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- Today, we're going to talk about
one of the most common types of pain.
In the US, it's the second most common reason
patients visit their doctor.
It's the number one cause
of disability in people under the age of 45,
and the third most common disability overall.
What kind of pain are we talking about?
Well, it's low back pain.
Studies show that 70-90% of people
have an episode of low back pain
at some point in their lives.
Of those, 80% will have a recurrent episode.
These are staggering statistics
for a treatable problem.
Why? Well, most adults with low back problems
seek treatment for their primary symptom.
That is, the pain.
Unfortunately, you can't just treat the pain.
You have to first identify the source of the pain
in order to correctly treat it
to prevent a recurrence.
Today, we're going to talk about
the common causes or sources of back pain.
How they occur, what the symptoms feel like,
and what the best treatment option for each problem is.
But now, let's first take a look at the anatomy,
or the parts list of your back.
When I talk about the anatomy, or parts list
of the lumbar spine,
I like to talk about four categories.
One, two, three, four.
First of all, there is a column of bones
that are called vertebrae.
Column of bones that are called vertebrae.
It is the last five bones, or vertebrae
that form the low back, or lumbar spine.
Secondly, there are some muscles.
In fact, there are a set of muscles
that attach on either side of this column
to this bone, called the ilium bone,
which is part of what we call your pelvis.
So, there's a set of muscles here,
attaching to this bone,
and a set of muscles here, attaching to this bone,
that produce some support for this column.
The third category is that of the joints.
The joints are of three types,
first of all, the facets.
The facets are joints that connect
these vertebrae in the back.
Then, there is the sacroiliac joint.
The sacroiliac joint, which is this joint here, and here,
anchors this column, or low back,
to the ilium bone, or pelvis on either side.
Finally, we have the discs.
The discs are these shock absorbers
that actually anchor these bones or vertebrae
in the front.
The fourth category is that of the nerves.
The nerves comprise the electrical system of the spine,
and there are two basic types.
There is the spinal cord,
and then branches of the spinal cord,
that are called the peripheral nerves.
The spinal cord travels down the middle of the column,
and the branches come out from either side
from the spinal cord.
In previous shows, we talked about abnormalities
that cause pain in the muscles.
We talked about abnormalities and problems
that cause pain in the facets,
and the sacroiliac joints.
Today, we're going to talk about problems
in the discs and the nerves that can produce back pain.
Let's look at a normal disc and nerve.
If we look at the front view of two vertebrae,
there's one stacked up on a second one, like this.
Between them is a doughnut-shaped structure
that's called the disc.
This is a doughnut that sits between them.
And it turns out that this is a jelly doughnut,
so it has some jelly in the middle.
Here's the jelly in the middle.
Again, running through the column within the vertebrae
is the spinal column.
And exiting from that spinal column,
or spinal cord, are those branches.
Now, let's look at an degenerative disc,
and pinched nerve.
Here is the vertebrae.
Now you'll notice that the vertebrae underneath this,
sits a little bit closer.
Because the doughnut, or disc,
has been kind of squished and compressed.
In fact, on this end, it's even ruptured.
The jelly, in turn, has squirted out,
and accumulated out here, to the side.
What's on the side, also?
That spinal nerve.
And as a result, that jelly pinches against
that spinal nerve, irritates it,
and we get pain.
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