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 not originate directly from it. The pain 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.
In a vibrant metropolitan city-state, people living in Singapore have a large diversity in lifestyle and work duties, but like many other developed cities, many of our jobs entail us to be sitting in the office and having a sedentary lifestyle. The most vulnerable part of our bodies that is subjected to weakening with such a lifestyle is the buttock (gluteal) region. With prolonged periods of sitting down, our gluteal muscles tend to be inactive. As these muscles play a major role in standing, walking and running, weakness in the gluteal muscles often leads to upper/lower back pain and knee pain.