Glossary

The spinal column, or the vertebrae, consists of 24 separate bones along with the fused bones of the sacrum and coccyx. The vertebral column is a strong, flexible rod that protects the spinal cord, supports the head and provides an attachment for the ribs.

There are four major components of the spine: the vertebrae, joints, discs and nerves.

Vertebrae

The separate bones of the vertebra link together to form a "tunnel" that protects the nerves and spinal cord. The lumbar vertebrae are under constant pressure from the weight of the upper body. The "wear and tear" of this pressure over a period of time can contribute to the development of low back pain.

Joints

Joints, or the spaces between two or more bones, are found throughout the body. Joints allow different degrees of movements that change the position of bones, since bones are too rigid to bend without damage. Joints are located at each vertebrae and provide flexibility and stability within the vertebral column.

Discs

Discs located in between the vertebrae act as "shock absorbers," preventing the vertebrae from rubbing together. Discs function as the "glue" that holds the vertebrae together and they also provide flexibility within the vertebral column. Discs often show the first signs of "wear and tear" associated with the aging process, since they are constantly "squeezed" and "stretched" under the forces of the vertebrae.

Nerves

At each disc level, a pair of spinal nerves exits and passes into the arms and legs. The spinal cord (which runs through the middle of the vertebrae) and the spinal nerves act as a "telephone" to allow messages, or impulses, to travel to the brain and then to the arms and legs to control sensation and movement.

What happens to the structure of the spine as people age?

Intervertebral discs have a fiber-like ring (annulus) and a gelatin-like center (nucleus). As people age, the nucleus of the disc begins to "dry up," reducing the effectiveness of the shock-absorbing quality of the discs. As this protection is lost, daily activities can wear down the vertebrae, causing the development of jagged edges (called bony spurs) on the vertebrae. Bone spurs can cause the center canal that encases the spine and the side canals which protect the nerves to become narrowed.

Causes Of Pain

Your lower back bears most of the weight and stress of your body. Back pain most often occurs from strained back muscles and ligaments, from improper or heavy lifting, or after a sudden awkward movement. Sometimes a muscle spasm can cause back pain. Often, there's an accumulation of stress with one particular event unleashing the pain. In many cases, there may not be an obvious cause.

The following specific conditions can also cause back pain. Because there's a definable cause, the conditions often also have a defined treatment.

Herniated disk

This occurs when disk material presses on a nerve.

Sciatica

This condition often occurs when a herniated disk impinges on the sciatic nerve causing sharp, shooting pain through the buttocks and back of the leg.

Spinal stenosis

This condition occurs when the space around the spinal cord and nerve roots narrows due to arthritis and bone overgrowth. This can press or pinch a nerve.

Spondylosis

Spondylosis is a type of arthritis affecting the spine. It is due to the degenerative changes in the spine that often come with aging.

Spondylolisthesis

This condition occurs when one vertebra in the spinal column slips forward over another.

These rare but far more serious causes of back pain also have specific treatment related to the underlying cause.

Cauda equina syndrome

This is a serious neurological problem causing weakness in the legs, numbness in the "saddle" or groin area, and loss of bowel or bladder control.

Cancer in the spine

A tumor on the spine can press on a nerve causing back pain.

Infection of the spine

If a fever and a tender, warm area accompany back pain, the cause could be an infection.

Injury

Damage to the bones, ligaments, or muscles of the back can cause severe pain. Repeated bouts of back pain or multiple failed surgeries can lead to chronic back pain. Chronic back pain may be related to changes in how nerves respond to frequent pain stimuli. Chronic pain can be difficult to treat.

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