Lower back pain affects 60-80% of adults, it is the second common reason for consulting your family doctor, and is the most common cause of disability in patients under 45 years old.  There are many different causes, and 80% of patients do not have definite diagnosis.  However, 90% patients recover and do well with conservative treatment.

 

What causes back pain?

The most common cause of back pain is a torn or pulled muscle or ligament strain

How best to prevent back ache?

Exercise regularly

Rest regularly

Avoid heavy housework/ lifting

Improve posture

Maintain healthy weight

Avoid repetitive work/ strain

Minimise mental stress

Minimise injury/ trauma

 

Other lower back pain causes (chronic)

Pain is considered chronic if the pain lasts for more than 3 months. Common causes include;

Disc degeneration

Slipped disc

Spinal stenosis

Facet arthritis

Fracture

 

Less common causes of back pain are from;

Infection

Tumour

 

Types of pain symptoms

• Fast (localized) and slow (aching/throbbing)

• Somatic (skin, joints, muscles and bones)

• Visceral (from internal organs)

• Acute and Chronic

 

Diagnosis

A diagnosis takes into account (and not limited to) the following;

• Patient history

• Clinical examination

• X-rays

• Blood/urine test

• Bone Mineral Densitometry

• Electromyography / Nerve conduction test

• Special scans (MRI scan, CT scan, Bone scan etc)

 

Who needs an X-ray or MRI Scan?

It is recommended that a X-ray or MRI scan if you are experiencing the following;  pain, have numbness or suffer from weakness or tingling.   In older patients, if you have difficulty in walking.  Other symptoms may appear, if you may have difficulty in passing motion/urine or have discomfort pain at night.

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Non-surgery back pain relief

Adequate rest

Good posture & habits

Appropriate exercises

Activity modification

Medication

Relieve pain

Anti-inflammatory

Muscle relaxant

Anxiolytic / antidepressant

Bone strengthening

Relieve numbness

Physical & occupational therapy

Spinal injections

Acupuncture, TCM therapy

 

Who needs surgery?

Pain from nerve compression

Pain from spine instability

Not better with non-surgery treatment

 

Conditions that may require surgery 

• Prolapased intervertebral disc (slipped disc)

• Spinal stenosis

• Spinal deformity (scoliosis, kyphosis)

• Spinal instability (eg spondylolisthesis)

• Fractures

• Spinal infection

• Spinal tumours