The human spine is a marvel of engineering. It’s complex and flexible and supports our weight and a wide variety of extreme physical activities. Unfortunately, it can also be fragile. When you are struggling with back pain, it can be difficult to know which structure in your back is causing the problem. Here is your primer on how your spine is built:
The vertebrae are the bones that make up the spine. You can think of them as the framing used in construction. They are the support structure that all the rest is built around. As you read this section you may recognize terms your providers have used when discussing your back pain.
Each vertebra has two facet joints, one facing upward and the other downward. These link the vertebrae together and act as a hinge. Doctors identify the vertebrae by labeling them according to where they are in the spine. You may already be familiar with the three main parts of the spine: the lumbar, thoracic and cervical. The lumbar is the lower back. It curves inward towards the center of the body. The thoracic is the mid and upper back. It curves outward, counterbalancing the inward curve of the lower back. The cervical spine connects the base of the skull with the shoulders and curves inward.
In addition to these three main areas, there are the coccygeal and sacral vertebrae. These make up the base of your spine, beginning with the tailbone. This area is fused and only moves as a single unit. The lumbar, thoracic, and cervical areas can move independently of each other.
As a patient, it can be helpful to understand the vertebrae so you know what your provider is talking about when they say you have a problem with the facet joint on your L2 vertebrae (this would be the second vertebrae from the bottom in your Lumbar spine.) You may be told that there is something wrong with the curvature of your spine. As mentioned above, each area has a particular curve. This is one of the most important aspects of the spine from an engineering standpoint. The curves distribute your weight evenly, help your spine absorb shock, and aid with flexibility. When one of the curvatures of your spine is off, it can cause problems throughout the spine as other curves change to compensate. This leads to back pain, stiffness, and more strain on other structures of the spinal column.
The curves in your spine help to protect it from shock, but since the spinal column must cope with huge amounts of shock, it needs additional structures to protect it. Enter the spinal disc. This structure is essentially a gel-filled cushion with a tough outer skin. Each vertebra has a disc between it and its neighbors. In a healthy spine, the discs create space between the vertebrae, act as shock absorbers, and contribute to the spine’s flexibility.
As we age, spinal discs become more compressed and less able to do their jobs. This is why many older adults experience more stiffness than younger people. Some individuals experience pain as a result of disc compression. Scientists aren’t sure why only some people feel pain, even though nearly everyone ends up with some disc compression. Certain repetitive stressors and traumatic injuries that throw off the vertebral alignment can cause one or more discs to compress, even in young people. These types of compressions are more likely to cause pain than age-related compression.
In addition to compression, spinal discs are also at risk for other types of injury. Remember the gel-filled center we mentioned? If a disc becomes herniated (typically due to trauma), this liquid will leak out through tears in the outer skin. Unfortunately, it is highly inflammatory and irritating to surrounding nerves and tissues. If you have a herniated disc, you may feel a burning sensation that radiates out from the injured area. Its also common to experience numbness, tingling, or weakness in the glutes, legs, or arms, depending on which disc is herniated. Irritated nerves mainly cause these symptoms.
Sometimes a traumatic event like a car accident doesn’t herniate a disc, but it does misalign the vertebrae and cause the disc to bulge out between them. The bulging disc can put pressure on nearby nerves and cause similar symptoms as a herniated disc.
The Spinal Cord
One of the functions of the spine is to protect the spinal cord. The spinal cord is a dense column of nerve tissue that connects the brain with the rest of the body. Nerves branch out through openings in the vertebrae to our limbs and organs. Misalignments in the spine and compressed or damaged discs can impair some branching nerves and cause systemic problems. It’s not uncommon for someone with a spinal subluxation to struggle with balance or digestive issues. Problems with the thoracic (mid-back) spine can even worsen asthma and other breathing problems. It is vital to keep our spines aligned and healthy in order to promote nervous system function.
Like the rest of our body, the spine depends on soft tissues like ligaments, tendons, and muscles to support it. Ligaments and tendons are both tough fibrous tissues with slightly different purposes. Ligaments attach bone to bone, helping to hold them together and stabilize them. Tendons attach muscle to bone and help with movement. Both ligaments and tendons can be torn or ruptured from overuse or trauma. Tendons and ligaments have a poor blood supply and, as a result, are often slow to heal. When the bones they attach to are thrown out of alignment, tendons and ligaments can become strained and more prone to injury.
Muscles help to support and protect all the other structures we’ve discussed. They receive a robust blood supply and usually heal well. Despite this, muscle injuries can be extremely painful and debilitating. As with ligaments and tendons, muscles can be put under strain if the bones they support are out of alignment. Problems with the spinal curve or subluxations can cause muscles to be chronically tense and create trigger points (knots). This puts them at a greater risk for traumatic injury.
Keeping the vertebrae aligned and receiving preventative chiropractic care can prevent painful injuries to soft tissues.
Spine Care in Houston
At Vanguard Spine & Sport, we specialize in keeping our patients’ spines in optimal condition. Our experienced providers are equipped to accurately diagnose which structures are causing your pain and provide effective treatment. We also provide preventative care that prevents chronic pain and systemic problems. Make an appointment today to learn more about what’s causing your pain and how to feel better.