By Cheryl Tan

[Above: A 30cm scar on Madam Choh's back is a reminder of her back-pain ordeal. The X-ray of her spine shows the metal rods inserted into her lower spine for support.]

At just 54, hotel cleaner Madam Choh Kin Sam had to throw in the towel and take early retirement because of her bad back.

The mother-of-four was in such pain that she could barely walk home at the end of her shift.

She was suffering from a degenerative lower-spine condition known as lumbar scoliosis.

The condition was diagnosed when she was 40, when she learnt that her lower back was curving abnormally to one side.

At the time, her doctor gave her the option of undergoing surgery to correct the curve.

But as her four daughters were still very young, she thought - misguidedly, as it turned out - that she could grit her teeth through the occasional bouts of pain.

Madam Choh is one of many Singaporeans suffering from degenerative spine conditions.

A recent study by a team of spine surgeons at National University Hospital (NUH) showed that nearly one in 10 Singaporeans over 40 suffer from this.

It's caused by 'wear and tear' of the spine and is 'part of the ageing process', says Professor Wong Hee Kit, head of the University Spine Centre at NUH.

But younger people can suffer from it too.

Other factors such as a person's genes and injuries can contribute to the wearing down of the spine, says the professor.

A younger person could inherit a tendency for his spine to curve, or else he might have previously injured his spine.

In the case of Madam Choh, now 61, it was when she hit 50 that the pain from her twisted spine increased till it was agonising.

In a bid to ease the stabbing pain that racked her lower back and legs, she shelled out thousands of dollars on massage chairs, acupuncture sessions and an orthopaedic bed. She even bought an $800 machine that stretched her back.

But these gave her only temporary relief.

She finally opted for surgery when she was in so much pain she could not walk after standing up to cook dinner.

On the other hand, Koh Tiang Lip was only 13 when he was diagnosed with lumbar scoliosis two years ago.

Unlike Madam Choh, the youngster had no painful symptoms. He discovered part of his spine was curved and protruding slightly only when he felt around his back.

To prevent the curve from increasing, he had to wear a custom-made back brace made of plaster (right).

This brace, usually prescribed for growing children as temporary support during puberty, has to be worn every day for at least one to two years, depending on the spine's condition. It can be taken off only during sports.

But for patients such as Madam Choh who discover their condition only later in life, a back brace is not much help. Older patients have a less malleable spine than teenagers.

Instead, they are encouraged to leave their spine alone if they do not feel discomfort, but to be aware of their posture and exercise regularly to improve muscle strength.

Doctors recommend painkillers or alternative treatments such as physiotherapy and acupuncture, though these are only meant for short-term pain relief.

Assistant Professor Tan Seang Beng, head of the department of orthopaedic surgery at Singapore General Hospital, says: 'Just because your backache is gone after your acupuncture session does not mean that your spine has been straightened.

'It is just like taking a Panadol for temporary relief.'

Surgery is recommended only for patients with intolerable pain and who have difficulty walking, he says.

Madam Choh is now recuperating from a spine operation she underwent just over a month ago. The pain is now gone, thanks to the metal rods attached to the spine for support.

She even goes for daily swimming sessions to strengthen her back muscles as part of her physiotherapy.
'I'm just thankful I have been finally relieved of the pain after suffering for 20 years,' she says.

tcheryl@sph.com.sg

Photos: Ashleigh Sim, Jean Loo for The Straits Times, SGH

This story was first published in thesundaytimes on June 29, 2008.