Back pain

Back pain is one of the most common medical conditions - it affects most of us during our lives, and is the one of the leading causes of work-related sickness absence. Approximately 1.1 million people in the UK are affected, with 95% of these having lower back pain.

95% of back problems occur in the lower back (coloured green)
spine zones

The spine is made up of 5 sections, each of which consists of a number of individual units called vertebrae. The sections are called the cervical spine or neck region, made up of 7 vertebrae; the thoracic or chest region, with 12 vertebrae, each attached to a rib; the lumbar region in the lower back with 5 vertebrae; the sacrum that is made up of 5 bones fused together, plus the coccyx that consists of 4 very small bones right at the base of the spine.

Each vertebrae, particularly in the thoracic and lumbar regions are separated by an intervertebral disc that consists of flexible cartilage. This allows for movement of the spine and a cushioning or absorbing action that prevents damage to the vertebrae. Attached to parts of the vertebrae are a series of muscle groups which help support the back and spine and help maintain our posture, by giving strength and support to the spine.

Back pain results when the physical structure of the spine and/or the supporting muscles veers away from the normal condition. For example, the vertebral discs can become displaced slightly, and if the disc then starts to impinge on the nerves in the area of the disc then pain is caused.

Sensations of aching and tension reported by back pain sufferers are caused by the supporting muscles either having to work harder to support the spine while healing of the disc takes place, or when the muscles go into spasm, which can lead to the lower back locking. This is very painful, as anyone who has suffered this will testify to.

Most incidents of back pain do not have a serious underlying cause, but usually caused by minor strains or injuries or pinched nerves. The triggers can be every day home activities such as lifting, carrying, pushing or pulling heavy objects, bad posture, over-stretching, and overusing the muscles during sporting activities.

This is the MRI side view of a lumbar spine. There is a disk herniation (black material bulging backwards) at level of L4-L5 with compression of the nerve root L5.

However, if the pain persists beyond six weeks, then the sufferer is said to have a chronic condition. Contributory factors here could be being overweight, stress, and long-term use of medications that are known to weaken bone density. Women often experience lower back pain during pregnancy.



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