The document provides an overview of back anatomy, common causes and symptoms of back pain, and treatment options. It details the structures involved in back health, potential sources of pain, and recommendations for home treatment and exercise to maintain a healthy back. It emphasizes the importance of avoiding prolonged inactivity and offers guidelines for proper posture and lifestyle choices.

1. ANATOMY, YOUR ACHING BACK, AND KEEPING THE BACK HEALTHY All About the Back

2. Your healthy back: anatomy

3. A healthy spine A Healthy Back is affected by: Muscles Ligaments Vertebrae Discs Joints Nerves Spinal cord From: Chiropractic Resource Organization

4. Back: X-ray view Here is an x-ray view of the spine. Notice the cervical (neck), thoracic (mid-back) and lumbar (lower back) vertebra. See how vertebra change as you look down the spine. This reflects the different functions of the neck, mid back and lower back.

5. Your pain, where it is and why it is Cervical spine (neck): Neck pain often caused by muscle, ligament or tendon strain. Will usually heal with time and treatment (ice, heat, medication, chiropractor. Thoracic Spine (upper back): Rarely source of pain. Can have pain with shoulder or upper back muscular strain. Lumbar spine (lower back): More motion than thoracic. Also, carries all the weight. Most injured area. We will look at this in depth. Sacral region (bottom of spine): pain mostly caused by sacroiliac joint, and more common in women.

6. Symptoms of back pain Back pain symptoms include: Aching or stiffness anywhere along spine from neck to hips Sharp localized pain in neck, upper back, or lower back Chronic ache in middle or low back Back pain that radiates from low back to buttocks, thigh, calf and toes Inability to stand straight without having pain From: Chiropractic Resource Organization

7. When to call the doctor Call your doctor if: You feel numbness, tingling or loss of control in arms or legs (may indicate damage to spinal cord) The back pain extends down the leg (may indicate sciatica) Pain increases when you cough or bend forward (may be herniated disc) Urine or fecal incontinence Dull pain in one area of spine when lying or getting out of bed (could be osteoporosis)

8. Sources of back pain Although the source is not always known, here are some possibilities: Disc degeneration Kidney problems Muscle spasm Alignment of vertebrae Ruptured disc Osteoporosis Spinal stenosis (narrowing of spinal canal) Severe curvatures (scoliosis or kyphosis) Strain to muscles or ligaments of back

9. The discs of the back There are 26 bones in the spine. The vertebral column protects the spinal cord. Between each vertebrae is an intervertebral disc. The discs are filled a gelatinous liquid, called nucleus pulposus . The liquid nucleus pulposus provides cushioning to the spinal column. The annulus fibrosus surrounds the nucleus pulposus to keep it intact during periods of stress to the spinal column. The intervertebral discs allows the vertebral column to be flexible and act as shock absorbers during activity.

10. What is disc degeneration? Disc degeneration refers to changes in the spinal discs. The changes can results from osteoarthritis (breakdown of cartilage the protects the joint), herniated disc (a bulge or breaking open of a spinal disc) or spinal stenosis (narrowing of spinal column) View diagrams of each condition on next screen…

11. Osteoarthritis of spine Herniated disc Spinal Stenosis

12. Home treatment for back pain Bed rest is NOT recommended. Reduce regular physical activities for a few days to calm back and reduce inflammation Apply ice for the first 48 to 72 hours, then heat and/or ice after that. An over the counter pain reliever (ibuprofen) will relax the muscles and decrease inflammation When sleeping, a side position (fetal) with a pillow between the knees might help. If you sleep on your back, then put a rolled towel under knees. Avoid heavy lifting or twisting of back Return to activity with light cardiovascular activity See a physical therapist for stretching and strengthening AFTER the pain subsides.

13. Avoid these exercises until approved by doctor. Jogging Golf Ballet Weight lifting Leg lifts when lying on stomach Sit ups with straight legs

14. Additional treatments Possible treatments may include: Injection of steroids or anesthetics Radiofrequency ablation (electrical stimulation to specific nerves) Antidepressants and/or anticonvulsants Chiropractors (use with caution) Acupuncture Psychotherapy (stress management & relaxation) Biofeedback Alexander Technique, Pilates, Feldendkrais Method, aquatic therapy and yoga have all been used with some success

15. Interventions: Video Spinal Fusion Low back surgery Acupuncture Uncommon pain relievers Distraction therapy Artificial discs Extreme exercise for back pain WebMD has a series of instructional videos. Here are a sampling of videos which help explain interventions for back pain. Click on the links.

16. Maintain a healthy back: Exercise Regular exercise is crucial in maintaining a healthy back. In addition to your regular exercise program, the following websites offer some specific ideas: FDA Lower-Back exercises WebMD (video) WebMD (text)

17. Other ways to maintain a healthy back Maintain a healthy weight Lift properly Maintain good posture Buy a good mattress Reduce stress Warm up before exercise Support lower back when sitting Posture illustration from APT

18. Additional things for a healthy back Avoid standing for long periods of time NO high heels If you sit for a long period of time, the chair should have an adjustable seat, back, armrests & swivel seat Use a stool under your feet so the knees are higher than your hips Place a small pillow or rolled towel behind your lower back Get up and walk around at least once an hour Quit smoking Relax…Try yoga, tai chi or massage

19. Final note Don’t let a bad back ruin a good life. Do something now!