Understanding Back Pain in Singapore
Back pain is one of the leading causes of doctor visits in Singapore, affecting up to 80% of adults at some point in their lives. While most back pain resolves within 4-6 weeks with conservative treatment, persistent or severe pain requires specialist evaluation.
✅ Most Back Pain is NOT Serious
- • 80-90% of back pain resolves with rest, physiotherapy, and time
- • Muscle strain from lifting, poor posture, or sudden movements
- • Mechanical pain that improves with position changes
- • Usually no imaging needed unless persists >6 weeks
⚠️ When Back Pain is Serious
- • Leg pain/numbness (sciatica—nerve compression)
- • Weakness in legs or feet
- • Bowel/bladder problems (emergency—call immediately)
- • Pain worsening despite treatment
- • Night pain that wakes you from sleep
💡 Singapore-Specific Factors
Singaporeans face unique back pain risks: prolonged sitting (office work, commuting), high smartphone/computer usage (text neck), air-conditioned environments (muscle tightness), and aging population (degenerative changes). Early intervention with physiotherapy and posture correction can prevent chronic problems.
Common Spine Conditions
Understanding your diagnosis is the first step to effective treatment.
Causes: Muscle strain, poor posture, degenerative disc disease, facet joint arthritis
Treatment: Physiotherapy, pain management, postural correction, rarely surgery
Symptoms: Sharp back pain, leg pain (sciatica), numbness, weakness
Treatment: Conservative care (80% improve), epidural injections, microdiscectomy surgery
Symptoms: Shooting leg pain, burning sensation, numbness in foot, weakness
Treatment: Physiotherapy, nerve pain medication, injections, decompression surgery
Symptoms: Leg pain when walking, numbness, improved when sitting or bending forward
Treatment: Physiotherapy, pain management, epidural injections, decompression surgery
When Should You See a Spine Specialist?
🚨 Seek Immediate Medical Attention If:
- • Loss of bladder or bowel control
- • Progressive leg weakness
- • Numbness in groin or inner thighs (saddle anesthesia)
- • Severe pain after trauma or fall
- • Fever with back pain
📅 Schedule Specialist Consultation If:
- • Back pain persists beyond 6 weeks
- • Pain radiates down leg (sciatica)
- • Pain interferes with sleep
- • Previous treatments (physio, medication) haven't helped
- • Numbness or tingling in legs
Treatment Options: Conservative to Surgical
Conservative Treatments (First-Line)
Physiotherapy
Most effective for: Mechanical back pain, muscle strain, chronic pain
Treatment: Core strengthening, stretching, posture correction, manual therapy
Success rate: 70-80% improve within 8-12 weeks
Medications
• NSAIDs: Reduce inflammation and pain
• Muscle relaxants: For muscle spasms
• Nerve pain medication: For sciatica (gabapentin, pregabalin)
Epidural Steroid Injections
For: Herniated disc, sciatica, spinal stenosis
Relief duration: 2-6 months, can be repeated
Cost: $800-$1,500 per injection
Lifestyle Modifications
Weight loss, ergonomic workstation, proper lifting techniques, regular exercise (walking, swimming)
Surgical Treatments (When Conservative Fails)
Microdiscectomy
For: Herniated disc causing sciatica
Procedure: Remove disc fragment pressing on nerve (minimally invasive)
Recovery: Walk same day, home in 1-2 days, return to work 2-6 weeks
Cost: $15,000-$30,000 (private), $5,000-$8,000 (subsidized)
Laminectomy
For: Spinal stenosis (narrowed spinal canal)
Procedure: Remove bone/tissue compressing nerves
Recovery: 6-12 weeks full recovery
Cost: $20,000-$40,000 (private), $6,000-$10,000 (subsidized)
Spinal Fusion
For: Instability, severe disc degeneration, spondylolisthesis
Procedure: Fuse vertebrae together with bone graft and hardware
Recovery: 3-6 months for fusion to occur
Cost: $35,000-$70,000 (private, 1-level), $12,000-$18,000 (subsidized)
Minimally Invasive Spine Surgery (MISS)
Benefits: Smaller incisions, less muscle damage, faster recovery, less pain
Available for: Many disc and decompression procedures
Cost: Add $5,000-$10,000 to traditional surgery cost
⏱️ The Conservative Treatment Timeline
Singapore spine specialists typically recommend 6-12 weeks of conservative treatment before considering surgery. This includes physiotherapy, medications, and possibly injections. Surgery is considered when: (1) Severe pain persists despite conservative treatment, (2) Progressive neurological symptoms (weakness, numbness), (3) Quality of life significantly impacted. Exception: Cauda equina syndrome (bowel/bladder issues) requires emergency surgery.
When is Spine Surgery Necessary?
Most back pain does NOT require surgery. However, certain conditions benefit significantly from surgical intervention.
✅ Surgery is Highly Effective For:
- • Herniated disc with sciatica: 85-95% get significant relief from microdiscectomy
- • Spinal stenosis: 70-80% improve with decompression surgery
- • Unstable spine: Fusion prevents pain and progression
- • Progressive neurological deficits: Prevents permanent damage
📋 Indications for Spine Surgery:
Absolute Indications (Clear Benefit):
- • Cauda equina syndrome (emergency)
- • Progressive muscle weakness
- • Severe spinal cord compression
- • Fractures or tumors
Relative Indications (Case-by-Case):
- • Persistent sciatica >6-12 weeks
- • Failed conservative treatment
- • Significant quality of life impact
- • Recurrent disc herniations
⚠️ Surgery May NOT Help:
- • Non-specific chronic back pain without clear structural cause
- • Pain without imaging findings (MRI doesn't show significant abnormality)
- • Multi-level disc degeneration (normal aging—very common on MRI)
- • Psychological factors (depression, anxiety without treatment)
💬 What Singapore Spine Specialists Look For
Reputable spine surgeons will NOT rush you into surgery. They look for:
- • Correlation between symptoms and imaging: MRI findings match your pain pattern
- • Failed conservative treatment: You've tried physiotherapy, medications, injections for adequate time (3-6 months)
- • Clear surgical target: Specific structure to address (disc, stenosis, instability)
- • Realistic expectations: You understand potential outcomes and risks
- • Healthy enough for surgery: Medical conditions controlled
If a surgeon recommends surgery on first visit without trying conservative treatment, consider getting a second opinion.
Frequently Asked Questions About Back Pain & Spine Treatment
Get answers to common questions from our spine specialists.