Seeking early treatment is key to reducing a recurring back pain.

Dr Serene Ng, a chiropractor at Integrative Chiropractic, said: 'The longer one puts off treatment, the harder it is to achieve full symptomatic relief.'

Initial treatment for back pain usually involves medication. Patients may be given neuropathic drugs which decrease the sensitivity of inflamed or compressed nerves, or painkillers.

Patients may also receive physical therapy like physiotherapy or heat or injection treatments, which works by blocking nerve sensation and reducing back pain.

Associate Professor Hee Hwan Tak, a senior consultant at the University Spine Centre at National University Hospital, called alternative measures like acupuncture and yoga complementary treatments.

He said: 'Acupuncture relieves pain by releasing endorphins which alter the brain's perception of pain. Exercises like yoga or Pilates work by improving the alignment of the spine or relaxing ligaments.'

Mr Wu Yue, a senior traditional Chinese medicine (TCM) physician at Raffles Chinese Medicine, said that in TCM, back pain is caused by blockage of meridians, stagnation of the qi (energy) and blood, accumulation of cold and internal imbalances like kidney deficiency.

Acupuncture, acupressure (tui na) and Chinese herbs relieve back pain by correcting these internal imbalances, he added.

Dr Peng Chung Mien, who has suffered from a slipped disc for many years, underwent physiotherapy and took anti-inflammatory drugs. He is among those who are reluctant to undergo surgery.

The chief executive officer of ST Medical Services said while he was at a medical conference in Boston in May, he learnt about the DRX9000, a machine that offers a non-invasive option for patients with chronic back and neck pain.

Suitable for patients with disc problems, the machine manipulates the spinal column at specific locations, freeing up space between the vertebrae and damaged spinal discs so as to help them heal. Each treatment cycle takes six weeks.

Dr Peng has since brought one of the US$125,000 (S$182,000) machines to Singapore. Each session costs between $100 and $150.

He said: 'The attractive thing is that the machine actually works on the discs and gives diseased discs a chance to heal naturally.'

Mrs Shyan Teo, 35, an educational therapist who also eschewed surgery to treat her back pain and went to a chiropractor instead, said: 'I won't go for surgery because I feel it's not necessary. With maintenance, my condition won't deteriorate so much.'

Surgical options

When patients fail to find relief with conservative types of treatment, surgery is then considered.

Discectomy, a surgical procedure on the spine to remove part of a slipped disc, and fusion surgery, performed to link together individual segments in the spine, or vertebrae, can relieve compression of nerves.

Posterior dynamic stabilisation surgery opens up the space available for the nerve roots and also relieves the compression of nerves.

Artificial disc replacement, as the name suggests, replaces the worn out disc while preserving motion at the operated spinal area.

However, not all patients - depending on age, physical condition or type of back problem - are suitable for surgery.

This story was first published in Mind Your Body, The Straits Times, on Oct 9, 2008.

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