The Truth about Back Pain Part 2 – The Human Spine

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Back painAs an Osteopath, the injuries I treat each year break down to a ratio of something like this:

70 – 75% lower back pain,

15 – 20% neck pain and

 5 – 10% thoracic spine or rib related pain.

 Why do people suffer lower back pain so frequently?

It’s very simple when you look at the amount of sitting we do every day whether it’s for work or for pleasure. Most of us have a lap top or PC at home these days and it’s very easy to lose track of time in front of these things not to mention most of us are interacting with a PC at work also. We sit in our cars for the trip to and from work and to pick up children and groceries. We then sit at home in front of the television sometimes for hours ….. it all adds up to a large amount of compression through the lower spine and disc’s.

The Spine is made of sections that interlock for support and distribution of forces but also allow movement that is specific to each section. The cervical spine sits on the top of the thorax and holds the head in such a way as to allow a wide range of motion (ROM) but is also incredibly supportive and strong. The thoracic spine provides the base or connections for the rib cage to attach to and move during our breathing cycle which is around 15 – 20 times per minute for most people. The lumbar spine along with our sacrum and pelvis provides the body with a strong base of support; so the movement at each vertebral level at the lumbar spine is less than, say, the cervical spine but each vertebra is thicker, heavier and more dense in order to withstand greater forces of compression.

When thinking of the lumbar vertebra there are 3 points of contact that dictate movement.  The vertebral body and its two posterior facet joints whose principle function is to bear axial load (compression), this is above and below each segment. The facet joints of the posterior vertebra help to guide and limit the amount of motion at the anterior of each joint. The reason for this is the disc that sits at the front of each joint provides the cushioning throughout the spine and must be maintained at all costs.

With everything in its rightful position the lumbar spine is a basic kinematic unit that represents a partnership of articulations that serves to protect the neural spine whilst allowing necessary motion. As an upright creature that works against gravity we require these principles to function correctly. When we lose this balance within the lumbar spine, or any other level of the spine, it places pressure on other segmental levels which in turn leads to instability and the loss of the normal ROM.

A unique characteristic of the segments within our spine is that of “coupled motion” meaning simply that motion in one segment affects motion in the other segment. How many times have I harped on about “nothing in the body happens in isolation”? When a lumbar joint becomes dysfunctional in movement and load bearing, the disc then becomes vulnerable, the facets become vulnerable and the spinal cord and nerves become vulnerable.

Our bodies often warn us of this change with sharp pain that lasts for 2-3 days but then often abates as quickly as it appears. This process may continue on and off for some years until it all falls over!!