The lower back comprises of main support structure which is the spinal vertebrae and many interconnecting structures like joints, muscles, ligaments and tendons. Between the vertebrae are discs that allow your spine to bend and work like shock absorbers. Spinal cord tunnels down through the central canal of each vertebrae, carrying nerves from your brain to the rest of your body.

Lower back pain is one of the most common problems in our society. Almost every person will have at least one episode of lower back pain at some point in his or her life

  • Mild pain/ache (with activities) to extreme pain (that cannot seem to find a comforable position to be in)
  • Sharp catching pain to dull ringing ache
  • Centralized pain at the lower back to radiating pain down the legs
  • Numbness, pins and needles down the legs
Back pain may result from abnormalities in the soft tissues – the muscles, ligaments and nerves as well as in bones and joints of the spine. With the weight of the upper body resting on the lower back, there is stress and strain applied to these structures. Motor vehicle and sporting accidents are common causes too, as they cause increased strain and tears up the supporting structures of the lower back.

Treatment of our back pain is dependent on the cause. The common causes are:

  • Poor Posture – Poor posture stresses your spine. Ligaments are over-stretched, muscles tire and joints and nerves are put under pressure. Long hours of sitting, strenuous lifting techniques and poor mattress can all contribute or aggravate the back pain.
  • Muscle Strains – Minor back muscle strains quickly and improves on their own, but more severe strains will need Physiotherapy treatment to relieve pain and promote healing.
  • Ligament Strains – Stretching ligaments too far or too quickly makes them tear and bleed into surrounding tissues, causing swelling and pain.
  • Disc Problems – Discs are anchored to the vertebrae above and below, so they cannot ‘slip’ out of place. They can wear down with age, but most disc problems arise from injury. Discs can bulge (prolapse) or herniated, pressing on the spinal nerves/spinal cord, causing pain and numbness down the legs, pins and needles, as well as legs’ weakening.
  • Sciatica – The sciatic nerve run from the lower back, through the buttocks and down at the back of your legs. Irritation anywhere along this pathway will cause pain in the back and legs.
  • Arthritis – Vertebral and facet joints can be affected by arthritis, causing degeneration and inflammation within the joint and the growth of bony spurs on the edges of the vertebrae.
  • Muscle Weakness – Recent research has shown that weakness of the deep abdominal muscles can contribute to increased strain on the lower back.
Treatment Options

The treatment of your back pain depends entirely on the cause of the problem.

  • Medical Help – Your doctor may prescribe some anti-inflammatories and pain-killers. Sometimes with an acute pain, injections or steroid (cortisone) are given.
  • Physiotherapy – A Physiotherapist will make a detailed assessment of your condition and put together a treatment program for your specific problems.


Your Physiotherapy treatment may include:

  • Spinal Decompression Therapy: Works different from a conventional traction, this is a specialised treatment targeting disc herniation or prolapsed disc-utilizing the DOC/DTS Systems (USA) to create negative intra-discal pressure and relieve the symptoms of herniation.
  • Mobilisation and Manual Therapy – To restore restrictred mobility between the spinal vertebrae. This aids to reduce pain, muscle spasm and stiffness.
  • Laser: This low-level laser therapy helps in pain management and wound healing.
  • Interferential Therapy: A medium frequency electrical current that stimulates the peripheral sensory and muscle nerve fibres, to reduce pain and inflammation.
  • Ultrasound: Improves cell metabolism and cell membrance permeability, thereby enhancing tissue healing.
  • Postural and Ergonomics Advice: To increase one’s postural awareness and reduce strain on the back. With the improved ergonomics at their workstation, the likelihood of straining their back is reduced too.
Exercise Therapy / Core Stabilization Program (SCORES)
Though the back pain may usually go away in 4 to 6 weeks, the deep stabilizing muscles along the spinal vertebrae remains impaired. Clinical research has shown that after back pain, these deep muscles are not activated as much as they should be and the activity of the superficial muscles is often increased. This diminishes the stability between the vertebrae and predisposes re-injury of the back.

Core Stabilization involves activating the deep lumbar and abdominal muscles. These exercises are taught progressively as back pain improves. With better core stability, recurrence of back pain is reduced.

Exercises with the use of Realtime Ultrasound and Achievo Core Stability trainer followed by mat and ball exercises, assist the effective activation of these muscles.

Please see our SCORES brochure for more information on this.

Useful Advice to Control and Prevent Back Pain
  • Work
    Avoid sitting for long periods. Frequently stand and take short walks from time to time.
  • Use of Back Roll and Foot Stool
    Helps to reduce the stress and strain on the lower back during sitting.
  • Practice Correct Lifting Techniques
    Keep your back straight and bending at your knees. Rather than working on an outstretched position, keep your task close to the body.
  • Maintain a Healthy Weight
    This will help to reduce the impact on the lower back.
  • Keep a Correct Posture
    White sitting, standing and sleeping