Where Does Your Back Pain Come From?
Where does your back pain come from is a frequent comment I get from my patients along with ‘I have no idea how I got this neck pain,’ or ‘I really don’t know where this back pain comes from.’
To answer these comments, it’s necessary to have a basic understanding of the spinal anatomy. Now this will be in layman’s terms, so should be easy to understand. Once you see how everything works, you will gain some understanding of how problems and pain arise.
The Anatomy of the Spine
In the back of the spine, as you would see the spine here, one of things is that you can see the cervical spine typically comprises of seven cervical bones right here, that have a curve in it and that part of the anatomy what we’re looking at mainly is the facet joint and this is what will cause the movement of the neck.
Most of the rotation in the neck comes from the atlas bone and then next thing when you bend your head forward and backward it comes from the axis bone that’s C2.
So first we have C1, C2 right here, and then we have the rest of the individual vertibrae and the joints as you can see a little bit on the side here how the plane of the facet sits. That facet is comprised of a capsule, a richly embedded capsule of joints moving around.
Whenever swelling occurs it puts pressure and generates pain that can send signals down the nerve pattern that’s coming out from the neck.
For example if I would share with you C6, and the nerve that comes out of here, that nerve pattern tends to run down the arm and into the thumb side and if you were to do an injection into the area, you would feel some of the change worsening or improving in that area, especially if there is swelling to that area.
But you’d identify the pattern of that.
The discs can be likened to shock absorbers and this is what gives you your height and what happens throughout the day, you may notice this perfect example that when you get up in the morning and you get into your car you have to adjust your mirrors from the night before.
Well we can lose up to an inch, even up to 2 inches for some people, but I’d say an inch inch and a half is more common of height a day.
That’s why you always have to adjust your mirror in the morning because your discs are more hydrated especially when you wake up in the morning, because when did your body heal? It was at night.
That’s why I encourage patients to have water before bed because the body needs water and that helps hydrate the disc.
Well the discs here are made up of hydrogenous type fluid, hyleronic acid, especially in the center, this is a jelly like donut right here in the center of the disc.
Then we have the rings, almost like the rings of an onion, and this is comprised of a lot of water essentially.
And we get back to looking at if what happens with these discs rupture the jelly form tends to come out and it ends up putting pressure in the center of the ring of the disc will put pressure onto the nerve and will reproduce that pain such as I said earlier about C6 feeling that.
You can have a herniation of the disc where some of the rings are just bulging out because one the disc becomes more compressed in there.
Like a tooth cavity
We see this often and this tends to happen when people come in to us with this type of situation I’m looking at worse case scenario that’s been going on a long time, and I compare this for patients as it’s a cavity on a tooth. A dentist does not have the drill and fill every single cavity that’s in your body in your teeth. They can still look at and watch the progression of it. It’s when that cavity starts to eat through the enamel and starts touching the nerve roots that’s when you’re really feeling the pain. The sensitivity as it gets worse.
So it’s the same thing and similar thing with your spine that when the disc starts wearing away, or the joints have been under constant stress they’re going to be pinching that nerve, and the disc will become more compressed and more permanent as it gets worse in there.
But the first thing is chiropractors, what we tend to look at when you present to us, we’re looking at your posture. And the posture of your head can cause a lot of pain so first of all your chest muscles tend to be stronger than your upper back muscles so strengthening and getting more of your core which is from your head down to your pelvic area, it is important and for your upper back and as well as preventing the shoulder forward position.
This is just one other area for where does your back pain come from.
Ten pounds per inch
So if you look at from the side if a patient’s shoulders roll forward and the head is in the forward position, we call it forward head carriage, forward head posture, forward head translation.
Just the head is in the forward position. So for every inch that the head moves forward, that shift is 10 additional pounds of pressure that goes onto the neck, or the neck muscles tend to feel.
The back of the neck tends to be pulling really tight, the front end of the neck muscles start to contract in there.
When you feel that, so for example, an average head weighs 10 to 12 lbs. Or something less for some people… and let’s just say for example your head is 5 inches forward position. That’s an additional 50lbs of pressure that’s occurring onto the neck muscles in the back here, the front neck muscles as well, the pressure onto the disc, pinching of the nerves so you can see that when we’re evaluating that we’re always going to talk to you as a chiropractor about your posture and how you can improve that.
Activity helps that getting the spinal bones back into alignment. So DCs, doctors of chiropractic are fully able to and are trained to assist you in helping one educate you to sometimes do joint mobility, mobilization of their exercises, their therapies, adjusting the spine and improving your posture.
So you can see the question where does your back pain come from has many variables and is not easy to answer without first examining the patient.