What are the most common causes of back pain?
- Working in a seated position, especially when exhibiting a slumping posture over many years
- Imbalance between the flexors and extensors of the torso (we do everything in a flexed or sitting position, but do very little extension of our spine during our normal routine).
- Lifting with tight hamstring muscles
- Weakness and inflexibility of the core muscles of the torso (abdominals, gluteal, hamstrings, hip flexors, TFL, rectus femoris). This requires abdominal compression back braces with mechanical advantage until strength to the core muscles is restored.
- Old soft tissue injuries or sprains/strains that have led to immobility and/or generative arthritis
- "Weekend Warrior Syndrome"
The first 3 segments are made up of 24 moveable vertebrae as follows:
- Cervical Spine (neck) - consisting of 7 vertebral segments, with the majority of rotation occurring in the upper two segments known as C1 and C2 while flexion/extension is most prevalent in the lower five known as C3-C7.
- Thoracic Spine (upper/mid-back/rib cage) - consisting of twelve vertebral segments and more limited motion due to the organ protection and support of the rib cage. Interestingly enough, more folks suffer pain in between their shoulders or in the thoracic area than anywhere else in the spine. One reason for such is because ribs fasten to the spinal vertebrae via a synovial joint and these joints become easily inflamed through postural stress, emotional tension or fast rotational movements of the spine (e.g. pushing a vacuum, swinging a golf club or tennis racket). Pain in this region is more often misdiagnosed than in other spinal regions and although maybe not as debilitating, the pain can be quite nagging, sharp and bothersome.
- Lumbar Spine (lower back) - consists of five vertebral segments that run from the lower thoracic spine to the sacrum. The majority of pain is sourced from the discs at the L4 and L5 because they are angled and form a major pivot or stress point with the less mobile spinal base. Fifty percent of forward bending (flexion) occurs in our hip joints while the rest occurs in the lumbar spine. The majority of motion is focused at the bottom two segments (L4/L5), and that is another reason the discs wear out more here than anywhere else.
- Sacral Region (base of spine) - this region consists of 5 fused or semi-fused vertebral segments that form a heart-shaped spinal base that is wedged between and forms a synovial joint with the pelvic bones. These are known as the "S/I Joints" and are the source of a great majority of lower back pain. The bottom of the sacral region (sacrum) joins with your coccyx or tail bone.
Common Areas of Spinal Failure
- Spinal Discs -- our spinal discs function as shock absorbers and space occupiers to allow room for spinal nerves. They are composed of (1) a
tough outer material, and (2) a soft, gelatinous (jelly-filled) inner core.
This is very similar to the design of a hydraulic shock absorber for your car.
Our hydraulic discs are made up of 75% water. Often, the discs may dehydrate, leading to dessication or degeneration; becoming inflexible or stiff. This, in itself can become what some describe as their typical morning stiffness. A logical progression of this degenerative process can lead to breaks in the outer tough fibers and actual leakage of the soft inner core. This is often referred to as a slipped or herniated disc because this herniated portion can apply pressure to sensitive nerve roots.
Sometimes a twisting injury damages the disc and can subsequently cause degenerative spondylosis (this is a special name given to arthritis when it involves the spinal disc) in this area. Much of the pain in these cases is the subsequent swelling that compresses the nerve root. Over much time, the body's amazing ability to heal lessens the amount of inflammatory proteins in the area, especially after age 60. Therefore swelling goes down and many of these low back conditions that had been chronic can sometimes subside on their own. This is nature's normal course, but assumes a lifestyle consisting of: a healthy weight, consumption of lots of water, a nutritionally sound diet and performance of a sound, regular exercise routine.
- Muscles, Tendons, Ligaments and how they affect your back:
Injuries to back muscles and soft tissues can cause spasm, immobility and pain.
If the pain lasts for more than two weeks, and proper treatment methods are not instituted, muscle weakness and tightness may occur; leading to chronic, recurring bouts of back pain.
HAMSTRING MUSCLE TIGHTNESS: I want draw particular attention to this most common instigator of low back injury. Not only do low back pain suffers often develop tight hamstrings leading to a chronic backache, but those folks with tight hamstrings will almost always eventually develop lower back pain. This is even true of young athletes who do not properly obtain and maintain good flexibility of these muscles. Remember, I said earlier that 50% of our flexing forward occurs at the hip joints. This CANNOT happen if the hamstrings are tight because they must release their hold on the pelvis, allowing it to rotate forward at the hip joints. If this motion is limited, then the slack is taken up at the L4-L5 vertebral levels, often discs and/or ligaments at that level.