BACK PAIN may be felt in the upper, middle, or lower back.
While upper back pain may radiate up into the neck and the head, or into the shoulders and arms, lower back pain may radiate up into the mid back region and shoulder blades, or down into the legs and even feet.
Lower back pain can be especially troublesome because all the nerves to the legs and pelvic organs exit the spine in the lower back area, namely the lumbar spine and the sacrum, often referred to as the lumbosacral region. (click on any picture for larger image)
Poor posture, lack of movement (sedentary habits) and improper use of the muscles supporting and moving the spine are major drivers of back pain, weakness, and stiffness.
Pregnancy takes a heavy toll on the entire spine, often causing neck and back pain that lingers for months or years.
Back pain may also be caused by trauma, degeneration of the spine, a slipped disc, osteoporosis, osteo- or rheumatoid arthritis, tumors originating in the spine or metastasizing to the spine from other areas, infections of the spine, or spinal stenosis (narrowing). Moreover, back pain may signal trouble with the gall bladder, pancreas, kidneys, or prostate.
Therefore, back pain or discomfort accompanied by numbness, tingling, pain radiating down one or both legs, loss of bladder or bowel control, balance issues, indigestion, throbbing or pulsating pain in the abdomen, fever, or weight loss needs to be discussed with a neurologist or other medical doctor.
Injury to any part of the spine may manifest in pain at the site of the injury as well as anywhere along the spine, even as head pain. Likewise, muscle tension in one area may over time spread to other areas as well. The reason will become clear as we explore the anatomy of the back by looking at the spine first and then the various layers of muscles along the spine, from the head to the sacrum.
All the bones of the body are held together at their respective joints by ligaments and moved by tendons when the muscles contract. Moreover, all the cells, tissues, organ, muscles, bones, and other body structures such as the blood and lymph vessels, nerves, and meridians (energy pathways of the body) are interwoven, enveloped and held together by the fascia, a type of connective tissue ubiquitous in the body.
Think of the fascia as a body stocking that creates space and compartments for all the body structures down to the cellular level. Hence, when this body stocking becomes “snagged” by injury (accidental or surgery), infection, or inflammation, the body becomes clogged, congested, and restricted. More about this later…
The spine is unique in that it is made up of essentially 26 parts, or bones, as follows: 7 neck vertebrae, 12 thoracic (chest) vertebrae, 5 lumbar (lower back) vertebrae, the sacrum, and the tail bone (coccyx). These 26 bones hang together like a necklace with joints between all of the bones. (click on any picture for larger image)
The unique structure of the spine gives it flexibility and resilience, and at the same time makes it extremely vulnerable to injury and degeneration (wear and tear). Furthermore, since the spine articulates with the occiput (back of the head) of the skull, injury anywhere along the spine may be transmitted to the skull, causing numerous seemingly unrelated symptoms, including headaches, mental fogginess, light headedness, and fatigue.
The vertebrae are held together at the joints by ligaments and are moved (acted upon) by very small muscles at the deepest level, and larger muscles at the middle, and superficial layers of the back. These muscles overlap each other to varying degrees and often work together, such as the erector spinae muscles which keep the spinal (vertebral) column upright and help to extend it (bend backwards). (click on any picture for larger image)
31 pairs of spinal nerves exit the vertebral column between the vertebrae at the intervertebral foramina. When various muscles become tense and no longer work together in harmony, they may “park” on one or more of these spinal nerves near the spine, or further away from it.
In response to being compressed or stretched, the sensory nerves send signals to the brain, eliciting a “pain” (heat, cold, tingling, numbness, or pain) response. Compression or stretching of the motor nerves, which exit the vertebral columns together with the sensory nerves, may result in twitching or weakness of the muscles.
As mentioned before, all the muscles are interwoven and enveloped by fascia (epi-, peri-, endomysium; a type of connective tissue), as are the nerves (epi-, peri-, endoneurium), the blood vessels, and the meridians (energy pathways of the body).
The fascia allows muscles which overlap each other to glide over each other to a certain degree. With trauma, infection, inflammation, and longterm muscle tension, the fascia becomes more sticky and rigid, reducing the amount of glide possible between the muscles. (click on any picture for larger image)
We experience this as tightness, discomfort, and decreased ability to move. Moreover, tightness in one muscle can easily affect other muscles because of the decreased amount of glide. In this fashion, the fascia may transmit pain, discomfort, or restrictions to muscles further away from the site of injury.
Thus, low back discomfort or pain may travel up to the neck or shoulder, or down to the hips and legs; neck injury may affect the lower spine; pain in the middle of the back may radiate up and around the rib cage, and so forth. Another way to put it, our fascial stocking has become snagged and distorted and doesn’t fit well any longer.
The fascia now acts as a straight jacket, locking in the discomfort or pain, as well as restricting our freedom of movement.
No matter whether the cause of back pain is injury, poor posture, improper use or overuse of muscles, or muscle tension caused by emotional or mental strain, therapy needs to include the release of tension and restrictions in the fascia for a complete recovery. Furthermore, back pain may never resolve completely post-surgery if fascial restrictions caused by scarring are not addressed with therapy as well.
Craniosacral Therapy and Energetic Unwinding of the Spine, Joints, & Muscles are particularly effective at releasing the tension and restrictions in the fascia anywhere in the body, promoting the return to health and function of your back.
These two therapies also gently help to speed up recovery from, as well as support rehabilitation after, back surgery.
Also see Homeopathic Remedies for back pain.