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Low Back Pain Management and Treatment

Be Pain Free from Back Pain!

Call us at (65) 6471 2744 or Email to: info@boneclinic.com.sg to schedule for an appointment.

What is Low back pain?

Low back pain can happen to anywhere in your spine, below the ribs and above the legs. The lower back connects the upper and lower body. It bears the most of your body’s weight. Due to this, your back is the most commonly injured compare to the rest of the body and you can easily hurt your back if you life heavy loads, overstretch or twisting. Everyone will have low back pain one time in their life.

What causes Low back pain?

Causes of low back could be injury or degeneration disease.

Cause Low back pain include:

What are the low back pain symptoms?

The symptoms of the low back pain varies with individuals. Some people may feel constant dull or sharp back pain. Some people may feel pain in a small area or a broad area. Some may feel muscle spasms to the back.

Sometimes low back pain can cause symptoms to the legs or thighs, such as pain, numbness, or tingling sensation over the thigh area and sometimes the low back symptoms may extend below the knee to the calf.

Cauda equina syndrome is a rare but serious low back pain problem. This is a condition whereby the nerves at the end of the spinal cord are squeezed. Seek specialist treatment if you feel weakness or numbness in both of your legs or you could not control your bladder or bowel.

Seek specialist treatment if your low back pain does not go away with rest. If you ignore your low back pain, it may result to chronic back pain.

How is low back pain diagnosed?

Our specialist will ask questions about you past medical history. He will examine your spine carefully.

If your low back pain lasted more than four weeks, or if our specialist suspect that you may have more than muscle pain after the examination, he may refer you for an MRI investigation.

How is it treated?

Minor low back pain will improve after resting for a day or two.

Other treatments for your low back pain includes:

  • Physiotherapy – Strengthening to your back muscles.
  • Epidural injection
  • Spinal manipulation
  • Back surgery for disc problem that may lead to nerve problem.

Low Back Pain Video:

How can you prevent low back pain from returning?

If you’ve had low back pain before, the chances of getting low back pain again is higher.

To prevent future low back pain, you can follow these activities:

  • Maintain good posture.
  • Low impact exercise like walk or swim.
  • Avoid wearing high heeled shoes.
  • Sleep on your side.
  • Watch your weight. Being too heavy, especially around your waist, puts extra stress on your back.
  • Avoid lifting heavy loads.

If you sit or stand for long periods at work:

  • Pay attention to your posture. Sit or stand up straight, with your shoulders back.
  • Make sure your chair has good back support.
  • Take regular breaks to walk around.

If your work involves a lot of bending, reaching, or lifting:

  • Use good techniques for lifting.

Cure Your Back Pain Today! Call us at +65 6471 2744 or SMS to +65 9235 7641 for an appointment

Guide to Low Back Pain

What Is Low Back Pain?

Low back pain is a universal human experience — almost everyone has it at some point. The lower back, which starts below the ribcage, is called the lumbar region. Pain here can be intense and is one of the top causes of missed work. Fortunately, low back pain often gets better on its own. When it doesn’t, there are effective treatments.

Symptoms of Low Back Pain

Symptoms range from a dull ache to a stabbing or shooting sensation. The pain may make it hard to move or stand up straight. Acute back pain comes on suddenly, often after an injury from sports or heavy lifting. Pain that lasts more than three months is considered chronic. If your pain is not better within 72 hours, you should consult a doctor.

Symptoms That Require Urgent Care

Severe back pain after a fall or injury should be checked out by a health care professional. Other warning signs include a loss of bowel or bladder control, leg weakness, fever, and pain when coughing or urinating. If you have any of these symptoms along with your back pain, contact your doctor.

Muscle Strain or Sciatica?

The kind of back pain that follows heavy lifting or exercising too hard is often caused by muscle strain. But sometimes back pain can be related to a disc that bulges or ruptures. If a bulging or ruptured disc presses on the sciatic nerve, pain may run from the buttock down one leg. This is called sciatica.

Back Pain Culprit: Your Job

If your job involves lifting, pulling, or anything that twists the spine, it may contribute to back pain. However, sitting at a desk all day comes with risks of its own, especially if your chair is uncomfortable or you tend to slouch.

Back Pain Culprit: Your Bag

Although you may wear your purse, backpack, or briefcase over your shoulder, it is the lower back that supports the upper body — including any additional weight you carry. So an overstuffed bag can strain the lower back, especially if you carry it day after day. If you must tote a heavy load, consider switching to a wheeled briefcase.

Back Pain Culprit: Your Workout

Overdoing it at the gym or golf course is one of the most common causes of overextended muscles leading to low back pain. You’re especially vulnerable if you tend to be inactive during the work week and then spend hours at the gym or softball field on the weekend.

Back Pain Culprit: Your Posture

Mom was right when she said, “Stand up straight!” Your back supports weight best when you don’t slouch. This means sitting with good lumbar support for your lower back, shoulders back, with feet resting on a low stool. When standing, keep weight evenly balanced on both feet.

Back Pain Culprit: Herniated Disc

The spine’s vertebrae are cushioned by gel-like discs that are prone to wear and tear from aging or injuries. A weakened disc may rupture or bulge, putting pressure on the spinal nerve roots. This is known as a herniated disc and can cause intense pain.

Back Pain Culprit: Chronic Conditions

Several chronic conditions can lead to low back pain.

  • Spinal stenosis is a narrowing of the space around the spinal cord, which can put pressure on the spinal nerves.
  • Spondylitis refers to chronic back pain and stiffness due to severe inflammation of the spinal joints.
  • Fibromyalgia causes widespread muscle aches, including back pain.

Who’s at Risk for Low Back Pain?

Most people get their first taste of low back pain in their 30s. The odds of additional attacks increase with age. Other reasons your low back may hurt include:

  • Being overweight
  • Inactive lifestyle
  • Jobs that require heavy lifting

Diagnosing Low Back Pain

To help your doctor diagnose the source of low back pain, be specific in describing the type of pain, when it started, related symptoms, and any history of chronic conditions. Your doctor may order X-rays, CT or MRI scans to look for damaged bones or discs, or other injuries to the spine.

Home Care for Low Back Pain

Back pain due to muscle strain will usually get better on its own, but you can take steps to make yourself more comfortable. A heating pad or warm baths may provide temporary pain relief.

The Bed Rest Debate

When your back hurts, you may not feel like getting out of bed. But if the problem is muscle strain, doctors recommend returning to your normal activities as soon as possible. Studies suggest that any more than a day or two of bed rest can actually make the pain worse and may reduce muscle tone and flexibility.

Yoga

If back pain doesn’t go away in three months, there’s evidence that yoga can help. In one recent study, people who took 12 weeks of yoga classes had fewer symptoms of low back pain than people who were given a book about care for back pain. The benefits lasted several months after the classes were finished. The study suggests conventional stretching also works just as well. Make sure your instructor is experienced at teaching people with back pain and will modify postures for you as needed.

Medications

Mild back pain often feels better with over-the-counter pain relievers, such as acetaminophen, ibuprofen, or naproxen. Pain-relieving creams may be helpful for muscle aches. For severe pain or chronic pain, your doctor may recommend prescription medication.

Injections

If simpler therapies and medications aren’t helping, your doctor may recommend injections to the back. One procedure, called a nerve root block, targets irritated nerves. Injections for back pain usually contain steroid medication.

Surgery

If long-lasting back pain is interfering with your daily life, and other treatments have not provided relief, you may be a candidate for surgery. Depending on the cause of your pain, a surgeon may remove a herniated disc, widen the space around the spinal cord, and/or fuse two spinal vertebrae together.

Physical Therapy

If back pain has left you inactive for a long time, a rehabilitation program can help you strengthen your muscles and get back to your daily activities. A physical therapist can guide you through stretches, strength exercises, and low-impact cardio that will help you be fitter without straining your back.

Strengthening the Back

Two types of strength-training moves that may benefit the lower back are flexion and extension exercises. In flexion exercises, you bend forward to stretch the muscles of the back and hips. In extension exercises, you bend backward to develop the muscles that support the spine. One example is doing leg lifts while lying on your stomach. Depending on the cause of your back pain, there are some exercises you should not do. If you have back pain, make sure to talk to your doctor about what exercises are safe for you.

Preventing Low Back Pain

There’s no sure way to prevent back pain as you age, but there are steps you can take to lower your risk:

  • Stay at a healthy weight.
  • Exercise regularly.
  • Lift with your legs, not your back.
  • Make sure your work station position isn’t contributing to your pain.

CURE YOUR BACK PAIN TODAY. CALL US AT +65 64712744 OR EMAIL TO: INFO@BONECLINIC.COM.SG FOR APPOINTMENT

Tips to Manage Low Back Pain at Home

Perhaps you bent the wrong way while lifting something heavy. Or you’re dealing with a degenerative condition like arthritis. Whatever the cause, once you have low back pain, it can be hard to shake. About one in four say they’ve had a recent bout of low back pain. And almost everyone can expect to experience back pain at some point in their lives.

Sometimes it’s clearly serious: You were injured, or you feel numbness, weakness, or tingling in the legs. Call the doctor, of course. But for routine and mild low back pain, here are a few simple tips to try at home.

Spinal Stenosis

Chill it. Ice is best in the first 24 to 48 hours after an injury because it reduces inflammation. “Even though the warmth feels good because it helps cover up the pain and it does help relax the muscles, the heat actually inflames the inflammatory processes,” she says. After 48 hours, you can switch to heat if you prefer. Whether you use heat or ice — take it off after about 20 minutes to give your skin a rest. If pain persists, talk with a doctor.

Keep moving. “Our spines are like the rest of our body — they’re meant to move. Keep doing your daily activities. Make the beds, go to work, walk the dog. Once you’re feeling better, regular aerobic exercises like swimming, bicycling, and walking can keep you — and your back — more mobile. Just don’t overdo it. There’s no need to run a marathon when your back is sore.

Stay strong. Once your low back pain has receded, you can help avert future episodes of back pain by working the muscles that support your lower back, including the back extensor muscles. “They help you maintain the proper posture and alignment of your spine. Having strong hip, pelvic, and abdominal muscles also gives you more back support. Avoid abdominal crunches, because they can actually put more strain on your back.

Stretch. Don’t sit slumped in your desk chair all day. Get up every 20 minutes or so and stretch the other way. Because most of us spend a lot of time bending forward in our jobs, it’s important to stand up and stretch backward throughout the day. Don’t forget to also stretch your legs. Some people find relief from their back pain by doing a regular stretching routine, like yoga.

Think ergonomically. Design your workspace so you don’t have to hunch forward to see your computer monitor or reach way out for your mouse. Use a desk chair that supports your lower back and allows you to keep your feet planted firmly on the floor.

Watch your posture. Slumping makes it harder for your back to support your weight. Be especially careful of your posture when lifting heavy objects. Never bend over from the waist. Instead, bend and straighten from the knees.

Wear low heels. Exchange your four-inch pumps for flats or low heels (less than 1 inch). High heels create a more unstable posture, and increase pressure on your lower spine. According to research, nearly 60% of women who consistently wear high-heeled shoes complain of low back pain.

Kick the habit. Smoking can increase your risk for osteoporosis of the spine and other bone problems. Osteoporosis can lead to compression fractures of the spine. One study found that smokers are about a third more likely to have low back pain compared with nonsmokers.

Watch your weight. Use diet and exercise to keep your weight within a healthy range for your height. Being overweight puts excess stress on your spine.

Try an over-the-counter pain reliever. Anti-inflammatory drugs can help reduce back pain. Be sure to check with your doctor or pharmacist about any interactions over-the-counter pain relievers may have with other medications you are taking. People with a history of certain medical conditions (such as ulcers, kidney disease, and liver disease) should avoid some medicines.

Call your doctor if:

  • Your low back pain doesn’t go away after a few days, and it hurts even when you’re at rest or lying down.
  • You have weakness or numbness in your legs, or you have trouble standing or walking
  • You lose control over your bowels or bladder

These could be signs that you have a nerve problem or another underlying medical condition that needs to be treated.

STOP YOUR BACK PAIN TODAY! CALL US AT +65 6471 2744 or EMAIL TO: info@boneclinic.com.sg FOR APPOINTMENT

Back Pain

Most people suffer from mild back pain from time to time and the exact cause of which may be difficult to diagnose. It is usually a sign that one or more muscles, joints, ligaments or discs are over-stretched or twisted by movement of the back in an awkward position. Severe pain may be the result of pressure on nerves from the misalignment of the bones in the back and warrants immediate medical attention.

Low back pain afflicts some 80 % of the adult population some time or other in their lives.

Many episodes of pain last only several hours or a day or two. By and large, 90% of patients should have recovered from their initial attack of pain by 6 weeks from the onset.

Symptoms

Early medical attention is necessary if certain symptoms (“red flags”) are present:

  • Constant pain with no significant relief at rest
  • Aggravated by bending in all directions
  • Localisable severe pain to a single spot on the back
  • Progressively severe pain over days/weeks
  • Persistent nerve pains, pain or sensation of numbness, pins & needles aching in one or both legs
  • Weakness of legs, difficulty in walking, unsteady walking
  • Bladder/bowel problems associated with back pain (difficulty in passing urine – incontinence)
  • General symptoms of poor health, loss of appetite, weight loss, lethargy, fever and chills
  • Previous history of cancer

Treatment

Rest is very crucial for patients with episodic attacks of back pain. Rest here may involve going home and lying down for a few hours, or it may be as simple as keeping the back straight and avoiding further stress to the back in the form of bending, lifting and sitting. In severe attacks, lying down for a day or two may significantly reduce the severity of the pain. If it does not, further bed -rest is not helpful.

Physical therapy is very important in the treatment and prevention of low back pain. In the initial period of acute back pain, combinations of heat, traction, manual treatment, and other techniques may help to rapidly reduce the severity of pain and stiffness. As pain subsides, exercises, to relieve stress and strengthen the back ,are gradually introduced. Regularity of such exercises can help to further reduce the pain, as well as protect the back from unhealthy stress and recurrent attacks of pain.

Different types of medications may be prescribed for different types of back pain.

In acute sciatica or leg pain associated with back disorders, the acute irritation of the nerve may be reduced by taking NSAIDS regularly for a short period of time. NSAIDS are often prescribed purely for pain relief rather than for anti-inflammatory effects. It is based on an as-required basis. These drugs are to be avoided if there is a history of allergy and kidney problems. In most cases, NSAIDS are well-tolerated, though most of them provoke gastric symptoms. The doctor must always be consulted.

Muscle relaxants help to reduce muscle spasm and stiffness that occurs during a pain attack. Sedatives and tranquilisers may be taken at night to ensure a restful sleep.

Ice packs, hot packs or heating lamps, ointments that usually contain methyl -salicylate and medicated plasters of various kinds may help.

30 – 40 % of patients suffer a relapse during the first few months following the attack. It is important to identify the factors that aggravated the pain.

I have severe back pain and sciatica that has not improved even with treatment. What should I do?

X-rays of the low-back should be obtained. Conditions like spondylolisthesis, infection and tumour should be excluded. Sophisticated imaging techniques such as MRI ( magnetic resonance imaging) may be required . MRI scans can show the severity of a prolapsed disc and more importantly , the degree of the nerve compression, if any. Other investigations such as bone scan, CT scans or myelograms may be performed in certain conditions.

Prevention

Recommendations for prevention of low back pain:

  • Try to modify the activity so that it is less likely to strain the back
  • Interrupt a repetitive task frequently by standing and stretching. This helps to reduce the stress on the back from building up to critical levels
  • Exercise programmes must be balanced to exercise all parts of the body, including the back.
  • Exercises should be done frequently in measured doses.

Slipped Disc

As a person gets older, a process called degeneration, the nucleus in the lower few discs of the low back . As a result , the discs are less capable of cushioning the spine , especially during repeated stressful activities. The capsule or annulus can then tear and cause pain. This is known as a slipped disc.

In a slipped disc, the annulus tears with different degrees of severity. Small tears heal quickly. Large tears can cause a small portion of the nucleus herniating through the tear to lie outside the wall of the disc. If this herniation is close to a nerve, intense irritation of the nerve can occur. “Sciatica “or feelings of pain, aching, numbness, “coldness ‘, paraesthesia or pins and needles of the thigh and calf may occur. This can involve one or both legs. Properly performed manual treatment using massage, mobilisation and manipulation may often be helpful in reducing the severity of low back pain.

Most cases recover without the need for surgery. As mentioned earlier, 90 % patients recover within 6 weeks. However a small group of patients have a significant portion of the nucleus that has herniated out of the annulus of the disc to compress the nerve and removal of the herniated fragment of disc will result in more rapid recovery of symptoms than without.

Frequently Asked Questions

Aside from a prolapsed disc, what other causes of recurrent back and leg pains are there?

Spinal canal stenosis and spondylolisthesis are 2 other common causes of recurrent back and leg pains . In older people, a condition termed as lumbar spondylosis, ( the facet joints of the spine can wear out ) can result in episodic back pains. Osteoporosis or softening of the bones can occur in the elderly, resulting in back pains. Patients who have had a previous history of cancer elsewhere, and having persistent back pains, should seek a medical opinion. Less commonly conditions such as rheumatoid arthritis, ankylosing spondylosis and various types of infections can also afflict the spine.

My back is often sore at the end of a day’s work. How can I prevent this?

Modification of activity or the work environment may be required. It is often how the person does that results in unnecessary stress to the back. Such instruction can be provided by the doctor or the therapist , either as an individual or in groups of patients attending “Back Care ” classes.

I am already doing a full day’s work. I also jog and play tennis Why do I need other exercises?

Work, no matter how strenous, is not exercise. In fact, some jobs especially those that involve repeated lifting or bending, or prolonged standing or sitting, add to the stress over the spine. Jogging, racquet games, golf, etc. may be good for general health and fitness but do not significantly exercise or strengthen the back. A balanced programme which includes improving the flexibility and strength of the back will help to prevent recurrent injuries.

STOP your Back Pain today! Call +65 6471 2744 or Email to: info@boneclinic.com.sg for Appointment