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Back Pain physiotherapy in singapore

Back Pain and Physiotherapy

Back pain physiotherapy is one of the most important treatments for treating back pain conservatively (this means without undergoing back surgery where possible), to

1. treat back pain / pain relief or reduction
2. restore back movement in the joints, muscles and tendons
3. build strength, stability and stamina

Of course, we first need to deep-dive to understand and address the root case of your back pain in the first place. Often we come across patients who had gone to multiple physios, chiros, massage and other providers who just treat with shiny tools or media without diving deep -

Unfortunately, when you dont understand the core problem the back pain will remain frustratingly recurrent and prevalent. 

common causes of back pain

Our backs are incredibly complex.

Bones, muscles, tendons, ligaments, cartilages and nerves. They all work together in a beautiful synergy, and if any of these parts are injured, strained, misaligned or something, it leads to having a painful back.

Here's a list of common causes of back pain

• Degenerative disc disease can cause disc bulge, causing pain with movement or with sitting.
• Disc bulge is a milder version of the more serious and commonly known slipped disc or herniated spinal disc can press onto the nerves in your back causing nerve to malfunction. Patients often experience numbness, tingling, pain and weakness over a certain area.
• Back muscle strains or injuries due to sports, falls or acute injury
• Sciatica refers to the compression of the sciatic nerve, that when compressed, it'd irritate the nerve and cause radiating tingling or pain down the leg (usually caused by herniated spinal intervertebral disc)
• Spinal stenosis refers to the narrowing inside the spinal canal. It's a little similar to the slipped disc where the slipped disc compresses the nearby nerve, however in the case of spinal stenosis the difference is the space in the canal compresses the nerve roots, leading to difficulty sitting or standing.
• Osteoporosis is the weakening (increasing number of pores) of the bones, making our bones easier to breakage and fractures. In some patients, the bones in the spine stops healing and regenerating...making it susceptible to compression, leading to more pressure in the back and even compression fractures of the spine.
• Arthritis (such as osteoarthritis) can affect the joints in your back causing back stiffness and pain.
• Back ligament / muscle strains from overuse or poor posture, causing compensatory movements and eventual back injury and pain
• Spondylitis is a type of spinal arthritis, that causes stiffness between the spinal cord bones (vertebrae). Over time, as the spondylitis worsen, patients start to hunch more and more, leading to more back strains and of course, back pains
• Spinal tumors (require very urgent immediate medical attention), sometimes develop along the spine, which can compress the spinal nerves, causing back pains and nerve-related symptoms
• Pinched or compressed nerves cause numbness, tingling, aching and weakness in your back muscles, tendons, ligaments etc
• Spinal / back bone fractures from sports injuries, car accidents, falls or attacks. Also, as we age, fractures become more and more common too due to development of osteoporosis, weakening of muscles, loss of balance etc

Nonsurgical Treatment to Prevent Back Injuries

Conservative (non-injection and non-surgery) treatments for patients with back pains depends a lot on the causes of the pain, severity and stability. That being said, most patients do not require back surgery and most patients respond well to back physiotherapy programs for their back injuries or pains.

Some of the common back pain physio treatments that we provide:

1. Manual therapy, which combines clinical palpation used both to assess and treat soft tissues, joints, muscles and nerve injuries and problems
2. Specific exercise therapy to balance out weak structures and normalize overcompensated structures, as well as improve overall strength and fitness
3. Controlled stretching combined with targeted deep tissue therapy to treat shortened and tightened soft tissue structures that causes imbalance
4. Clinical pilates which will help to build a more stable and strong balanced core which will help prevent back injuries and pains in the future.
5. Electrotherapy such as ultrasound therapy that helps both soft tissues and hard tissues to accelerate healing rate, bring down inflammation.
6. Where applicable, we may prescribe shockwave which helps with increasing nutrient absoption into disk as well as breakdown scar tissues to improve recovery rate
7. Dry needling for tight muscles and trigger points will ignite the body's natural healing process by triggering tissue healing and regeneration
8. Deep tissue and sports massage (especially when done regularly will help prevent back pain)

Physiotherapy Back Pain relief, treatment and Management

Physiotherapy for back pain is a globally accepted treatment in medical and healthcare, that's why we treat back aches and pains all the time in our clinics.

Our backs are very complex with a lot of moving parts:

1. muscles
2. tendons
3. ligaments
4. joints
5. cartilage
6. nerves

which are interconnected and works synergistically together. That's why all back pains require a combination of physiotherapy interventions to treat, with different treatments at different stages of acute, post acute, range building, strength and stability stage to lastly, high performance stage.

We aim to break the back pain cycle, get you back to normal and equally important, prevent future back injuries and aches from coming back or getting worse.

Every new injury we begin with in-depth assessment, to deep-dive and understand and find out what the root cause of your back pains.

1. We'd ask about your past pain and medical history
2. When it started, what aggravates it
3. What sports, work or lifestyle activities you cant do before of your back pain

Followed by physical assessments and tests to determine the soft tissues, any risk of more severe issues such as fractures, before we piece together your back pain goals and treatments.

Treatment of mid and Upper Back Pain

Our middle and upper backs tend to be more hardy and resilient to injuries when compared to the 

• neck
• lower back
• tailbone

Of course that doesnt mean that it's damage-proof, it just means that it's a bit more stronger / defensive against injuries and forces. Most of the time, middle and upper back injuries are caused by

1. muscle instabilities
2. imbalance

The treatment is same as with neck pain physio or lower back pain physio:

Taking an in-depth health history, to find out:

• When did your neck pain start (how long ago)
• How did you first get your neck pain
• What is the type of neck ache or discomfort you felt and has it changed
• Where is the location of the neck pain, has it moved
• Is there a specific time or temperature or activity that aggravates or triggers the neck pain
• What specific activities you cant do right now in your work, life, play because of your neck

Next, physical and assessment to check for neck problems such as:

• Range of motion: how much can you actively bend, extend and rotate your neck. Check if there's any blockage and locking of neck joints or structures or pain
• If there's any nerve triggered with neck movements
• For weaknesses in the muscles of and around the neck
• Sensory losses or deficits or numbness
• Reflexes
• Cervical joint stiffness
• Muscle tightness
• Postural issues and tightness
• Difficulty moving such as standing, sitting, walking etc

If there's any or multiple of the neck problems above, we will plan out your neck physio treatment (it's part of our spinal back and neck physiotherapy program) and get you back to normal working, living and playing again.

If we suspect any more potential severe problems during your neck cervical assessment and treatments, we will refer you to a neck orthopedic doctor who we trust to get an MRI done.

If you'd been recently injured from a fall, accident or sports, or your upper back pain is simply caused by sitting in front of your computers for long periods, our spine physios can help. We'll provide personalized physio for middle and upper back to help you / with

• pain relief
• stretch and improve range of motion / mobility
• strengthen weak muscles or structures

Without pain injections or risky surgeries.

Physiotherapy after Back Surgery

A small number of back pain patients medically require back surgery, be it due to:

1. very unstable spine / severe
2. constant pain
3. preference

If it's necessary or preferred, go for it. 

Whenever back surgery is necessary, physiotherapy will 100% be beneficial and useful, both

1. BEFORE the surgery
2. AFTER the surgery

Before surgery, our back physio will get you to a stronger back so that your down time and hospitalization stay will be as short as possible; and after surgery, physiotherapy will help to prevent / work on post-op loss of

• flexibility / range of motion
• strength
• stamina

and of course, lots of short term surgery pains.

After your back surgery, our spine physiotherapist will take you through a personalized post back surgery physio program to get you back on your feet as quickly as possible, without pain and able to sleep better and even play better than before.