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The Anatomy of Back Pain

The Anatomy of Back Pain

The Anatomy of Back Pain

Anatomy Overview

How much your back pain affects your daily life is determined, in part, by how much you understand your specific problem. The following section will help you understand more about back problems so that you can make better treatment decisions.

The Spine

The most common site of problems in the low back is the L5-S1 segment because this level bears more weight than any other segment. The center of gravity passes through this segment and the angle between the lumbar and sacrum at this level is greater than those between other vertebrae. Therefore this joint has a higher chance of having stress applied to it. There is also a greater level of movement at this joint compared to others

The low back consists of the last five lumbar vertebrae of the spine. The vertebrae provide support and protection for the spinal cord. The vertebrae has a large round piece of bone in the front, called the vertebral body, which is attached to a bony ring. ,These rings are stacked on top of each other to form a tube of protection around the spinal cord and nerves. Discs separate the bodies of the vertebrae. A series of facet joints, much like links in a chain, connects the bony rings of the vertebrae and allow for movement in the spine. The nerves come out through the facet joints.


Problems arise when the shock absorbing ability of the disc is compromised by repeated stress, which causes the outer edges to weaken, deteriorate and possibly bulge. The disc consists of a nucleus pulposus, the soft shock absorbing section, and an annular ligament that connects the vertebral bodies. The bulging can compromise the space in the ring area or facet joints and cause irritation or pinching of the nerves. Bending over can cause compression of the disc, which can cause it to bulge backwards. If a weight is added to this by lifting something heavy or improperly, then the outer ring of the disc will tear.

A tear in the annular ligament results in the nucleus pulposus to squeeze into the spinal canal. This is known as a herniated disc and is quite painful. The nerve root is compressed by the disc resulting in pain numbness and weakness in the areas supplied by the nerve. The nerve itself can become inflamed from the pressure and irritation.

When the disc between the vertebral bodies has been compromised, a condition known as segmental instability occurs. This condition describes the shift of one vertebrae on another. This excess motion causes muscle spasms to occur. The muscles tighten up to stop the painful spinal segment from further shifting.

If degeneration of the spine continues, bone spurs can cause spinal stenosis. Bone grows in relationship to stress. The stress of the shifted segmental instability leads to the narrowing of the spinal canal from bone growth. Spinal stenosis describes the narrowing of the canal. This can happen from bone spurs growing from the facet joints and the disc bulging into the spinal canal.
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