Category: Blog

In this lesson, I am going to try to explain how the spine bones all fit together, and talk about nerves, so you can more easily understand some of the more common back issues I’ll talk about further down the track.

Spine Bones (Vertebra)
As we learned previously, the spine is made up of a bunch of square looking bones that stack on top of each other to make the spine. In the picture below, the chunky square part faces toward your front, and the poky bit is at your back and you can touch this.

In the picture, you can also see that between the square chunky bit and the poky bit, there is a hole. When the bones all stack up on one another, a tunnel is created running all the way down the spine. This is called the spinal canal, and in it, lives the spinal cord. We all know the spinal cord is very important, which is why it is very well protected in this tunnel of bone.

Spinal Cord and Spinal Nerves
The spinal cord is like a big thick rope that comes out of your brain. All the way down along the spinal cord, there are smaller pieces of rope attached called “spinal nerves”. This is how the messages travel from the brain to the rest of the body. Like a train in the tunnel.

So, a message to move your arm will leave the brain and travel down the spinal cord inside the bony tunnel. At some point in the neck region, the message will leave the spinal cord and continue on the smaller spinal nerve which runs down the arm, and delivers the message.

As well as the messages for movement, messages of sensation like pain and pressure also run in the spinal nerves then up the spinal cord and back to the brain.

If you need to move your leg, your brain will send a message down the spinal cord. It will run all the way down the spinal cord in the tunnel to the level of your lower back, where the message will move from the spinal cord to the spinal nerve, and travel down the spinal nerve toward the leg, and the leg will eventually move.

 

A great system, til it isn’t.
It’s a very clever system, and for the most part works very well.  But you can imagine, there are lots of things that can go wrong.

As a physio we commonly see the system get compromised mecahnically at 2 different places.

Spinal stenosis
If the tunnel gets narrowed, the spinal cord gets squashed and sends pain into your arms, legs or body. When the canal gets narrowed, this is called spinal stenosis. I will explain spinal stenosis more in depth another time.

Neural Foramen
Just as the spinal cord travels down a tunnel of bone, when the spinal nerve leaves the spinal cord and heads out to the rest of the body, it also passes through a smaller tunnel. This smaller tunnel is made by very convenient matching dents on each side of the vertebra, which make a nice little hole or tunnel for the spinal nerve to pass through.

This neural foramen (hole for the nerve) is fraught with problems. Anything that narrows this hole by even a mm irritates the spinal nerve, and that sends pain into your body.  Ie if the spinal nerve gets squashed or irritated at the level when it leaves your neck, your arm will hurt. Even if there’s nothing wrong with your arm!! (how rude!) And if it gets squashed in your lower back, your leg will hurt. And what’s more,  it they get squashed even more, the messages of movement won’t be able to get through either.

In the clinic
The irritation of spinal nerves, and the subsequent pain that they cause, is probably the single most common thing we see in the clinic. And to the non professional, the signs and symptoms of these two causes are very similar. Back and leg pain are the most commonly self diagnosed and treated conditions with the help of Dr. Google.

However, although the symptoms are very similar, the treatment for these two are polar opposites. So rather than diagnose and treat yourself, make yourself an appointment and let’s work out what is going on with your body, and which course of action is best for you!

By Lesley Tompson.

 

 

Let’s keep it simple and get to know your lower back.

Location: Your lower back, also called the lumbar region, is the area below your ribcage and above your hips. It’s made up of five vertebrae, or small square bones, stacked on top of each other. The the bottom Lumbar vertebra is number 5 and they number up from there. So if you read L4 on an xray, it is referring to the 4^th Lumbar vertebra in the stack of 5. So the second to bottom one.

 

Joints and Discs: The space between each vertebra is called a joint, and a shock-absorbing disc sit in each of these joints. These allow movement and protect your spine.

Muscles: There are LOTS of muscles that surround your lower back. There are big strong muscles on the outside that you can touch (front and back) that provide support, but also a whole lot of tiny little muscles deep inside that you probably don’t know about, that provide stability. There are even muscles that wrap around you from the front to the back.Think of them all as your body’s built-in back brace.

Curves: Your lower back has a slight inward curve (lordosis) that’s important for balance and shock absorption.

Purpose: Your lower back is like a flexible bridge between your upper body and legs. It helps you stand, bend, twist, and lift things.

Common Troublemakers: The most common cause of lower back pain is stiffness in the joints, or damage to the disc. When these occur, the muscles try to help to protect the back, and also commonly become super tight or strained.

Remember, your lower back is a vital part of your body, and taking care of it can make a big difference in your overall well-being. If you have questions or need advice, don’t hesitate to reach out to a physiotherapist like me! We’re here to support your spine’s health journey.

Do you wish you could understand even a little bit of what your xray report was going on about? Although medical words look difficult, they are actually just small bits of Latin words all smooshed together. Use this resource to look up some of these latin bits, and see if you can make sense of some common medical terms. Here’s a few that popped in to my head; Arthritis Arthr = Joint itis = Inflammation Arthritis = Inflammation of the Joint Neuraligia Neur = nerve algia = Pain Neuraligia = Pain from the nerve Angiogram Angio = Heart Gram = record or writing Angiogram = Record of the heart Polymyalgia Poly = many My= muscle algia = pain Pain in lots of muscles Pulmonectomy Pulm= lung ectomy = remove or excise by surgery Pulmonectomy = Surgical removal of lung tissue Try some! It’s super fun, and look how your knowledge is expanding! Remember, if in doubt, chat to a medical professional for clarification. By Lesley Tompson   a(n) absence of acou, acu hear aden(o) gland aer(o) air alg pain andr(o) man angi(o) vessel ankyl(o) crooked, curved ante before anter(i) front, forward anti against arteri(o) artery arthr(o) joint articul joint ather(o) fatty audi(o) hearing aur(i) ear aut(o) self bi, bis double, twice, two brachy short brady slow bucc(o) cheek carcin(o) cancer cardi(o) heart cephal(o) head cerebr(o) brain cervic neck chol(e) bile, or referring to gall-bladder chondr(o) cartilage circum around, about contra against, counter corpor body cost(o) rib crani(o) skull cry(o) cold cut skin cyan(o) blue cyst(o) bladder cyt(o) cell dactyl(o) finger or toe dent tooth derm(ato) skin dipl(o) double dors back dys bad, faulty, abnormal ectomy excision (removal by cutting) emia blood encephal(o) brain end(o) inside enter(o) intestine epi outer, superficial, upon erythr(o) red eu normal extra outside gastr(o) stomach gen become, originate gloss(o) tongue glyc(o) sweet, or referring to glucose gram, graph write, record gyn woman hem(ato) blood hemi half hepat(o) liver hist(o) tissue hydr(o) water hyper excessive, high hypo deficient, low hyster(o) uterus iatr(o) doctor infra beneath inter among, between intra inside itis inflammation lact(o) milk lapar(o) flank, abdomen latero side leuk(o) white lingu(o) tongue lip(o) fat lys(is) dissolve mal bad, abnormal malac soft mamm(o) breast mast(o) breast megal(o) large melan(o) black mening(o) membranes my(o) muscle myc(o) fungus myel(o) marrow nas(o) nose necr(o) death nephr(o) kidney neur(o) nerve nutri nourish ocul(o) eye odyn(o) pain oma tumor onc(o) tumor oophor(o) ovaries ophthalm(o) eye opia vision opsy examination orchi(o) testes osis condition osse(o) bone oste(o) bone ot(o) ear path(o) disease ped(o) child penia deficient, deficiency peps, pept digest peri around phag(o) eat, destroy pharmaco drug pharyng(o) throat phleb(o) vein phob(ia) fear plasty repair pleg(ia) paralysis pnea breathing pneum(ato) breath, air pneumon(o) lung pod(o) foot poie make, produce poly much, many post after poster(i) back, behind presby elder proct(o) anus pseud(o) false psych(o) mind pulmon(o) lung pyel(o) pelvis of kidney pyr(o) fever, fire rachi(o) spine ren(o) kidneys rhag break, burst rhe flow rhin(o) nose scler(o) hard scope instrument scopy examination somat(o) body spondyl(o) vertebra steat(o) fat sten(o) narrow, compressed steth(o) chest stom mouth, opening supra above tachy fast, quick therap treatment therm(o) heat thorac(o) chest thromb(o) clot, lump tomy incision (operation by cutting) tox(i) poison uria urine vas(o) vessel ven(o) vein vesic(o) bladder xer(o) dry