Have You Got Your Own Back?

Back pain has become one of the most common factors responsible for pain and discomfort in adults. Depending upon the age, gender, occupation, and activity levels, the cause of back pain differs in every individual. Understanding your back and recognising the first signs of pain will enable you to seek help sooner. Here's a general guide to get you started:

What makes up the spine?

Let's begin by understanding what makes up our spine or vertebral column.

  • It is built with 33 blocks called vertebrae, extending from the base of the skull to the end of the tailbone.
  • A tiny gel-like mattress called the vertebral disc is present between adjacent vertebrae.
  • The vertebral disc acts as a shock absorber and takes up any excessive forces that might occur on the spine.
  • These discs also ensure that adequate space is maintained between adjacent vertebrae so as to protect the delicate nerves that pass through these spaces.
  • The spine houses one of the most important neurological structures of the body- the bundle of nerves which make up the spinal cord. It is situated in a canal formed by openings in each vertebra lined up together, called the spinal canal.
  • A strong network of muscles and ligaments support the spine and allow different movements at each level of the spine.
  • This box is called the 'core' and the major muscles included are the pelvic floor muscles, transversus abdominis, multifidus, internal and external obliques, rectus abdominis, erector spinae, especially the longissimus thoracis, and the diaphragm. The muscles attached to the spine form a strong box-like structure which hoists the spine.
  • The interaction of the vertebrae, muscles and other soft tissue structures allow us to perform various movements such as forward and backward bending, side bending, and rotations.

What causes the sudden catch in my back?

Weakness of any of the core muscles can give rise to a generalized, dull, aching pain along the neck, mid, or low back. A weak core may put you at risk for acute spasm, that is a 'catch' or 'chamak' on performing any sudden movement such as lifting a heavy weight off the ground, turning too quickly, getting out of the bed too fast, any sudden jerks of the spine, etc. These might give rise to a phenomenon known as 'paraspinal muscle spasm' which is basically sudden tightening and swelling of the muscles surrounding the spine, in response to an acute injury or pain.

Is the tingling in my arm or leg because of my spine?

With age, the vertebral discs lose their elasticity and tend to become 'dry' or, as a doctor might say, 'degenerated'. This leads to a reduced space between adjacent vertebrae, giving rise to back pain, painful movements of the spine, or compression of the nerves that pass between two adjacent vertebrae. At the level of each vertebra, a pair of nerves called spinal nerves exit from small spaces between vertebrae. Often, these sites become smaller with age and degenerative changes, causing compression on these spinal nerves. This leads to neurological symptoms such as tingling, burning, pain or loss of muscle strength along the course of the respective nerve. The doctor might diagnose this as spondylosis or radiculopathy. But don't let these scary names discourage you. An appropriate exercise program will not only help you overcome these symptoms, its consistent practice will reduce the risk of recurrence of these conditions.

Further, the narrowing of the spinal canal due to an overgrowth of known or unknown origin may be diagnosed as a 'canal stenosis' and is most common at the level of the low back. Simply put, this narrowing causes compression on the spinal cord and the nerve bundles present in this canal, giving rise to neurological symptoms of varied severity while performing movements of the spine. The most common symptoms are pain or tingling in the legs after walking short distances, standing up erect, or even lying flat on your back.

Who will be able to help with my condition?

These common conditions of the spine usually appear with a gradual onset and may get worse with time. Therefore, the best option is to consult a physiotherapist or an orthopedic doctor to avoid worsening of the pain or other symptoms. They will be able to examine, diagnose and/or treat your condition better if it is presented early. 

An orthopedic doctor may refer you to a physiotherapist if your condition can be easily managed through proper rehabilitation and exercise. 

On the other hand, your physiotherapist may advise you to consult an orthopedic doctor if your condition does not get better with exercise or if it can be better managed medically or surgically.