Back pain: What you need to know

By Shezna Shums

Professor Hee Hwan Tak is the Medical Director and Senior Consultant Centre for Spine and Scoliosis Surgery Singapore. He spoke about back pain and what a patient needs to know.

Back pain is very common, accounting for the second most common reason for abaxsence from work. It affects 90 per cent of the working population at some point of their life. There are many causes of back pain, but the most common are due to problems from the spinal column such as discs, facet joints and the supporting ligaments and muscles.

Professor Tak’s lecture highlighted the different types of back pain and the need to rule out red flag or serious spinal conditions.

Conservative treatment works in the majority of low back conditions. Back education and adjustment of lifestyle form important components in the management of back pain.

“For the minority who do not improve, we have at our disposal newer technologies to help them, for example minimally invasive spine surgery and non fusion spine surgery,” said Professor Tak.

He noted that low back pain was a common disability. Sources of back problems may come from the spinal column, or a lesion outside the spine, aggravated injury and others.

Doctors would usually ask where the pain runs through to figure out what are the other nerves that are affected. The causes of back pain vary with different age ranges and it was noted that lower back pain is a symptom, not a disease per se. The problem may be within the spinal column, or a lesion outside of the spine.

Spondylogenic back pain is derived from the spinal column and associated structures. Aggravated activities, and relieved to some extent by rest. Intervertebral disc-an annular tear is most common source of back pain Facet joints are a common source of back pain as well as osteoarthritis.

Neurogenic back pain is when there is tension, irritation or compression of lumbar nerve root(s) will cause radiation of pain down the legs. Viscerogenic back pain is associated with disorders of kidney or pelvic organs among others. The backache rarely is the only symptom and the pain is not aggravated by activity or relieved by rest.

Degenerative disc disease is acute back pain which is self limiting (90 per cent recovers within six weeks).

Professor Tak spoke of several other conditions and symptoms and noted that many of the concerns the patients had was whether it was a serious problem, whether it would paralyse the patients and whether they would need surgery.

Some of the potential risk issues that brings about back pain are awkward back postures, poor chair adjustment or function and improper working height. Other risks are limited working space, restricted postural position and improper task requirements.

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