TREATMENTS
Causes of Back Pain
There are many lifestyle issues that contribute to a person’s predisposition to experiencing back pain.
Most people go through life with poor postural habits that over time create unnecessary stress on the discs, joints, and muscles of the back. This unnecessary stress speeds up the degenerative process of the spine. Occupations that include frequently carrying heavy loads, being required to bend over a lot, or having to work in awkward positions can put you at greater risk of having a low back injury. To understand how these physical stresses contribute to back pain, it is important to understand the intervertebral disc in more detail.
The spine, or vertebral column, is composed of a series of 26 bones. The vertebrae are divided into groups as follows: 7 cervical vertebrae in the neck area, followed by 12 thoracic vertebrae in the middle back. Next are 5 lumbar vertebrae in the lower back, followed by the sacrum and the coccyx (tail bone). The vertebral column is designed to enclose and protect the spinal cord and nerves. As the nerves branch off the spinal cord, they exit the vertebral column and form the peripheral nerves that innervate the body.
Between the vertebrae are intervertebral discs that form strong joints, permit the various movements of the spine, and act as shock absorbers. The disc together with the vertebra above and below it, comprise one spinal motion segment. In addition to protecting the spinal cord and nerves, the spine (or vertebral column) is a strong, flexible rod that allows us to bend forward, backward, and sideways. The entire vertebral column is protected and stabilized by the ligaments and muscles of the back.
In their function as shock absorbers, the intervertebral discs are designed to allow movement and withstand the compressive loads transmitted through the spine. In the centre of the disc is a gel-like substance called the nucleus pulposus. There are several rings of tough fibrous tissue surrounding the nucleus called the annulus fibrosus. Compressive loads to the spine are distributed by the nucleaus pulposus to the annulus firbosus. The annulus is the principal load bearing structure of the disc. The annulus firbosus will be able to withstand the comprehensive loads as long as forces are adequately distributed by the nucleus. Any impairment in the structures of the intervertebral disc will compromise its ability to withstand compressive loads and will ultimately cause the disc to fail.
The discs in the lumbar spine are subjected to greater compressive loads than the other discs of the spine, especially the discs between the 4th and 5th lumbar vertebrae, the 5th vertebrae and the sacrum. If the supporting structures that protect the spine become injured or weakened, the pressure in the nucleus may become great enough to rupture the annulus fibrosus. When this occurs, the nucleus pulposus may push on the wall of the annulus fibrosus (bulging disc), or may itself protrude (herniated disc) through the annulus fibrosus, toward the spinal cord and nerves. The pressure exerted on the spinal cord or nerves may cause considerable pain. For instance, when the roots of the sciatic nerve are irritated, the pain can radiate down the buttocks, the back of the thigh, through the calf, and occasionally into the foot. This is called sciatica.