Back Pain

A low back pain patient walks into a physical therapy clinic. It may sound like the start of a riddle however, there is no funny punch line. Ask a physical therapist about low back pain and most will answer that it can be complex and that not all back pain presents the same. With 30 bones that make up the spine and more than 20 muscles that have attachments to it, it is no wonder the back is prone to injury. There are a variety of things that can go wrong. Some of the common culprits muscle strain, disc related injuries, hypo and hyper mobility as well as sacroiliac joint dysfunctions. So how can we prevent these injuries from happening? Before we can answer that question I think it is important to get an understanding of the anatomy so you are better able to understand the source of your pain. [...]

The Spine:
A person’s spine can be divided into 5 different sections:
1. Cervical Spine (Vertabrae C1-C7)- Make up a
persons neck
2. Thoracic Spine (Vertabrae T1-T12)- Connect ribs to
the spine
3. Lumbar Spine (Vertabrae L1-5)- Low back
4. Sacral Spine (Fused Vertabrae S1-S5)- Connects
the hip bones to the spine
5. Coccyx- Tailbone

Disc-
Between each vertebrae sits a jelly doughnut like disc. When people describe having disc problems it is because poor mechanics can cause the fluid in this disc to push towards the back on your spine putting pressure on the spinal cord which causes pain.

Muscles:
There are more than 20 muscles that connect to the spine and help support us while we do all the bending, lifting and twisting required during the day. The problem comes when we repeatedly do these movements without proper mechanics. Pain can also be caused when other muscles have to work overtime making up for weaker muscles.

So now that you have some more information about the anatomy of the back, let’s get back to answering that question. How can we prevent these injuries from happening?

Proper Posture: 
A healthy back starts with good posture. This can be difficult in the world of technology that we live in where we are constantly looking down at screens and slouching in our chairs, putting strain on our backs. This forward head rounded shoulder position can cause some of our postural muscles to become tight and put a stretch on other muscles. When we are sitting in poor seating that causes us to slouch this also puts our lower backs in poor posture again causing some muscle to become tight and others to be put on constant stretch. When we maintain good posture the strain we put on our backs is reduced. How can we help to ensure we have good posture then you ask?

Exercise and stretching:
It is important to take care of our bodies and regular exercise has been shown to help relieve
and reduce lower back pain. Exercises that help to strengthen your core are key to preventing low back pain. These muscles help to stabilize the spine preventing unwanted strain that can cause pain. It is also important to actively stretch tight muscles. When muscles become tight we tend to compensate by moving our bodies in ways that can actually be harmful and lead to pain. Unfortunately it is not enough just to exercise we have to make sure we are doing it correctly.

Proper Mechanics:
For most people the idea of good posture isn’t novel. I am sure most of us have been told at
some point to “Sit up tall” and most people know that regular exercise is good for you. What is harder to understand is that just having good posture and exercising regularly isn’t enough unless you are doing it properly. In fact, repetitive exercises when done without proper mechanics can actually put you at risk for injury. It is important to understand the mechanics of the exercise and ensure you are using the appropriate muscles in the right way and protecting your back from injury in the process.

To sum it all up we need to have good posture, regular exercise and good body mechanics in
order to help stabilize our backs and reduce the risk of injury. This might be a simple answer to a complex question and there are definitely other parts that can play a role but, they are all related and affect one another and if one part is missing the risk of back injury can increase.