Your spinal column is a complex structure with many moving parts. The lower back is especially vulnerable to injury or degeneration because it must support the majority of the pressure.
The purpose of the spinal column is to protect the spinal cord from injury and support the head, neck, and torso. Lower back pain causes can come from any of the bones, discs, muscles, joints, or nerves that make up the spine. Identifying where your pain is coming from is the first step in developing a lower back pain treatment plan with your doctor.
The spinal column is made up of 33 stacked vertebrae bones, divided into five sections. Starting at the top are seven cervical bones (C1-C7), twelve thoracic or upper back vertebrae (T1-T12), five lumbar or lower back vertebrae (L1-L5), five fused bones of the sacrum, and four fused bones of the coccyx, or tailbone. There are some common conditions that result from problems with the bones of the spine:
- Compression fractures are usually the result of weakened bone structure due to osteoporosis or cancer and can lead to chronic pain or spinal deformity.
- Isthmic spondylolisthesis occurs when excessive stress fractures a lumbar bone, causing it to slip forward onto the vertebral bone below it.
Intervertebral disks separate each vertebra. These flat, spongy, flexible pads of cartilage work as shock absorbers between the vertebrae bones. These discs allow your spine to move and prevent the bones from touching each other. The nucleus pulposus is the inner gel-like portion of the disk, and the annulus fibrosus is the elastic outer portion that holds the disk together. Problems that develop with the discs can cause chronic lower back pain include:
- Lumbar degenerative disc disease occurs as the spongy discs wear down over time. Pain is often tolerable, but can be worse when sitting since the lower back has a heavier load to bear.
- Lumbar disc herniation occurs when the inner gel bursts through the outer portion of the disc due to sudden injury or long-term degeneration.
Muscles and Joints
Ligaments and tendons are bands of tissue that attach the spinal column to the muscles of the back. These muscles keep your spine in place, provide stability, and support the torso. Each vertebra also has a pair of bone protrusions, called facet joints, which maintain alignment while bending and twisting. There are nagging injuries and pain that can result from problems with your back muscles and joints:
- Strained or pulled muscles are the most common cause of lower back problems. Heavy lifting, bending, or repetitive motion can cause the muscles to become sore.
- Sacroiliac joint dysfunction is caused by too much movement due to loose ligaments, often caused by pregnancy, or too little movement due to degenerative diseases, such as osteoarthritis.
The central canal of the spinal cord extends from the base of the skull to the lower back. Small nerve roots extend from the spinal cord along the back through small openings between each vertebra. The spinal cord ends at the start of the lumbar section where a bundle of nerve roots called the cauda equine branch out to connect the buttocks, legs, and feet. Because your nervous system is so extensive, nerve problems can lead to some chronic, debilitating conditions:
- Lumbar spinal stenosis causes pain when the nerves exiting the spine become constricted. This is mostly due to osteoarthritis or bone spurs causing the holes along the spine to constrict.
- Lumbar radiculopathy or sciatica is used to describe any pain, numbness, or weakness along the sciatic nerve from the lower back to the foot caused by irritation to the lumbar nerve root.
If you are experiencing chronic lower back pain and would like to know more about your options for lower back pain treatment, contact Arkansas Surgical Hospital at 877-918-7020 for an appointment. Our renowned orthopedic surgeons will evaluate your condition and recommend the most effective treatment.