be helpful. Acupuncture is also helpful in some cases.
Question by yangching
Hello Dr Tan
i 'graduated' from headache to migraine some 20years ago. in medicine, i 'graduated' from panadol to ponstan to cafergot, and luckily cafergot has been working fine for me for those many years. i noted that when the sun is too hot for my liking and when i don't get to clear my bowels early morning daily, the migraine comes fast and furious and weakens me badly. i tried drinking lots of water on hot days and it helps, but for sometimes only. in my own opinion, my body gets very heaty easily and this led to the migraine. i really am tired of having migraine continuously. i hope that you can suggest some solutions.
Answered by Dr. Tan Kian Hian Consultant & Director, Pain Management Centre Dept of Anaesthesiology Singapore General Hospital
There are some medications that can be taken to prevent migraine attacks, rather than taking medications to abort the attack when they occur. See your doctor, confirm the diagnosis and discuss the treatment options available.
Question by Nisha Daniel
In olden days for pain management, experts recommended heat therapy. Now alternate heat and cold therapy is recommended. Which is good for managing pain and why?
Yours Faithfully,
Nisha Daniel
Answered by Dr. Tan Kian Hian Consultant & Director, Pain Management Centre Dept of Anaesthesiology Singapore General Hospital
Heat and cold therapy can both be useful for pain management. They can function as a form of replacing the pain signal with the sensation of cold or heat.
They can also improve blood circulation or reduce swelling during acute phases of injuries. Extreme heat and cold can be very harmful though. Extra precautions in patients who have nerve disorders including patients with diabetes.
Question by s1630548j
Dear Dr Tan
I am having constant headaches and doctors alway said that it was due to stress but personally I don't really think so. Is there any other reasons why I always have headaches?
Thank you.
Answered by Dr. Tan Kian Hian Consultant & Director, Pain Management Centre Dept of Anaesthesiology Singapore General Hospital
There are many different types of headaches, and hence many causes. See your doctor and see which type you have and the appropriate treatment can be instituted.
Question by meowy
Dear Dr, Can you enlighten us on the various ways to interpret abdominal discomfort and pain at the various quadrants of the abdomen ? As we all know Steve Jobs died of pancreatic cancer and detection is poor, and there are always dime a dozen kinds of pain in the abdominal region, and I always heard this can really drag even after all the visits to gastro clinic and still no test/imaging positive signal for anything. Some enlightenment from you may help some of us to be more educated to subtle symptoms. Thank you.
Answered by Dr. Tan Kian Hian Consultant & Director, Pain Management Centre Dept of Anaesthesiology Singapore General Hospital
There are many organs within the abdomen and the signs and symptoms can be subtle and in many cases, there may not be even any signs or symptoms. If there are any pains in the abdomen or persistent discomfort, please see a doctor and have it examined.
Question by thm
Yes Dr. I have been having aching pain from my neck down to shoulder and both my arms. I wonder if it was because I had been carrying my daughter from infant till she is 6years old. From 0 - 10 aching pain was almost like 8. Please help....
Answered by Dr. Tan Kian Hian Consultant & Director, Pain Management Centre Dept of Anaesthesiology Singapore General Hospital
This may be related to nerve impingement in the neck. You may need to see a doctor who may suggest a MRI done to see if this is the case.
Question by chin yok mooi
I have had diagnosed with Cervical spondylosis many years ago . Recently I experienced my neck and shoulder pain more often then before , comes with fingers numbness, and also experience stiff neck after wake up in the morning, the pain last about more than 10 days. Besides taking muscles relaxant medicine Neurobrion, I also went for TCM treatment. Any another treatment & management available? Many Thanks.
CYM1006
Answered by Dr. Tan Kian Hian Consultant & Director, Pain Management Centre Dept of Anaesthesiology Singapore General Hospital
You may need to see a doctor again and see if your condition has worsened over the years. You may need a nerve pain medication to manage this pain. Some patients benefit from an epidural steroid injection for the nerve pain. Surgery may also be necessary in some cases.
Question by Amy Chong
I have a swollen left side but most disturbing is that when I move my head the pain will be from back of my head area to ear,chin, jaw line area. When I swollen I can feel pain on my left throat area. Today my left ear drum feels like going to burst
Seen a family doctor & given antibodies as he think its due to sinus. Taken the medicine since yesterday.
Family doctor wants me to try the medicine first before referring to specialist. Should I see a specialist now or wait?
Answered by Dr. Tan Kian Hian Consultant & Director, Pain Management Centre Dept of Anaesthesiology Singapore General Hospital
The symptoms are not very clear. I would suggest going back to your family doctor first and he will refer you to the appropriate specialist if necessary.
Question by kathchua
Dear Dr Tan
In the recent years, I have been experiencing this throbbing headache and dizziness and at time I will feel better after vomiting.
Generally the pain residing mostly within the right side of my head coupled with the stiff neck. I do experience numbness on my hands occasionally.
During my younger day, I was hit by a tree "branch" and I can still feel this mild pain if I were to rub the right side of my head. Just wondering whether this could be the root cause of the headache, apart of being severly overweight and the lack of exercise.
Apart from controlling my diet and exercise more reguarly, what else can I do to reduce the number of occurrences?
Thanks and regards
Katherine
Answered by Dr. Tan Kian Hian Consultant & Director, Pain Management Centre Dept of Anaesthesiology Singapore General Hospital
You may need to see a doctor to assess why you are having such severe attacks of headaches and whether this is related to your neck. I am unable to comment if the incident resulted in your headaches. Exercise is very useful in managing many different types of pain and also improves your overall health and well-being.
Question by [email protected]
Hi Dr Tan,
I'm a 28 yrs old female with pain in the lower back and neck/shoulder on the right. For my back, I was diagnose of a protrude disk in the lower back and physio does not improve the pain. It's a dull pain that sometimes goes up to the whole back.
As for my neck/shoulder, I find it to be very stiff and could not raise my right arm and feel it to be weak and sometimes numb in the hands. Do you think massage or chinese 'tui nai' helps?
Could you please advise what I could do to ease the pain in the back and neck/shoulder?
Answered by Dr. Tan Kian Hian Consultant & Director, Pain Management Centre Dept of Anaesthesiology Singapore General Hospital
One protruding disc should not cause pain in the entire back. There are many causes of back pain. You may want to see your doctor and find out the cause of the pain.
If there is weakness and numbness in the hands, you should see a doctor urgently. A MRI of the neck may be necessary to find out if your nerve is severely pinched.
Ref: T12
