Philippine President Rodrigo Duterte was forced to cut short his attendance of the enthronement of Japan's emperor on Tuesday, due to what his office said was "unbearable pain" in his lower back after a motorcycle mishap last week.
The health of Mr Duterte, 74, and his absences from the public spotlight are often the subject of fervent speculation, and the source of complaints from critics that his administration is not forthcoming about the extent of his ailments.
Mr Duterte had a minor fall from a motorcycle in the grounds of his palace last week, causing hip pain, bruises and scratches on his elbow and knee.
He used a walking cane in Tokyo during a ceremony for Japanese Emperor Naruhito's ascendancy to the throne but skipped a banquet to return home and see his neurologist.
It was the third time this month that the government has tried to allay concerns about Mr Duterte's health after the maverick former mayor told the Filipino community in Moscow that the frequent drooping of one eyelid was due to a chronic neuromuscular disorder. Mr Duterte's known problems include back pain, migraines from nerve damage after a previous motorcycle accident and Barrett's oesophagus, affecting his throat. His circulation is impacted by Buerger's disease, from heavy smoking when he was younger. He last year said he had tested negative for cancer.