The spine is made up of small bones, called vertebrae, which are stacked on top of one another to create the natural curves of the back. These bones connect to create a canal that protects the spinal cord. The spinal cord extends from the skull to the lower back and travels through the middle of the stacked vertebrae. Nerves branch out from the spinal cord through openings in the vertebrae and carry messages between the brain and muscles.
Discs sit in between the vertebrae and work as shock absorbers for the spine. Discs have a jelly-like center (nucleus) and an outer ring (annulus). Between the back of the vertebrae are small facet joints that help the spine move. They have a cartilage surface, like a hip or knee joint.
Arthritis is the degeneration of any joint in the body. The lower back is the most common site of arthritis back pain, because it bears more of the body's weight. In the spine, arthritis can result from disc degeneration and loss of water content. When that happens, the protective joint cartilage wears away and the facet joints begin to degenerate and develop arthritis. Symptoms include back pain, numbness, tingling, and weakness that may radiate to the buttocks or legs.
Aging causes degenerative changes in the spine. Intervertebral discs begin to wear away and shrink. In some cases, they may collapse completely and cause the facet joints in the vertebrae to rub against one another, resulting in back and neck pain and stiffness.
Lower back pain can be mild to severe, gradual or sudden, and intermittent or constant. Low back pain can make everyday activities difficult. Sometimes, a specific movement such as lifting or bending can cause low back pain. The aging process plays a role in many back conditions. Symptoms of low back pain include muscle soreness, stiffness, and pain that extends from the back into the buttock or outer hip area.
Myofascial pain syndrome (MPS) refers to pain and inflammation in the body’s fascia, which is connective tissue that covers the muscles. Myofascial pain symptoms involve muscle pain with specific trigger or tender points that worsen with activity or stress. Causative factors responsible for MPS include injury or excessive muscle strain, inactivity, obesity, nutritional deficiencies, hormonal changes, and tobacco use. People with MPS sometimes suffer with depression, fatigue, sleep disorders, headaches, and behavioral disturbances.
Spinal nerves exit and pass into arms and legs from each intervertebral disc. The spinal cord and the spinal nerves send messages to the brain and then to the arms and legs to control sensation and movement. The fibers of one spinal nerve root affect a specific area of the body, so a nerve that is compressed or pinched causes symptoms in a specific region of the body. Symptoms include pain and stiffness in the neck, upper back, or lower back, and burning pain, numbness, or weakness that spreads down the legs, arms, or buttocks.
As intervertebral discs degenerate and cartilage wears away, weight is transferred to the facet joints. To support the vertebrae, the body may grow new bone, which can narrow the space around the spinal cord and put pressure on the spinal nerve roots. Pressure on the nerves can cause spinal stenosis. Symptoms depend on the location of the stenosis: cervical spine (neck) or lumbar spine (lower back). Numbness, weakness, pain, and balance and mobility difficulties are common symptoms of both locations.
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