A Comprehensive Guide to Lower Back Pain: Insights from an Orthopaedic Surgeon

  • Home
  • A Comprehensive Guide to Lower Back Pain: Insights from an Orthopaedic Surgeon

An estimated 60-90% of adults will experience lower back pain at some point in their lives. The risk is notably higher among males and those involved in manual labour and repetitive tasks. The surge in remote work has contributed to the global problem of back pain, as it often involves prolonged periods of sitting, reduced physical activity, and easy access to snacks, which contributes to weight gain and muscle loss.

This decrease in muscle strength increases the likelihood of experiencing back injuries. Lower back pain may appear after running, standing for extended periods, deadlifting, or engaging in other strenuous activities. Additionally, extended periods of sitting put extra pressure on the lower spine, further elevating the chances of developing back pain.

Understanding Lower Back Pain and Its Causes

The causes of back pain can be categorized as either injury-related or non-injury-related. Injury-induced back pain stems from accidents such as motor vehicle collisions or falls. In other cases, back pain emerges without a specific accident. Mundane actions like reaching for an object, bending to pick something up, or even sneezing can trigger atraumatic back pain. In certain cases, infections or spinal tumors may cause back pain, particularly if this pain accompanied by unexplained weight loss or fever. Fortunately, preventive measures and self-care strategies can alleviate most back pain instances, particularly for individuals under 60 years of age. If prevention falls short, you can always consult an orthopaedic surgeon for proper diagnosis and treatment.


Understanding the Symptoms Related to Back Pain

Symptoms related to back pain can vary widely and may be indicative of underlying. Understanding these symptoms is crucial for timely diagnosis and appropriate treatment. Here are some common symptoms associated with back pain:

  • Buttock pain frequently arising from worn-out facet joints in the spine, causing referred pain.
  • Shooting pain down the leg, commonly known as sciatica or radicular pain, is typically caused by nerve passage narrowing due to disc damage or osteoarthritis in facet joints.
  • Leg or foot numbness and weakness can result from nerve compression in the spine, affecting sensation and motor function.
  • Leg cramps may occur in individuals with back pain, particularly when spinal canal narrowing is severe, resulting in crampy leg pain during walking.
  • Tingling, burning, or crawling sensations may arise due to nerve compression within the spinal canal, a condition known as paraesthesia.
  • In very severe cases of disc injury, patients may experience loss of bowel and bladder control, a rare condition referred to as cauda equina syndrome, where the disc presses on nerves controlling these functions.

How Bad Posture Can Lead to Lower Back Pain

Poor posture can lead to back pain even at a young age. Incorrect posture places stress on muscles, spinal joints, and discs, which can accumulate and weaken these structures over time. Prolonged hunching while standing or sitting strains back and core muscles, leading to stiffness and weakness. When exercising, be sure to avoid incorrect lifting techniques which can result in lumbar disc herniation and radiating pain. Even working on a laptop while lying on the belly can negatively impact the lower spine. It’s important to note that maintaining correct posture will benefit you in the long run.


First Aid Solutions for Back Pain: Tips for Effective Management

Here are tips for handling back pain and maintaining activity:

  1. Initially, you can limit regular physical activity for the first few days to ease symptoms and reduce inflammation in the affected area.
  2. Apply ice during the first 48 to 72 hours, then transition to using heat for pain relief.
  3. Consider taking over-the-counter pain relievers as directed by your orthopaedic surgeon.
  4. Avoid activities involving strenuous actions such as heavy lifting. This may exacerbate the pain.
  5. Refrain from exercise immediately after experiencing back pain; gradually reintroduce exercise under the guidance of your orthopaedic surgeon who can recommend suitable exercises for your condition.

Preventive Measures to Avoid Recurrent Back Pain

To prevent back pain, it’s crucial to maintain good posture while sitting and standing and incorporate regular exercises that strengthen your core muscles. Here are some tips to prevent back pain:

  • Avoid prolonged standing; use a footstool for specific activities if needed.
  • As much as possible, choose cushioned sole shoes over high heels.
  • Ensure ergonomic seating with a straight-backed, adjustable chair, armrests, and a swivel seat.
  • Place a small cushion or rolled towel for lumbar support during extended sitting or driving.
  • Take breaks during long drives to stretch and walk.
  • Quit smoking, keep a balanced diet, and maintain a healthy weight.
  • Strengthen abdominal muscles through exercises to support your core.
  • Incorporate relaxation techniques like yoga or massage into your routine.


Diagnosing Lower Back Pain

To diagnose and address your back pain, the process begins with a thorough medical interview and examination to understand your symptoms and potential causes. You may also undergo back X-rays or MRI scans to pinpoint the source of the pain. After gathering this information, your orthopaedic surgeon will provide you with a diagnosis and discuss treatment options.

Treatments for Lower Back Pain

The approach to treating back pain primarily focuses on addressing the underlying cause. The treatment plan may include both surgical or non-surgical methods, or a combination of both. These procedures are delivered by a specialized team of professionals dedicated to managing your back condition. These treatments encompass medication for alleviating back, buttock, and leg pain, guidance on lifestyle modifications to better manage back pain, physiotherapy targeting back and core muscles to enhance strength and function while reducing discomfort, pain procedures to address the root causes of back pain, and surgical interventions aimed at relieving pinched nerves and stabilizing deteriorated spines.



How can I distinguish between a normal back strain and a serious lower back injury?

Differentiating between a regular back strain and a serious lower back injury depends on the duration and intensity of symptoms. Mild to moderate discomfort that responds well to rest and self-care is typical of a common back strain, whereas severe and persistent pain, along with leg numbness or weakness, may signal a potentially serious lower back injury that warrants immediate medical attention.

What should I do if I experience sudden lower back pain after standing too long?

If you experience sudden lower back pain after prolonged standing, it’s advisable to rest, apply ice or heat, and consider over-the-counter pain relievers, but if the pain persists or worsens, consult a healthcare professional for a proper evaluation.

Is it possible to recover completely from lower back pain without the use of medications or surgery?

It depends on the severity of the pain and the patient’s condition. For mild cases, it’s possible to achieve complete recovery from lower back pain without medications or surgery through a combination of physical therapy, lifestyle adjustments, and exercises. It is best to consult an orthopaedic surgeon for this.

Is there any advice on how to prevent further injury when performing deadlifts at the gym?

To prevent further injury when performing deadlifts or other exercises at the gym, ensure proper form, engage your core muscles, lift with your legs, and start with a manageable weight. Do not overexert yourself.

What role does posture play in managing chronic back pain?

Good posture is crucial in managing chronic back pain as it helps reduce stress on the spine, muscles, and ligaments, which can alleviate pain and prevent worsening of the condition.


  1. https://www.spine-health.com/blog/poor-posture-causing-your-back-pain
  2. https://medlineplus.gov/ency/article/002119.htm
  3. https://www.theorthopaedicandpainpractice.com/service/lower-back-buttock-pain/

Dr Yong Ren’s Profile

Dr Yong Ren graduated from the National University of Singapore’s Medical faculty and embarked on his orthopaedic career soon after. Upon completion of his training locally, he served briefly as an orthopaedic trauma surgeon in Khoo Teck Puat hospital before embarking on sub-specialty training in Switzerland at the famed Inselspital in Bern.

He underwent sub-specialty training in pelvic and spinal surgery, and upon his return to Singapore served as head of the orthopaedic trauma team till 2019. He continues to serve as Visiting Consultant to Khoo Teck Puat Hospital.

Well versed in a variety of orthopaedic surgeries, he also served as a member of the country council for the local branch of the Arbeitsgemeinschaft für Osteosynthesefragen (Trauma) in Singapore. He was also involved in the training of many of the young doctors in Singapore and was appointed as an Assistant Professor by the Yong Loo Lin School of Medicine. Prior to his entry into the private sector, he also served as core faculty for orthopaedic resident training by the National Healthcare Group.

Dr Yong Ren brings to the table his years of experience as a teacher and trainer in orthopaedic surgery. With his expertise in minimally invasive fracture surgery, pelvic reconstructive surgery, hip and knee surgery as well as spinal surgery, he is uniquely equipped with the tools and expertise necessary to help you on your road to recovery.

Lorem ipsum dolor sit amet consectetur adipiscing elit ut arcu a dignissim suscipit non ac eget tellus in nisl mauris nec.

Author Image Link

Sarah Taylor

Obstetrics & Gynaecology