NuVasive®, Inc.
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Back Pain

Back pain can be felt constantly or intermittently, and may present as a dull, sharp, piercing, or burning sensation. The pain can stay in one place or radiate (travel) to other areas, such as the front, sides, back, and legs. Low back pain is often associated with radiating leg pain.

Acute pain comes on suddenly, and can be severe, but usually lasts a relatively short time. Chronic pain is persistent and does not get better on its own over time. Besides pain, other symptoms are often associated with back pain, such as muscle spasms, stiffness, decreased motion, numbness in the groin, shifted posture, and muscle weakness. Acute pain is more common and many of these symptoms will typically clear up within a short period of time. If symptoms persist, you should consult your doctor.

Muscles

Back pain can be the result of a sudden, awkward movement, strained back muscles and ligaments, lifting heavy objects, or using improper body mechanics .

Nerves

Pressure or impingement of nerve roots in the spinal canal can be caused by herniated discs, arthritic conditions, bone spurs, or displacement of vertebrae, and can result in pain throughout all areas of the back, and often into the extremities.

Disc Herniation

Posterior displacement of disc tissue from the intervertebral disc space produces pressure on the nerve roots or on the contents of the spinal canal. This pressure causes pain to radiate down into the legs.

Disc herniations are often treated surgically to relieve nerve compression.

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Using proper body mechanics can alleviate pain.

Lifting

Let your legs do the work. Keep your back straight and bend only at the knees. Hold the load close to your body. Avoid lifting and twisting simultaneously or lifting excessive weight.

Sitting

Choose a seat with good lower back support. A chair with armrests helps maintain proper posture, and a swivel base moves with you, preventing twisting that can cause strain. Consider placing a pillow or rolled towel in the small of your back to maintain its normal curve. Keep your knees and hips level.

Sleeping

Recent studies indicate that a medium-firm mattress might be best for those with back pain. Use pillows for support, but don’t use a pillow that forces your neck up at a severe angle.

Standing

Be aware of your posture when standing and maintain a neutral pelvic position. When standing for long periods of time, alternately placing your feet on a low object, such as a footstool, will take some of the load off your lower back.

Exercise

Aerobics

Low-impact aerobic activities put a minimal amount of strain on the back. Aerobics can increase strength and endurance in your back and allow your muscles to function better. Walking and swimming are good options.

Stretching

Increasing core (abdominal and back) muscle strength is important. When these muscles are strong, they can work together like a natural corset for your back. Flexibility in your hips and upper legs aligns your pelvic bones to improve wellness in your back muscles.

Other Considerations

Smoking

If you smoke, quitting can make a difference. Diminished oxygen levels in the spinal tissues of smokers can hinder the healing process.

Weight

Maintain a healthy weight. Being overweight puts strain on your back muscles. If you’re overweight, trimming down can prevent back pain.

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The Spinal Column/Vertebrae

The spinal column is made up of 33 bones, called vertebrae, which stack one on top of another with intervertebral discs between, and connecting at, the facet joints. The spinal column supports the load of the upper body, serves as an attachment point for muscles and ligaments that provide constrained motion, and protects the spinal cord.

There are five regions of the spine:

  • The top seven vertebrae make up the cervical (or neck) region.
  • The next 12 vertebrae are attached to the ribs and make up the thoracic (or chest) region.
  • The next five vertebrae support most of the weight of the torso and make up the lumbar (or lower back) region.
  • The next five vertebrae are fused into one bone called the sacrum.
  • And the final four vertebrae are fused to make up the small coccyx (or tailbone).

Intervertebral Discs

Each vertebrae in the spinal column is separated by an intervertebral disc (except the fused bones of the sacrum and coccyx). These discs are made up of a tough, elastic outer ring of collagen fibers (annulus) surrounding a soft gel center (nucleus). The discs cushion the spine during loading and bending activities. The aging process naturally causes the discs to lose water over time; this is known as the degenerative process. Degenerated discs don’t cushion the spine as well as normal discs, which can lead to disc herniation, pain, and instability.

Spinal Ligaments

Ligaments are tough bands of elastic tissue that connect bones together and help to restrain excessive motion at the joints. The five spinal ligaments, which help to stabilize the spinal column during motion, include:

  • Supraspinous ligament
  • Interspinous ligament
  • Ligamentum flavum
  • Anterior longitudinal ligament
  • Posterior longitudinal ligament

Spinal Nerves

The shape of the vertebrae allow for the passage of the spinal cord from the brain to the lower part of the body through the spinal canal. Spinal nerves stem from the spinal cord and exit the spinal column between each vertebra on both sides. The spinal cord ends at the upper lumbar region, below which is a bundle of spinal nerves called the cauda equina. After exiting the spinal canal, these spinal nerves then further entwine and extend to send signals between your brain and your organs, muscles, and other tissues. The lumbar spinal nerves innervate your lower back, abdomen, and legs. If any of these nerves are pinched by a bulging disc or the position of your vertebra, you might experience back, groin, and/or leg pain or numbness. The spinal nerves include:

  • Exiting nerve
  • Cauda equina

Back and Trunk Muscles

The final stabilizers of the spine are the muscles that attach to it. The paraspinal muscles, which extend along the center of the back, are often the source of pain, both before, and often after surgery (from the surgical approach).

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