Overview

Low back pain is very common. Fortunately, it is rarely life threatening. Most backaches are due to weakened and inflexible muscles and ligaments in the back, hips, thighs and abdomen. Our lower back supports most of our body weight, which therefore makes it more susceptible to injuries and other problems.

Causes

What are the common causes of Low Back Pain?

• Mechanical injury which may result from poor postures, obesity, lack of exercise, smoking and incorrect body mechanics.
• Herniated disc (slipped disc) may cause irritation to the nerves and cause sciatica, a condition where pain travels down the buttocks or legs.
• Degenerative disease affecting the spine.
• Rare conditions may include spinal tumour, infection and fracture.

Symptoms

You should seek medical advice of if you experience any one of the following:

1. Persistent pain
2. Upper back pain
3. Bladder and bowel dysfunction
4. Fever and unexplained weight loss
5. Numbness or weakness develops / worsens
6. Recent fall/injury associated with back pain Scan of a spinal cord tumour that can cause low back pain Spinal Cord Tumour Herniated Disc causing nerve root pressure Spinal cord Herniated nucleus Herniated nucleus

Prevention

Low back pain can be prevented through lifestyle modifications:

• Maintain good body postures at all times.
• Maintain healthy weight range.
• Use proper body mechanics/ lifting techniques. Avoid bending at waist level.
• Modify workplace/space (workplace ergonomics) to reduce back strain.
• Exercise regularly. Proper exercise can help to strengthen and increase flexibility of back muscles and help to increase bone density. Swimming, brisk walking and cycling are good examples of exercises for back pain sufferers.
• Stop smoking.
• Avoid staying in the same position for a prolonged period of time.
• Sleep on a firm mattress. It helps to protect the spinal curvature. Try to sleep on the sides, with knees bent and a pillow between them. If you prefer to lie on your back, place a pillow under your knees.

Diagnosis

What are the investigations for Low Back Pain?
1. Clinical examination by the doctor
2. Blood test
3. Radiological investigations e.g. x-ray, CT scan, MRI

Treatment Options

• Rest
  You may need to restrict your activities or have bed rest in the first 1-2 days and resume your activity level gradually.
• Medications
  The doctor may prescribe some analgesics and muscle relaxant to help relieve the pain.
• Physical Therapy
  Perform the flexibility and strengthening exercise at least twice a day, focusing on the muscles at the back, stomach and hip. Hot or cold therapy is used to relax the muscles. It is a short term pain relief method.
• Surgical Management
  Surgery is seldom required unless you are experiencing any of the following symptoms: - Bladder or bowel dysfunction - Lower limb numbness/ weakness - Persistent pain despite therapy