Myth busting: Smacking the warm bus seat before sitting prevents piles

You may not see many people doing it now on public transportation – especially with everyone trying to minimise contact with any type of surface – but you’re eventually bound to spot one.

We’re talking about the practice of smacking the bus or MRT seat before sitting down on it.

So why do some people do it? The rationale, at least for those who believe this old wives’ tale, is that that it’s supposed to cool the seat down – because the body heat left behind by the previous sitter can do strange things to your bum, like cause piles or haemorrhoids.

Myth busted: “There is actually no proven harm in sitting on a warm seat,” said Dr Sabrina Wee, the head of the Gastroenterology Workgroup at SingHealth Polyclinics. Instead, she said, what does harm you is how long you spend sitting on something, regardless of whether it’s warm or not. And most of the time, it takes place somewhere more private than a bus – your toilet seat.

WHAT CAUSES PILES AND WHO ARE LIKELY TO DEVELOP THEM?

Piles, also known as haemorrhoids, are swollen veins that can occur in the anus or rectum, said Dr Wee. They can cause pain, itchiness and bleeding when they become inflamed. “In Singapore, it is estimated that about 33 per cent of Singaporeans suffer from haemorrhoids,” she said.

Both men and women, regardless of age, can develop piles for a variety of reasons. Straining is certainly one way as the action causes blood to pool in the veins around the anus. For that reason, constipation, diarrhoea and childbirth are common culprits as they cause you to strain, said Dr Wee.

Interestingly, prolonged sitting or standing can also contribute to piles; the action allows gravity to push the swollen blood vessels down and out of the anus. For this reason, individuals with jobs that require them to sit a lot, such as taxi drivers and office workers, are prone to developing piles.

WHAT RELIEF IS THERE FOR PILES?

Obviously, sitting on a hard surface while having a case of inflamed piles is a painful experience – whether or not the seat is warm. But typically, the inflammation subsides on its own in about two weeks.

During this time, Dr Wee advised to avoid sitting too much. If you have a desk-bound job, stand instead of sit at your desk. If you must sit, get a cushion to ease the swelling, she said.

It also makes sense to try and soften your stool during this period, so get on a high-fibre diet, limit fatty food (it can exacerbate constipation) and increase your fluid intake to 2 litres a day, she said. While on the toilet, avoid prolonged sitting and excessive straining.

While a warm seat doesn’t give you piles, having a warm sitz bath – where you literally sit in water – can actually help to relieve the pain if you already have it, said Dr Wee. There are also over-the-counter medicated creams and ointments to reduce the pain during a flare-up.

“Surgery may be required if the methods above do not help, and the piles do not resolve,” said Dr Wee. “Consider seeing a specialist if the piles are persistent and especially if there is recurrent bleeding.”

But the moral of the story is: Prevention is always better than cure. “Take adequate fluids and fibre, avoid straining when moving bowels, and avoid long sessions on the toilet,” said Dr Wee.


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Myth busting: Smacking the warm bus seat before sitting prevents piles

Knuckle cracking: It's annoying to others but can it also cause arthritis?

Cr-aaack! Hearing the sound of someone’s knuckles being popped either makes you want to crack yours too, or it just gives you the shudders. Sometimes, the snapping sound comes from your knee or hip, but you've not done anything other than get up from your seat.

So, what’s going on with your joints and why are they popping away? “Popping” would be the right word for it because the sound actually comes from air bubbles bursting in your joints, said Dr Soumen Das De, Associate Consultant with the Hand & Reconstructive Microsurgery Centre at National University Hospital.

If you’re trying to stop someone’s irritating knuckle-cracking habit, you’ll need a better reason than saying "you’re ruining your joints".

Yes, there is naturally dissolved air in your joints, and when you crack them, you create a negative space that lets the dissolved air form bubbles, he explained. “This process typically happens within seconds. The joint cannot be cracked for several minutes afterwards because the air needs to re-accumulate in the joint space.”

The snapping sound can also be caused by a tendon sliding over a bony protrusion or excessive motion between bones, said Dr Das De.

WHY THE KNUCKLES?

You’d notice that many people, who crack their joints, tend to do it to their knuckles. What makes them so irresistible to manipulate?

“Knuckle cracking is a common behaviour enjoyed by many. It can become a habit or a way to deal with nervous energy; some describe it as a way to release tension,” said Dr Robert Shmerling on Harvard Health Publishing.

Furthermore, “the small joints of the hand, such as the knuckles or metacarpophalangeal joints, are easier to crack,” said Dr Das De. “Larger joints, such as the knee and elbow, require a considerable amount of force to generate the same degree of negative pressure.”

But having said that, there are individuals who derive satisfaction from cracking their backs.

WHAT’S THE DAMAGE?

Should you listen to your mother and abstain from cracking your joints? Happily, the answer is no, you don’t have to. (Sorry, Mum!) “There is no evidence that cracking a joint increases the risk of long-term degeneration and osteoarthritis,” said Dr Das De. The damage it can cause, though? Annoying the heck out of the people around you.

All that said, this does not give you the licence to pop your joints with abandonment. Ringo Yee, Principle Physiotherapist at Tan Tock Seng Hospital, said that injury to the soft tissue, ligaments or surrounding structures of the affected joint, such as blood vessels, is possible. “Typically, pain is the first common symptom. Other signs relating to soft tissue injury, such as swelling, may occur,” he said.

And if you’re constantly cracking a particular joint, such as your back, to ease the pain, you might be better off seeing a chiropractor instead. A study in the Journal Of The American Medical Association found that pain in the lower back is only momentarily relieved by cracking the back, and wouldn’t add up to any significant improvements.

It’s also not a good idea to be constantly cracking your neck, according to a Healthline article: “Cracking your neck too forcefully can pinch the nerves in your neck. Cracking your neck too hard can also strain the muscles around your joints and the joints themselves. When your muscles or joints become strained, moving your neck can feel like a chore."

The article also cautioned against overdoing the neck cracking as it can over-stretch your ligaments permanently, and increase your chances of developing osteoarthritis.

WHAT YOU SHOULD NEVER CRACK

According to Yee, getting your partner or colleague – unless he or she is medically trained – to crack your neck or back for you is a bad idea. “They may unknowingly exert too much force and cause pain. The possible injuries are ligament sprains, fractures and dislocations.”

That said, if you experience persistent pain, swelling, bruising and stiffness after a massage that involves cracking your neck and/or back, see a doctor immediately to rule out any injuries.

Individuals who have “joint osteoarthritis and recent bone, joint and/or soft tissue injuries (e.g. tendon, ligament) should refrain from this habit because there is a considerable risk of re-injury,” warned Dr Das De. “If you are recovering from an injury and are in doubt about cracking your joints, it is always prudent to check with your doctor.”

In fact, even the joint cracking that results from the manual therapy techniques used by physiotherapists should be avoided for certain individuals, said Yee. These include patients with fractures, tumours, infections, inflammation, or are on long-term steroidal use or anticoagulation medication.


Taken from this article:
Knuckle cracking: It's annoying to others but can it also cause arthritis?

Myth busting: Why pregnant women develop dark patches on the face

When it comes to the dos and don’ts in life, you’ve probably heard a few cautionary tales. Don’t walk in the rain; you’ll catch a cold. Eating chocolates will lead to acne breakouts.

Some of these make sense, but some are also old wives’ tales or myths. Sometimes, the latter persist like warts that refuse to go away because the “advice” seems medically sound on surface level (for example, many think that cracking your fingers will lead to arthritis). Others could be time-honoured practices passed down from generation to generation – so they can’t be wrong, right?

For the first instalment of our health myth buster series, we’re taking a look at something that affects many pregnant women: Melasma, or those dark facial patches that the superstitious think are caused by evil spirits.

Yes, you may laugh at how silly the notion is but there are still people of the older generation who believe there are supernatural reasons to it. The darker the patches, the more malevolent the spirits latching on to you are. Also, that pregnant women are vulnerable because the discolouration is seen more often on their faces than non-pregnant individuals.

WHAT CAUSES THESE DARK PATCHES TO APPEAR?

As you might already know, there is nothing remotely supernatural about these patches. Your skin naturally produces a pigment called melanin, which determines the colours of your eyes, hair and skin. Sometimes, your skin produces more melanin than usual when, for instance, you’ve been out in the sun.

If you are prone to melasma, the higher amount of melanin will concentrate in areas such as the cheeks, forehead, bridge of the nose and chin – and create these dark patches, said Dr Angeline Yong, consultant dermatologist at Angeline Yong Dermatology.

According to her, there are three types of melasma. And the deeper the pigmentation, the harder it is to treat:

• Epidermal melasma: Brown with well-defined borders and affects the top layer of skin.
• Dermal melasma: Blue-gray patches that affect the deeper dermis level.
• Mixed melasma: Brown-gray pigmentation affecting both the epidermal and dermal layers of the skin.

OTHER THAN PREGNANT WOMEN, WHO IS LIKELY TO GET MELASMA?

It can be common for mothers-to-be to develop the patches, which is also known as “the mask of pregnancy”. The reason lies with their higher levels of female sex hormones that trigger melasma, said Dr Yong.

Similarly, situations such as being on oral contraceptives and hormone replacement therapy – both of which increase hormonal levels – can also increase your risk of melasma.

Your complexion may also get patchy if you're using skincare products that contain alpha-hydroxy acids, or you're on certain antibiotics and antihistamines. These compounds can cause your skin to become sensitive to sunlight and cause it to pump out more melanin as protection, said Dr Yong.

Other reasons include hormonal changes, inflammation, stress, thyroid disorders and age.

Genes also play a role; you are likely to develop melasma if your mother has it, according to a study published in the Journal Of The European Academy Of Dermatology And Venereology.

Situations such as being on oral contraceptives and hormone replacement therapy – both of which increase hormonal levels – can also increase your risk of melasma.

HOW IS MELASMA TREATED?

Melasma is difficult to treat because it’s a “complex condition caused by multiple factors”, said Dr Yong. “The condition also tends to relapse because the factors are not always easy to identify and control. While you can manage melasma, it has no permanent cure.”

To treat melasma, Dr Yong advocates using sun protection (including wearing a hat and a broad-spectrum sunscreen of SPF50 and above when you're out) and the following:

• Topical treatments

These include a combination of hydroquinone, tretinoin and a steroid, said Dr Yong. Together, they exfoliate, and inhibit melanin formation and cell activity. Sometimes, azelaic acid, kojic acid, ascorbic acid and/or cysteamine hydrochloride may also be used in addition to the combo, she said.

• Oral tranexamic acid 

It reduces heavy bleeding during surgery and menstruation, said Dr Yong, but oral tranexamic acid is also known to reduce melanin production. According to studies, said Dr Yong, twice daily doses of oral tranexamic acid showed improvements in melasma after four weeks.

• Chemical peels 

Usually, a combination of lactic and salicylic acids is used to slough off the outermost layer of skin. This encourages cell regeneration to create a brighter and less pigmented complexion, said Dr Yong.

• Laser treatments

"Picosecond laser treatments are another excellent solution to reduce melasma," said Dr Yong. She prefers them to traditional Q-switched lasers as there is less damage to the surrounding tissues. This also helps to prevent the pigmentation from returning with a vengeance should there be inflammation.

Can the above treatments be used on someone whose melasma is caused by a medical condition such as a thyroid disorder? Can the skin disorder be treated concurrently as the medical issue?

“I see no harm in embarking on treatments for melasma, particularly topical agents, which do not conflict with or impair thyroid treatments that you may be taking concurrently,” said Dr Yong.


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Myth busting: Why pregnant women develop dark patches on the face