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ANATOMY LESSON
To understand what causes
back pain, here is a short anatomy lesson. This overview
will help you understand your spine specialist and you will
understand better what treatment your doctor is recommending
for you.
Cervical, Thoracic and Lumbar
Spine
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Your spine is made up of 24 vertebrae.
Each vertebra is made up of the vertebral body in the front,
the facet joints in the back and the pedicles, which connect
the vertebral body to the facet joints. The human spine is divided
into three sections: 1) the cervical spine or neck is made up
of 7 vertebrae, 2) the thoracic spine made up of 12 vertebrae
and 3) the lumbar spine or low back which consists of 5 vertebrae. |
Intervertebral Discs
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The discs are located between each
vertebra allowing for bending, twisting and shock–absorption.
A herniated disc is sometimes mistakenly referred to as a "slipped
disc". In reality there is no such thing as a slipped disc.
Discs cannot slip because they are attached to the vertebrae
above and below by strong ligaments. |
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When a disc herniates, the jelly
center squeezes out through the disc wall putting pressure against
a nerve. While pain in the back and leg from pressure on the
nerve can be relieved by various treatments, the damage done
to the disc will be permanent and may have real consequences.
Aging also results in a decrease in blood supply to the disc
by age 20. Dehydration also occurs with aging. This leads to
a flatter, drier disc more susceptible to herniation. Regular
exercise helps to prevent injury through self–lubrication and
increased blood flow. |
Nerves
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Nerves in the lower back come
together to form the sciatic nerve, which runs down the back
of the leg. A "pinched nerve" from a herniated disc
can cause pain down the back of the leg sometimes referred to
as "sciatica". |
Facet Joints
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In the back of the spine hinge–like
structures called facet joints are located. These joints link
the vertebrae together along with the discs in front allowing
for complex spinal motion. These joints may be injured by lifting
or straining, severe twisting or hyperextension. Rest, ice and
a few Aspirin will often help the pain. Facet injections with
a small amount of anesthetic and cortisone are sometimes performed
in resistant cases. |
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Spinal Muscles
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It is estimated that most
back pain is caused by soft tissue injury such as muscle strain.
Our back muscles allow us to stand straight and lift things.
In the normal situation, the back muscles contract and relax
as the back moves. But under strain, the poorly conditioned muscle
can spasm, tensing up until it becomes a hard painful knot. |
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The pain may be quite severe. Fortunately,
with rest, ice and a few aspirin, the pain will often subside.
Stretching and exercise will help prevent repeat strains. |
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