Back Pain

Back Pain and Injury

Spinal anatomy is a remarkable combination of strong bones, flexible ligaments and tendons, large muscles, and highly sensitive nerves. It is designed to be incredibly strong, protecting the highly sensitive nerve roots, yet highly flexible, providing for mobility on many different planes.

Four Major Regions of the Spine

  1. The Cervical Spine (Neck) – The neck supports the weight of the head and protects the nerves that run from the brain to the rest of the body. This section of the spine has seven vertebral bodies (bones) that get smaller as they get closer to the base of the skull. The lowest cervical spine vertebral is in line with the top of the shoulders approximately.
  2. The Thoracic Spine (Upper Back) – The 12 vertebral bodies in the upper back make up the thoracic spine. The firm attachment of the rib cage at each level of the thoracic spine provides stability and structural support to the upper back and allows very little motion. The thoracic spine is basically a strong cage and it is designed to protect the vital organs of the heart and lungs.
  3. The Lumbar Spine (Lower Back) – The lower back has a lot more motion than the thoracic spine and carries the weight of the torso, which makes it more prone to injury.
  4. The Sacral Region (Lower Spine) –  Below the lumbar spine is a bone called the sacrum, which makes up the back part of the pelvis. This bone is shaped like a triangle that fits between the two halves of the pelvis, connecting the spine to the lower half of the body.

Most of us take this juxtaposition of strength, structure, and flexibility for granted in our everyday lives—until something goes wrong. Once we have back pain, we’re driven to know what’s wrong and what it will take to relieve the pain and prevent a recurrence.

Common Back Injuries:

Muscular Pain

The most common cause of acute back or neck pain is a muscle injury, in which muscle fibres stretch too far and tear. Muscle injury may be caused by overuse, such as from heavy lifting, as well as by repetitive motions that put continual stress on the back or neck muscles. While a muscle injury may not sound like a serious issue, the resulting pain can be severe.

Lower Back Muscular Pain Superficial Muscles of the Back and Neck Deeper Paraspinals muscles of the Back and Neck

Lumbar spinal disc

A sturdy, fibrous structure that acts as a ligament between vertebrae.  A spinal disc can cause pain from:

  • Lumbar disc herniation. A herniated disc occurs when the soft, gel-like interior of a disc bulges or leaks outward, irritating nearby muscles, joints, or nerve roots. A  herniated disc typically causes sharp, stabbing pain down the backs of the legs (sciatica), which is usually more pronounced than low back pain. It can also be associated with muscular weakness and loss of reflex, which are more concerning signs in the patient assessment and required further investigation.
  • Lumbar degenerative disc disease. Wear-and-tear on the spinal discs casues a loss of disc heigh and thus can lead to narrowing of the space where the joints and nerves can move.  This can cause chronic low back pain is called “lumbar degenerative disc disease”. This condition typically causes chronic, low-level low back pain that intermittently flares up for a few days or weeks before returning to normal.

Intervertebral Disc Vertebral body, Facet Joint & Intervertebral disc. Spinal disc herniation

Lumbar Spine Facet Joints Ligaments of the Spine

Joints and Vertebrae

Central Spinal Canal

  • Osteoarthritis. Spinal osteoarthritis consists of wear-and-tear on the facet joints, causing excess friction when twisting or bending the spine. This friction can lead to bone spurs that pinch a nerve root and produce sciatica pain. Other symptoms include stiffness and tenderness around the joint. Osteoarthritis is more common in adults over age 60.
  • Sacroiliac joint dysfunction. The sacroiliac joint connects the hip bones (the ilia) to the sacrum, a triangular bone at the base of the spine. When the sacroiliac joint experiences too much or too little motion, it may cause pain in the hips, pelvis, and lower back.
  • Spinal stenosis. Narrowing of the spinal canal due to a bone spur, herniated disc, or another irritant can cause leg pain (sciatica). While back pain may occur with spinal stenosis, it is usually not as severe as the leg pain caused by nerve root irritation. Spinal stenosis is more common in adults over age 60.

If you have lower back pain, please call us to set up an appointment so that we can assess your injury, provide you information that is specific to you, and help you get back on track with what you need to do to move and feel better.

Learn More about Treatment for Back Pain

Check out our Physiotherapy Treatment Videos and our Informational Videos about back pain.