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Lower Back Pain

Lower Back Pain

Lower back pain can affect individuals across all age groups. It can arise from various factors, such as muscular strain, poor posture, and spinal abnormalities. Understanding the different types of lower back pain and their underlying causes is crucial for effective treatment and preventive measures.

Medically reviewed by Dr Chua Soo Yong ,

Consultant Orthopaedic & Spine Surgeon

MBBS (S’pore), MRCS (Edinburgh), MMed (Ortho),FRCS (Ortho), FAMS (Ortho)

What is Lower Back Pain?

Lower back pain is one of the most common reasons why people seek medical attention and is also a common cause of work-related disability. It usually refers to pain or discomfort resulting from injury or illness affecting the muscles, ligaments, bones, and joints of the lower back. Regardless of the cause or severity, lower back pain should always be assessed by a medical professional for proper diagnosis and treatment.

What are the Types of Lower Back Pain?

Lower back pain is a common condition that affects many individuals at some point in their lives. Common types of lower back pain include:

Mechanical Pain – Also known as axial pain, mechanical pain manifests in a specific region of the back. Individuals may experience a dull ache or sharp discomfort that occurs constantly or sporadically. Typically, the pain is localised in the lower back region and extends to the buttocks, hips, and thighs. Several factors can contribute to lower back pain, such as degenerated discs, facet joint issues, and damage to soft tissues, muscles, and ligaments.
Radicular Pain – This occurs when the nerve roots in the spine become compressed or irritated, leading to pain that travels from the back down the leg. In addition to pain, individuals may experience numbness, tingling, and muscle weakness. The most common causes of radicular pain include herniated discs, spinal stenosis, or nerve root injuries. This type of pain can impede everyday activities and mobility, making simple tasks like walking and standing challenging.
Referred Pain – This pain usually appears as a dull, achy sensation that moves around (migratory) and fluctuates in intensity with each episode. An individual may experience pain either at the injury site or in a different area, depending on the extent of the injury. Referred pain typically originates in the back and radiates outward, affecting the groin, buttocks, and upper thigh.

What are Common Accompanying Symptoms of Lower Back Pain?

Continuous lower back pain that doesn’t improve even while resting
Persistent pain that lasts for days or weeks
Constant nerve pain or numbness in the legs
Leg weakness leading to difficulty standing or walking
Muscle spasms and tightness

If you notice any of the above symptoms, it is important to get diagnosed so you can embark on a targeted treatment.

Contact Dr Chua Soo Yong at 6262 0555 today.

What are the Causes of Lower Back Pain?

Sciatica

This refers to pain that is caused by an inflammation or compression in the sciatic nerve, which runs from the lower back down to the hips, buttocks, and legs. It occurs when a part of the sciatic nerve becomes pinched.

Slipped Disc

Also known as a herniated or ruptured disc, this typically occurs along the spine and the lower back. It begins when the jelly-like nucleus of the tissue found between the bones of the spine bulges out or pushes through a weakness in the disc’s outer ring, resulting in pressure in the spinal cord and nerve roots.

Spinal Stenosis

This occurs when the spinal canal or space becomes narrow, placing additional pressure on the spinal cord or nerves and resulting in pain and numbness.

Other causes of lower back pain include osteoarthritis, resulting from wear and tear of the joints; a deformity that changes the shape and curve of the spinal column; as well as muscle and tendon strains caused by overstretching the back muscles.

How is Lower Back Pain Diagnosed?

Medical History

The orthopaedic specialist will begin by discussing the symptoms, medical history, and activity level or any recent injuries that may have contributed to lower back pain. This information helps in identifying potential causes and guiding subsequent diagnostic tests.

Physical Examination

A thorough physical examination is typically conducted to assess the range of motion, muscle strength, reflexes, and any indications of discomfort or tenderness. This allows the doctor to understand the nature and severity of the condition.

Imaging Tests

The doctor may conduct imaging tests, such as X-rays, MRIs, or CT scans. These tests generate detailed images of the bones, spine, and soft tissues, which can help identify conditions like herniated discs, spinal stenosis, or fractures.

Laboratory Tests

In some cases, the doctor may order a blood test to detect infections or underlying conditions that may contribute to back pain.

Specialised Tests

Depending on the symptoms and causes, the doctor may conduct specialised diagnostic tests, including electromyography (ECG), nerve conduction tests, or bone scans. These tests can provide insights into nerve function, bone density, or issues related to spinal discs.

What Can Cause Lower Back Pain in Women?

While both men and women experience lower back pain, women are found to be more susceptible to chronic back pain. This is especially true for those who are pregnant, post-menopausal or above 50 years old. The most common causes of lower back pain in women are:

Menopause, Pregnancy and Hormonal Issues

Studies show that menopausal women have a higher chance of developing chronic pain such as lower back pain. Lower back pain in pregnancy also occurs due to hormonal changes that causes the ligaments to relax, resulting in less support for the back (leading to pain).

Dysmenorrhea

This refers to pain that is felt during menstruation that is caused by uterine contractions. It is typically felt during the first two days of a menstrual period.

Endometriosis

This occurs when uterine lining forms outside the uterus, usually in the ovaries, fallopian tubes or pelvic lining. Left untreated, it causes severe lower back pain, painful periods and fertility problems.

Sacroiliac (SI) Joint Dysfunction

This is pain from the SI joint, which connects the spine and pelvis. Women tend to have smaller SI joints, leading to higher stress in joints.

Relieving Lower Back Pain at Home

Exercise and Stretching

When done right, these can help relieve pain and strengthen the muscles.

Posture

Avoid slouching as improper posture contributes to lower back pain. Good posture helps in the alignment of bones and even distribution of weight in the spine.

Diet

Having an anti-inflammatory diet (alongside a varied and nutritious diet) could help reduce lower back pain.

What are the Treatments for Lower Back Pain?

Treatment for lower back pain can range from at-home treatment, medications to surgery, depending on the patient’s diagnosis. Treatment for lower back pain in Singapore includes:

Medication

Anti-inflammatory medications can help relieve inflamed nerves or muscles. If symptoms persist, the doctor may recommend alternative drugs like antiseizure, pain relievers, prescription non-steroidal anti-inflammatory drugs (NSAIDs).

Physiotherapy

Personalised physiotherapy exercises will help improve strength and mobility, as well as reduce pain.

Surgery

Serious cases may require lower back surgery, especially if other treatments are not enough to relieve the pain. Types of lower back pain surgery in Singapore include:
- Discectomy, which removes the herniated areas of the lumbar disc that cause pressure in nerves.
- lowerbackpain, which removes the lamina to make space for the spinal canal to relieve pressure from the spinal cord and nerves.
- Spinal fusion, which connects two or more vertebrae to form a single bone and remove painful spinal motion.
- Foraminotomy, which enlarges the opening of the spine to remove pressure of the nerves from the spinal column.

Non-surgical Treatment

This includes muscle relaxants, back braces and epidural steroid or nerve root injections.

When Should You Seek Medical Care?

Lower back pain that does not go away for several weeks, or affect your daily activities, may indicate a more severe condition and require medical attention. Seek medical attention if you experience any of the following:

Pain that radiates down the back of the leg or into the groin area
Numbness, weakness, or tingling sensation in the legs
Pain caused by a fall, trauma, or injury to the back
Pain accompanied by fever, unexplained weight loss, or bladder or bowel dysfunction
A history of cancer, osteoporosis, or other bone-weakening conditions

BACK AND SPINE PAIN SURGEON

Dr Chua Soo Yong

Consultant Orthopaedic & Spine Surgeon

MBBS (S’pore), MRCS (Edinburgh), MMed (Ortho), FRCS (Ortho), FAMS (Ortho)

Dr Chua Soo Yong is an orthopaedic and spine surgeon in Singapore with over 10 years of specialist experience in treating patients with lower back pain and other orthopaedic and spinal conditions. With his expertise, Dr Chua specialises in a comprehensive range of spinal surgery, including both open and minimally invasive procedures, to help patients find relief from their pain and restore their overall well-being and quality of life.

Make an appointment with our specialist, Dr Chua Soo Yong, at 6262 0555 today.

We are well-equipped to diagnose and treat all back, spine, and neck injuries.

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3 Mount Elizabeth Suite #06-09,
Mount Elizabeth Medical Centre
Singapore 228510

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