Dear Straits Times, I take umbrage at your broscience content on back pain

umbrage editorial integrity
Did anyone manage to get their hands on the Umbrage t-shirt that was on Lazada? Credit: Coconuts Singapore

The umbrage incident happened almost two months ago now. While it may be considered old news, it’s always a good time to discuss editorial integrity. And if media companies and/or content creators have an obligation to publish evidence-based content.

Good and accurate online content about back pain exists.

back pain news articles

To be clear, good articles on pain does exist! Guardian did publish a few articles on pain that were congruent with the latest research. The Irish Times most recent article debunking posture myths was titillating.

On that rare occasion, CNA did post an article about sleep being more important than posture for neck aches and stiffness. Sure, it was not an original article from them but at least it’s a start.

Good content exists! They are just rare in Singapore.

Why is sponsored content important?

I do agree that sponsored content has a role to play in society. Afterall, declining revenue was the reason Singapore Press Holdings to transfer their media business to a not-for-profit entity.

It is also good that all paid content must be identified accordingly under Singapore law.

Because of this, we know that the “news” article we are discussing today is paid for by Tylenol.

What is Tylenol used for?

tylenol drug types
Tylenol comes in all shapes and sizes! Even liquid versions. Did you know Korea had a Tylenol shortage when their government recommended taking it to treat fever post COVID vaccination.

Based on their website, Tylenol is a paracetamol. The company recommends that Tylenol is used for various conditions including muscular pain and joint pain.

Writing about a specific drug brand does feel strangely awkward. There’s possibly a chance that they will take some legal action against us.

If you are so inclined to do so, please take my unreserved apologies! I cannot afford to play against Big Pharma. 

What does The Straits Times have to say in their branded content?

straits times sore back headline
I would be surprised if there is even a single high quality support the use of paracetamol for carpal tunnel syndrome.

I like that our broadsheet attempted to make some citations for their claims. For example, they attributed their claim that poor workstation setups can be detrimental to your health to “Geneagles Hospital, 2020”.

low back pain clinical guideline, lancet low back pain
Ergonomics can be so sexy to talk about. Despite being a billion dollar industry, it has absolutely no place in back pain management.

Well, not true.

The Lancet, which is far more authoritative than any hospital, asserted ergonomic interventions are ineffective. We talked about this lots of times in our previous articles on Secretlab, working from home, why exercise is not enough, why good data matters.

If you are sick of hearing it, we apologise.

But tolong lah, go spread the word. Your friends and family need to know the truth.

Is Tylenol good for back pain?

clinical recommendation medication
Not my words. The Lancet recommended against paracetamol in their guidelines.

I will give it to The Straits Times for keeping their recommendations for Tylenol cryptic. In that sense, it’s not possible for us to criticise on any single point.

To be super clear, they never explicit suggested that you should take Tylendol for back pain.

According to Google’s “people also ask”, people do really want to know if it helps for back pain.

Well, the short answer is no.

No major clinical guidelines, to the best of my knowledge recommends paracetamol for back pain. The Lancet low back pain series specifically recommended against paracetamol.

They are not the only one.

The UK national guidelines also dropped paracetamol from their recommendations since 2016.

The University of Sydney in their latest research (2021) reported that paracetamol, despite being the most popular painkiller in Australia, may be no better than placebo!

What is the 20-20-20 rule?

To be fair, their article is not all useless. I did learn something new!

The 20-20-20 rule is a recommendation by optometrist Dr. Jeff Anshell to take a 20-second break every 20 minutes by looking at an object 20 feet (six metres) away.

I am not sure if it is empirically beneficial but I can see the benefits of moving more and sitting less.

chef coping with stress
There are two ways you can go relieving your pain. You can turn down the heat by reducing aggravating factors. You can also use exercises to increase your pot size so your body can better support your lifestyle!

It is true that you may experience some neck stiffness or back soreness with prolonged sitting. In such situations, it makes sense to practise being kind to yourself. You can reduce your discomfort by taking regular breaks.

This is akin to turning down the heat so you can feel less pek chek.

Having said that, this doesn’t mean that sitting is bad for you! We still maintain that your spine is robust and adaptable. In that sense, you can use exercises to increase your neck capacity so you can sit for longer hours!

“In God we trust, all others must bring data.”

I totally appreciate that recovery is challenging.

It really comes as no surprise because we are fed with false information all the time! Sometimes with really solid exercise-is-good-for-you advice mixed in that it’s possible to tell which is which.

This is why we choose to adopt a rigid evidence-based approach at Square One Active Recovery.

It’s not about what he says or what she says. It’s not about if I took umbrage.

It’s about science. It’s about the truth. It’s about you having your best shot at finding true freedom from pain.


Frustrated by the lack of results-driven and ethical chiropractic clinics in Singapore, Chiropractor Jesse Cai found Square One Active Recovery to deliver meaningful and sustainable pain solutions.

Our goal? To make our own services redundant to you.

*We do not offer temporary pain relief such as chiropractic adjustments, dry needling, or any form of soft tissue therapy.