ESWT Treatment For Plantar Fasciitis

Watch as Dr Edwin Ong, Resident Doctor, Dr Tan & Partners (DTAP clinic) talks about ESWT, Extracorporeal Shock Wave Therapy, as an effective treatment for Plantar Fasciitis. Shock Wave therapy is a safe, quick and non-invasive treatment using energy from sound waves to activate the self healing properties of the body and accelerate the recovery process.

What is Plantar Fasciitis?

If you have ever experienced intense pain over the bottom of your heel whenever you wake up in the morning and take your first few steps, chances are that you have had plantar fasciitis.

Plantar fasciitis is the most common cause of heel pain and affects approximately 1 in 10 people at some point during their lifetime. The pain is typically sharp and sudden and usually happens in only one foot, although both feet can be affected at the same time.

Shockwave Therapy: 

  1. Firstly, through a process known as cavitation, Shock Wave therapy stimulates the production of fibroblasts and tenocytes. These are the cells responsible for the healing of connective tissues such as tendons. The end result is tissue regeneration.
  2. Secondly, the Shock Waves stimulate microscopic circulation and therefore metabolism within the treatment area, which promotes healing and the breakdown of calcification deposits, also known as spurs.
  3. Lastly, Shock Wave therapy diminishes pain by over-stimulation of the nerves that send pain signals to the brain.

To conduct the treatment for plantar fasciitis, we place the treatment probe over the affected area and deliver the required number of shocks. The treatment for plantar fasciitis is tolerable. Most patients will need about 2 to 3 sessions each 2 weeks apart. If you are suffering from plantar fasciitis and require treatment for plantar fasciitis, speak to your Doctor and ask if Shock Wave therapy is right for you.

Please call or visit our Siglap Branch or drop us an email at hello@dtapclinic.com for an appointment.

ESWT Treatment For Elbow Pain

Watch as Dr Edwin Ong, Resident Doctor, Dr Tan & Partners (DTAP clinic) talks about ESWT, Extracorporeal Shock Wave Therapy,  as an effective treatment for elbow pain. Shock Wave therapy is a safe, quick and non-invasive treatment using energy from sound waves to activate the self healing properties of the body and accelerate the recovery process.

Common causes of Elbow Pain:

Tennis elbow, or lateral epicondylitis, is a painful condition which affects the tendons that attach to the outside of the elbow.

Golfer’s elbow, or medial epicondylitis, is a similar condition affecting the inside of the elbow instead. Tennis elbow is much more common than golfer’s elbow. Despite their names, these injuries can occur in people who overuse their wrists and arms through repeated motions and do not affect just tennis players and golfers only.


Shockwave Therapy: 

  1. Firstly, through a process known as cavitation, Shock Wave therapy stimulates the production of fibroblasts and tenocytes. These are the cells responsible for the healing of connective tissues such as tendons. The end result is tissue regeneration.
  2. Secondly, the Shock Waves stimulate microscopic circulation and therefore metabolism within the treatment area, which promotes healing and the breakdown of calcification deposits, also known as spurs.
  3. Lastly, Shock Wave therapy diminishes pain by over-stimulation of the nerves that send pain signals to the brain.

To conduct the treatment for elbow pain, we place the treatment probe over the affected area and deliver the required number of shocks. The treatment for elbow pain is tolerable. Most patients will need about 2 to 3 sessions each 2 weeks apart. If you are suffering from elbow pain and require treatment for elbow pain, speak to your Doctor and ask if Shock Wave therapy is right for you.

Please call or visit our Siglap Branch or drop us an email at hello@dtapclinic.com for an appointment.

Is Skull ‘Horns’ Caused by Prolonged Device Use?

An article was recently published in the Straits Times on 21st June 2019 titled “Skull ‘horns’, text necks, trigger thumbs: 6 health issues that may be linked to smartphone use”, reporting about the impact of modern life on the skeleton in young adults.

Before your imagination starts running wild, the situation is not as terrifying as it sounds, and no, teenagers are not growing actual horns out of their skulls.

What are Skull ‘Horns’?

External occipital protuberance

Credit: (wikipedia.org)

In 2016, Professors David Shahar and Mark Sayers from the University of the Sunshine Coast in Queensland, Australia, found that out of 218 people aged 18 to 30, about 40% had a bony growth near the base of the skull called an enlarged external occipital protuberance, or EEOP.

They followed with a second study in 2018, where they studied X-rays from 1,200 people aged 18 to 86, of which a third showed growths. People aged 18 to 30 were the most likely to have an Enlarged External Occipital Protuberance (EEOP), which was an unexpected finding as the researchers had expected older adults to have the highest risk.

The term “skull horns” was later coined by the media as a means to sensationalise the extent of these growths when in actual fact they are only between 1 to 3 cm in length; definitely noticeable, but probably not as dramatic as the mental image one might conjure.

The significance of these studies

Bony projections, also known as enthesophytes, are more commonly found in the elderly and are assumed to be a normal part of the ageing process.. However, these recent studies have shown that such growths are occurring more commonly in younger people than previously thought. Importantly, this is also proof that musculoskeletal degenerative processes can start and progress silently from an early age.

From this, the researchers postulate that the advance of technology has altered the timeline for this type of bone growth. They link EEOP with excessive forward head posture and sustained neck flexion, which tends to be associated with the usage of mobile phones or other technological devices. They also suggest that EEOP is a sign of a serious posture deformity that can potentially lead to chronic headaches and neck and upper back pain.

Definitive conclusions could not be drawn about whether these skull ‘horns’ were caused by prolonged device use, as neither study actually assessed individuals’ phone use. This is simply an educated hypothesis made by the researchers based on the demographics of frequent gadget users.

Modern Problems

In today’s world, technology is deeply ingrained into our daily lives and it is impossible to get through a day without our gadgets, but make no mistake, technology is also ruining our posture. The long hours spent toiling away in front of computer screens and other electronic devices put tremendous stress on our musculoskeletal system.

Constantly tilting one’s head forward or downward to look at screens, instead of holding it upright as it is meant to sit, may strain the neck and back of the head enough to result in bone growth in the surrounding tendons and ligaments. This is similar to the way the skin thickens into a callus as a response to pressure or abrasion.

Other terms such as “office syndrome”, “text neck,” and “texting thumb” have also been used to describe the impact of device usage on our musculoskeletal system.

You can read more about Office Syndrome here:

How Can We Prevent This?

The solution is not necessarily to swear off our gadgets and devices. Instead, an emphasis should be placed on developing good posture habits and positioning of our screens.

#1 Practice proper posture.

Sit up straight with your shoulders rolled back and your chin tucked to elongate your spine. Good posture is always important, even when not at work.

#2 Adjust your sitting position regularly.

Adjust your sitting position regularly. Doing so every 1-2 hours helps to prevent muscle fatigue and subsequent slouching. You can also change the angle of your seat, and avoid sitting at the edge of your seat.

#3 Remember to take a break.

Take short breaks throughout the day to rest your eyes. This is also a good time to stretch, or take a walking break.

Take care!


Other Reads:

  1. What are the signs & symptoms of Nose Cancer
  2. Mycoplasma Genitalium (MG) – STD Screening, Testing & Treatment
  3. Chronic Pelvic Pain Syndrome Or Prostatitis
  4. 5 Ways to Fight Depression
  5. 8 Ways on How to Cope with Anxiety
  6. 7 Common Causes of Knee Pain
  7. De Quervain’s Tenosynovitis – Causes, Symptoms Treatment 
  8. Plantar Fasciitis – Causes Symptom Treatment
  9. Shoulder Pain – Cause, Symptoms & Treatment 
  10. Trigger Finger – Cause, Symptoms & Treatment
  11. Tennis Elbow & Golfer’s Elbow – What You Need to Know 
  12. STD Symptoms in Women

Also on DTAP’s blog; hiv test singapore

8 Common Symptoms of Knee Osteoarthritis (OA)

What do golf superstar Tiger Woods, basketball legend Kobe Bryant and Hollywood actor Patrick Stewart all have in common? They are famous examples of people who live with  Osteoarthritis (OA). Also known as degenerative or “wear and tear” arthritis, OA is the most common form of arthritis. Learn more about Knee Osteoarthritis
Osteoarthritis most often occurs in the knee joint. In Singapore, a National Health Surveillance Survey (NHSS) conducted in 2013 found that the estimated national prevalence of knee OA was 11%. Women were more likely to be affected than men. Knee OA was more prevalent among Indian ethnicity (20.5%), followed by Malay (17.7%), and Chinese (9.3%).
Unsurprisingly, knee osteoarthritis is more likely to occur with increasing age. In recent years, however, the prevalence of Knee Osteoarthritis in younger people between the ages of 18-50 years old has been steadily rising. This trend is the result of a rising interest in sports and consequently, knee injuries.
With the knowledge that knee osteoarthritis is so common, it is therefore important to recognise the 8 Common Symptoms of Knee Osteoarthritis.

8 Symptoms of Knee Osteoarthritis

1. Pain

This is the most common symptom and is typically worse on waking up in the morning or after an extended period of inactivity. In severe cases, the pain can be excruciating and result in disability.

2. Stiffness

Again, stiffness is worse in the morning or after a period of inactivity. The stiffness usually reduces after a short period of walking about.

3. Swelling

This tends to occur at the end of a long day and particularly if a lot of standing or walking was involved.

4. A “Grating” or “Crunching” Sensation

A person with knee osteoarthritis can either hear this or feel it when placing a hand on the knee cap while bending or straightening the knee. This occurs due to degenerated meniscus and cartilage, loss of synovial fluid and the presence of bone spurs.

5. Decreased Range of Motion

This occurs in the late stages of knee osteoarthritis. Some people are not even able to fully straighten their knees at all.

6. Locking or “Jamming” of the joint

This happens when the meniscus is degenerated or torn and flaps about during joint movement. Another reason is due to fragments of bone or soft tissue floating within the joint space.

7. Joint Instability

In the late stages of knee OA, the soft tissues of the joint are severely damaged. This includes ligaments, which play a crucial role in maintaining joint stability.

8. Joint Deformity

This also occurs in the late stages of Knee Osteoarthritis. Severe soft tissue damage and joint space narrowing affect the alignment of the knee joint. The knees start to appear bowed and deformed.
If you or any of your loved ones are experiencing these symptoms, speak to your doctor to learn about the available Knee Osteoarthritis treatment options.
Our Siglap Branch also provides a range of joint pain diagnosis & treatment. You can call us at +65 6962 2144 or drop us an email at hello@dtapclinic.com for an appointment with our doctor.
Take care!


Also Read:

  1. 7 Common Causes for Knee Pain
  2. Are All Shock Wave Machines For Erectile Dysfunction The Same?
  3. Office Syndrome – Causes, Treatment & Accossiated Symtopms 
  4. Tennis Elbow & Golfer’s Elbow – Causes, Symptoms & Treatment
  5. Trigger Finger – Causes, Symptoms & Treatment
  6. Shoulder Pain – Causes, Symptoms & Treatment
  7. Plantar Fasciitis – Causes, Symptoms & Treatment
  8. Knee Pain – Causes, Symptoms, Treatment
  9. De Quervain’s Tenosynovitis – Causes, Symptoms & treatment

7 Common Causes for Knee Pain

Knee pain affects people of all ages and affects sedentary individuals just as much as active athletes. The knee is one of our main weight-bearing joints, and also happens to be the joint most prone to injury. More often than not, we tend to take our knees for granted, and it is not until a serious injury occurs that we truly appreciate how important they actually are in our daily lives.

There is a multitude of causes for knee pain. Some are relatively mild conditions that can improve simply with proper rest, while some are serious and require prompt medical treatment or surgery.

via GIPHY


7 Common Causes of Knee Pain

(PS: Listed below, not in any particular order)

#1 Knee Osteoarthritis (OA)

Also known as degenerative arthritis or “wear and tear” arthritis, Osteoarthritis (OA) is the most common form of arthritis. Osteoarthritis is caused by cartilage degeneration and osteophyte formation, leading to joint space reduction and ultimately, bone rubbing against bone. Knee Osteoarthritis tends to occur with increased age, but there are many other risk factors that also predispose one to OA. Other than knee pain, people with OA typically experience joint stiffness, swelling, reduced range of motion and deformity.

#2 Ligament Injury

The ligaments of the knee joint work together to provide stability. Ligaments are strong, tough bands of fibrous tissue, but can be strained or ruptured as a result of excessive physical forces. For example, anterior cruciate ligament (ACL) injury may occur as a result of a sudden change in direction or twisting of the knee, most commonly when playing sports such as basketball or football. More than one ligament may be involved, and sometimes meniscal injuries can occur in conjunction with ligament injuries.

#3 Meniscal Injury

The menisci are two thick crescent-shaped pads of cartilage that act as shock absorbers and also reduce friction. They can tear when the knee undergoes a twisting motion while it is bent, usually as a result of playing sports. They can also be worn out with increasing age, overuse and obesity. Other concurrent symptoms include locking or “jamming”, difficulty straightening the knee, and swelling.

#4 Patella Dislocation

A twisting injury or direct blow to the knee can cause the kneecap to slip completely out of place, leading to intense pain on movement. This is known as patella dislocation. When the kneecap slips partially out of place, it is called a subluxation. There are other factors that increase the risk of patella dislocation, such as hyperflexible joints and weak quadriceps muscles.

This condition occurs more frequently in athletic teenagers. The initial treatment requires prompt relocation of the patella by a trained medical professional, followed by rehabilitation. Without physiotherapy, the chance of recurrence is 50% and eventually, surgery may be required.

#5 Gout

Gout is caused by excessive buildup of uric acid crystals in the affected joint. Repeated attacks to the same joint over time eventually leads to joint erosion and arthritis. Gout tends to occur in only large joints, and usually, only one joint is affected at any one time.

Symptoms can come on acutely, and patients typically suffer from intense pain and swelling of the joint. Gout is usually diagnosed clinically. If there is any doubt, the gold standard test performed is knee joint aspiration, whereby the presence of uric acid crystals confirms the diagnosis.

#6 Fracture

Knee fracture can occur as a result of trauma (eg. road traffic accident) or falls. People who have fragile bones due to osteoporosis may sustain a knee fracture by simply tripping or stepping wrong. The pain may be excruciating but sometimes can simply present as a nagging ache. Depending on the type of fracture and the location within the knee joint, treatment may be conservative with cast immobilization, or surgery.

#7 Patellar Tendonitis

Patellar tendonitis, also known as jumper’s knee, refers to inflammation in the patellar tendon located just below the kneecap. It is more common in people who participate in sports that require frequent jumping, such as basketball and volleyball. However, it can occur in non-athletes as well. The pain is felt at the location of the patella tendon in the front of the knee.

The above are some of the common causes of Knee Pain. If you wish to speak to our doctors about Knee Pain issues, please drop us an email at hello@dtapclinic.com ,or you can call us at +65 6962 2144 or visit our Siglap Branch (joint pain clinic).
Take Care!


Other Reads:

  1. What is Office Syndrome – Causes, Symptoms & Treatment
  2. What are the signs & symptoms of Nose Cancer
  3. Mycoplasma Genitalium (MG) – STD Screening, Testing & Treatment
  4. Chronic Pelvic Pain Syndrome Or Prostatitis
  5. 5 Ways to Fight Depression
  6. 8 Ways on How to Cope with Anxiety 
  7. De Quervain’s Tenosynovitis – Causes, Symptoms Treatment 
  8. Plantar Fasciitis – Causes Symptom Treatment
  9. Shoulder Pain – Cause, Symptoms & Treatment 
  10. Trigger Finger – Cause, Symptoms & Treatment
  11. Tennis Elbow & Golfer’s Elbow – What You Need to Know 
  12. STD Symptoms in Women


Office Syndrome – Causes, Symptoms Treatments

What is Office Syndrome?

If you live in a big city and work in an office environment, chances are you may suffer from Office Syndrome even though you may not know it.
Office Syndrome is not a disease but instead refers to a group of symptoms related to the unhealthy sitting posture. The typical office worker spends hours upon hours sitting in the same position, toiling away in front of computer screens.
At first glance, one may not think much about such a lifestyle, but if left unaddressed, Office Syndrome can potentially lead to serious issues, especially for one’s muscles and spine.

What is the Cause of Office Syndrome

A poor working environment is a major cause of Office Syndrome. Inadequate table height and positioning of the computer and keyboard leads to an unnatural sitting position. Slouching or hunching over with rounded shoulders causes constant muscle contraction, gradually resulting in weak core muscles and increased tension in other muscle groups.
Dry eyes and headache can also result from long hours facing computer screens. Psychological symptoms such as depression, insomnia and fatigue may occur as well. All these also fall under the spectrum of Office Syndrome.

via GIPHY

What are the Symptoms?

What are the Treatments?

If you suspect that you are having symptoms related to Office Syndrome, speak to your doctor about it. Based on the symptoms as described above, investigations such as X-ray, ultrasound scan or blood tests may be recommended.
The treatment essentially depends on the symptoms and body part that is of concern, and commonly involves medications, physiotherapy and alternative therapies such as acupuncture.
However, as the saying goes, “an ounce of prevention is worth a pound of cure”, it is much easier to take measures to prevent Office Syndrome rather than have to deal with the problems when they develop.

Office work does not equal Office Syndrome!

How to Avoid Office Syndrome!


Not everyone who works in an office is destined to develop Office Syndrome. All that is required are some adjustments to the workplace and the development of good habits, and Office Syndrome can be easily avoided.

1) Practice proper posture.


Practice proper posture. Sit up straight with your shoulders rolled back and your chin tucked to elongate your spine. Good posture is always important, even when not at work.

2) Adjust your sitting position regularly.


Doing so every 1-2 hours helps to prevent muscle fatigue and subsequent slouching. You can also change the angle of your seat, and avoid sitting at the edge of your seat.

3) Try to exercise


Try to exercise for 30 minutes or more, at least three times a week. Focus on exercises that can strengthen your core muscle groups, which in turn can help with your posture.

4) Desk ergonomics.


Desk ergonomics. The computer mouse and keyboard should be directly in front of you, at a comfortable distance, with your arms properly supported. The computer screen should be an arm’s length away from you, and level with or slightly below your line of sight. Standing work desks are great, and nowadays there are even adjustable desks for both sitting and standing.

5) Take a break.


Remember to take a break. Take short breaks throughout the day to rest your eyes. This is also a good time to stretch or take a walking break.
Take care!


Other Reads:

  1. What is Office Syndrome – Causes, Symptoms & Treatment
  2. What are the signs & symptoms of Nose Cancer
  3. Mycoplasma Genitalium (MG) – STD Screening, Testing & Treatment
  4. Chronic Pelvic Pain Syndrome Or Prostatitis
  5. 5 Ways to Fight Depression
  6. 8 Ways on How to Cope with Anxiety 
  7. 7 Common Causes of Knee Pain
  8. De Quervain’s Tenosynovitis – Causes, Symptoms Treatment 
  9. Plantar Fasciitis – Causes Symptom Treatment
  10. Shoulder Pain – Cause, Symptoms & Treatment 
  11. Trigger Finger – Cause, Symptoms & Treatment
  12. Tennis Elbow & Golfer’s Elbow – What You Need to Know 
  13. STD Symptoms in Women


On an unrelated note: rejuran, rejuran healer