Lower Back and Pelvis

Acute Low Back Pain

Lower back is very common, and, in most cases, it is not serious and can be resolved in a few days or a week. However, some backaches do require a full assessment and intervention by a Physiotherapist or a Physician.

The most common cause of back pain, especially lower back pain, is a combination of poor posture and lack of movement, typically seen with people who sit for long periods. This is known as mechanical or acute low back pain and is not a serious condition.

Mechanical back pain also can arise from poor biomechanics during exercise, lifting or while performing your household chores. However, it can be uncomfortable and frustrating to experience a constant ache or pain in your back.

At River Physio, our range of back care equipment helps manage mechanical back pain with more ease. Along with our modern equipment, simple posture advice, suitable exercises and a little lifestyle modification helps resolve your pain in a few days to week.

Disc Prolapse / Slip Disc

The shock-absorbing fibrocartilage present between bony vertebral bodies while allowing movement at each spinal level is called an intervertebral disc. The disc between the vertebrae may become damaged and bulge slightly, causing pressure on the nerves. This can cause back pain, leg pain, pins and needles and possible numbness and the symptoms may vary depending upon the extent of the disc injury.

The disc might be slightly bulged, torn, protruded or extruded and each may show different signs and symptoms.

A very careful and detailed examination is the most important step while treating a disc injury. Our experienced physiotherapists will be devoting most of their time in assessing you and your back condition to make the right diagnosis on your first visit.

At River Physio, our Physiotherapists are trained in spinal manipulation techniques and have loads of experience in managing complicated disc injury cases. At River Physio, we are also equipped with spinal decompression, a non-surgical treatment approach.

Facet Joint Arthrosis

Facet joint pain can either be of sudden or gradual in onset. facet joint pain is most times unilateral yet , it may be worsened with compression of the irritable joint resulting in the opposite side joint too.

Occasionally, there is a somatic referral pattern down the legs, where the brain perceives jumbled signals to create the leg pain, rather than an actual injury to the leg. Treatment usually includes manual therapy, moist therapy, gentle stretches, strengthening exercises and soft tissue release.


Approximately 5%-6% of males, and 2%-3% of females have spondylolisthesis, a condition where the vertebral body slips over anteriorly on the other vertebra. The causes are multifactorial. Posture, gravity, torsional forces on the spine, high concentration of stress loading all contribute in the development of spondylolisthesis. It can appear in as young as 10-year-old children.

Most patients with spondylolisthesis will have no symptoms and are mostly detected in an x-ray while investigating for a different problem. Some patients who have symptoms such as pain and tenderness in the low back, especially after exercise. Increased lordosis and buttock pain,

Protruding abdomen associated with pain and/or weakness in one or both thighs and legs which in turn may lead to tight hamstrings. In cases of advanced spondylolisthesis, it may begin to affect the way of walking, resulting in waddling gait. This causes the abdomen to protrude further, due to the low back curving forward more. The torso (chest, etc.) may seem shorter; and muscle spasms in the low back may occur.

Apart from pain medications, such as acetaminophen, and/or NSAIDs (e.g. ibuprofen, COX-2 inhibitors) or oral steroids to reduce inflammation in the area, the mainstay of treatment is physiotherapy.

The recovery and improvement usually may take a few months. Exercise is the mainstay of treatment and some experienced physiotherapists do even perform manipulation as needed.

At River Physio, we follow an integrated approach which involves physiotherapy for pain relief and strengthening, occupational therapy for lifestyle modifications and a nutritionist’s advice to improve bone strength and weight loss if required.

Some rare patients may require surgery depending on the grade of slip and we at River Physio will be able to suggest it to you, if conservative therapy will be a success for you.

Lumbar Spondylolysis

Spondylosis is a type of Osteoarthritis of the spine. 30-40% of people with lumbar spine spondylosis do not experience symptoms. In some cases, spondylosis can cause back pain and neck pain due to compression or pinching of nerves in the area And also Morning stiffness, Tenderness Weakness in the back associated with numbness or tingling in the lower legs.

Our highly skilled Physiotherapists at River Physio will design a treatment program which usually involves a variety of evidence based therapies and treatments to help reduce your pain and get you back on your feet as quickly as possible.

Piriformis Syndrome

It is an uncommon neuromuscular disorder that is caused when the piriformis muscles compress the sciatic nerve. Nerve compression caused by spasm of the piriformis muscle. The pain in the deep gluteal region radiates low back pain, numbness, difficulty in walking. This is frequently misdiagnosed as piriformis syndrome and sciatic pain. A physiotherapist can make an accurate diagnosis of your lower back problem if your pain arises from your lower spine or piriformis muscle.

Once your diagnosis is established, treatment could involve pelvis and spine re-alignment techniques, electrotherapy to help decrease pain and spasm in your piriformis muscles, deep core stability program in certain cases of leg length discrepancy.

Our physiotherapist will then seek podiatrist expertise to help restore foot and lower extremity alignment.

Sacroiliac joint dysfunction

This condition is generally more common in young and middle age women, due to hormonal changes and childbirth. The Interesting fact is 30% of low back pain is believed to be caused by the SIJ. It can result from a fall onto the bottom or knee or lifting heavy objects.

All patients, if not most patients do recover completely with proper physiotherapy treatment. Pregnancy often causes SIJ pain as ligaments become stretched and the pelvis is under more strain. Some of the common symptoms of SI joint dysfunction are Back Pain – particularly low back pain, buttock Pain, thigh Pain and Sciatic-like Pain – Pain that travels from the lumbar region into your buttocks, back of your thighs, and sometimes calf and foot.

An experienced Physio should be able to arrive at a diagnosis with a detailed clinical assessment.

At River Physio, we treat most SI joint dysfunctions successfully in two weeks’ time.


Pressure on the sciatic nerve from a herniated disc is usually what causes sciatica. It may also result due to degenerative changes in the lumbar bones causing pressure on the exiting nerves Some of the numerous causes of sciatica are bulged or slip disc, spine and facet joint injuries, piriformis syndrome, spinal stenosis, spondylolisthesis and sacroiliac dysfunction.

Usually pain occurs in the rear of the leg that is worse when sitting. Burning, or tingling in the leg is the most common sign of a sciatica. In severe conditions, weakness, numbness, or difficulty moving the leg or foot with a constant pain on one side of the rear calf which sometimes lead to shooting pain that may make it difficult to stand up

Our physiotherapist will examine you, paying special attention to your spine and legs. If you have an associated injury, fever, problems controlling your bowels or bladder, previous cancers and whether you’ve been losing weight, you may require medical attention and we will be able to advise you immediately after our assessment.

Most patients do recover with non-surgical approach and at River Physio, we are fully equipped with expert back care physios and necessary tools such as spinal decompression to recover you completely.

Sciatica do tend to recur. The main reason, it is thought to recur is due to insufficient rehabilitation. At River Physio, we never do incomplete jobs.

You won’t be comfortable to do any job with back pain. Get your back pain treated at the best facility in Singapore. Come to River Physio for effective back pain physiotherapy treatments.

At River Physio,

You are not just a patient. You are family.