Dr Colum Nolan
Senior Consultant Spine & Neurosurgeon
MB, BCh, BAO, LRCPSI, MRCSI, FRCSI (Neurosurgery)
Many people suffer from repeated episodes of back pain that resurface time after time. While initial moments of discomfort may fade, it is common for them to return weeks or months later, often without a clear cause. This pattern can be frustrating and may cause disruption to your daily life, as well as raise concerns about whether a more serious condition is developing.
In many cases, recurrent back pain is not caused by a single major event, but by ongoing daily habits that place repeated strain on the spine. Prolonged sitting, poor posture, improper lifting mechanics or reduced physical conditioning can all contribute to what is often described as a “pain cycle.” This cycle typically involves strain or irritation, partial recovery as symptoms improve and then re-aggravation when the same underlying stresses continue.
Understanding why back pain keeps coming back is the first step towards breaking this cycle. By recognising common triggers and knowing when symptoms warrant medical evaluation, you can take informed steps to manage your spine health more effectively.
Everyday Triggers That Can Worsen Back Pain
There are many triggers in daily life that can aggravate back pain, whether it’s caused by a condition or a result of temporary muscle aches.
Prolonged Sitting and Poor Posture
Spending long hours seated at a desk, in front of a screen or in a driver’s seat can place sustained pressure on the lower back. Slouching or leaning forward shifts the spine out of its neutral alignment, increasing strain on discs, joints and supporting muscles. Over time, this repeated stress may contribute to recurring back pain.
Repetitive Bending, Lifting or Twisting
Frequent bending, heavy lifting or twisting movements can overload the structures of the spine. Even if a single movement does not cause immediate injury, repeated mechanical strain may irritate muscles, ligaments or spinal discs and trigger flare-ups.
Weak Core Muscles and Physical Deconditioning
The abdominal and lower back muscles play an important role in stabilising the spine. When these muscles are weak or underused, the spine may rely more heavily on passive structures such as ligaments and discs for support. This imbalance can increase the likelihood of recurrent pain episodes.
Inadequate Rest and Recovery
Resuming strenuous activity too soon after a back pain episode may prevent full recovery. Without adequate time for tissue to heal and muscle strength to rebuild, the same area may become irritated again.
Stress and Muscle Tension
Psychological stress can contribute to increased muscle tension, particularly in the neck and lower back. Persistent muscle tightness may reduce flexibility and alter movement patterns, which can aggravate existing back pain or make it more likely to recur.
When Is Recurrent Back Pain a Cause for Concern?
Occasional back pain that improves with rest and simple measures is common. However, recurring episodes that become more frequent, more intense or longer lasting may warrant closer attention. While many cases are related to mechanical strain, certain patterns of symptoms can suggest underlying nerve involvement or structural issues within the spine.
Back pain may be a cause for concern if it:
- Persists beyond a few weeks despite appropriate self-care
- Gradually worsens rather than improves
- Radiates into the buttocks or leg
- Is accompanied by numbness, tingling or weakness
- Interferes significantly with work, sleep or daily activities
If recurrent back pain does not follow a predictable pattern of strain and recovery, or if neurological symptoms are present, a structured medical assessment can help determine the underlying conditions that may be linked to it.
What Medical Conditions Can Cause Recurring Back Pain?
Cervical Radiculopathy
Cervical radiculopathy occurs when a nerve in the neck becomes irritated or compressed, often due to disc changes or narrowing around the nerve roots. Although it originates in the cervical spine, it may cause neck pain that radiates into the shoulder, arm or hand, sometimes accompanied by tingling or weakness. When nerve irritation persists or recurs, symptoms may flare up intermittently rather than resolving completely.Slipped (Herniated) Disc
A slipped or herniated disc develops when the soft inner portion of a spinal disc protrudes through its outer layer. This may irritate nearby nerves and lead to back pain that comes and goes, depending on activity level and inflammation. Recurrent symptoms can occur if the disc remains vulnerable to strain or if pressure on the affected nerve fluctuates.Sciatica
Sciatica refers to pain that radiates along the sciatic nerve, typically from the lower back into the buttocks and down the leg. It is often caused by nerve compression in the lumbar spine, such as from a disc herniation or spinal narrowing. Symptoms may improve and then recur, especially with prolonged sitting, bending or lifting.Slipped Vertebra (Spondylolisthesis)
Spondylolisthesis occurs when one vertebra shifts forward relative to the one below it. This displacement can contribute to mechanical lower back pain and, in some cases, nerve compression. Depending on the degree of slippage and activity level, discomfort may fluctuate, leading to repeated episodes of back pain over time.How Doctors Diagnose and Treat Recurrent Back Pain
Diagnosis
Diagnosis usually begins with a detailed consultation. Your doctor will likely ask about the pattern of pain, triggers and whether there are symptoms such as numbness or weakness. A physical examination follows, assessing posture, spinal alignment, mobility and areas of tenderness. If nerve involvement is suspected, neurological testing can be performed to evaluate muscle strength, reflexes and sensation. Imaging studies may be recommended when symptoms persist or when structural issues are suspected. These may include:- X-rays to assess spinal alignment and stability
- Magnetic Resonance Imaging (MRI) to visualise discs, nerves and soft tissues
- CT scans in selected cases where detailed bone assessment is required
Treatment
Treatment for recurrent back pain depends on the identified cause, severity of symptoms and response to prior therapies. Many cases improve with non-surgical approaches, while others may require interventional or surgical management. Available treatment options may include:- Epidural injections & nerve block
- RF ablation
- Nucleoplasty
- Lumbar discectomy or decompression
- Neck nerve decompression (posterior cervical foraminotomy)
- Spinal fusion
- Cervical disc replacement / arthroplasty
- Anterior cervical discectomy and fusion (ACDF)
- Posterior cervical decompression and fusion (PCDF)
- Scoliosis correction surgery
- Vertebroplasty for osteoporosis fractures
Breaking the Cycle of Recurrent Back Pain
Recurrent back pain can be frustrating, particularly when it disrupts work, sleep and daily activities. Although mechanical strain and lifestyle factors can seem like the direct triggers of such pain, the root cause is often an underlying condition that requires further evaluation.
Understanding common triggers, recognising warning signs and seeking timely medical assessment when appropriate can help prevent repeated flare-ups from progressing. With a clear diagnosis and a structured management plan, many individuals are able to reduce recurrence, improve spinal health and return to their usual activities with greater confidence.
At Oxford Spine & Neurosurgery Centre, we aim to understand why back pain continues to recur, rather than simply easing discomfort temporarily. Breaking the cycle of back pain requires a unique approach for each patient, and we tailor treatment plans to their unique circumstances.
Our senior consultant spine & neurosurgeon, Dr Colum Nolan, adopts a systematic and evidence-based approach when evaluating back and leg symptoms. By carefully clarifying the source of pain, he aims to guide patients towards appropriate treatment options that not only relieve symptoms but also reduce the likelihood of repeated flare-ups.
If persistent back pain, leg pain, numbness or weakness is interfering with your daily activities, seeking timely medical evaluation may help prevent further progression. Early assessment can provide clarity and direction for the next steps in your care. Contact us to arrange a consultation and discuss a structured plan to address your symptoms.
Our Spine Specialist in Singapore
Dr Colum Nolan
Senior Consultant Neurosurgeon
MB, BCh, BAO, LRCPSI, MRCSI, FRCSI (Neurosurgery)
Dr Colum Nolan is a senior consultant spine and neurosurgeon, as well as the Medical Director of Oxford Spine & Neurosurgery Centre. He undertook specialist neurosurgery training in Ireland and Australia, and later on completed a complex spine surgery fellowship at Addenbrooke’s Hospital in Cambridge, UK.
Dr Colum held key leadership roles including Director of the Spine and Spinal Disorders Programme at the National Neuroscience Institute (NNI), as well as the Head of Neurosurgery Service at Sengkang General Hospital.
With his depth of experience, Dr Colum is committed to guiding each patient towards the safest and most effective treatment for their needs.
