This report covers the real causes of back pain.

Basic Anatomy of the Vertebral Column

Functions

The vertebral column, or spine, is a complex system of bones, intervertebral discs, ligaments, muscles and nerves, designed to fulfil many seemingly incompatible functions. It must offer support to the body (to hold us upright) whilst allowing a large range of movement in many directions. The spine also functions to protect the delicate spinal cord that carries nerves to every part of our bodies, as well as acting as a shock absorber to decrease the forces transmitted to the brain when walking, running, jumping etc.

Vertebrae

The bones of the spine – the vertebrae – are stacked one upon another, separated by discs, in such a way that three normal curves are maintained – slight inward curves at the neck (cervical) and lower back (lumbar) areas, and an outward curve in the chest (thoracic) area. These curves and discs are mainly responsible for shock absorption. Each vertebra is attached to the next by a complex of three joints.

Ligaments

A number of ligaments bind these bones and discs together. They surround the joints of the spine, some being short and travelling the distance of only one or two vertebrae, others being longer, travelling over several vertebrae to the entire length of the spine. These ligaments are partially responsible for the support function of the spine, preventing the vertebrae from slipping “out of place”.

Muscles

Muscles surround and are attached to the vertebrae to provide movement, or add to stability. In general, muscles perform one of these two functions. Some produce movement of joints – these muscles are typically long and thin, can act quickly, producing high tension over short periods of time. Other muscles are designed specifically to provide stability across joints – they are generally shorter and thicker, supplying low tension for extended periods of time. They produce small movements constantly, and “fine-tune” the position of the joints – these are our postural muscles.

Stability

Stability of each spinal segment – each vertebra and its joints – is essential for pain-free movement. Any movement of any part of the spine puts a strain on the spine and its surrounding structures. Any movement of other body parts also impacts upon the spine, causing stress to the structures of the spine.

All Things Are Connected

The legs are attached to the spine via the pelvis, with leg movements causing movement of the pelvis and therefore of the spine ( “the knee bone’s connected to the thighbone” – yep, it’s true – all the bones in the body are ultimately connected … to the spine!) Similarly, the arms are connected to the torso via the clavicle (collarbone) and scapula (shoulder blade). Therefore movement of the arms ultimately puts stress on the spine. This is why stability of the spine is so important – every movement you make is putting stress on your spine, and if the spine is not being held stable, the spinal joints will have more movement imposed upon them, putting more stress on the joints and surrounding structures.

Now we’re getting to the really interesting parts.

Three Elements for Stability of the Spine

This necessary stability or support of the spine is provided at three levels, or sub-systems.

1. Passive.

The passive sub-system provides stability via the bones, joints and ligaments. The design of the passive system of the spine allows approximately 2 to 3 kilograms of pressure to be managed. (When you consider that the average person’s head weighs 5kg, it shows how important the second and third subsystems are in just holding yourself upright).

2. Active.

The active sub-system refers to the support and stability given by postural muscles in the area, specifically designed for this task.

3. Neural Control.

The brain controls the muscles of the active sub-system through the neural control sub-system in response to feedback from structures surrounding the spine. This enables the provision of stability when it is needed.

These three sub-systems work together to provide optimum stability of the spine when it is needed. Any upset to any sub-system will lead to decreased stability, resulting in increased stress being placed on the spine.

But what we have discovered is that the third element – Neural Control – is the missing link from almost all treatments currently available. Most treatments concentrate on re-aligning the vertebra, strengthening muscles, restoring function to ligaments, etc.

Very few make any attempt to ensure the nerve paths to injured muscles are functioning. And even if they were aware of this critical factor, most practitioners have absolutely no idea how to get these nerve paths functioning again.

Posture

A vital element for the correct and optimum functioning of these subsystems is correct posture. Ideal posture should maintain the three natural curves of the spine in any body position – sitting, standing and lying down. Any decrease or increase of these curves will stress the whole spinal system. (That’s probably why lying on your back for any length of time causes stiffness – the natural curves have been flattened and distorted, so when we finally get up, we feel like stretching and moving in funny ways just to get rid of this stiffness.)

When our posture is incorrect for any length of time, the ligaments surrounding the joints will either be over-stretched or lax, joints will be forced into poor positions, the muscles surrounding the area (whether movement muscles or postural muscles) will be working from a position that is not optimum for force generation, and will therefore tire more easily. And the neural control system will also not work as effectively. All this adds up to an increase in stress and strain on the spine.

The Better Back Technique exercises produce a very welcome side-effect: your posture will automatically improve out of sight.

Now to answer today’s question: What Causes Back Pain?

Back strains or injuries are initially caused by an external stress or load that is greater than the spine’s structural capacity. Most injuries occur during a sudden unprotected or awkward movement. Back pain initially can be caused by injury to, or incorrect functioning of any of the components of the spine – bone, joints, ligaments, and muscle – or any change in alignment of the whole vertebral column. On the other hand, back pain after injuries have settled is more likely to be a result of the dysfunction (poor performance) of one or more of the three components I spoke about earlier – 1. Passive: bones, joints & ligaments; 2. Active: movement & postural muscles; and 3. Neural control: nerve paths to the muscles.

There are a group of exercises which directly address all three elements, and these will be discussed in an upcoming article.