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Low Back Pain Physiotherapy

Can you imagine that 25% of the society has low back pain in the last 3 months?

In many cases, their low back pain is more of a short episode, and disappears on its own...but a staggering 50% of them, their low back pain become long term (chronic) pain.

Usually, that often mean disability, low energy and difficulty in participating in many activities, play and even sleep is disrupted.

Low Back Pain Warning

If your low back pain is accompanied by the following symptoms, you MUST visit your local accident and emergency department immediately:

  1. Loss of bowel or bladder control and / or
  2. Numbness in the groin or inner thigh

These symptoms might indicate a spinal condition called "cauda equina syndrome," in which nerves at the end of the spinal cord that control bowel and bladder function are being compressed and squeezed.


Everyone's low back pain can differ - some may be 

  • dull ache
  • burning feeling
  • sharp stabbing
  • general large area or pinpoint
  • etc

Some have that with muscle spasms or stiffness or both. 

In some others, the symptoms may spread into one or both legs too.

Generally, there are three (3) types of low back pain:

  1. Acute – low back pain lasting less than 3 months
  2. Recurrent – acute low back pains' symptoms coming back again
  3. Chronic – low back pain lasting longer than 3 months

Unfortunately, most patients who have an episode of acute lower back pain will have at least one (1) recurrent episode...but most have multiple recurrent lower back pains =(

That is one thing.

The other thing is that often the actual cause of low back pain isn't truly or fully known, based on recent research and studies. In the past, we used to think it's purely mechanical (injury, repetitive strain, medical condition) but research seems to point that lower back pain is more complex.

What the studies show is that key variables that will help patients are:

  1. confidence
  2. determination

which work to help patients cope with the lower back pain and limited energy or abilities caused by the pain. Especially when the low back pain seem to recur again and again.

Although low back pain is rarely serious or life threatening, there are several conditions that may be related to your low back pain, such as:

HOW we diagnose LOW BACK PAIN

Our senior spinal physiotherapists always have to start off with an in-depth and thorough evaluation that will include:

  1. understanding your past medical and pain history
  2. questions about your low back pain and its symptoms
  3. physical examination and tests to assess the quality of your movements, and any risky movement patterns that may delay your back pain recovery
  4. tests to identify signs that may point towards more serious health issues, such as fractures or cancer
  5. understand how you use your body at work, home, play

In cases where we need you to do an imaging (if you hadnt done so yet), we will refer you to our trusted spinal orthopedic doctors whom we had worked with for years, to do:

  1. x-ray
  2. CT scan or
  3. MRI (magnetic resonance imaging)

to have more clarity of the diagnosis, which will drive the accuracy of our treatment. Knowing the problem solves at least 50% of the problem.

Do you need to do an MRI?

Not always - it depends entirely on the problem and the outcomes.

  1. Normally for mild cases, with little to no need for surgeries or injections, or easy to diagnose, MRI are typically not necessary. Examples of this are patients who have minor strains, or repetitive strain injuries that are straightforward.
  2. MRIs are always necessary if we're unsure if there's something more serious, such as slipped disc resulting in a compressed spinal nerve and with nerve-related symptoms, such as numbness. A severe nerve-related symptom are difficulty with urinating or unable to move a limb.

If you're unsure, reach out to us for a chat, I'm happy to guide.

HOW OUR SENIOR PHYSIOTHERAPISTS can help with your low back pain problem

Our senior and experienced low back pain physios will help you to / with

  1. pain relief and management so that you can sleep better, participate in life and work activities etc
  2. improve your lower back range of motion, power and stability, then activity tolerance
  3. get you back to 100% participation in life, work and play, with full confidence and no fear of lower back pain during or after the activities

Because not all low back pains are the same, that's why low back pain physio programs must be tailored and customized to each patient, according to specific symptoms, conditions and goals.

Low back pain physiotherapy treatments may include:

  1. Manual therapy, including lower back mobilization and manipulation, to improve the mobility of joints and pliability and function of soft tissues
  2. Use of cold therapy or heat therapy treatments or electrical stimulation to manage the lower back pain during and between physio sessions
  3. Back-specific work/sports-specific strengthening and flexibility exercises
  4. Computerized spinal decompression traction physiotherapy to relieve muscle spasms and helps to align the spinal joints, which helps with decreasing back pain


In a nutshell, yes, to a large extent.

The key to prevention of lower back pain revolves a lot around:

  1. strengthening the core muscles, back muscles and overall fitness on a regular basis
  2. regular deep tissue massage to loosen up muscles that tighten naturally over time and use
  3. regular maintenance spinal physiotherapy to find and treat any soft tissue anomalies in the joints, muscles, tendons, cartilage
  4. regular training for sports

Other than these, are the general lower back advice:

  1. Good posture (which is helped with regular workouts as opposed to sedentary lifestyle)
  2. Good ergonomics: placing items, equipment and products within good range
  3. Good lifting mechanics if you carry loads or weights (keep weights close to your body, dont overreach, ask for help)
  4. Regularly exercising and stretching

If i have lower back pain, what can i do?

Oh, I'm sorry for your lower back pain - I too have episodic low back pains - it's terrible with the pains.

There's a few things we can recommend:

When there's a flare up of pain

  1. See a doctor (we can refer you to a good spinal orthopedic doctor in Singapore)
  2. Stop the activities that aggravate the pain
  3. See a spine / lower back pain physiotherapist.
  4. If you have anti-inflammatories or painkillers, take some according to the instruction given
  5. Remain as active as possible with minimal pain experience. This is 100% better than being fully bed bound for prolong periods of time.

When there is no pain / between episodic pains

  1. Do the stretches and exercises prescribed by your physio
  2. Be as active as possible
  3. Avoid chairs or beds that are soft or aggravates your lower back pain
  4. Strengthen your lower back and improve posture
  5. Purchase and use ergonomic tools and products

Top tips for back pain

  1. Moving, exercise and continuing to be active are one of the most important ways of helping yourself if you have back pain - you've got to keep moving and continue with activities such as walking or swimming
  2. Paracetamol or similar pain-killers, taken as advised by your GP or physio, can help you keep moving with less pain and more comfort
  3. One should avoid sitting for too long when driving or at work (unless your work is largely sitting down, then schedule regular stretch and walk breaks)
  4. Regularly and gently stretch to prevent stiffness
  5. Be very careful and take care when lifting: bend your hips and knees to use the power in your legs
  6. Once in a while, check your posture when you're using computers/games or watching television
  7. Check the mattress on your bed to ensure it supports you properly (not too soft, not too hard, but must be JUST nice).
  8. Please don’t smoke – smoking impairs your circulation by destroying capillaries, which affects how quickly your body can recover. The slower your recovery rate, the slower you recovery from pains and diseases.
  9. Strengthen your trunk and core muscles as they both form your internal body pillar and they may help to protect your back
  10. Make sure your car seat and office chair are adjusted correctly and support your back - check out sitting ergonomics
  11. Eat a healthy diet and exercise regularly, as being overweight can be a cause and aggravator of back pain