Singapore General Hospital (SGH) is one of the best hospitals in the world!

According to the latest rankings from Newsweek, Singapore General Hospital is ranked 8th best hospital in the world.

SGH was also ranked 8th position in 2020 but came in at an impressive 3rd place in 2019, after Mayo Clinic and Cleveland Clinic.

I did know that our healthcare system is one of the best in the world. But I didn’t realise our hospitals ranked so highly globally.

Given their prestige, I thought it will be interested to see what the hospital promotes when it comes to musculoskeletal condition, specifically neck pain.

Aren’t hospital information always accurate?

man with back painMost of you will expect hospitals to provide accurate and up-to-date information. However, this is often not the case.

A study published in 2019 found that 57% of government agencies and hospital presented information that is not accurate on their website. For some conditions, only a mere 16% is deemed to be accurate.

Today, we explore how well does our country’s biggest, oldest, and world-acclaimed hospital fare for neck pain.

What are the commonest causes of neck pain?

neck pain, home exercise, pain relief
Just because posture correction exercises make sense doesnt mean it actually works A lot of what make sense to us is based on our culture values beliefs and even biases

SGH claims that the poor posture as well as “wear and tear” from old age or arthritis cause neck pain. Unfortunately, no references were provided so we can’t exactly fact check their data source.

Based on the latest research, however, both are unlikely causes. This was previously discussed in our text neck article and we will not repeat the same points.

While there was a review that recently suggested forward head posture could be associated with neck pain in adults. all three studies in the review had some serious flaws!

Study 1: No neck pain scores.

If I want to know if some one is good at mathematics, I would have to actually assess their mathematics skills right?

What this study did was to determine person A’s mathematics skills by getting him to check if a ruler is as good as a measuring tape.

Yes, it was that bad.

The purpose of the study to determine if Electronic Head Posture Instrument is as good as x-rays for measuring posture (i.e., ruler versus measuring tape). It wasn’t designed to assess if bad posture is bad for you!

Even though the researchers repeatedly emphasised that poor neck posture was correlated with more pain, they didn’t include the actual neck scores of their participants.

They also didn’t make a comparison between good posture and bad posture comparison.

This study did nothing to demonstrate that poor posture lead to more neck pain.

Study 2: Super crazy methodological flaws.

neck pain, chiropractor, bad posture, back pain
Painting in Sennedjems burial chamber He served King Tut who reigned 1332 1323 BC 18th Dynasty Note his posture

If you want to have a good study to compare posture versus pain, you can’t just cherry pick participants with more neck pain, right?

Well, they study did just that. It seemed like the researchers excluded participants with low pain scores! That’s a no-go when it comes to good research.

That’s not it though — they didn’t include the pain-free participants into the data pool when they evaluated the correlation between and posture and pain.

It’s kinda like trying to assess if redness of the apples is correlated with sweetness and you decide to not include sweet apples in your data analysis.

Would you think that’s fair?

It’s quite disappointing that studies like this still make it to print.

Study 3: Even more crazy methodological flaws.

You will think study 2 was already bad enough right?

Well, study 3 is worse.

This is their selection criteria:

Neck pain that predominantly becomes worse due to the adaptation of poor posture during daily activities and is reduced by postural correction.

I want to know if green grapes are likely to be more sour than red group. To study this, I will only choose green grapes that are sour.

That is a problem right?

Um, I’m speechless.

Bad posture doesn’t cause more pain.

I get that you want to believe that bad posture gives you more pain. However, there’s just no credible to research to support that is true.

You can see from the examples above that only studies that are poorly designed — to the point where they don’t make sense — can show that bad posture is a problem.

“Wear and tear” exists for both pain-free and painful individuals.

degenerative disc disease, spinal decay
May look scary but degenerative findings are just as common in healthy pain free individuals

We like to demonise degeneration. Because society tells us that we become useless with age, our body break down, we get more pain.

Nope, not true. A study that looked at cervical MRI of patients with and without neck pain found that abnormal findings (e.g., degeneration) is common even in pain-free population.

back pain, disc degeneration, wear and tear
Disc degeneration is a normal progression of ageing A lot of people have disc degeneration WITHOUT any symptoms

The table shows the percentages of people without pain (i.e., asymptomatic) that has degeneration. By the time you are in your 30s, half of people in your age group — without any issues — will have degeneration.

This number steadily increases as you age! Our current understanding is that degenerative changes are a normal aspect of ageing. It’s NORMAL.

The wear and tear narrative has been debunked in medical journal as archaic, pejorative, and inaccurate!

Don’t trust everything you read online.

We take the content we write very serious. We insist on referencing research studies so you can do your own fact-checking.

At the end of the day, there’s just simply too much fake news out there.

For whatever reasons, even the information our public hospitals is sharing isn’t inaccurate. Perhaps they didn’t write it themselves?

Perhaps it was accurate but is outdated.

These are fair reasons. Nonetheless, it still boils down to that you have to do your own research.

Don’t blindly trust everything you read online!


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.