The Anatomy of Back Pain

Todd Albert, MDWe might think of our back and spine as important to our active physical function. However, everything that we do, from walking to sitting and even lying down, relies on a functional spine. This may be one of the reasons why up to 80% of people develop back pain at some point; the spine is constantly in use. Being in use is only a vague reason, though. To understand back pain, we have to understand the relationship between the various parts of the spine, the nervous system, and the rest of the body. 

Understanding the Spine & Back

The spine is a complex piece of anatomy with 4 segments and dozens of bones, muscles, and connective tissues all working together. The purpose of the spinal column is to protect the spinal cord and its numerous nerve roots. These nerve roots pass through the bones of the spine to deliver messages from the brain to the body and back again. In addition to the cervical, thoracic, lumbar, and sacral vertebrae, the spine also has numerous discs. These gelatinous structures provide shock absorption between the bones of the spine. Finally, each set of vertebrae are connected by joints called synovial joints. These flexible structures give movement to the spine.

Back pain may occur for several different reasons.

Muscle and soft tissue problems

The spine is supported by muscles, ligaments, and tendons. Back pain may originate in one of these soft tissues as a result of stress or strain. Stress and strain may be brought on by improper lifting, a physical injury such as a fall or auto accident, or even from poor posture. Sometimes, back pain may stem from a muscle strain in another area, such as the hamstring.

Disc problems

Conditions such as a herniated disc or disc degeneration account for many cases of back and neck pain. Discs may tear, bulge, or rupture as a result of wear and tear. Disc problems are commonly found in the lower back, though cervical discs are also at risk of deterioration.

Vertebral problems

Vertebrae are relatively protected by discs and connective tissues. However, the bones of the spinal column may suffer compression fractures due to arthritis. A fall or sports injury may also cause damage to one or more vertebrae.

Spinal Cord and nerve problems

Some cases of back pain are caused by the narrowing of the spinal canal, called spinal stenosis. When the space inside the spinal canal narrows, multiple nerve roots may become compressed and painful. Since nerve roots travel out into the body, compression can lead to symptoms in areas away from the spine and back. This is referred to as radiculitis. Sciatica is an example of this condition.

Finding Solutions for Back Pain

Many people do not obtain the care they need for back pain because they fear they will be told they need surgery. Ultimately, if surgery were needed, it would likely resolve the problem and improve quality of life. However, patients should know that even the most experienced spinal surgeon will recommend nonsurgical protocols such as medication, injection therapy, and physical therapy before considering surgical intervention. When surgery is necessary, surgeons use the most minimally invasive techniques possible.

Don’t let back or neck pain keep you from your best life. Schedule a consultation so you can at least understand your pain better and explore options for reducing it. For an appointment in our NYC office, call 212-606-1004.

Posted in: Back Pain

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