A large majority of the population has experienced back pain or problems at some point, according to the National Institute of Health. A long list of factors such as being overweight, poor physical health and getting little to no exercise can all contribute to back problems. Because everyone has one, understanding the anatomy and physiology of the back can go a long way in knowing how to protect it from injury and disease.
Structure
Thirty-three ringlike bones called vertebrae make up the spine, which is divided into five sections: the cervical spine with seven vertebrae, the thoracic spine with 12 vertebrae, the lumbar spine with five vertebrae, the sacrum with five fused vertebrae and the coccyx with four fused vertebrae. Individual vertebrae in the cervical, thoracic and lumbar spine are joined by slightly movable joints called facet joints. Although individual vertebrae do not have a wide range of movement, the spine as a whole is extremely flexible. A complex web of ligaments and muscles surround and support the spine.
Identification
An occasional ache or pain in the back is typical. Most people know the cause and can treat it with a non-steroidal anti-inflammatory drug such as aspirin. If symptoms includes stiffness, and the pain comes on suddenly, it may be due to a strain of the muscles or ligaments in the back. If the pain begins gradually, the pain may be due to a problem affecting the joints between the vertebrae. If bed rest relieves the pain and stiffness, the cause may be a back strain. If there is a long period of morning stiffness and pain, or bed rest aggravates the symptoms, inflammation of the spine and pelvic joints or osteoarthritis may be the cause.
Physical Examination
When seeing a physician for back pain, she will listen to the symptoms, take a medical history and determine what parts of the body to inspect. An examination for back pain may include testing joint movement and stability and observing for stiffness, range of motion and gait. The doctor will examine the shape and contour of the spine and attached muscles. She will feel for the presence of muscle spasms and muscle tone. She will note skin color and presence of tenderness or swelling around the affected area.
Tests
Imaging techniques can identify signs of structural damage and disease in the spine by detecting signs of pressure on the spinal cord or spinal nerve roots, and other spinal disorders. A plain X-ray is usually the first diagnostic test ordered. A magnetic resonance image, or MRI, produces a cross-sectional image of the spine and its supporting structures. A computed tomography, or CT, scan can identify disc prolapse, tumors of the spinal cord and stenosis or narrowing of the spinal canal. Myelography uses a contrast agent to produce an image of the spinal cord, the spinal canal and the nerve roots extending away from the spinal cord.
Making a Diagnosis
By combining the physical examination, medical history and test results, doctors are often able to make a definitive diagnosis. Rest, physical therapy, medication or surgery can often successfully treat musculoskeletal disorders. By taking measures to help reduce the symptoms and eliminate further injury to the surrounding tissue, pain, muscle strength and mobility often improves.
