Back Pain Singapore Treatment - Is it time to visit?

Let’s face it, almost all of us get back pain some time in our lives. Besides occasional strains, common causes of pain in your lower back include awkward positioning in sitting, standing, or sleeping while working or playing sports. Some of us may get pain when lifting up heavy objects with outstretched arms. Others may experience it gradually while sitting at work with tensed back muscles. In most cases if we change our position, do some stretching exercises, or massage the area for a while, the discomfort may just go away gradually. Recurring lower back pain may be a presentation of an underlying disease or structural imbalance in the body. Hence, if the same type of symptoms reappears repeatedly, or the severity has worsened and lasted longer than before, it is recommended to seek help from medical professionals such as doctors and physiotherapists.

What is Back Pain?

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.

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
  • Disc Herniation
  • Slipped disc
  • Sciatica
  • Lumbar Spondylosis
  • Scoliosis
  • Spinal Stenosis
  • Fracture of vertebrae
  • Bone spurs / osteophytes
  • Scoliosis

Signs and Symptoms of Back Pain

Back pain is one of the most common complaints of discomfort in Singapore, and it is a leading cause of disability worldwide. Most people have pain in their upper or lower back at least once in their lives. Fortunately, you can take measures to prevent or relieve most upper and lower back pain episodes. Back surgery is rarely needed as a treatment for back pain.

Signs and symptoms of upper and lower back pain can include:

  • Muscle ache
  • Pain that radiates down your leg
  • Pain that worsens with bending, lifting, standing or walking

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:

  1. Massage
  2. Back Brace
  3. Lumbar spine traction
  4. Electrotherapy modalities
  5. 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.

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:

Poor posture

Over time, muscle weakness can lead to pain due to strain or discomfort. When a person slouches in the chair, it may cause a loss of muscle strength. What happens is that the pressure from the upper body forces the back, neck, discs and ligaments to get pushed down in an inappropriate manner. This pressure can cause pain and other problems over time. Your doctor may require you to undergo an x-ray to see the condition of your spinal cord.

Fortunately, the muscles can get stronger and more durable with the right treatment methods. This method begins by adjusting the posture while sitting down and taking occasional breaks from your office desk. Exercises can also boost strength in the upper back. Another tip we can give you is to set an alarm to remind you to keep arching backwards and stretching to prevent you from slouching.

Joint dysfunction

Joints in the thoracic spine can become unstable and painful due to sudden injury or ageing. A joint capsule tearing is one common example of this. We’ve mentioned joint dysfunction can occur during ageing, which makes it a common occurrence for older individuals in Singapore.

Muscular irritation / spasm

The shoulder girdles’ connects to the scapula and back of the rib cage with the help of the broad muscles. These broad muscles are susceptible to tightness or strains that can be painful and hard to relieve. Muscles in the back are normally de-conditioned or overused due to irritation in the upper back. Patients may improve their muscles through weight lifting and exercises. 

Over time, many people in Singapore can decondition their muscles by not properly using them. Deconditioning is as simple as sitting on a desk with a wrong posture for too long. This condition can lead to further discomfort and damages in certain muscles, including back muscles. Muscle irritation usually occurs to those who work in the office.

Muscle Overuse

Another cause of upper back pain in Singapore is an overuse of back muscles. This condition normally happens because the same movements are repeated over time. Other repetitive tasks may cause related pain. For instance, someone who has to walk and stand through the entire day or lift items that overlap their heads may experience muscle irritation or strain. If they disregard these symptoms, it could become chronic pain.

Muscle overuse treatment and pain relief typically starts with rest in the area and with the use of heat or ice packs to encourage the circulation of muscle tissue. It could also help if you could find ways of preventing repeated motion, or of breaking between activities.

Referred pain from cervical, shoulder or organs

Referred pain is a condition where the pain in one part of your body is directly triggered in another part of your body which can be caused by an injury. For instance, an injured pancreas may cause back pain or jaw pain associated with a heart attack. Referred pain can be a symptom of significant events in our bodies. How and why it happens is important to understand in order to avoid this from worsening in the future. Also, having knowledge about referred pain will help you act immediately in case you’re experiencing sudden pain as it may be linked to something serious.

Other systemic diseases

  • Gallstones
  • Heartattack
  • spinal deformity
  • scoliosis
  • fibromyalgia

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 upper 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:

Poor posture

One common cause of damage to the back for patients in Singapore is a bad sitting position. The discs can be stressed by sitting in a sluggish or hunched position. Painful spasms and muscle weakness may be attributed to bad posture. Some people could change their stance, which could intensify the pain. In the case that your bad posture is not causing your lower back pain, it can still worsen the condition. A sports doctor may help you correct your posture. X-rays and a diagnosis may be needed in order for them to come up with a treatment plan for pain relief. With the treatment plan that you’ll get from your sports doctor, surgery won’t even be an option anymore.

Herniated disc

The jelly core of a lumbar disc can move through the hard outer layer and irritate the nerves’ nearby root. The herniated part of the disc is filled with proteins that cause inflammation in the nerve root, and nerve compression and inflammation cause nerve root pain. The disc wall is richly supplied with nerve fibres, and serious pain can arise from tearing through the wall.

Muscle irritation / spasm

Lower back spasms can be due to several potential causes, including bad posture, muscle overuse and strains. A doctor should be seen for a physical examination for people with chronic or worsening spasms or discomfort.

A lower back spasm normally feels like muscle contracts or moves firmly. However, it could also feel like a dull ache, sharp pain, or a combination of these painful sensations. Some individuals in Singapore also note that lower spasm pain spreads to other parts of the body, such as the hips or legs.

Joint dysfunction

There are two types of joint dysfunction associated with lower back pain: Facet joint dysfunction and Sacroiliac joint dysfunction. 

  1. Facet joint dysfunction: In each movement of the lumbar, there are two facet joints behind each disc. These joints contain cartilage and have a capsular ligament surrounded by nerves. These joints can encounter pain on their own or can be associated with disc pain.
  2. Sacroiliac joint dysfunction: The sacroiliac joint attaches the sacrum on either side of the pelvis at the bottom of the spine. It is a strong, low-motion joint that mostly takes in the shock and stress between our bodies’ upper and lower part. Inflammation can cause the sacroiliac joint to become painful, or in some cases, if the joint is moving too much or too little.


Osteophytes are bony lumps that form in or around the spinal cords. They also develop near osteoarthritis-affected joints and cause joint pain and stiffness. The wear and tear of the discs and facet joints result in that condition. It induces varying degrees of discomfort, inflammation, instability which stenosis and may take place at one or several degrees of the lower spine. Spinal arthritis, which is steadily progressive, is linked to ageing, thus making it a common lower back pain problem for the elderlies in Singapore.

Back Pain Treatments

  • Radiofrequency TECAR Therapy
  • Therapeutic ultrasound
  • Neck & back traction
Manual Therapy
  • Myofascial release
  • Trigger point release
  • Joint mobilization and manipulation
  • Facilitated stretch
  • Posture enhancement
  • Gait training
  • Core control training
  • Specific muscle activation
  • Kinetic chain exercises
  • Work / sports specific exercises
  • Life Energy Exercises
  • 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.

Singapore's Back Pain Specialists at Balance Core

At Balance Core, all our Physiotherapists are specialised in a detailed analysis of the whole body presentation, so that we can identify both the nature of the injury as well as the underlying root causes. With the focus on restoring the body’s holistic balance, we have helped people with chronic back pain recover and fully embrace their life. Some have even suffered for more than ten years and tried various treatment options in the past but to no avail. The root problems are usually linked to certain wrong habits in their body position or actions, and the pain will recur and worsen if the wrong habits / behaviours are not changed. Our physiotherapists are specialised in helping our clients to change their postural or movement habits to ensure that they will get long term relief and solution.

What are the common back pain conditions treated at Balance core?

Many of our patients with chronic back pain have seen a doctor and been told that they have conditions such as “degeneration of the back”, “wear and tear of the back”, “slipped disc in the back”, “nerve impingement”, “Spinal joint arthritis”, etc. They may have been advised to go for orthopaedic back surgery to reduce spinal cord or nerve compression. They may have tried several medications for pain management, and other back pain treatments such as acupuncture, chiropractic adjustment, osteopath treatment, etc. All these may have helped them to a certain extent, but unfortunately, the pain still returns. If pain still persists, you can resolve to taking anti-inflammatory medication or pain relievers for the meantime. Pain relievers help ease the pain, especially when you’re too busy to handle your pain problem in your current situation.

Your doctor may require you to undergo a bone scan or ct scans to further clarify your pain issues. Depending on the diagnosis, the treatment advised to you may include pain surgery or surgery in the bones.

Services that Balance core provide

Changing habits is always not a simple task. However, with years of clinical experience, our Balance Core Physiotherapy Centre founder, Mr Michael Yan, has formulated a step-by-step pathway to change one’s postural or movement habits systematically. We begin with identifying the structural misalignments or restrictions in the body and using manual techniques to unblock restrictions and restore healthy body alignment thoroughly. Secondly, we teach our patients how to activate the muscles that are neglected by the brain due to wrong habits, and carefully train these weak muscles to perform proper control tasks. Thirdly, we integrate the proper control muscles with the power muscles to form good movement sequences. We get our patients to perform repeated movements to condition the muscles so that new habits can replace the old. Lastly, we teach them the best practice of those tasks involved in their work or sport. Ultimately, they are not only pain-free but also able to perform at their work or sports with proper skills, preventing future injuries.

Contact Balance Core Singapore for back pain management

Are you suffering from upper or lower back pain and it doesn’t seem to go away? It is best for you to seek assessment and treatment from Balance Core Physiotherapists in Singapore. All our physiotherapists spend quality time with each patient to do a thorough assessment to identify both the present issues as well as background issues. With accurate diagnosis and individualised treatment, we ensure every client gets quality care and fastest recovery. To book an appointment, please call us at 64582575, or message us at 91714325.