How does the backbone work?

 

 

Backpain questions range from 'What causes backpain' to qustions about treatment, exercise, backache while driving, and so on. It is probably helpful if we start with an understanding of our spinal structure.

The spine, or backbone, is made up of a column of 33 bones and tissue extending from the skull to the pelvis. These bones, or vertebrae, enclose and protect a cylinder of nerve tissues known as the spinal cord. Between each one of the vertebra is an intervertebral disk, or band of cartilage serving as a shock absorber between the vertebrae.

The types of vertebrae are:

 

• Cervical vertebrae: the seven vertebrae forming the upper part of the spine
• Thoracic vertebrae: the 12 bones between the neck and the lower back
• Lumbar vertebrae: the five largest and strongest vertebrae located in the lower back between the chest and hips
• The sacrum and coccyx are the bones at the base of the spine. The sacrum is made up of five vertebrae fused together, while the coccyx (tailbone) is formed from four fused vertebrae.

What Is Back Pain?

The most common backpain question. It is an all-too-familiar problem ranging from a dull, constant ache to a sudden, sharp pain that can leave you incapacitated. It can come on suddenly - from an accident, a fall, or lifting something too heavy - or it can develop slowly, perhaps as the result of age-related changes to the spine. Regardless of how it happens or how it feels, you know it when you have it. And chances are, if you don't have it now, you will eventually.

 

Backpain is the symptom of a problem - usually nature's way of telling us we have done something wrong..............

What causes back pain?

Another common backpain question, not always as easy to define. The causes of back pain can be complex. They can include accidents, muscle strains, and sports injuries.

 

Are some people more at risk?

Haulage workers, builders and farmers appear to be at an increased risk for low back pain compared with the general population. They are all involved in a wide variety of tasks that put strain on the lower back. Such tasks include operating heavy equipment (often for long periods without a break), lifting heavy objects, and daily exposure to the same repetitive motions.

What can I do to help prevent back pain?

Backpain questions about prevention are less common than those about how to treat it! Some general tips include:

• Maintain good posture - step closer instead of reaching, and keep your feet shoulder width apart when standing.
• Use assistive devices whenever possible to simplify tasks.
• Wear a body belt.
• Observe good lifting technique.
• Change positions frequently, stretching before and during a task.
• Stay positive!

 

What Is the Difference Between Acute and Chronic Pain?

Pain that hits you suddenly - after falling from a ladder, being tackled on the football field, or lifting a load that is just too heavy, for example - is acute pain. Acute pain comes on quickly and often leaves just as quickly. To be classified as acute, pain should last no longer than 6 weeks. Acute pain is the most common type of back pain.
Backpain questions about Chronic pain are more difficult to answer since it may come on either quickly or slowly, and it lingers a long time. In general, pain that lasts more than 3 months is considered chronic. Chronic pain is much less common than acute pain.

What can I do to prevent low back pain?

Experts estimate that approximately 80 percent of us will experience significant back pain sometime in our lives. Back pain is the second most frequent complaint in doctor's office visits (after the common cold) and it results in more lost productivity, both at home and at work, than any other medical condition.

Fortunately, back pain usually is preventable. While back pain can result from inevitable situations such as trauma or illness, it also can be caused by lifestyle factors which you can control. The use of proper lifting techniques, a healthy diet, and regular exercise are some of the keys to promoting good back health. Take a look at your everyday habits to reduce the risk factors that may be causing your back pain.

Keep your back muscles fit

Stretch and strengthen the muscles that support the spine, including those in the abdomen and lower back. Exercising can make the back more resistant to strain and injury.

Always lift properly

When lifting, keep your back straight and bend only at the knees. This shifts the weight of what you are lifting to your legs, thus taking the pressure off of your spine and back muscles. And always try to keep the item you are lifting close to your body, even if it's light.

Watch your weight

Excess weight puts additional strain on your back by stretching and weakening the muscles. It can increase the risk of back pain and prevent quick healing of injuries.

If you smoke, quit

Nicotine has been shown to increase the risk of disc degeneration and back pain. It can also slow or prevent recovery by reducing the amount of blood flow to tissues that are trying to heal.

Avoid sitting for long periods of time

The discs in your back are under the most pressure when you are sitting. While sitting, keep your upper back straight and your shoulders relaxed. Try to take short walks periodically if you must sit for great lengths of time.

Relax!

Stress can cause your back to tighten, and can prolong your recovery once the hurting begins. Imagine yourself in a tranquil place and take a vacation in your mind… your back will thank you!

How do people find the best care for their back pain?

That's a really good question and a hard question to answer. How do you get people who know enough about pain and how do you get your primary-care doctor to refer you to specialists? There simply aren't enough experts, and a lot of insurance companies won't pay for patients to go to outside specialists.

In the UK your obvious first call should be to your GP. He or she will have knowledge of local specialists but do bear in mind that not all doctors agree on the cause or treatment of backpain. In the US, the American Pain Foundation and the National Pain Foundation can help patients find physicians throughout the country. They even have directories. In the UK you can try BackCare, the new name for the National Back Pain Association.

Will I need surgery for my back pain?

Most people with back pain can be treated conservatively. For most patients surgery is deferred until all non-surgical modalities are exhausted. All patients with severe or persistant back pain, or back pain associated with other symptoms, such as fever, burning on urination, or weight loss, should consult their GP at an early stage.

Will I need an MRI?

An MRI is necessary to image the intervertebral discs, because these do not show on a plain x-ray. Imaging of the disc allows your GP to diagnose disc herniation, disc protrusion, disc bulging, as well as other related conditions, such as spinal or foraminal stenosis.

Will I need X-Rays of my back?

Plain x-rays are helpful to examine the bony structures. These can be abnormal in case of fracture or metastatic disease.

What are the risks of surgery?

Back surgery is less risky now because less invasive procedures are used for the majority of patients with disc disease. Nevertheless, surgery is invasive and requires anesthesia, which also poses a risk by itself. For a more detailed discussion, please click here.

What do I need to know about epidural steroid injections?

Epidural steroid injections involve the placement of cortisone solution adjacent to the inflamed nerve root through the use of a long needle which is passed through the skin of the back. Bruising is common, and discomfort is minimized through the use of anesthesia. This procedure is much less invasive than surgery, and can result in symptom relief for those patients with radiculopathy (e.g. sciatica due to disk herniation).

 

See also our glossary of medical terms.

If you have a specific backpain question or if you don't understand anything on this site - because we haven't fully explained it - please use our contact form and be sure to head it Backpain questions. We always try to answer promptly.

Why continue to suffer?