- Back pain is a common complaint.
Pain can start with a single injury,
like a muscle strain, or it can develop gradually
from the stress and strain of your daily activities.
Over time, parts of your spine start to degenerate.
This wear-and-tear process is also
a common cause of back pain.
Your low back, or lumbar spine,
is a unique portion of your spinal column.
Your low back absorbs shock,
withstands the pressure from your body weight,
resists the forces of muscles pulling on it,
allows you to lift, carry, twist, turn.
But as you age, so does your spine.
Your spine begins the wear-and-tear process
as early as your 20s in men, and your 30s in women.
Most adults with low-back problems
seek treatment for their primary symptom,
that is, pain.
In order to correctly treat your pain,
you first have to identify the source of the pain.
Today, we're gonna talk about some common causes,
or sources, of back pain,
how they occur, what the symptoms feel like,
what the best treatment options are for each problem.
Let's first take a look at the anatomy,
or the parts list, of your back.
I like to talk about four categories.
One, two,
three, and four.
First of all, we have a column of bones
that are called vertebrae,
the lower five of which, form the lumbar spine,
or low back.
So, column
of bones,
called the vertebrae.
Then we have the muscles
that start on each side of this column,
and attach to this bone called the ilium,
so there's a group of muscles from here to here,
and from here to here.
These help support this column.
The third category is that of the joints.
The joints are of three types:
there are the facets,
which are the joints that connect
these vertebrae in the back.
The sacroiliac joints,
there are two of them,
one on the left and one on the right,
that anchor this column to the ilium bones
on each side of your pelvis.
This is a joint here, and a joint here.
Finally, the discs.
The discs connect these vertebrae in the front.
These are the discs here, and here.
The fourth and final category
is that of the nerves
that comprise the electrical system of the spine.
These nerves come in two basic flavors:
the spinal cord,
which fits in a hollow area
in the middle of this column
and is protected by the column.
From the spinal cord come
the branches, or peripheral nerves.
These structures on either side
of the column.
First, let's talk about
problems with the muscles.
Once again, we're looking at the front view
of the column, so, muscle.
Here is the column.
The column is connected
to the sacrum bone.
The sacrum bone is connected to the
ilium bone, on each side.
Supporting this column are muscles
on either side
that connect from the column to the ilium bone.
You can think of this as a
mast on a ship
that's being supported by the
ropes on either side.
When these ropes, or muscles,
tear, or sprain,
this, first of all, causes pain,
stars mean pain.
And also cause these muscles to tighten up.
When they become tight,
your spine almost feels crooked,
and has a tendency to veer in that direction.
Let's talk about problems that occur
with the joints that are called the facets.
Here is, again, a front view
of the column, there are two vertebrae.
On the ends of the vertebrae
are these flat, sliding joints
called facets.
This facet slides on this facet,
this facet slides on this facet,
and they do so in an even manner.
When the spine
incurs a sudden shift,
these facets can become
out of alignment,
like this,
and cause pain.
Finally, let's talk about
how the sacroiliac joint, the SI joint,
can cause pain.
Again, we have our column of bones.
On the end of the column,
we have the sacrum.
The sacrum is attached
to the ilium bones.
I like to think of this connection
between I, the ilium,
and S, the sacrum,
I, the ilium, S, the sacrum,
as constructed like
tongue and groove in furniture.
In other words, if we take this area here and blow it up,
here is the S side,
and here is the I side
that fits nicely within it.
If there, again, is a sudden
twist of the spine,
and injury to the spine,
there can be a shift
of this tongue and groove,
such as this.
Here is the S,
and here is the I.
There is a shift, often upwards,
of these two structures
that then results in pain.
It also results, once again,
in your feeling crooked.