Why You Hurt

The human spine is comprised of 24 bones, or “vertebrae”, stacked one on top of the other, forming the upper or cervical spine, the middle or thoracic spine and the lower or lumbar spine. The lower 5 vertebrae, often referred to as L1-L5, are supported from below by the sacrum which is a triangular shaped bone that sits in the middle of the pelvis. This lumbar-sacral complex is commonly known as “the lower back.”

Each vertebra is comprised of a large bony part called the “body”, which provides the main structural support of the spinal column. A bony ring is formed behind each body, forming a protective “tube” where the spinal cord is housed as it descends from below the brain. The spinal cord forms nerve roots at each level of the spine which travel out to the extremities for neurological control. The spinal cord remains rope-like until approximately L2, at which point it becomes a bundle of separate nerves called the “cauda equina” which is latin for horse tail. Each vertebra is connected to the vertebra above and below by joints on either side called “facets.” These joints, like all other joints, are protected by a layer of cartilage which cushions and lubricates the joints to allow for proper movement and function.

Between each vertebral body rests a specialized cushion called an intervertebral disc, which helps stabilize the spine and provides absorption of compression forces. Each disc has a central jelly-like portion referred to as a “nucleus” which provides the primary cushioning. Surrounding the nucleus, thick ring-like ligaments form the “annulus”, which keeps the nucleus contained and protected.

A “spinal segment” is comprised of (a) 2 adjacent vertebrae, (b) the facet joints adjoining the two vertebrae, (c) the intervertebral disc in between, and (d) the nerve roots that exit through the tunnel-like “neural foramen” on either side of the segment.

Supporting each spinal segment, thick ligaments span the length of the spinal column. These are called the anterior and posterior longitudinal ligaments. Additional ligamentous support is given by the joint capsule of each facet joint. However, ligaments do not provide adequate support alone. Deep stabilizing muscles which cross each segment, lower abdominal muscles, and pelvic region muscles must also function normally for proper spine control and function. Above the deep layer of spinal muscles, larger, superficial muscles are responsible for gross movements such as trunk bending and twisting.

The spine is an extremely intricate system, which requires organized and synchronized function in order to operate properly and without pain.

But, when things go wrong….

Painful Conditions:

Arthritis

The joints that connect the vertebrae of the spine are normally covered by a substance called cartilage. This substance acts as a cushion and additionally produces a lubricant called synovial fluid to ensure smooth movement and function. When this cartilage wears away, the joints become inflamed (irritated) and this can cause considerable pain when the joints are loaded with pressure as with standing, sitting, etc. Furthermore, bone spurring can occur as the body tries to “heal” the affected joints, thereby irritating the joint and surrounding tissues. Although a medical “cure” for arthritis is yet to be discovered, there are several things you can do to minimize and control this condition. To learn how, follow this link.

Ankylosing spondylitis

This is actually a form of rheumatoid arthritis which causes the joints of the spine to fuse together, resulting in significant pain and severe “stiffening” of the spine. Furthermore, this condition can lead to the development of bone spurs which may compress and irritate the nerves of the spine, resulting in additional pain. Again, this condition cannot be medically “cured” but can be effectively managed so as to diminish your pain and resume normal daily activities. To learn more about effective management techniques, click here.

Degenerative Disc Disease

Between each vertebrae in your spine, you have gel-like cushions which act to absorb shock and provide spinal stability. When these structures deteriorate due to injury or normal wear and tear that occurs as we age, the resulting inflammation can directly cause what is called “discogenic” pain. Furthermore, as these cushions become smaller, the spacing between the vertebrae can be compromised, which may result in nerve compression and pain. A degenerative disc may progress to a disc bulge or herniation which can be more serious. There currently is no accepted treatment to completely reverse this process, but there are simple techniques to help slow down the progression and to provide pain relief. To discover how, click here.

Disc Bulge

This diagnosis describes a disc which has lost support along its outer edge allowing for the inner disc material to “bulge” beyond its normal shape. This can cause not only pain from the disc itself being stressed but also by compressing the spinal cord or nerve roots of the spine. Fortunately, there is a simple exercise sequence that in many cases can alleviate the pain and may “reduce” the bulging. Learn these techniques by clicking here.

Disc Herniation

This is a more serious form of disc bulge that occurs when the inner material of a disc actually prolapses (escapes) from the disc. The technical term for this is Herniated Nucleus Pulposus (HNP.) This can cause serious harm if it compresses the spinal cord or nerve roots. It has recently been discovered that when this occurs, the injury site releases chemicals which inflame and irritate the surrounding tissues, causing pain even when there is no direct compression. While some of these cases do actually warrant surgery to correct, there exists a simple treatment method which has effectively reversed the symptoms in many sufferers. This method has been recommended to many patients as a “last-ditch” effort before resorting to surgery. Find out more about this treatment by clicking here.

Instability

Spinal instability occurs when the components of the spine responsible for control and movement become weak or ineffective. Every movement of the trunk is carefully controlled on a deep spinal level through muscular and ligamentous structures. When this deep stability is compromised or absent, the joints of the spine may move further than they are supposed to which can result in significant pain and disability. Because of the poor deep stability, superficial muscles which are normally only used for “gross” movements such as bending and twisting may go into a “spasm” as they try to provide the absent stability. This condition occurs frequently along with many other lower back disorders, and regaining the stability can drastically improve symptoms that are thought to be from other issues. To learn how to regain your spinal stability, click here.

Lower Back Pain

This diagnosis is typically given to patients when a more specific cause of the pain cannot be pinpointed. This is not a true diagnosis in the traditional sense, but rather a description of your symptom. By some estimates, close to 80% of back pain cases cannot be specifically diagnosed which results in assignment of the “diagnosis” of Low Back Pain (LBP). Fortunately, a more specific diagnosis is not always necessary to properly treat this condition and rid your body of the pain. The most effective currently available methods of treatment can be found by clicking here.

Misalignment or Mechanical Back Pain

This condition refers to cases where the bones of the spine are not aligned properly with normal joint position and mechanics. As a result, considerable strain is placed upon the ligaments and muscles that have to work harder to provide support in absence of the structural support normally provided by proper spinal alignment. Eventually, these tissues become inflamed and painful as they near their failure point. Muscle spasms are sometimes present as the muscles overlying the misaligned joint(s) are constantly contracted in order to compensate for the instability. Many people find relief from this condition through joint manipulations provided by Physical Therapists, Osteopathic Physicians and Chiropractors. However, if the proper deep stability is not regained, the misalignment is highly likely to reoccur. Fortunately there are self-treatment options which may provide complete relief and correction. To learn about these techniques, click here.

Myelopathy

This is another diagnosis that refers to a symptom rather than a cause. The term describes damage to the spinal cord or nerve roots which results in loss of muscular control and/or sensation which is normally provided by the affected neural tissue. This condition warrants a visit to a physician to rule out any serious issues. Any time the spinal cord or nerve roots are compressed, inflamed, severed or otherwise compromised, this condition may result. A common cause of this condition is spinal stenosis, in which the spinal column is narrowed where the spinal cord and/or nerve roots normally pass unhindered. However, any “space occupying” condition such as bulging discs, herniated discs, bone spurring, or anklyosing spondylitis has the potential to cause myelopathy. This is sometimes considered a “red flag” depending on the severity and in the presence of other “red flags” may indicate the need for a surgery. However, with proper treatment of the actual cause of the myelopathy, this can be corrected and reversed. To learn more about the available treatment options, click here.

Osteoporosis

As we age, our bones will gradually lose density and strength, but when this is severe, Osteoporosis is the diagnosis. This weakening of the bones can result in increased risk for fracture which can cause severe pain and possibly compromise the proper functioning of the spinal cord and nerve roots if collapse of the vertebrae occurs. There are many supplements and medications currently available to treat this condition, but there are also important self-management and treatment techniques you should be doing to counteract the disease. Discover these methods here.

Piriformis Syndrome

The piriformis muscle lies beneath the large gluteal muscles of the buttocks, spanning from the pelvis and sacrum (tailbone) centrally, to the bony prominence of the femur (greater tuberosity) laterally. Its primary function is to externally rotate and stabilize the hip. However, when this muscle becomes tight or restricted due to injury, strain or from compensating for other weak muscles, it can compress the sciatic nerve. This pressure on the sciatic nerve can result in Sciatica which is characterized as pain that can travel from the buttocks down the back of the leg to the foot. Very rarely does this condition result in surgery, but in severe cases it may. Thankfully, there exists a simple treatment regimen which can effectively alleviate your pain and difficulty walking. To learn how, click here.

Psychosomatic Pain

The brain has a powerful influence over our bodies. This diagnosis does NOT mean that your pain is not real, but rather that there is a very real mental component to your condition. Studies have proven that in the absence of any true spinal disorder or condition, many people experience severe, debilitating lower back pain that may be due to negative thoughts or emotions. Furthermore, when someone has an actual spine issue, the pain and disability may be amplified by negative thoughts which will naturally accompany dealing with their condition. When this happens, a negative feedback loop is created and without addressing the mental component, the pain may continue well past the point it should. Fortunately, there are simple treatments available to you, which may completely alleviate your pain without drugs, surgery or even exercise. Find out how to “turn off” the pain here.

Radiculopathy

Again, this is not so much an actual diagnosis as is it a symptom. Radiculopathy refers to pain, numbness, and/or tingling which travels or “radiates” from the lower back or buttocks down one or both legs. In more serious cases, weakness in the legs or feet may also be present. This occurs when the nerve roots which exit the spine at each level are compressed or irritated. This can be due to any condition which exerts pressure on the nerve roots themselves, such as bulging discs, herniated discs, stenosis or any other degenerative condition. The presence of radiculopathy certainly warrants a visit to a physician to ensure there are no serious issues occurring. In the absence of such, addressing the underlying cause of the Radiculopathy may effectively and completely alleviate the symptoms through simple treatment techniques, which can be found here.

Sacroiliac (SI) Dysfunction

The sacroiliac joints join the sacrum (base of the spine) to the large iliac bones of the pelvis on either side. These joints are extremely important in that these are the points where compressive loading forces are transmitted from the legs, through the pelvis, and into the spine. When the ligaments supporting these joints are sprained, misalignment and instability may occur, resulting in severe pain in the lower back and possibly radiating pain down the leg and into the foot. According to certain research studies, SI problems may play a role in up to 80-90% of lower back pain cases. To learn how to effectively stabilize the sacroiliac joints, follow this link.

Sciatica

The sciatic nerve is a large nerve (the largest in the human body) which travels from the lumbar spine into the buttocks and down the backs of your legs all the way to your feet. When this nerve becomes compressed, stretched or otherwise irritated (inflamed), you may feel severe pain anywhere along its pathway. This is often misdiagnosed as a radiculopathy, as the nerve roots of the spine eventually form this nerve after leaving the spinal column. This condition is commonly a result of Piriformis Syndrome which occurs when the piriformis muscle exerts abnormal pressure on the sciatic nerve as it passes underneath, and in roughly 15% of the population, passes THROUGH the muscle belly. Fortunately, there are proven, simple techniques which may completely and effectively treat this condition. Learn how by clicking here.

Scoliosis

This condition describes abnormal curvature of the spine. Normally, the spine should appear completely straight when viewed from behind. However, some people develop side to side curving of the spine described as a “C” curve or sometimes a “S” curve when more severe. This may be caused by birth deformities, spinal muscle “wasting” or atrophy, cerebral palsy, differences in leg-length, tumors or spina bifida. As such, a visit to a physician for diagnostic work-up is a good idea. However, 8 out of 10 cases cannot be attributed to any particular cause, normally showing up during adolescence. The resulting postural abnormalities can result in serious pain, difficulty breathing and sometimes difficulty with overall function and movement. Treatments range from hard, turtle-shell type bracing, to surgeries to correct the abnormal curves with implanted metal rods. However, more conservative treatment techniques and methods do exist. To learn how to treat your scoliosis, click here.

Spondylolisthesis

This condition occurs when one of the vertebrae of your spine slips forward over the underlying vertebra with which it articulates. From this point, the slippage can affect the disc above as well, resulting in a “domino” effect. In turn, the spinal canal is narrowed, which can compress the spinal cord, potentially leading to myelopathy. This condition occurs more frequently in people who exert tremendous extension / compression forces upon their spine during activities such as heavy lifting and contact sports. Symptoms of this condition include lower back pain and sciatica. In more severe cases, surgery is sometimes necessary to ensure more serious trauma or damage does not occur secondarily. With this condition, there are certain movements and positions you should AVOID at all costs. Fortunately, there are also other movements and postures that will actually help to ease your pain. To learn more about how to properly manage this condition, click here.

Spondylolysis

Describes the condition in which a vertebra is fractured at a point known as the pars interarticularis. This is sometimes referred to as a “pars defect.” This normally occurs in adolescents who repeatedly hyperextend and place increased compressive forces upon their spine. Such forces are typically experienced by those who participate in gymnastics, dance or football (lineman are particularly susceptible.) It most commonly occurs in the lowest of the spinal vertebrae, L5 (5th lumbar), but can occur elsewhere. Besides local back pain from the fracture itself, leg radiculopathy may occur as well. As the body heals itself by creating more cartilage at the fracture site, sometimes too much cartilage forms, creating a bump or “spur” which can cause irritation of the nerve roots as they exit the spinal column. Seldom is surgery necessary, this condition will typically respond to rest and bracing immediately following the fracture, and proper flexibility and stabilization techniques once healed. To learn how to properly recover from this condition, click here.

Spondylosis

The joints that connect the vertebrae of the spine are normally covered by a substance called cartilage. This substance acts as a cushion and additionally produces a lubricant called synovial fluid to ensure smooth movement and function. When this cartilage wears away, the joints become inflamed (irritated) and this can cause considerable pain when the joints are loaded with pressure as with standing, sitting, etc. Furthermore, bone spurring can occur as the body tries to “heal” the affected joints, thereby irritating the joint and surrounding tissues. Additionally, as we age the discs begin to deteriorate, thus affecting the stability of the spine, and resulting in excess joint movement. There is currently no 100% effective means to reverse this condition, however, there are several crucial things you can do to minimize and control this condition. To learn how, follow this link.

Sprain

This refers to injury of the ligaments that surround and support the joints of the spine. There are large ligaments spanning the length of the spine on the front and back sides of the vertebrae (anterior and posterior longitudinal ligaments), as well as ligaments stabilizing each facet joint on each vertebrae. These ligaments serve to help stabilize and control the spine so as to prevent excessive and potentially harmful movement. When a ligament is stretched or torn, it can result in acute pain at the site of trauma, but the potential for more severe pain and dysfunction due to instability is the main cause for concern. Ligaments are inelastic, meaning they will not return to their original length if overstretched. At this point, it is essential to have sufficient stability through proper muscular strength and control of specific areas in order to compensate for the lack of ligamentous stability. Learn how to achieve this by clicking here.

Strain

This diagnosis refers to overstretching or tearing of muscle and tendon tissue of the lower back musculature. It is a more commonly assigned diagnosis than lower back “Sprain”, and usually is used to encompass injury to both muscular related tissues and ligaments, as they commonly occur simultaneously. The muscles of your body have plentiful nerve endings and are therefore the primary cause of pain when this occurs. Additionally, if the muscles do not regain their proper strength and control, instability is certain to follow. This type of condition is very common, although the potential for concern that it is something far more serious is high, due to the painful nature of this injury. Fortunately, with proper management and care, this will typically resolve completely. Learn how to effectively aid in your body’s natural healing by clicking here.