Back pain – it’s surprising it doesn’t happen more often. The complexity of the make-up of our backs really isn’t given enough credit; a structure made up of bones, muscles, joints and nerves.
The spine is made up of a total of 26 bones in the adult body and 33 pre adolescence (there are 9 bones that do not fuse together until adolescence is reached) and supports the weight of the upper body whilst providing posture and making allowances for flexibility and movement – it also protects the delicate spinal cord and meninges.
5 regions of the spine –
Cervical – The Cervical region is made up of the 7 vertebrae in the neck; these vertebrae are extremely thin and delicate, giving the neck great flexibility. Pain and injury to the cervical region is less prevalent than other regions in the back, but pain experienced in this region may extend to the arms and even legs.
There are conditions such as Foraminal Stenosis and Stenosis Myelopathy which require surgical treatments in this region, however Cervical Osteoarthritis and Dengerative Disc Disease can occur as the joint and bones in this region can degenerate. As well as being treated with pain relief, physical therapy and neck exercises can help to strengthen the neck, maintaining the original range of movement and reducing pain.
Spinal discs have a blood supply to their peripheral areas, and therefore have limited means of repairing themselves; early pain in the discs can last for many years.
Thoracic – Is the chest region and is comprised of 12 vertebrae. The thoracic vertebrae are extremely large and strong but less flexible that the cervical vertebrae, it is built for stability. Each vertebrae in the thoracic region forms joints with a pair of ribs to form the ribcage.
The most common ailments in the thoracic region stems from muscle and soft tissue injury; poor posture, prolonged sitting and overuse as well as sudden trauma like a sports injury or fall can cause damage and pain. These issues can present themselves as pain and tenderness in the mid back region, a stiffness in the neck or even pain when coughing or sneezing.
Bad posture put a lot of strain onto the muscles in the region as it unbalances the appropriate distribution of weight; heavy and repetitive exercise such as weight lifting can also cause stress and damage to the muscles and tissues in this region – having the correct form in this type of exercise is crucial. Sprains and other tissue damage in the thoracic region can be treated with massages, acupuncture and strengthening physical therapy as well as taking painkillers or using topical treatments.
Conditions such asymptomatic disc herniation are fairly common as are other degenerative and inflammatory conditions, may need more extensive treatment.
Lumbar –The 5 vertebrae in the lower back form the Lumbar region, even larger and stronger than thoracic vertebrae they are also flexible as they are free of adjoining ribs. The lumbar region is responsible for bearing the full weight of the upper body and is the most common area of the back to experience problems, because the discs and ligaments are inherently weak.
Undue stress from lifting heavy objects, twisting with sports like golf or a jolting movement can cause the muscles (muscle strain) and ligaments (lumbar sprain) can be overstretched and torn in this region, presenting as pain, inflammation and muscle spasm in the back itself as well as pain in the top of the buttocks.
Exercise is a good remedy for pain in the lumbar region, but it is crucial to visit a physiotherapist to discuss which exercises are going to help the specific cause of your pain and the correct form they should take when being carried out – it is also important to be aware of the exercises that can aggravate the pain.
Spinal manipulation by a chiropractor or osteopath physician applies pressure to the area of the lower back to relax the muscles, releasing endorphins and reducing pain; massage and acupuncture can have the same effect.
Obesity can have a significant impact on the lumbar region, so a focus on losing weight could elevate pain in this instance.
More serious conditions include Lumbar Degnerative Disc Disease and Herniated Disc; if back pain is accompanied by any loss of bladder/bowel control – this could be a sign of a more serious underlying issue.
Sacral – The sacrum is a single bone made up of 5 bones that fuse together in adolescence, it is a triangular shaped, flat bone that sits between the hip bones.
The sacral region is surprisingly easy to injure, and can be done so as the result of serious impact such as a fall or trauma. Those suffering with osteoporosis and rheumatoid arthritis could developed stress or fatigue fractures in this region.
The damage to the sacrum is prevalent in pregnant women due to the hormone ‘Relaxin’ softening the supporting ligament structures.
Women experiencing concentrated pain on one side of the back that continues down the leg could be experiencing Sacroiliac Joint Dysfunction; as the sacrum is shorter and wider in women they are more susceptible to this condition – it is usually treated with anaesthetic injections.
Coccygeal – The coccygeal region contains the coccyx – a single bone that is also made by the fusion of single bones in adolescence, this time usually 4 tiny vertebrae (though it can range between 3 or 5). The Coccyx bears our body weight whilst we are sitting down and is a point of attachment for pelvic and gluteal muscles.
A fall, repetitive strain from rowing or cycling and pregnancy can all cause pain in this region. The coccyx can sometimes form bony spurs; it is also possible to experience referred pain, where the pain originated in one region but is felt in another.
Pain can express itself as sharp and pinpointed, as numbness, as well as in the buttocks themselves and diagnosis of the problem usually requires X rays and MRI scans, manual treatments and pain control are the usual course of action.
In conclusion, depending on the region of the back that is experiences, visiting an osteopath, masseuse or physiotherapist can ease, soothe and treat the trauma and pain without having to reach for strong painkillers that often only mask the problem. Here at Total Health Clinics we have a team of experienced staff in all of these areas that will be able to advise you of any further treatment is needed by other professionals or of exercises you can carry out in your own time so maintain a healthy back.