An overview of back pain
So what causes back pain & what are the treatments?
Back pain is the most prevalent cause for long-term disability and work related sickness in the UK, accounting for more than thirty million sickness days lost per annum. There are many underlying reasons for the high rates of disability. Our lifestyles, including working postures and sports/hobbies, combined with some traditionally counterproductive treatments for back pain that are still being promoted, play a key role.
In this section we'll go through the different types of back pain, look at their potential causes and let you know about the ways you can manage any pain you might have. We've also highlighted how back pain is diagnosed as well as potential treatment options that may be appropriate.
The spine is needed for most of the movements throughout our daily lives. These roles include the need for a large range of motion, providing the strength to life & carry weight, as well as supporting complex loading tasks related to sports. Furthermore, the spine is responsible for maintaining a balanced posture at all times, including when we are sitting, standing or moving.
More about the spine
To carry out these tasks efficiently, the spine is comprised of twelve joints through the middle (thoracic) spine and five joints through the lower (lumbar) spine. Each spinal segment consists of a number of movable parts. The intervertebral discs lie between the blocks of bone known as the vertebral bodies at the front of the spine. The facet joints are two, small joints which lie at the back of the spinal segments and provide a system to interlock the upper and lower vertebral body with one another.
The facet joints unlock and allow the spinal segments more movement the further in to forward flexion the spine moves. In this way the spine has some much needed flexibility with tasks such as squatting and bending forwards but is very stable when in a standing or waking position.
The entire spinal column is also covered in multiple strong bands of soft tissue known as ligaments which provide a springy resistance to any external force which overstretches the spinal joints.
Another feature of the spine which aids it’s strength is the huge number of muscles. Smaller muscles help to stabilise individual spinal segments and larger muscles produce the huge force needed to lift heavy loads. Other muscles which help to move the hip joints or the shoulder blades also attach to the spine and as such have a dual role in maintaining spinal posture as well as moving the limbs.
Another main function of the spine is to provide a protective space for the spinal cord which lies in a cavity behind the discs and vertebral bodies at the front. The discs provide some height at each spinal segment which allows a left and right sided nerve root to exit to supply the sensation and power to the relevant body areas.
The vast majority of back pain occurs in the lumbar spine rather than the thoracic spine. The cause for this is the stability and stiffness the ribcage affords to the thoracic spine compared with the lumbar spine. With this number of differing structures and the balance between flexibility, strength and stability that the spine is required to perform, problems can arise with the discs, nerves, facet joints and even the vertebra bodies.
The different types of back pain Managing back pain