ANATOMY, YOUR ACHING BACK, AND KEEPING THE BACK HEALTHY

All About the Back

Your healthy back: anatomy

A healthy spine

A Healthy Back is affected by:•Muscles•Ligaments•Vertebrae•Discs•Joints•Nerves

•Spinal cord

From: Chiropractic Resource Organization

Back: X-ray view

Here is an x-ray view of the spine.Notice the cervical (neck), thoracic (mid-back) and lumbar (lower back) vertebra.

See how vertebra change as you look down the spine. This reflects the different functions of the neck, mid back and lower back.

Your pain, where it is and why it is

1. Cervical spine (neck): Neck pain often caused by muscle, ligament or tendon strain. Will usually heal with time and treatment (ice, heat, medication, chiropractor.

2. Thoracic Spine (upper back): Rarely source of pain. Can have pain with shoulder or upper back muscular strain.

3. Lumbar spine (lower back): More motion than thoracic. Also, carries all the weight. Most injured area. We will look at this in depth.

4. Sacral region (bottom of spine): pain mostly caused by sacroiliac joint, and more common in women.

Symptoms of back pain

Back pain symptoms include:Aching or stiffness anywhere

along spine from neck to hipsSharp localized pain in neck,

upper back, or lower backChronic ache in middle or low

backBack pain that radiates from

low back to buttocks, thigh, calf and toes

Inability to stand straight without having painFrom:

Chiropractic Resource Organization

When to call the doctor

Call your doctor if:You feel numbness, tingling

or loss of control in arms or legs (may indicate damage to spinal cord)

The back pain extends down the leg (may indicate sciatica)

Pain increases when you cough or bend forward (may be herniated disc)

Urine or fecal incontinenceDull pain in one area of spine

when lying or getting out of bed (could be osteoporosis)

Sources of back pain

Although the source is not always known, here are some possibilities:

Disc degenerationKidney problemsMuscle spasmAlignment of vertebraeRuptured discOsteoporosisSpinal stenosis (narrowing of spinal canal)Severe curvatures (scoliosis or kyphosis)Strain to muscles or ligaments of back

The discs of the back

•There are 26 bones in the spine.•The vertebral column protects the spinal cord.•Between each vertebrae is an intervertebral disc.•The discs are filled a gelatinous liquid, called nucleus pulposus.•The liquid nucleus pulposus provides cushioning to the spinal column.•The annulus fibrosus surrounds the nucleus pulposus to keep it intact during periods of stress to the spinal column.•The intervertebral discs allows the vertebral column to be flexible and act as shock absorbers during activity.

What is disc degeneration?

Disc degeneration refers to changes in the spinal discs. The changes can results from

osteoarthritis (breakdown of cartilage the protects the joint),

herniated disc (a bulge or breaking open of a spinal disc) or

spinal stenosis (narrowing of spinal column)

View diagrams of each condition on next screen…

Osteoarthritis of spine Herniated disc

Spinal Stenosis

Home treatment for back pain

Bed rest is NOT recommended.Reduce regular physical activities for a few days to

calm back and reduce inflammationApply ice for the first 48 to 72 hours, then heat

and/or ice after that.An over the counter pain reliever (ibuprofen) will

relax the muscles and decrease inflammationWhen sleeping, a side position (fetal) with a pillow

between the knees might help. If you sleep on your back, then put a rolled towel under knees.

Avoid heavy lifting or twisting of backReturn to activity with light cardiovascular activitySee a physical therapist for stretching and

strengthening AFTER the pain subsides.

Avoid these exercises until approved by doctor.

JoggingGolfBalletWeight liftingLeg lifts when lying on stomachSit ups with straight legs

Additional treatments

Possible treatments may include:Injection of steroids or anestheticsRadiofrequency ablation (electrical stimulation to

specific nerves)Antidepressants and/or anticonvulsantsChiropractors (use with caution)AcupuncturePsychotherapy (stress management & relaxation)BiofeedbackAlexander Technique, Pilates, Feldendkrais

Method, aquatic therapy and yoga have all been used with some success

Interventions: Video

Spinal Fusion

Low back surgery

Acupuncture

Uncommon pain relievers

Distraction therapy

Artificial discs

Extreme exercise for back pain

WebMD has a series of instructional videos. Here are a sampling of videos which help explain interventions for back pain. Click on the links.

Maintain a healthy back: Exercise

Regular exercise is crucial in maintaining a healthy back. In addition to your regular exercise program, the following websites offer some specific ideas:

FDA Lower-Back exercisesWebMD (video) WebMD (text)

Other ways to maintain a healthy back

Maintain a healthy weightLift properlyMaintain good postureBuy a good mattressReduce stressWarm up before exerciseSupport lower back when

sitting

Posture illustration from APT

Additional things for a healthy back

Avoid standing for long periods of timeNO high heelsIf you sit for a long period of time, the chair

should have an adjustable seat, back, armrests & swivel seat

Use a stool under your feet so the knees are higher than your hips

Place a small pillow or rolled towel behind your lower back

Get up and walk around at least once an hourQuit smokingRelax…Try yoga, tai chi or massage

Final note

Don’t let a bad back ruin a good life.

Do something now!