From arthritic knees to shingles to a bulging spinal disc, retiree Aberdeen Sng has suffered the gamut of old age pains. APRIL CHONG reports

She was in so much pain that she would sometimes cry in bed at night.

Retired schools clerical officer Aberdeen Sng, 73, suffered a gamut of pain – from arthritic knees to shingles to a bulging spinal disc.

Her knee problem was the first to show up over a decade ago, when she began finding it difficult to squat. Walking caused her pain too.

Doctors told her she had “water on the knee”, a condition where arthritis leads to fluid accumulation in the knee joint. It got so bad that she eventually needed knee replacement surgery in 2008 for her right knee, followed by a few months of physiotherapy and rest. Now, she can sweep the floor and climb the stairs
to get to her third-storey apartment if the lift breaks down.
 
However, that was not the end of her pains.

Towards the end of 2008, she developed shingles. While the rashes were mainly in her upper abdomen and back, the pain seemed to be all over, said Madam Sng.

At the time, she did not know she had shingles and tried to soothe the pain by applying Chinese medicinal oil.

“It was very painful. I would cry at night as I could not sleep,” she recalled.

Her ordeal went on for nearly two
months before she finally saw a doctor and was given medication.

Unfortunately, there was more suffering in store for Madam Sng.

Since last year, she has been having pain in her spine that she can only describe as “nervy” and which radiates from her lower back all the way down to her calves.

After a magnetic resonance imaging (MRI) scan at a hospital, she was diagnosed with a bulging spinal disc, with the protrusion pinching the nerves.

She was given tablets to suppress the pain but they did not help after a while.

Doctors then recommended a steroid jab, which she resisted taking as she was worried about the procedure.

However, the pain, which strikes suddenly, has become unbearable and she has decided to have the injection after Chinese New Year.

Her pain doctor, Dr Tan Kian Hian, Singapore General Hospital’s Pain Management Centre director, said that if the steroid shot does not work, the next option is a nucleoplasty procedure to shrink the swollen disc.

This works by subjecting the nucleus of the affected disc to radio waves via a catheter to break down the disc tissue. Despite her years of pain, the wife, mother of one son and grandmother of three teenagers is upbeat. She continues with her household chores and takes part in social activities such as choral singing
at her church.

“I take it one day at a time now,” she said with a grin.

THREE COMMON AILMENTS AND THEIR TREATMENTS
1 Osteoarthritis
Joint degeneration can lead to osteoarthritis, the most common form of arthritis in the elderly.

The wearing of the cartilage between bones can cause them to grind against each other, bringing pain and stiffness to joints such as the knees, shoulders, fingers and even the spine. There may be swelling and stiffness, and movement or carrying heavy items may make the pain worse. Sometimes, crepitus – where
there is crackling of the joints – occurs. In severe cases, pain can occur even when the person is immobile.
 
In the case of degeneration of the spinal discs, these may bulge and compress the spinal nerves, causing pain that can radiate all the way from the lower back to the feet. The pain can get worse in cold weather.

Prevention
Largely a wear-and-tear condition, degeneration may be hastened by injury and mechanical stress.

Avoid putting continual heavy stress on joints. One way is to avoid carrying heavy objects.
 
Practise proper techniques and use appropriate shoes during sports and other physical activities.

As exercise is an excellent way to stave off pains later in life, you should start exercising regularly in your youth to build up strength in your body to support the joints.
 
Keep a check on your weight. Being overweight puts additional stress on your joints, especially the knees.

Take glucosamine to build up your joints.

Treatment
Doctors will usually prescribe painkillers or nerve medication to reduce the pain and appropriate exercises to strengthen your joint-support systems.

Rest also helps to bring the condition under control.

Anti-inflammatory drugs such as steroid jabs may be given if the painkillers do not work. However, their effect usually lasts for months at the most. Anaesthetic injections are also an option.

Physiotherapy may help and some people go for traditional therapies such as acupuncture.

Joint replacement surgery is the option of choice to treat serious problems but older patients may baulk at it.

Other more novel alternatives include subjecting nerves to radiofrequency treatment. For example, to treat spinal disc pain, a radiofrequency needle may be inserted into the spine to disrupt the pain nerve fibres in the
affected areas by heating them to 80 deg C. This can diminish the pain but is not a permanent solution as the nerves can grow back after a few months.

2 Shingles
This is a painful rash caused by the varicella zoster virus. The virus would have first manifested itself through a chicken pox attack when the patient was younger.

Once the chicken pox infection is over, the virus remains in the body and may cause shingles in later life, usually in older people or those with a lowered immunity.
 
During a shingles attack, there may be a painful skin rash with blisters on one part of the body. Even if the rash heals, a stinging or stabbing pain may remain for months because of damage to the nerves that were affected during the infection.

Prevention
Doctors say that the best prevention for shingles is to maintain a healthy lifestyle, a balanced diet and a strong immune system.

Treatment
Shingles treatment involves pain control through pills, creams or plasters.

Antiviral drugs may also be used to limit the infection.

3 Diabetic nerve pain
Diabetics may, over time, develop nerve disorders. Older people who have had diabetes for decades are most
susceptible.

The diabetes may damage peripheral nerves and cause numbness and pain in the hands, legs and feet.

Prevention
Watching your diet and maintaining a healthy weight will keep diabetes in check and prevent the nerve pain from occurring.

Treatment
While medication can reduce pain, the main way to treat this is to bring the blood sugar levels back to normal as soon as possible.

Information from Dr Tan Kian Hian, director of Singapore General Hospital’s Pain Management Centre; Dr James Low, senior consultant and head of the department of geriatric medicine at Alexandra Hospital; and Dr Jason Chia, consultant sports physician at Changi Sports Medicine Centre and Singapore Sports Medicine Centre