You have already grudgingly accepted that you are not invulnerable, but this new back pain is driving you crazy! It just hurts when you try to do the things you are used to doing. How could your back betray you like this?!?!
Before we talk about treating back pain, let's look at the bait wonsic set-up of the human spine, and a few of the things that can go wrong.
The spine is composed of around 26 bones. We say "around" as some people have bones that have naturally fused together or that haven't fused when they should have.
The first 24 bones are the vertebrae (singular - vertebra). These are irregular bones, whose job it is to help us stand erect, and to protect the spinal cord and the nerves below the spinal cord.
The topmost seven vertebrae are the cervical, or neck, vertebrae. They are named C1 through C7. C1 and C2 are also called Atlas and Axis, respectively. Interestingly, a giraffe also has a mere seven cervical vertebrae, just much bigger than ours!
The next twelve vertebrae are the thoracic vertebrae. Each of the thoracic vertebrae have two ribs associated with it. Like the cervical spine, the thoracic vertebrae are named T1 to T12.
The final five vertebrae are the lumbar vertebrae, or low back. They are named L1 to L5.
Below the lumbar spine are the sacrum and coccyx, which are both composed of fused vertebrae. For some people, the first vertebrae of the sacrum does not fuse, and the person has a sixth lumbar vertebra. For others, the last lumbar vertebra fuses with the sacrum, giving them only four lumbar vertebrae.
The spinal cord runs inside of the spinal canal formed by the vertebrae. The cord itself extends to around the L1 level. Below that, it breaks up into individual nerve groups and is called the cauda equina (horse’s tail).
Some of the same types of back injuries occur in other joints occur in the spine. If muscles are damaged or overused, we can have a spinal strain. If ligaments are damaged, it is a sprained back. Vertebrae can be broken and become misaligned. Nerves can become pinched or swollen as the exit the spine. Spinal disks, the cartilaginous pad between vertebrae, can be damaged.
Treatment for these injuries is as varied as the injuries themselves. While most of these injuries can be treated conservatively (without surgery or other invasive procedures), even a minor back injury can be debilitating.
Let’s look at some potential treatment modalities for some of these injuries.
- Sprains and Strains. These injuries can normally be treated and resolved using conservative therapy. This may include cold, heat, rest and immobilization or bracing. These types of injuries can often be avoided by back strengthening exercises and good knowledge of body mechanics.
- Fractured Vertebrae. Fractures can happen from direct trauma to the spine, or even by extreme movement. Having a “broken back” is not necessarily as life changing as many people think. The processes that project off of the vertebrae can be broken, or even the body of the vertebra itself can be broken, without causing neurological damage. Sometimes, if there is no neurological danger and the pain is bearable, no surgery is needed. With rest and bracing, the bones can heal themselves.
- Pinched Nerves. A spinal nerve root can be pinched or compressed as it exits the spine between two vertebrae. Sciatica is an example of a pinched nerve. To treat this condition, you have to either make the nerve smaller or the hole it goes through bigger. These can often be successfully treated with anti-inflammatories and rest. If that isn’t successful, sometimes steroid injections around the nerve can shrink the nerve sufficiently. If all conservative treatment measures fail, surgery to open up the bony passage may be indicated.
Yes, it hurts right now, but it won’t always hurt like this. If your orthopod recommends back braces or supports, contact us. We will help you get back in action soon. It’s what we here at Mueller’s have been doing since 1960.