back pain, Lower back pain and spinal arthritis


Non-invasive treatments for low back pain and sciatica

The non-invasive treatments have two types, (a) non-pharmacological intervention and (b) pharmacological intervention.

(a) Non-pharmacological intervention includes:

(1) Self-management – self-management is advice and information tailored to individual needs and capabilities to help themselves self-manage their low back pain.

(2) Exercises – group exercise programme (aerobic, mind-body or a combination of approaches) for people with specific needs or flare-up of low back pain with or without sciatica.

(3) Manual therapies – manual therapy include spinal manipulation, mobilisation or soft tissue techniques such as massage for managing low back pain with or without sciatica, but only as part of a treatment package including exercise.

(b) Pharmacological intervention
Pharmacological intervention includes oral non-steroidal anti-inflammatory drugs (NSAIDs) for managing low back pain, taking into account potential differences in gastrointestinal, liver and cardio-renal toxicity, and the person’s risk factors, including age.

If NSAID is contraindicated or not tolerated or has been ineffective, weak opioids (with or without paracetamol) is usually considered for managing acute low back pain.

Invasive treatments for low back pain and sciatica

Invasive treatments have two types, (a) non-surgical interventions and (b) surgical interventions.

(a) Non-surgical interventions includes:

(1) Radiofrequency denervation

Referral for assessment for radiofrequency denervation for people with chronic low back pain has to be considered when non-surgical treatment has not worked for them and the main source of pain is thought to come from structures supplied by the medial branch nerve and they have moderate or severe levels of localised back pain (rated as 5 or more on a visual analogue scale, or equivalent) at the time of referral.

(2) Epidurals

Epidural injections of local anaesthetic and steroid are usually used in people with acute and severe sciatica and tend not to be used in people who have central spinal canal stenosis.

(b) Surgical Interventions

Most performed surgical interventions are spinal decompression, spinal fusion and disc replacement.

Spinal decompression is usually considered for people with sciatica when non-surgical treatment has not improved pain or function and their radiological findings are consistent with sciatic symptoms.

Spinal fusion is not usually offered to people with low back pain unless as part of a randomised controlled trial.

back pain


(1) Avoid bed rest for a long period.
In the few days of a new episode of back pain, avoiding aggravating activities may help to relieve pain. However, staying as active as possible is important in aiding recovery.

(2) Exercise and activity to prevent back pain.
Exercise helps tackle back pain and is also the most effective strategy to prevent future episodes of back pain. No one type of exercise is proven to be more effective than others, so just pick an exercise you enjoy and that you can afford to maintain in the long-term and that fits in with your daily schedule.

(3) Painkillers.
They should only be used in conjunction with other measures such as exercises. Painkillers should be a short-term option as they can bring side effects after long term use.

(4) Surgery is rarely needed.
Most back pains do not require surgery however, in some uncommon back conditions where there is pressure on the nerves that supply the legs and there is incontinence, surgery may be recommended.

(5) You can have back pain without injury.
Many psychological factors, general health lifestyle factors and social factors may cause back pain. At times a combination of these factors may also cause back pain.

  • Psychological factors including fear of not getting better, feeling down and being stressed.
  • General health lifestyle factors like being tired, not getting enough good sleep, not getting enough physical activity.
  • Social factors such as difficult relationships at work or home, low job satisfaction or stressful life events.

(6) If your back pain does not clear up after 6 – 8 weeks make an appointment to see your doctor or a physiotherapist.

coccydynia, Coccyx, coccyx or tailbone pain


In general, coccyx pain is caused by injury. Coccyx injuries are due to direct impact from a fall onto your bottom. The severity of the injury can range from a bruise to a fracture. Most coccyx injuries heal on their own given time and self-management.

Below are some of the advice to help people with coccyx pain:

  • People with coccyx pain are advised to avoid sitting for long periods, so if you can stand during the day, that is recommended. If you must sit, leaning forward will take some of the pressure off your coccyx.
  • Some people find sitting on a “coccyx cushion”, which has a U-Shaped design at the back, helps to avoid weight bearing on the coccyx while sitting.
  • Cold compression can be applied for up to 20 minutes at a time, several times throughout the day.
  • Simple pain killers such as paracetamol and/or ibuprofen can be very effective for helping with pain and swelling, but don’t use them for more than 2 weeks without seeking medical advice.
  • Exercises. It is important to keep your lumbar spine moving normally. The exercises below will help to gently maintain or regain normal movement:
  • (a) Extension Facing Wall. Stand, leaning against a wall with your feet 30 cm (1 foot) from the wall. Puch your stomach and pelvis towards the wall and hold for 5 seconds before returning to the start position. Repeat 2-3 times each hour. (Note – if your stomach touches the wall, move your feet backwards a little for the next stretch.
  • (b) Side Flexion in Standing. Stand with your arms by your side. Slowly slide one hand down the outside of your leg so you feel a stretch. Slowly return to the upright position and repeat to the opposite side. Repeat 2-3 times every hour.
back pain, Pain between shoulder blades


Possible causes of back pain between shoulder blades

(1) Shingles
Depending upon which nerve roots the virus affects, shingles can cause pain nearly anywhere in the body and may occur well before a rash is noticed. The pain may be most pronounced in the region between your shoulder blades but tends to concentrate on one side of your body.

(2) Epidural anaesthesia
People who have an epidural for labour or a C-Section sometimes experience intense interscapular pain. This pain resolves when the drip is slowed down and this pain goes away after labour.

(3) A vertical compression fracture in the thoracic region.
Compression fractures, often due to osteoporosis, may cause interscapular pain.

(4) Scoliosis
Scoliosis of the thoracic spine may cause pain between shoulder blades.

(5) Pulmonary Embolism
Pulmonary emboli occur when clots in the leg (deep vein thrombosis) break off in the leg and travels to the lungs. The pain is often sudden in onset, sharp and may be associated with severe shortness of breath, although sometimes people notice only mild discomfort.

(6) Acid Reflux
Gastroesophageal reflux (acid reflux) may cause referred pain to the back in the region between the shoulder blades. Other symptoms include chest pain, hoarseness and difficulty swallowing.

(7) Nerve entrapment
Nerve entrapment on rhomboid muscles can cause pain between the shoulder blades.

(8) Gallbladder disease
Referred pain from gallbladder disease often occurs as a stabbing pain between the shoulder blades and may be associated with pain on the right upper quadrant of the abdomen and nausea.

(9) Muscle strain
The most common cause of pain between the shoulder blades is a muscle strain. This can result from poor posture (especially leaning forward with prolonged sitting or standing), excess lifting and activities that involve twisting.

(10) Trauma
Example of this is trauma on the shoulder.

(11) Arthritis
Arthritis in the neck or even the ribs may cause interscapular pain.

(12) Herniated or Bulging Discs

(13) Heart Attack

(14) Cancer
Lung cancer can cause referred pain between the shoulder.

back pain


  1. Muscle spasm and strained muscles or ligament. Activities that can lead to muscle strains or spasms include; lifting something improperly, lifting something too heavy, making an abrupt and awkward movement.

2. Injuries on the back, fractures and falls can cause back pain.

3. Ruptured disks. Each vertebra in the spine is cushioned by disks, if the disk ruptures, there will be more pressure on a nerve resulting in back pain.

4. Bulging disks. In much the same way as ruptured disks, a bulging disk can result in more pressure on a nerve.

5. Sciatica. A sharp and shooting pain that travels through the buttock and down the back of the leg caused by a bulging or herniated disk that is pressing on a nerve. Sciatica can also cause numbness, tingling and weakness in the lower back, buttocks, legs and feet.

6. Arthritis. Osteoarthritis can cause problems with the joints in the hips and lower back.

7. Spinal stenosis. A narrowing of space around the spinal cord.

8. Abnormal curvature of the spine. If the spine curves in an unusual way, back pain can result. An example is a scoliosis in which the spine curves to the side.

9. Osteoporosis. A condition where the bones, including the vertebra of the spine, become brittle and porous making compression fracture more likely.

10. Kidney problem. Kidney stones or kidney infection can cause back pain.

back pain

What are the warning signs of a serious problem when you have back pain?

Pain that travels down the leg is a sign of a serious problem.

Also, if you have any of the following symptoms, you should seek urgent medical attention:

  • difficulty controlling or passing urine,
  • loss of control of your bowels,
  • numbness around your back passage or your genitals,
  • a serious weakness in your legs so you find standing difficult, and
  • severe and ongoing back pain that gets worse over several weeks.

The above symptoms could potentially be linked to a rare but serious condition that needs urgent medical attention.

back pain


Back pain is a common problem and will affect many of us at some point during our lives.


Often back pain doesn’t have one simple cause but may be due to one or more of the following:

  • muscle strains or sprains
  • poor posture
  • lack of exercise resulting in stiffening of the spine and weak muscles
  • sciatica – this is caused by a nerve in the spine being pressed or squeezed. In most cases, sciatica is caused by a bulging disc pressing on the nerve causing pain that travels all the way down the leg and foot
  • spinal stenosis – this is a condition where the space around the spinal cord narrows and compresses a section of nerve tissue. This can happen from birth or can develop as we get older. Like sciatica, the main problem with spinal stenosis tends to be leg pain more than the back pain
  • bone problems such as a fracture on the back bone – often caused by trauma or thinning of the bones called osteoporosis
  • infection in the bones
  • a tumour
  • inflammation, for example ankylosing spondylitis


Although it’s common, most cases of back pain tend to clear up without the need to see a doctor. However, you should see your doctor if your pain:

  • stops you from working or doing the things you enjoy
  • affects your everyday activities
  • gets worse
  • is really bad
back pain, seat cushion


Sitting in one position for too long can cause discomfort, soreness, and even injury. Sitting on top of a memory foam pressure relieving cushion:

  • help to mitigate the negative effects of prolonged sitting,
  • work by distributing the body’s weight across a wider area and this allows to improve blood flow and postural stability.

Sitting on a hard surface for a long period of time may lead to a lot of negative effects, including pressure on the lower back, reduced blood flow, risk of developing pressure sores and/or abscess. Some jobs require people to sit on a chair for a long period of time but sitting on top of the memory form seat cushion will help reduce the negative effects of prolonged sitting on a chair or on a hard surface.

back pain


Some back problems start for no obvious reason and this can be very frustrating. Back problems are rarely due to any serious disease or damage. Back problems can cause a range of symptoms, including:

  • muscle spasms
  • pins and needles due to nerve irritation
  •  stiffness
  • hot, burning, shooting or stabbing pains in your back and sometimes into one or both of your legs

In many cases, new or flare-up of long-standing back problems should begin to settle within few weeks without the need to see a healthcare professional. For most back pain problems, you’ll not normally need an X-ray or MRI scan. However, speak to a healthcare professional as soon as possible if you:

  • feel unsteady when you walk
  • have back pain that starts when you’re ill with other problems – such as rheumatoid arthritis or cancer
  • feel generally unwell


Although most back problems start for no obvious reason, back pain can be caused by:

back pain, Back pain from driving a truck


As a truck driver you are on your rear for long periods of time. A great memory foam seat cushion can save you from having back issues like sciatica, muscle degeneration or other health issues related to prolonged sitting while driving.

Driving long distances is very common for truck drivers, so its common to expect truck drivers to sit for long periods of time. While driving truck doesn’t sound too bad, sitting for long periods of time inside a vibrating vehicle can cause damage to human body.

Since truck drivers sit for long period of time driving trucks most of the day, its important for them to think about the type of seat they may use. The benefits of sitting on memory foam seat cushion may be more than sitting on a regular seat. Not only does memory foam seat cushion provide much needed support, but it also feels more comfortable to sit down on for hours at a time.


Vibration happens when a moving vehicle is in operation and can get worse if the vehicle passes over uneven road or pavement. The design of a large vehicle like a truck makes it more susceptible to harbouring minute vibrations, which do get ”absorbed” by the human body as the reverberate throughout the entire vehicle.


Although many trucks and larger vehicles are fitted with comfortable seats, sitting on top of a memory foam seat cushion can add more benefit.

The memory foam in a seat cushion helps reduce pressure on the tailbone (coccyx) and lower back. The curved design also help improve circulation to the legs and improves posture, reducing pressure on the spine while evenly distributing body weight. The memory foam seat cushion is available on the following link