Low Back Pain is a Big Deal

You would know someone suffering from chronic back pain and would have also heard your parents or your colleagues at your workplace talking about their aches and soreness. You probably also have a friend who sees a chiropractor! It is no surprise – almost nine in 10 people would experience low back pain at some point in our lives!

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Pain is a big problem for Singapore. It is no surprise - almost nine in 10 people would experience low back pain at some point in our lives!

Causes of Lower Back Pain

You probably think your lower back pain started from an injury years ago. The truth is back pain is multifactorial unlikely to be the result of a single cause. For most parts, we don’t think it is possible to identify a singular cause for your pain. In fact, the latest research are telling us to ditch the specific diagnoses for chronic musculoskeletal pain and instead treat the patient’s pain as a unique pain experience.

Why am I telling you this?

Instead of focusing on the why and the problems, we highly encourage you to focus on your goals. Think of how you want your life to look if your low back pain is no longer an issue. This is the evidence-based approach to treating chronic low back pain and we made all of our clients do this. The result? Over 80% of our clients will leave our care within four to seven visits.

The causes of back pain are obscure in most instances. In a minority of cases, doctors can identify a direct link to an organic disease. Many chiropractors and doctors order elaborate imaging studies for back pain against the recommendations by international health guidelines. Although disc protrusions and degenerative findings are often detected on MRI, they rarely are responsible.

Consequentially, surgery is seldom successful at alleviating it.

Back Pain Treatment Truth #1: You Don’t Need an X-ray or MRI

As we mentioned earlier, back pain is unlikely to be the consequence of a singular cause. Therefore, trying to find the cause of your back pain through radiographic imaging does not help.

The latest research found that patients who had imaging done for low back pain spent more money on their treatment and were absent on more days from work compared to people who did not have x-ray or MRI. If you don’t think that’s too bad, patients with imaging also experience lower sense of well-being and are EIGHT times more likely to go for surgery.

The current international clinical guideline does not recommend for radiological imaging for chronic low back pain. If a chiropractor or specialist say you need the x-ray or MRI, consider a second opinion.

Back Pain Treatment Truth #2: Manual Therapy Doesn’t Work

You would be disappointed to know that manual therapy doesn’t work. Manual therapy refers to any form of treatments that are “hands on” and treamtnets like chiropractic adjustments, IASTM, massage, myofascial release all fall under the category.

You heard me right – chiropractic adjustments do not work. There’s a good chance they help in the short-term for lower back pain but unlikely to have any long-term change. We blogged about this before at Breaking News: Prestigious Medical Journal Endorses Chiropractic Care.

The other popular treatment people are going for is IASTM therapy (instrument-assisted soft tissue mobilisation). Unfortunately, research also does not support them as a treatment for low back pain. In fact, there’s some research to show patients who undergone IASTM treatment have worse outcomes than those who didn’t. Read more at IASTM Doesn’t Work.

The latest clinical guideline recommendation puts manual therapy as an adjunct treatment. This means they are unlikely to deliver results and should only be use as an accessory/supplementary treatment for lower back pain.

Back Pain Treatment Truth #3: Drugs and surgeries also do not work

When it comes to slipped disc, people think surgery ultimate pain solution because you go straight in and solve the root cause of the problem. What if I told you that’s not true? The truth is that slipped disc is poorly correlated with back pain. The current understanding of slipped disc is that it’s a normal and natural progressive response to age. No difference from wrinkles and white hair. We’ve written extensively about it at MRI and Slipped Disc: Back Pain From A Chiropractor’s Perspective.

Maybe you think I am only saying this because I am a chiropractor. Well, The Lancet, one of the world’s most prestigious medical journal, published a low back pain series last year to put discectomy and laminectomy surgeries as adjunctive treatment options while spinal fusion surgery’s role in low back pain remains uncertain.

The American College of Physicians (ACP) published in Annals of Internal Medicine their low back pain guidelines in 2017. In their recommendations, exercise and other conservative treatments were recommended first-line treatment options. Medications should only be considered only if non-medication treatments fail.

What You Need to Know

  • Keep active and try to continue with your daily activities. Research has shown that bed rest is likely to make the pain worse
  • Use heat packs for temporary pain relief – you can buy them from your local pharmacy such as Guardian or Watsons
  • Although it may be challenging, staying optimistic and recognising that your pain should get better will help you recover quicker

Lower back pain is one of the most common reasons for medical consultation (Hoffman et al. 2013). However, back pain usually gets better on its own within a few days and you may not need to see a chiropractor or other healthcare professional.  It is a good idea to seek help if:

  • The pain lasts for more than six weeks
  • The pain stops you from doing your day-to-day activities
  • The pain is very severe
  • The pain progressively worsens with time
  • You experience pain, numbness and tingling, or a burning sensation in one or both legs
  • You’re worried about the pain

Research has confirmed that most Singaporeans continue to work despite their pain problem. Early recognition of your pain symptoms will allow effective prevention and treatment to be offered. 

The best chiropractor or physiotherapist for your care would be one who is evidence-based and also some one whom you can trust. We highly recommend seeking professional help from therapists with clinical training and use exercise therapy as the main part of their treatment approach.

If you need a second opinion on what is the best way forward for your care, do drop us an email.

Do you know most insurance in Singapore cover chiropractic treatments? For a little over $100 per year, your insurance coverage can include chiropractic care! Personal Accident policies from companies such as AIA, Great Eastern, AXA, and Sompo include chiropractic care as part of their plan. To find out more, reach out to us via the contact form.

Many people with an acute back pain think, “But gosh, I didn’t even do anything!” But what many folks don’t realise is that it’s almost never a case of what you were doing ten minutes ago or what you did the night before that’s causing the current problem. Struggling to keep on top of your back pain? Schedule a visit with our practice to find out how we can help.