Eliminating lower back pain causes starts with understanding a little about how your back works. Before you delve into the site to find out about back pain relief, please take a couple of minutes to read this brief summary of the main ‘moving parts’ that make up your back and why they can sometimes be vulnerable to stress or injury. Firstly, you may have noticed that your spine is not straight but slightly curved (in an S-shape).
Not everyone’s back is exactly the same shape, but we all have a slight hollow in the base of the neck and in the small of the back (lumbar region). You should try to maintain this shape as much as possible, especially when carrying out day-to-day activities.
The spine is made up of thirty-three small bones called vertebrae, with discs that act as ‘shock absorbers’ and enable the spine to be fairly flexible. The inside (nucleus) of each disc is made up of a soft jelly-like substance. This is contained within a thick, stretchy, fibrous outer layer (annulus). When people talk about a ‘slipped’ or herniated disc, it is important to realize that discs don’t actually slip – there is nowhere for them to go! Instead, the annulus develops a crack and either it or the nucleus then puts pressure on the surrounding nerves. This results in pain and sometimes ‘pins and needles’ feelings or sensations of weakness.
The spine also protects the spinal cord, which contains the nerves that come from the brain. Nerves come out from between the vertebrae to send messages to various parts of the body, as well as receiving messages. Each nerve supplies both muscles and joints and therefore has more than one role.
Prolapsed Discs (‘Slipped Discs’)
When you have a prolapsed disc, the bulging disc may press on a nerve coming from the spinal cord. There may also be some inflammation around the damaged disc. The most common discs to prolapse are at the base of the spine.
Nerve Root Pain and Sciatica
Nerve root pain occurs because a nerve coming from the spinal cord is pressed on (‘trapped’) by a prolapsed disc, or is irritated by the inflammation around the injured disc. Although the problem is in your back, you are also likely to feel pain right down your leg. This leg pain can be more intense than back pain.
With a slipped disc, the sciatic nerve is the most commonly affected nerve. (The term ‘sciatica’ means nerve root pain of the sciatic nerve.) The sciatic nerves are made up of several nerves that come out of the spinal cord in the lower back. There are two sciatic nerves – one for each leg – and each sciatic nerve runs deep inside the buttock and down the back of the leg. The irritation or pressure on the nerve next to the spine may also cause ‘pins and needles’, numbness or weakness in part of a buttock, leg or foot.
In a few cases, the nerves pressed on by a prolapsed disc are ones that control the bladder and/or bowel. If this occurs it is a medical emergency and needs urgent treatment. You should tell your doctor immediately if you have any sudden problem with incontinence of urine or faeces, or if you cannot pass urine, especially if these symptoms develop at the same time as back pain, numbness in the inner ‘saddle area’ of your bottom and thighs, or other nerve root symptoms.
Back Muscle Problems
Strong ligaments and muscles are attached to the vertebrae. The ligaments and other surrounding muscles give the spine extra support and strength. A common form of back pain occurs when the back muscles go into spasm. This may happen when you have been carrying out strenuous activity, such as digging in the garden or lifting something heavy.
If the pain dies down and there are no unusual symptoms (e.g. numbness, ‘pins and needles’ or pain down the leg), it may be caused by muscle spasm. However, if the pain lasts more than 48 hours and increases (rather than decreases), you should contact your doctor.
The lower (lumbar) region of the back is the most vulnerable area of the spine, because it bears the entire weight of the upper body. It is also the point where your mobile spine meets a fused bony ring (your pelvis), and so takes a great deal of stress and strain. Your spine is strong however. It’s a clever piece of engineering that is designed to be used and is important not to be frightened of moving it.