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Patient Education is Crucial

Musculoskeletal Consumer Review’s editor, Cindy Tan, took an opportunity to sit with Sylvia Ho, a Principal Physiotherapist at Core Concepts to discuss about what she thought were some key issues facing patient today to help themselves get better.

MCR: What are some of the key challenges facing someone with back problems?

Sylvia Ho: The first and perhaps largest hurdle is simply first understanding the problem. Back problems are extremely common. Statistics have shown at that any one point in time, some 20% of the population is having some form of back or neck pain within the past few weeks. Perhaps the fact that it is so common, people tend not to dwell on it. Of course until they experience it themselves.

Plus the fact that quite often, the pain resolves itself after some days of rest. The human body is quite an amazing machine that heals itself. Also, one rarely falls very ill from back pain, though there are certain cases where you can. But by far, back pain is not a life threatening disease though it can be life-limiting.

MCR: Why is understanding the problem important from a patient’s perspective?

SH: Understanding what’s causing your pain is very important with musculoskeletal conditions - that is problems with your muscles, joints, nerves and skeletal structures. A large of part of the treatment or recovery process requires very active participation from the client. Meaning there are things to do for the client.

Take for example when a problem is caused by some movement dysfunction caused by using the wrong set of muscles. This could happen because the correct set of muscles is not working too well or the nervous system is having problem getting them to respond. After finding out what’s wrong, we need the patient to begin to re-learn using the right set of muscles. And they have to continue doing so after they leave the clinic between their sessions. They need to know exactly what they need to do and what they must not do. This is what’s going to get them better in the long run. And they are only going to be able to do this if they understand what has happened, why the change is needed and what to do and change in their lifestyles. Understanding here is key.

Movement dysfunction can be as basic as not breathing right. There are quite a few ways to breathe using different sets of muscles. Using one particular set could affect muscle activation in your lower back. If the right set of muscles supporting your lower back doesn’t function properly, you will over time have lower back problems. Breathing using the right set of muscles and how that affects your low back pain is not generally intuitive for most people.

xEducation
  • Master of Physiotherapy, University of Melbourne 1999
  • Bachelor of Applied Science (Physiotherapy), University of Sydney, 1994
Professional Highlights
  • Sylvia is a Principal Physiotherapist with Core Concepts. Her area of interest is the spine.
  • Sylvia is a regular writer on health matters. She has been interviewed for articles by health magazines such as Shape, Ezyhealth, Her World and Female magazines.

MCR: What if they don’t understand?

SH: Well, firstly at our end we try to make it as simple as possible. At Core Concepts, we don’t throw out a lot of jargons. We make it a point to communicate clearly. If someone throws a lot of jargons at you, don’t get intimidated. Stop them and ask for simpler terms.

Don’t get thrown off by terms like ‘idiopathic scoliosis’. ‘Idopathic’ simply means ‘cause is not known’. Technical terms are important. They help professionals communicate faster and more precisely with each other. But often they don’t help patients to understand their conditions better.

Secondly, we layer the solution; working on the important bits first, before moving on so as not to overwhelm the client. Usually, we have one to two approaches for a particular problem and we will try to see which one works best for the client.

MCR: What about treatment that involves electrotherapy devices such as traction and short-wave diathermy?

SH: Our approach compared to using electrotherapy devices is fundamentally different. Most electrotherapy devices are focused on relieving the immediate pain symptoms. We obviously care about relieving your pain but also making sure that you stay pain-free. We do use such device usually at the early stages of acute pain before moving to use what is known as manual therapy.

A therapist that is more dependent on electrotherapy aides usually don’t need a high level of patient education on the client’s part. Very much like if you have a fever, you just take some medication. You don’t really need to know how the pills work but just that you need to take them at the prescribed times at the right amount. Pills are fixed quantities; it is harder to get them wrong.

With more a complicated disease like diabetes, you need to know more – about the symptoms, what to do when your blood sugars get too high or too low. If you just depend on the doctor handling your condition, you are going to run into problems at some point.

MCR: Based on your experience, what’s the level of patient education these days?

SH: Obviously, there is an entire spectrum of clients with different levels of patient education.

But overall, the level has certainly risen over the past few years. I believe that the internet has made a big impact in making more information available. There are also more health talks, magazines and newspaper articles today on health. We often find clients today asking us deeper and sharper questions. They have done their research before hand. We love these sorts of clients as we usually progress faster with their treatment.

But this is a double-edged sword. With more information out there, there is also more misleading information. Some are just plain wrong.

Massages are also another method of relieving pain. Increasingly, we see more massage ‘techniques’ appearing to solve more and more complicated problems. Often with conditions related to the muscles, joint and other supporting structures, muscles will get tight and tense. They will feel achy. Massage will help relieve that pain. But it does nothing to solve the underlying problem. If patients don’t understand this, they will walk thinking that their condition is better.

MCR: If someone is already suffering from pain, what can they do to help themselves?

SH: Seek help. Unresolved pain that lasts more than several weeks is not likely to get resolved on its own.

Find out more about your condition. Besides reading up on your own, asks lots of questions. A good doctor, physician or therapist will be more than happy to explain it to you.

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I went in when i felt a sharp pain in my back that traveled to my left leg. For my first session with Slyvia, she asked me about my nature of the pain i felt and asked me to bend over. Immediately she could tell me what was causing the pain and that it was a small issue, easily fixed over a couple of sessions. There after she massaged the affected area to relieve the tension that was causing the pain. All this was done within a 30min session! After the first session my back was already alot better and i did not feel anymore sharp pain. Slyvia arranged additional massage therapy sessions that she felt i needed. The massage sessions were really good. For 1 hr they are able to get in the problematic areas i never knew i had issues with and massage all the tension out. I felt super relaxed after each session.Slyvia also arranged pilates sessions for me with Rohini to help me with how i was not bending down properly like i should, which was the reason why i felt pain as i was hinging from a particular spot on my back. Rohini was also aware that i have diastasis recti and focused on helping me build up a stronger core which also in turn helps my back. With each sessions it created a greater awareness of my own body and the bad habits that it has. Rohini also gave great advices when i told her i wanted to strengthen my upper back.Everyone in Core Concepts knows exactly what they are doing. It was such a great experience and different services work together brilliantly to help me heal and function properly.
Very professional and caring Therapists. My left foot has been hurting for a month. After 3 sessions, 80% of the pain is gone. I just need one more session and I think I should be fine. Thank you very much.
I had an excellent sports massage by Wan Ling, which was very different from the usual massage I've tried elsewhere. Wan Ling skillfully and systematically loosened every muscle in my upper back and neck over the course of an hour. If anyone is seeking relief from tense muscles, I would highly recommend making an appointment with Wan Ling.
Came to see Xue Ting with a broken shoulder for the last 6 weeks and was impressed with her attentiveness and ability to make me feel me feel comforted in my condition . Very dedicated and good therapist indeed .
They adopt a scientific and personal approach. The therapists put in a lot of effort to diagnose the issue before attending to it. Overall, I would strongly recommend their professionalism and methods.
Really good sports massage! Booking process was efficient too :)
Friendly and really professional service! I immediately felt welcomed the moment I stepped into the clinic! The physio offered me great advice beyond what I had asked, which allowed me to have a deeper understanding as to why I had my issue in the first place. With this kind of service, I would honestly recommend this physio if you are serious about getting better.
Thoughtful and sincere service. Highly recommended!
My mum received her first Apos treatment. We intend to continue until her hip muscles become strong. We believe in the treatment as we saw how amazing it was. The idea was simple. Really love that she can be herself again, for long term. The hip and knee cap operations offers 15yrs. Hence we reject the cost and short-life. My wish is that the treatment cost can be lowered and more are aware of this treatment. God bless and thank you team.
Look for Soo, he is a great physiotherapist . Always communicating and always asking for my feedback. I’m on the right path to recovery all thanks to Soo. Two thumbs up.
Xue Ting has been working on my troublesome QL, hip girdle - basically the whole left lower kinetic chain! She has been patient, strong and cerebral in her approach to my 48 year old compensatory mechanisms. Her strong massage will finish with an assessment of muscle imbalance and poor activation with finally a retraining back to healthy movement.I’m impressed! Thanks Core Concepts!
I went from barely understanding physical therapy for injuries, to highly recommending Core Concepts to friends and family for their aches and pains. Ken was knowledgeable, patient and explained symptoms and consequences in a simple, relatable manner. I hope more people will come to understand how physio is a much better alternative to short-term painkillers.
Ken is really amazing!
The physiotherapist here explained the problem very well and provided me with exercises that helped improved my condition.
I have been experiencing great pain on my shoulder coupled with occasional numbness on my arm. Thanks to Ken Liew, I felt so much relieved after my first session. He was very patient and knowledgeable and had definitely made my 1st visit to a physiotherapy clinic a very memorable one. Thank you so much Ken
I have been experiencing knee pains lately especially walking up and down the stairs. The pain was so bad that I was very concern. I chanced upon CoreConcept on FB and book an appointment with them at Camden Medical Centre. My therapist was Ken Liew, he is very professional and knowledgeable. He did a thorough job to assess my condition. To my surprise I felt immediate relieved on my knee after the first session with him! Amazing! Looking forward to my next session. 😊
Hi I am Sally and I am in my late sixties. I have endured a year of thigh(joint) pains and thought that it must be due to old age. Visited Core Concepts at Novena and after only 2 sessions, my condition improved so much that I was able to climb stairs easily again. THANKS to my Physiotherapist Samuel Ong who is extremely polite, professional and knowledgeable.
I have had several sports related injuries and Core Concepts has saved me and put me "back to new" each times! The therapists are excellent - knowledgeable and professional, and the receptionists (Carol, Adiqah and Rin) are always friendly and helpful. They even give me oreo cookies for my children! :)
A very friendly and professional physiotherapist as well as receptionist within the clinic. Jordan Cave is very patient to help my right knee to recover.
Highly recommended for sports massage
Extremely friendly staff and therapists! Folks Novena Square are just simply smiley and happy. Coming here towards the end of the work day always brings up my mood. Therapist and coach are fabulous. My condition improve so much that I can even start to train up some of my predominately unrealized problems. Highly recommended!
I go to Novena and Cheryl is my therapist. She was upfront from the get go about my neck condition. I liked her honesty and said we'll give it a try. I was better after 4 weekly sessions and continued to go to her every 2 weeks. With her help I am in a better condition, had to put in effort on the exercises she taught me as well.
Li Hoong is a very dedicated sports massage therapist and functional trainer. Her ultimate goal is the client's holistic well-being. Highly recommend.
i have tried different physiotherapy sessions with almost 10 physiotherapists in india and in Singapore, my back pain was treated well by CHERYLL, with God's grace , i was pain free only after Cheryll attended to me. Thank you Cheryll and core concepts for the great experience.
I am working with Yiren on my knee after my ACL/MCL reconstruction and recovery has been good! He does a thorough job to assess my progress each session and challenges me to push myself to get to various milestones. He's extremely friendly and helpful despite my many questions. Thanks!
After many different physio and massage sessions in different places, my experience with the core concepts team has been the best. I started seeing them for sports massage, and now for my knee rehab. The level of care and attention makes me want to do more for myself. Isn't this most important when one tend to slack off with the prescribed exercises?
Very friendly and professional physiotherapist as well as receptionists within the clinic. Dr. Issac Wong is easy to approach and came up with alternative ways for me to strengthen my weak thigh muscles and it really helped in reducing my knee pain! Thanks :)
The best physiotherapist ever. Cheryl is really good. Doesn't shortchange me of time and make sure I feel better before she lets me go. The front desk staff are great too. Very accomodating and friendly. Thank you Carol and Farrah. Only thing if they can give instructions to how to go to their place will be great. Usually only unit number but do give some details like mrt exits and directions to lift and such will be excellent. Coz I almost got lost in 2 different places. Overall still love core concept because of Cheryl! Thank you Cheryl!!
Found out about Core Concepts last year through social media and made an appointment as i was experiencing some neck and shoulder discomfort after a traffic accident. My therapist was evidently experienced and was able to pinpoint the cause of my aches. The one thing i loved about my experience at Core Concepts is that they are not like typical physiotherapists who simply prescribe take home exercises, instead my therapist was extremely hands on, helping me to massage my neck at the right spots to relief the stiffness - best massage ever! Would highly recommend Core Concepts!!
Easily the best physio clinic I've been to.
The only physio clinic i trust! A unique approach to treating pains, you simply have to try it out for yourself. Have recommended many friends and family and core concepts has not disappointed. Thumbs up!!!
From the reception to the therapist, they are friendly and nice. I was taught on a 2 steps stretching to strengthen my leg muscles that I can do it myself daily and It did help :) Will recommend to anyone who wish to have therapy sessions.
Knowledgeable and brilliant!
-emails with advertisement and birthday wishes came, but they didn't think that their customer (with 4/10 sessions remaining in his package) would have expected a reminder of ANY kind if his package was already expiring. I asked the clerk from my last visit how many sessions I had remaining, and she told me 4, with no update on the expiry at all. -assumed I wanted a physiotherapy (PT) appointment when my past SMS have always been for sports massage (SM); whenever I asked for "available slots", they would give me the slots for SM. yet they suddenly gave me the list of available slots for PT ytd. I'm also to blame for not verifying and reading their long SMS carefully.-their masseuse is very good though, skilful and respectful. They ask important questions to understand their client before starting on the SM. I'd still return even though the administrative process is lacking.
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