By Dr Tony Setiobudi BMedSci, MBBS, MRCS, MMed (Ortho), FRCS (Ortho)

There’s nothing in this world that beats a good night’s sleep. One that leaves you refreshed and ready to start a new day. However, having a good sleep for those suffering from back pain may not be easy.

Pain and sleep are intertwined in a vicious cycle, meaning they can be mutually reinforcing. Pain can disrupt sleep, but at the same time, poor sleep can make it more likely that a person will experience having pain or pain get worse.

It is possible to get a good night’s rest and help relieve back pain with proper sleeping strategies. Here are some tips below that can help you to sleep better.

1. Fix your sleeping position

A sleeping position affects spinal alignment. Wrong sleeping positions can put pressure on the lumbar spine, which can cause pain and stiffness. It is important to maintain the natural curve of the spine when lying in bed, thus helping ease your back pain. To do this make sure that the head, shoulders, and hips are aligned and properly supported. Put a pillow underneath your legs for extra support. If you sleep on your side, put a pillow between your knees and another one behind your back. Avoid sleeping on your stomach because it puts a lot of strain on your back.

2. Get a good mattress

Mattress choice can influence and alleviate nighttime back pain. A mattress that doesn’t support the lumbar spine can induce or exacerbate lower back pain. Soft mattresses make you sink in too deep, twisting your joints, causing back pain. Research has shown that a very hard mattress is also not good. In general, a medium-firm mattress is probably better for people with back pain. However, there is no right answer, because every person has different preferences and needs that are important to consider. You should try which type of mattress is the most comfortable for you.

3. Exercise

Building strength and flexibility in the core muscles can help ease back pain. It also lowers the chances of you straining your back and experiencing muscle spasms during the night. Exercise also helps reduce your stress and make you sleep better.

4. Heating pad

The heating pad is effective as it can improve circulation. Hence, a heating pad can help ease aches and pains as well as reduce stiffness in the muscles and joints. Taking hot baths may ease your back pain as well.

5. Self-massage

A self-massage can be effective in reducing lower back pain.  It can give immediate relief from pain, aches, and reduce tension in your muscles. It helps improve blood circulation in the muscles and helps relax them, which altogether results in a reduction of stress-related pains.

Quality sleep is essential to your health and overall well-being. Having a good night’s sleep can help prevent or reduce back pain. While knowing how to sleep when you have back problems can help cope with pain and contribute to healing and recovery.

Consult with your doctor if back pain is interfering with your sleep quality. For more details about your back pain condition, Spring Hope Orthopaedic Spine and Surgery can give you solutions. Schedule an appointment with us.

Dr Tony Setiobudi is an Orthopaedic & Spine Surgeon at Mount Elizabeth Hospital (Orchard), Singapore. He treats bone, joint, muscle and ligament problems in adults and children. He has a special interest in nerve compression and spine problems such as back & neck pain, scoliosis, kyphosis, spine tumor & infection, spinal cord injury, osteoporosis fracture, spinal stenosis and slipped disc.

Back pain is one of the most common health problems among all the population of the world. People can suffer from different forms of back pain which in turn can lead to chronic backpain, lower back pain or spinal pain. It is important to get your chronic backpain taken care of before it gets worse. Preventing chronic back pain before it begins starts with doing all that you can to reduce your risk for a future back injury.

There are several key factors that could significantly increase the risk for developing back pain over time. Some factors are unavoidable such as age, genes, or sex. However, knowing the different risk factors to change your lifestyle that may lessen back pain or help you to cope with it better.

OCCUPATIONAL RISK

Having a job that requires activities increase the likelihood of future back problems, such as lifting, pulling, pushing, bending, repetitive motion patterns and heavy physical exertion, can lead to injury and back pain. Long distance driver who always sitting behind the steer for prolong of time with vibration

Certain jobs and activities put a greater strain on your back. Working at desk all day which involves prolonged periods of sitting can contribute to pain, especially poor posture or sitting in a chair with not enough back support.

SMOKING

Smoking may not directly cause back pain, but it increases your risk of developing low back pain. Smoking accelerates degeneration of the lower spine. Nicotine restricts blood flow to vertebrae and disks, so they may age and break down more quickly. Smoking may also interfere with the body’s ability to absorb and use calcium, leading to osteoporosis- related bone and back problems. Smoking also slows healing and prolongs pain. Smokers are also much more likely than nonsmokers to develop chronic, disabling back pain.

WEIGHT

Body weight alone (along with your height and general build) appears to have little to do with your likelihood of developing back pain in the first place. However, being overweight, obese can put stress on the joints and pressure on the vertebrae and discs and lead to low back pain. Individuals who have extra weight also showcase signs of a lack of physical activity.

POSTURE

Despite your parents’ admonition to “sit up straight,” experts now agree that, in most cases, posture alone, whether bad or good, will neither predispose you to back pain nor shield you from it. Slouching doesn’t seem to have much effect on the basic health of your spine. But before you slump down in your chair, note that poor posture can worsen exist­ing pain. Improving your body mechanics can help relieve your symptoms and prevent flare-ups Being physically out of condition is an important reason people have recurring bouts of the “sprain and strain” type of back pain.

PSYCHOLOGICAL STRESS

A study published in Arthritis Care and Research suggest that people who suffer from depression have a 60% greater chance of developing back pain in their lifetime than those who don’t. Stress, anxiety, and negative emotions can influence how closely one focuses on their pain as well as their perception of its severity.

Part of the answer may lie in the fact that chronic pain and depression share some of the same bio­chemical features. Imbalances in the neurotransmitters serotonin and norepinephrine, for example, play a role in mood disorders such as depression and also are involved in producing the sensation of pain. This could explain why people suffering from depression tend to experience more severe and long-lasting pain than other people.

Anxiety and depression can also sensitize you to pain, making you feel worse. So can the disturbed sleep that often accompanies depression and anxiety. Fortunately, you can often address psychological influences on back pain with cognitive behavioral therapy, where a counselor helps you recognize negative thoughts, behaviors, and feelings and respond in a more positive way.

Dr Tony Setiobudi is an Orthopaedic & Spine Surgeon at Mount Elizabeth Hospital (Orchard), Singapore.

By Dr Tony Setiobudi BMedSci, MBBS, MRCS, MMed (Ortho), FRCS (Ortho)

Back pain is a very common problem in our society. Most of them are self-limited. Some become chronic back pain which is disturbing and difficult to treat. I am going to explain how neuropathy contributes to the development of chronic back pain.

Neuropathic pain is distinct from other types of pain. If a person breaks a bone or got a cut, pain signals are carried via nerves from the site of the trauma to the brain. That is how we can feel pain when we have an injury. With neuropathic pain, however, pain signals originate in the nerves themselves.

How Neuropathic Pain Develops

In many cases, the nerves become damaged or dysfunctional after responding to an injury or trauma, causing hypersensitivity to pain. The nerves then send faulty signals of pain even when the injury has healed. Neuropathic pain or neuropathy, is a chronic condition, meaning it does not go away. Instead, the pain becomes the disease process. An estimated 7 to 10% of people have neuropathic pain. Chronic back pain is a common example of neuropathic pain.

When Back Pain Causes Neuropathy

Neuropathy can result from any type of pain that compresses or impinges on a nerve. A slipped disc, for example, could press against a nearby nerve, causing pain. Neuropathic pain originating from the back or spine may include:

• Chronic pain radiating down the leg (sciatica) or the arm (cervical radiculoapthy)
• Chronic back pain

Why Early Treatment is Crucial

Early treatment is important, since more aggressive treatment may be needed if symptoms are not addressed soon. Over time, exposure to significant pain can cause changes to the central nervous system that make the body become more sensitive to even a slight touch. This phenomenon is known as central sensitization.

As with other types of chronic pain, delays in treatment may also make other health problems more likely. Depression, anxiety, difficulty sleeping, and an inability to work and take part in other activities are some health issues associated with untreated neuropathy.

Managing Chronic Pain

Chronic back pain does not go away completely even with the right treatment. The treatment aims to manage the pain so that the person can be functional. The first step is to get a thorough medical evaluation to determine the cause of the pain. It can be muscle strain, arthritis, slipped disc, or other things.

The medical treatment depends on the cause of the pain. Whatever the problem is, there are a number of effective strategies for coping with chronic back pain.

1. Reduce the stresses in your life. It may be your job or problems in the family. You have to try your best to sort out this problem
2. Have enough sleep. Our body carries out repair work when we are asleep.
3. Avoid activities that worsen your pain. E.g. bending down, prolonged sitting, and carrying heavy things.

I hope this information is useful to all of you.

Dr Tony Setiobudi is an Orthopaedic & Spine Surgeon at Mount Elizabeth Hospital (Orchard), Singapore. He treats bone, joint, muscle and ligament problems in adults and children. He has a special interest in nerve compression and spine problems such as back & neck pain, scoliosis, kyphosis, spine tumor & infection, spinal cord injury, osteoporosis fracture, spinal stenosis and slipped disc.