
This highlights the importance of recognising early warning signs or “red flags” that may point to more serious underlying conditions.
According to robotic and spine surgery consultant Dr Lau Choon Ping, 80-90% of lower back pain cases in Malaysia are caused by muscle weakness and prolonged sitting, and not due to bone or disc issues.
He explained that these “functional” cases are becoming increasingly common owing to sedentary lifestyles, particularly among office workers and students who sit with poor posture for extended periods.
“Many patients experience pain, yet imaging scans show no abnormalities. The problem is not with the spine itself, but the muscles have become too weak to adequately support the body,” he told Bernama.
Lau said lower back pain, which affects the lumbar region, can be classified by cause – either mechanical or non-mechanical – and by duration: acute (less than six weeks), sub-acute (six to 12 weeks), and chronic (more than 12 weeks).
Mechanical pain arises from structural problems in the spine or bones – such as fractures, bone cancer, spinal instability, or slipped discs compressing the nerves – which are usually detectable through imaging.
Non-mechanical pain, on the other hand, occurs when the spine’s structure appears normal, but discomfort stems from functional issues such as weak muscles, poor posture, or prolonged sitting.
“Patients must take an active role in their treatment rather than relying solely on quick fixes such as massages or painkillers, which do not address the root cause,” he advised.

Lau recommends avoiding excessive bending and heavy lifting while performing regular spine-strengthening exercises. Early intervention, he said, can help control symptoms and potentially prevent the need for surgery.
“With early detection, many conditions can be managed effectively before they become severe. Even mild instability can often be treated without surgery,” he added.
On treatment advances, Lau highlighted that modern spine surgery has become safer and less invasive through technologies such as robotic systems, computer navigation, neuromonitoring, and endoscopic techniques.
“With keyhole surgery and real-time nerve monitoring, we can reduce risks and accelerate recovery. Even slipped discs can be removed through a small incision using a camera,” he said.
Lau urges those with persistent lower back pain – particularly students and working adults – to seek early diagnosis: the crucial first step in a treatment journey that leads to better long-term outcomes and improved quality of life.