Ask an Orthopaedic Surgeon: Dr Chang Kok Chun from Sunway Medical Centre Velocity Malaysia

Ask a Doctor ForumCategory: Orthopaedic SurgeryAsk an Orthopaedic Surgeon: Dr Chang Kok Chun from Sunway Medical Centre Velocity Malaysia
dr. Chang Kok Chun asked 3 years ago
I am Dr. Chang Kok Chun, Orthopaedic Surgeon at Sunway Medical Centre Velocity, a comprehensive private hospital in Kuala Lumpur, Malaysia. My clinical focus covers:
  • General Orthopaedics
  • Trauma Orthopaedics
  • Spine
  • Sport Injuries
  • Joint replacement
  • Pain intervention
My procedural focus includes:
  • General and Trauma Orthopaedic Surgeries
  • Spine Surgeries ( Open, Minimal Invasive, Endoscopic )
  • Arthroscopy & related surgeries
  • Arthroplasty Joint replacement surgeries
  • Percutaneous pain intervention procedures
My educational qualifications include:
  • Master Degree in Orthopaedic Surgery ( University Malaya )
  • CMIA ( NIOSH certified disability independent assessor )
  • AO Trauma Fellowship ( Austria )
  • Fellowship in Spine Surgery ( Hong Kong )
  • Medical School, University Malaya, Malaysia
I currently hold memberships in the Malaysian Medical Association (MMA), Malaysian Orthopaedic Association (MOA) Malaysian Spine Society (MSS), AO Spine, and the Malaysian Association for the study of Pain (MASP). Learn more about Sunway Medical Centre Velocity here: Learn more about me here: I am excited to be here to share/discuss Bone Health with everyone. Whether you've got questions about orthopaedic conditions, trauma orthopaedic and replacement surgery, or how to maintain good bone health, ask me anything! === Want to ask a question? Submit your question at the bottom of this page. Don’t forget to include your name and email address to get notified when the doctor answers your question.
13 Answers
Sami Mawijan answered 3 years ago
Doctor, everyday I feel as if my shoulders are heavy and I cannot lift my arms. If I force myself to lift them, the pain radiates to the neck. What disease is this, Doc?
dr. Chang Kok Chun replied 3 years ago

Hi, good day.
You are having shoulder pain.

Though the pain radiate to the neck, the origin of the problem is likely to be at the shoulder joint itself as the pain is aggravated by shoulder movement. ( not a cervical spine problem )

Shoulder joint is common site of degenerative problem ranging from impingement to rotator cuff tear.
Early disease can be treated by simple subacromial shoulder injection. Advanced disease need MRI scan assessment and probably surgical treatment. Most shoulder surgeries nowadays can be done arthroscopically ( key holes ).

It is important to keep moving your shoulder despite pain, otherwise complication of frozen shoulder with progressive stiffness ensued. Physiotherapy is beneficial.

Teniawinarsih answered 3 years ago
Doctor, how do I treat a sudden cramp on the lower back? Sometimes it happens when I stand or sit. To relieve myself, I have to lie down.
dr. Chang Kok Chun replied 3 years ago

If this is something that happens occasionally, the likelihood of having severe or advanced disease is low.
You may do regular physical exercise to improve your joint flexibility.

If the attack become frequent or persistent, you need to see an Orthopaedic doctor for check up in particular of your lumbar spine.

Narsiti K answered 3 years ago
Doctor, I feel pain on the back of my knee. Some people said it is because I sit too much. How can this be treated, Doctor?
dr. Chang Kok Chun replied 3 years ago

Pain at the back of knees.

In young people with history of sport injury, this might be symptoms of meniscus injury, which is a supporting structure inside the knee. MRI scan will confirm the diagnosis, and treatment is by arthroscopic surgery.

In middle age people without history of injury, this might be early sign of degenerative osteoathritis of the knee. You may have an X-ray done to assess the condition. If the pain is not severe, you may take short course of pain killer ie one week. Long term improvement might be achieved with oral supplement glucosamine or lubricant injection into knee joint ( Hyaluronic acid ). In resistant case, arthroscopic debridement and repair of cartilage defect can be done.

If there is swelling at the back of knee ( compared to opposite site ) , you might be having Baker's cyst, which is a protrusion of fluid filled sac from the knee. The diagnosis can be confirmed by ultrasound or MRI scan. Surgical removal or arthroscopic decompression is recommended.

Krisna answered 3 years ago
I feel stabbing pain in my spine when I sit for too long. I am 35 and drive everyday and sit to work in front of the computer for hours. Is this a common condition for my age? How to treat this and what lifestyle improvements should I make if I want to stay physically fit for a long time?
dr. Chang Kok Chun replied 3 years ago

Good day.

You are young, and having a common problem of office workers ie sitting intolerance.
The most common cause of this condition is lumbar disc degeneration with or without annular tear ( wear and tear of disc between 2 segments of spine ).

Your spinal cord and spinal nerve are not affected since you have no leg symptoms.
The diagnosis can be confirmed by MRI scan of lumbar spine, which in T2 image, the affected disc became black color as compare to white color in normal disc.

What you can do is – not to sit too long ie less than 1 hour , sit with good posture, better use ergonomic office chair, do regular back exercise.

If the pain is not getting better, or recur frequently, then a minimal invasive procedure using Radio-frequency needles to treat the painful disc is an option ( percutaneous RF annuloplasty ).

Eka Sila answered 3 years ago
I am 58 years old. I want to ask about joint pain in the knee – based on my x-ray results, on my right knee there are growing bulges between the knee bones, which makes it difficult for me to bend or straighten my knee. It’s also difficult for me to walk, and I cannot stand for long. It feels like the leg muscles are being pulled and there is pain. I’ve taken a variety of drugs – these are some of the medicines that my doctor prescribed: methylperdnisolone, diclofenac sodium, paracetamol, Alpentin 100mg, hi bone, GCM.   It’s been more than 2 months since I took the drugs above but my condition did not improve. Instead, the pain is now attacking my left knee. What is the solution without surgery? Thank you.
dr. Chang Kok Chun replied 3 years ago

Good morning. Your symptoms is consistent with severe osteoarthritis of the knee. If confirmed by X-ray, the best solution might be surgery ie Total Knee Replacement, especially if you need regular pain killer for relief. Methyprednisolone is a steroid medicine, give fast but short lasting relief. It has a lot of side effects, and is best avoided. In severe osteoarthritis, oral supplement eg glucosamine and knee injection of hyaluronic acid ( lubricant ) probably wouldn't work.

Ellis answered 3 years ago
Both of my knees have calcification. What is the solution?
dr. Chang Kok Chun replied 3 years ago

Hi, good morning. I am not sure what do you mean by ' calcification ' of the knee ? Is it osteophyte ( spur ), loose bodies, pseudogout with calcification of meniscus or gout with uric acid deposit on the joint surface observed during arthroscopy?

Osteophyte mean osteoarthritis of the knee. You may take short term pain killer for exacerbation of pain, Oral supplement eg glucosamine, knee injection of Hyaluronic acid ( lubricant ) or in severe case for knee replacement surgery. Loose bodies need arthroscopic surgery for removal of free floating bone pieces in the knee joint. Pseudogout attack can be treated by knee injection with steroid. Gout arthritis need long term treatment of diet control ( low purine diet ) and regular oral uric acid lowering drug ( allopurinol ).

Yulista answered 3 years ago
Doctor, thank you for responding to my question. I have a history of scoliosis & HNP in L 4 & 5. It has been more than 5 years. I have checked with several bone doctors, some are suggesting surgery & some say it's not severe. In the last year I complained more intensely. The last time I went to the orthopedist was about half a year ago - I was given an injection in the pelvis & for a few months I was free from pain. My complaint is that if I am squatting, my knee hurts & in just minutes, the spine feels like it’s going to break - it hurts so much. If I bend my knees and then stand straight, they become so stiff and sore. According to the injecting doctor, my complaint is not about my joints but my fingers are numb & stiff. I also can't stand sitting or standing for long. The back of the waist hurts. I have gout complaints. According to the doctor it can also be a cause. I'm confused now, where should I focus - bones, joints, gout? Thank you
dr. Chang Kok Chun replied 3 years ago

Looks like you are having degenerative disc disease of the lumbar spine L4/5. Your condition can be improved with good posture ( ergonomic way of sitting, standing & heavy lifting ) and regular exercise of your spine. If the pain is not getting better or having frequent attacks, then you may go for another round of pain intervention treatment ie the injection at pelvis ( i presumed that is some epidural injection or radio-frequency treatment ). If the relief is not lasting, the last resort would be to have surgery ie spinal fusion. Proper MRI re-assessment must be done to look out for changes over time.

Bagus Nurdin answered 3 years ago
Good afternoon doctor. Lately, why do I feel pain on my elbow although there are no specific causes? I even have problems moving my arm. Please give me your advice doctor.
dr. Chang Kok Chun replied 3 years ago

Good day.

You might be having ' Tennis Elbow " , which is a common tendinitis problem (inflammation at the forearm muscle attachment to elbow).

Simple solution is having steroid direct injection to the painful region.

In resistant case, minor surgery is performed to clean up the abnormal / degenerated tissue.

Husein answered 3 years ago
Doctor, I have pain on the back of my shoulder. Last year, I experienced a collision in that area, but at that time I didn't feel pain nor was it swollen. Do you think it is related to my previous accident?
dr. Chang Kok Chun replied 3 years ago

It is probably not related to the previous impact since you had no pain immediately after the impact.
Pain at the back of shoulder is often related to cervical spine disease C5/6 or C6/7 level ( neck ). This is especially so if you are spending long time with computer. Typically the pain is not aggravated by shoulder motion.

However, the cause of pain needed to be confirmed. You are advised to see Orthopaedic Surgeon for diagnosis.

If the pain is indeed related to cervical spine, and you are spending long hour with computer, the pain would improved if you reduced your screen time.

Thank you.

Soeparmi answered 3 years ago
Good evening, Doctor. I am 61 years old. My left knee has been aching and swollen for more than 1 month. The pain is relieved slightly if I take voltaren, but thereafter, it persists, and hurts more if I carry something heavy or stand for too long. What problem do I have in my knee and what is the proper medication for this condition? Thank you
dr. Chang Kok Chun replied 3 years ago

You are probably having Osteoarthritis of the knee, which is due to wear & tear of the knee joint with age.
If pain & swelling have not subsided after one month, you should see an Orthopaedic surgeon to assess the severity of your arthritis ( usually by X-ray ), and hence what is the appropriate treatment.

Pain killer like Voltaren is effective in relief, but not good for long term use because of side effect of kidney damage and gastritis.

Oral supplement for joint health eg Glucosamine is a slow acting remedy, which you need to take at least 2 months to get relief. But if the pain persisted after more than 2 months consumption, then oral supplement probably wouldn't work for you as the arthritis is too severe.

Another option is knee joint injection by Hyaluronic acid with or without PRP blood product.
If you are not responding to the above treatment, joint replacement surgery is indicated. The surgery is suitable for your age, as you are still strong enough for undergoing such surgery and get the maximal benefit as you are still active.

Frans tiwow answered 3 years ago
Doctor, every time I lift my left arm or move it to scratch my back, I feel pain on my shoulder joint and the left arm itself. Why is this so? Thank you
dr. Chang Kok Chun replied 3 years ago

You are having typical symptoms of painful arc syndrome of the shoulder. It is usually caused by degenerative changes of the 'roof' of shoulder, which form a sharp edge and impinge on your tendon (rotator cuff) upon shoulder elevation.

You may see an orthopaedic surgeon, who usually will give you an injection into the shoulder (subacromial steroid injection).

If the pain is not improving, or become recurrent, you may benefit from shoulder arthroscopic surgery (subacromial decompression & acromioplasty).

Thank you.

wilzan answered 3 years ago
Doctor, I am a 37 year old male. This week, almost everyday, my body is stiff. My fingers and the sole of my feet hurt and is warm. What is the likely cause, Doc?
dr. Chang Kok Chun replied 3 years ago

Your simple description might fit into the diagnosis of Rheumatoid Arthritis ie multiple small joint pain of hands & feet, associated with swelling & warmth. But typically Rheumatoid Arthritis is more common among women.

However, in tropical countries, especially with present of fever, body ache, happening within a week, one must also look out for mosquito borne diseases eg Dengue & Chikungunya disease.

You are advised to see a doctor to confirm your diagnosis ( blood test ) & get appropriate treatment.

Luh Sukeni answered 3 years ago
Doctor, I have uric acid in the soles of my feet and in my knee. I had an examination and the results showed my uric acid is more than 7. What medicines should I take?
dr. Chang Kok Chun replied 3 years ago

You are having gouty arthritis due to high uric acid in your blood. The source of uric acid is both from your food & liver production. As such, you need to control your diet & take uric acid lowering medicine.

You may consult a dietician, or surf internet for low purine diet. Few categories of well known high purine diet to avoid are
1) Red meat
2) 2) internal organ
3) 3) Beans
4) 4) Seafood except white meat fishes
5) 5) Mushrooms/Yoghurt/flowery vegetables.
You should take long term medication of Allopurinol to reduce liver production of uric acid

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