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Common causes
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The most common form of back pain, which accounts for 90% of all cases in Singapore is called ‘non-specific back pain’, which means the cause of the pain is unsure. While it may be classified under a general category of pain, different pain experiences may be associated with different structures of the body.

 

For example, a muscle spasm will feel like a constant ache that may be localised or around a small area and worsen when attempting to exert effort towards a certain direction. On the other hand, ligament or joint strain is a sharper and more localised pain and has aggravation with a certain position or angle. Injury of deeper tissues such as intervertebral discs or deep ligaments may irritate nerves, thus creating a painful experience that radiates over larger or more distant areas. In the case of a fracture in the bones, any movement will be excruciating. Hence very limited movement is occurring around the back region.

 

Sometimes, pain experienced over the back may be a referred symptom from the neck or internal organs. In patients with multiple painful areas across the body, such as fibromyalgia, emotional stress may also lead to physical stress. The varying complexity of issues makes chronic low back pain a global challenge for patients and healthcare providers.

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Common forms of back pain complaints in Singapore

Back pain can manifest in many forms – and it can occur to anyone. It is common to hear that back pain is a result of a sedentary lifestyle and no doubt, being inactive is one of the risks of back pain. However, upper or low back pain can also occur in active individuals, especially in athletes or gym-goers in Singapore. This can be due to improper training techniques or overtraining.

Upper Back Pain

T4 syndrome

 

Scapular pain

 

Rib pain

 

Scoliosis

Lower Back Pain

Acute low back pain

 

Disc Herniation

 

Slipped disc

 

Sciatica

 

Lumbar Spondylosis

Scoliosis

 

Spinal Stenosis

 

Fracture of vertebrae

 

Bone spurs / osteophytes

Common Treatments for Back Pain in Singapore

In Singapore, there are many treatment options for back pain that we can choose from. These include massage, gua sha, acupuncture with Chinese physicians, chiropractic adjustments, conventional physiotherapy, medical treatment by doctors, etc. Most of these treatment options provide reasonable help for patients with acute back pain and localised issues, and they include but are not limited to:

Massage

Back Brace

Lumbar spine traction

Electrotherapy modalities

Joint mobilisation

However, a large group of individuals in Singapore suffer from recurring or chronic back pain, and the usual treatment options may not be able to give them lasting or a permanent solution. Our clinical analysis of such cases indicates that the underlying root causes are usually related to habitual errors in their resting position or the way they use their bodies at work / during sports. Without identifying and addressing the underlying habits, conventional pain relief and treatment options will only provide temporary symptom relief. At Balance Core, we clearly identify the underlying root problems and closely guide each client to change their bad habits and form good postural or movement habits. This will help them to not only get lasting pain relief, but they also perform better at work or during sports, preventing recurrences.
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Upper back pain

Pain experience over the upper area is quite different from the lower area as it usually indicates different structures at fault. Common origins of the problems may be at the neck, rib cage, or shoulder blades. While healthcare practitioners may well recognise neck and shoulder issues, rib cage positioning errors may be under-recognised. Clinically we have found out that along with overall postural errors, certain ribs, when positioned in a wrong manner, may lead to lasting discomfort over the upper back. When a diagnosis is done and such a problem is clearly identified and corrected with our manual techniques, the pain relief usually happens instantly, and the upper body’s movement becomes normalised.

Causes of upper back pain

Discomfort in the upper back can also happen due to an injury resulting in back pain issues such as joint dysfunction or muscular irritation. Minor discomfort in the back will only require bed rest for a period of time, while a much more severe condition may need professional help from a doctor. Patients will be asked to go through a physical examination and an x-ray to further analyse what’s causing the back pain issues.

To avoid any pain from occurring in the future, below are the common causes of upper back pain:

Lower back pain

In order for lower back pain to be resolved, the pelvis and hip position needs to be balanced. In the ideal sitting posture, the buttocks need to be wide with the tailbone not touching the seat. The thighs should not be crossed or too close to each other. In the ideal standing posture, the buttocks need to be relatively closed with the tailbone pointing down, and the thighs having some gap in between. Lower back pain is usually associated with abnormal tilt or shift at the pelvis and hip region. These ideal postures ensure the stresses loaded to the lower back are minimal.

Causes of lower back pain

Injuries or inflammation typically contribute to lower back pain. The cause can be minor in some people, such as a mild muscle strain. But, a significant underlying disorder, including a herniated or fractured spinal disc, may be liable in other individuals. If there is a stiffness and swelling in the area where the pain is located, it’s best you have it checked in a clinic so the doctor can prescribe you anti-inflammatory medications.

Some of the most frequent causes of low back pain include:

Back Pain Treatments

1

Modalities

Radiofrequency TECAR Therapy

 

Therapeutic ultrasound

 

Neck & back traction

2

Moderate injury

Manual Therapy

 

Trigger point release

 

Joint mobilization and manipulation

 

Facilitated stretch

3

Exercises

Posture enhancement

 

Gait training

 

Core control training

 

Specific muscle activation

 

Kinetic chain exercises

 

Work / sports specific exercises

 

Life Energy Exercises

4

Others

Ergonomic adjustment / advice

 

Dry needling

 

Sports taping

 

Bracing

 

SHAPECRUNCH customized foot In-soles

When to See a Back Pain Specialist?

If the back strain lasts more than a week or radiates away from the back to other areas, it may indicate a more serious problem than a simple strain or bruise. In Singapore, numerous people tend to avoid seeing a back pain doctor or physiotherapist unless they are in severe pain. It is important to seek help early to detect the underlying root cause and to avoid delay in healing. If help is not rendered in the early stage, it may lead to more complicated issues later.
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    Frequently Asked Questions

    Do I need an appointment?
    Yes, our treatment is generally on one to one basis, and you will need to contact us to schedule an appointment.
    Do I need a referral letter from a doctor?
    In Singapore, physiotherapy sessions are regulated by the Allied Health Professions Council, and under the current regulation, this is not a mandatory requirement to obtain a referral from a doctor before seeing a physiotherapist. When the attending physiotherapist deems that the patient needs medical attention, we will refer the client to a relevant doctor for further care.
    Do I need to take an X-ray or MRI scan before seeing a physiotherapist?

    Your physiotherapist will perform a thorough assessment to evaluate the problem and identify the problem’s root course. A detailed explanation will be given so that you can fully understand your issues and the outline of subsequent physiotherapy treatment plans.

    Thereafter, a treatment involving muscle release, specific muscle activation or joint mobilization, etc. will be rendered to provide symptomatic pain relief and address underlying root problems.

    What attire should I wear for my appointment?
    Comfortable clothing – preferably T shirt and shorts. We do provide clothings for you to change into if needed.