Back Pain and Backs Explained
Structure of Your Back
he upper back or neck is referred to as the cervical region and is made up of the uppermost 7 vertebrae which are known as C1 to C7. The cervical region bears the weight of your head, which is actually very heavy! The cervical region is therefore doing quite a bit of work, keeping you head held high, and has connections to your shoulders.
he middle part of the back is referred to as the thoracic region and is made up of 12 vertebrae which are known as T1 to T12. It can be prone to problems due to poor posture, for example from sitting for too long with desk based office work.
he low back is referred to as the lumbar region and is made up of 5 vertebrae which are known as L1 to L5. This region carries the whole weight of your upper body and of course any objects you are carrying around. The lumbar region is therefore under continuous load as well as the additional pressure of bending, twisting and lifting. Its a pretty key piece of kit and is well worth looking after!
Your back is a complex structure that also consists of:
- Joints – tiny joints in the spine which allow movement.
- Shock absorbing discs (intervertebral discs) that cushion forces on the bones and allow the spine to bend.
- Ligaments to hold vertebrae and discs together.
- Tendons to connect muscles to vertebrae.
- Spinal cord (carries nerves from the brain to the rest of the body).
Types of Back Pain
efers to any pain experienced from the base of your skull to your shoulders and which may extend into your upper back or arms. Felt as stiffness, tightness or a sharp pain. In bad cases neck pain can reduce the movement of your neck and head. Tension headaches can also be caused by neck pain.
The muscles in the neck are permanently in action in order to support your head, in contrast to most other muscles in your body which relax completely when you are not using them. Excess strain on the neck can result in pain developing at any age although it is most common in people over fifty.
Excess strain may be placed on the neck from long periods doing computer work, slouching or even simply having slept in an awkward position. If you have had an accident you can also develop neck pain. Whiplash, sustained when the head is thrown forward then backward in a car accident, is perhaps the most well-known.
A pain in the neck is not usually the result of an accident or serious injury though, and will often reduce after a few days. It is generally best to try and keep moving if you are experiencing neck pain and continue your normal routine. However, it would be sensible to look at the information about lifting, sitting, driving and computing to understand if these are contributing to your condition and how you can minimise their impact. If your neck pain is such that you cannot turn to properly view traffic you should avoid driving and seek advice.
Over the counter painkillers may help you maintain movement. You can look at the section on painkillers in the treatment section.
efers to any pain between the base of your neck to the bottom of your ribcage. This section of your back, around the thoracic vertebrae of the spine, is known as the thoracic region.
The bones in this area of your back do not move and flex as much as your neck or lower back. This type of back pain is therefore less common but can still be a cause of pain.
Pain, in common with many other types of back pain, ranges from aching and stiffness to a sharp pain or burning sensation. Pain in this area can also be caused by pinched nerves in the neck.
One very common cause of thoracic back pain is poor posture. Keeping your back as straight as possible and balancing your weight on both feet evenly should help when standing. When sitting, keep your shoulders rolled back and really try to think about a good position when sitting, driving and using computers.
Information on sitting, driving and computing is available in the prevention section of our site.
efers to any pain between the bottom of your ribcage down to the top of your legs. The back is a delicate area of muscles, nerves, bones and joints and the lower back is continuously working hard to support your whole upper body.
Pain in your lower back is therefore most common of all back pain and about 8 out of 10 people will be affected by it at some point in their lives. Sufferers of low back pain may feel tension, stiffness, sharp pain and soreness.
Most people’s low back pain is not caused by rare conditions such as cancer or fractures and is therefore described as non-specific. This is perhaps a bit unfortunate, as it can feel a bit dismissive, but it simply means it is caused by the structures of the back rather than some other specific medical condition.
Pain in your lower back is most frequently triggered by everyday activities like bending awkwardly, lifting incorrectly, slouching when sitting, driving and standing for long periods without taking regular breaks.
The prevention section can help you to guard against these common causes of back pain.
ou may think it strange that pain in your bottom or legs is in this section about back pain. But pain felt here can be caused by several low back pain conditions. Pain can be referred to this area from your back by a pinched nerve or tight muscles.
The sciatic nerve is the longest nerve in your body. It starts at the lower spine, running from the back of your pelvis, through your buttocks, and all the way down both legs, ending at your feet.
This kind of pain is commonly called ‘sciatica’. Sciatica is caused by irritation or compression of the nerves that radiate out from your lower back and travel down your leg, sometimes to your calf. It can be mild to extremely painful. The most common cause of sciatica is a slipped disc. This occurs when one of the discs that sit between and cushion the vertebrae is ruptured. It can also be caused by degenerative changes (‘wear and tear’) in your spine.
Sciatica can pass without needing attention and a combination of the self-help measures such as over-the-counter painkillers, exercise and hot or cold packs can relieve the symptoms.
In very rare cases, surgery may be needed to control the symptoms.
ost back pain is annoying and painful but not usually an indication of something more serious. However, there are a number of warning signs known as “Red Flag Symptoms” to healthcare professionals.
These red flag signs include:
- High temperature (fever) of 38C (100F) or above.
- Unexplained weight loss.
- Constant back pain that does not ease after lying down or resting.
- Pain that travels to your chest or that is high up in your back.
- Pain down both your legs and below the knees.
- Recent trauma or injury to your back.
- Loss of bladder control.
- Inability to pass urine.
- Loss of bowel control.
- Numbness around your genitals, buttocks or back passage.
If you have any of these signs or symptoms do not delay in contacting your GP. Our initial consultation would pick up on these red flag symptoms.
Back Pain Treatments
anual therapy, like that provided by a Chiropractor, is designed to provide physical relief from your symptoms.
The NHS states that there is evidence to show manual therapy is beneficial in treating some types of musculoskeletal conditions, such as long-term back pain.
The National Institute for Health and Clinical Excellence (NICE) advises the NHS that manual therapy can be used to treat persistent lower back pain. The availability of manual therapy through the NHS is limited and chiropractic is not currently available through the NHS in the North East.
Although chiropractors practice a particular type of manual therapy there are other professions offering manual therapy such as Osteopaths and Physiotherapists. The important thing is to find what works for you, but in our opinion any practitioner should:
- Be fully qualified and registered with the appropriate regulatory body.
- Conduct a thorough and systematic initial examination and allow sufficient time to do so and to listen to you properly. 1 hour is common.
- Give you a considered report of their findings following the initial examination.
- Explain what treatment they are recommending and why it is appropriate, or why it is not appropriate if that is the case.
- Give you a realistic idea of the chances of relief after the initial examination, how many treatments they estimate it will take and what the cost will be.
- Refer you to another healthcare professional if they believe you will benefit more from the treatment they offer.
- Allow sufficient time for treatment sessions.
- Have systems and processes in place to monitor your progress.
- Provide advice and guidance that will help you beyond manual therapy in the treatment room.
Practitioners with quality mark awards will operate to these standards as a minimum.
ot so long ago back pain sufferers were told that rest was the best cure and that is a myth that still persists.
It is now known that resting can be positively harmful because it allows your core muscles to weaken which actually delays recovery, and prevents correct healing of soft tissue structures.
Staying mobile and active is an important part of recovery. Keeping as active as you can, maintaining your daily routine and returning to work as soon as possible are generally the right course of action.
However, it may be that some aspect of your life may be causing, or at least aggravating your back pain. We cannot recommend strongly enough that you have a look at the prevention area of our website for ideas and advice on the most common contributors to back pain to see if you can rectify the problem.
You only have to catch yourself from time to time to think about how you are lifting, sitting, driving or computing to become aware of how problematic these things may be for you.
edication could be an option if you find the back pain you are experiencing is severe enough to interfere with your daily activities because it is important to keep moving for things to heal correctly.
NHS recommendations are that you first try over-the-counter medication such as paracetamol. If that doesn’t provide sufficient relief, try ibuprofen. In either case, make sure you are taking the painkillers as regularly as the dosage information recommends.
Don’t wait until your back pain is very bad. If you want any further advice on this, speak to your GP or pharmacist. Your chiropractor is also able to advise you on basic pain medication.
t is important to know when to use the right one! Pain that is the result of inflammation is better relieved by cooling so do not automatically assume that if it hurts heat is the best option. Heat will actually aggravate anything inflamed.
If you are unsure about the cause you should probably seek advice from your chiropractor or other healthcare professional.
Cold packs can be bought from pharmacies and can be left in the freezer until required. Many can also be heated in the microwave; depending on the type of relief you require. Always follow manufacturer’s instructions.
If you can’t get your hands on a specially manufactured pack, a bag of frozen peas will do the same job! It is not advisable to apply a hot or cold pack directly to an area, instead make sure it is wrapped in a thin piece of towel.
You may be considering your options for treatment. The NHS has produced a table of pros and cons for common treatment strategies.
Joints and muscles in the spine are massaged and manipulated, usually by a chiropractor, physiotherapist, or osteopath.
A complementary medicine; needles are placed in different parts of the body.
Programme of group exercises designed to strengthen muscles and improve posture.
A structured programme that contains exercise and psychological therapy.
Spinal Fusion Surgery
Two or more vertebrae (bones) in the spine are fused together to improve stability of the spine.
Anti-inflammatory Painkillers (NSAIDs)
Ibuprofen or naproxen.
Prescription painkillers ranging from moderate-strength (e.g. codeine) to powerful (e.g. morphine).
Antidepressants used for their painkiller effect.
|Information from NHS Choices|