Conditions & Advice: Back Pain
The spine is made up of 33 vertebrae:
- 7 in the neck,
- 12 in the thorax,
- 5 in the lower back,
- 5 fused vertebrae in the sacrum and
- 4 fused vertebrae in the coccyx.
The vertebrae are separated from eachother by discs made of cartilage, but connected to eachother by joints known as facet joints. The spine is not very strong and relies on muscular support to help it do its job. The muscles act in the same way as guy ropes on a tent, holding everything in a state of balanced tension, regardless of whether you are sitting, standing or doing cartwheels. The best way to avoid back problems is to keep fit – the stronger your muscles are, the more support your spine has. Desk work is the enemy of a healthy back! Compensate for it by taking regular exercise.
When you get back or neck ache, we have to work out what structure is causing the pain. It may be that a facet joint is strained, typically causing pain on one side that is made worse by leaning back or to the side. Turning may also make symptoms worse, such as looking over your shoulder to reverse the car. If you lean forward, this opens out the joints and often eases symptoms. If the pain is in the mid back it may be that a rib joint is disturbed, where the rib connects to the spine. Joint problems usually resolve quite quickly. Some people, however, may have a spondylolisthesis , where one vertebra is shifted forward or back relative to its neighbour, usually following a major back injury. This can cause recurring back problems. Again, strength in the lower back, pelvic floor and abdominal muscles is the key to managing this successfully.
If there is a disc problem, bending forward is usually difficult and you may have symptoms (such as shooting pain or tingling) into one of your arms (from the neck) or legs (lower back). Usually the limb symptoms are worse than the back pain. Often disc problems occur after bending, lifting and twisting. Symptoms are caused by the disc either directly squashing a nerve or causing local inflammation which then squashes a nerve. This is why anti-inflammatory drugs, such as ibuprofen, are often prescribed. Lying down and sitting are usually uncomfortable and it is easier to walk about or change position frequently. Disc problems can go on for months. It may be worth asking your GP for an MRI scan to see exactly what is going on (X-rays don't show discs). In rare cases, an operation is called for.
Strains to muscles or ligaments usually feel like a deep ache, often across the lower back or where the neck joins the top of the back. This kind of pain may result from activities involving lifting, working at arms length (e.g. hedge cutting) or bending over. Sometimes stress or emotional upset will cause muscle tightness and fatigue, leading to pain. If you are getting pain at the top of the neck and headaches it is probably due to hunching over the computer with your chin out, forcing the muscles at the back of your head to contract for long periods, leading to fatigue and pain. Sit up and drop your chin down!
There are other, non-mechanical causes of spinal pain so it is important to get a proper diagnosis. Your osteopath will give you a thorough assessment and refer you to the GP if they think that an X-ray or MRI is needed, or if they think the cause of symptoms is something more serious.Back to top