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Your Back

Healthy backs are vital to being able to easily perform all of your daily activities. Your back is a complicated network of bones and muscles, and if injured, you may experience pain and even the inability to perform even the simplest of activities.

Anatomy of the Back
Your Back

The cervical spine (neck) has seven vertebral bodies (segments)

Your Wrist and Hand is comprised of:

Most of the rotation in the neck is located in the first and second vertebral segments.

The next five segments have three joints each, including one disc in the front and joints in the back.

The thoracic (upper back) has twelve vertebral bodies. These structures have very little motion because they are

firmly attached to the ribs and sternum. Therefore, this region is not generally the source of pain.

The lumbar (lower back) has five vertebral bodies that extend from the lower thoracic (chest) to the sacrum

(bottom of the spine). The vertebral bodies are stacked on top of each other with a disc in between each one.

Fifty percent of flexion (bending forward) occurs at the hips, and fifty percent occurs at the lower (lumbar) spine.

The vertebral disc has the primary purpose to act as a shock absorber. Discs are composed of two parts: a tough outer core and a soft inner core.

Sometimes a twisting injury damages the disc and starts a cascade of events that leads to degeneration. The disc itself has very few nerve endings and no blood supply. Without a blood supply the disc does not have a way to repair itself, and pain created by the damaged disc can last for years.

The spinal cord comes off the base of the brain, runs throughout the cervical and thoracic spine, and ends at the lower part of the thoracic spine. Therefore, spinal cord damage may accompany trauma or diseases of the cervical or thoracic spine. The spinal cord does not run through the lumbar spine. After the spinal cord stops in the lower thoracic spine, the nerve roots come off the bottom of the cord.

The nerve roots run through the bony canal, and at each level a pair of nerve roots exits from the spine. The nerve consists of one long cell from the back/neck down to the foot/hand, so the nerves tend to heal slowly. They heal from the top down, and depending on how much damage is done at the time the nerve becomes impinged, it may take weeks to months to heal.

Treatment of neural impingement is directed at relieving the pain and then allowing the nerve to heal on its own. Nerves need both inflammation and pressure to be painful, so either relieving the inflammation or the pressure can relieve the pain.

The soft tissues around the spine also play a key role in low back pain. The large paired muscles in the low back help hold up the spine. With inflammation the muscles can spasm and cause low back pain and marked limitation in motion.

An episode of low back pain that lasts for more than two weeks can lead to muscle weakness (since using the muscles hurts, the tendency is to avoid using them). This process leads to disuse atrophy (muscle wasting), and subsequent weakening, which in turn causes more pain because the muscles are less able to help hold up the spine.

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