The number one complaint from patients that I see is low back pain. Why does the back seem to bother most people? To answer that question, let’s take a look at how the back is formed.

At a very early age in gestation, the neural elements are formed, and the bony elements eventually form separately )about 26 of the 33 segments separate). Together, they form the spine. A baby is born with a straight spine, only taking the adult curves when the baby begins to walk. The lower back bends into a lordotic curve (backward bend) and the thoracic spine into a kyphotic curve (forward bend).

Gravity influences the spines development. Spinal discs are made of cartilage and fill the spaces between the vertebrae. The discs are filled with fluid, with about 85% of the disc composed of water. The disc has two parts; the soft, gelatinous nucleus, and the tough, outer ring or annulus. The nucleus moves as we move; the annulus controls the amount of motion of the nucleus.

The greatest pressure put upon the discs are when we sit down, while the least amount of pressure is when we are lying down. Standing, bending, walking, squatting, and lifting all takes a toll on the spine.

The segments of the spine are all supported by ligaments, which connect one spinal bone to another. There are also joints in the back of the spine called facet joints. Both of these structures are stimulated by small nerves carrying impulses to and from the brain.

As we age, the water content of our entire body diminishes, and the spine is no exception. The discs start to shrink, and fissures begin to develop in the annulus. Inflammatory chemicals like histamine and interleukins are expressed from these tissues. They intercept nerve fibers and send impulses of discomfort to the brain. The body makes some adjustments such as laying down more bone to increase surface area, tightening the ligaments to decrease range of motion, and shortening and contracting muscles to give the body more support and stop stresses on the spine. The laying down of bone also creates stenosis (calcification) , a major complaint by those over 65 years of age. This calcification irritates nerve endings coming out of the spine and going into the periphery, such as the buttocks and legs.

As I’ve said before, sitting is the root of all fitness evil. The muscles of the pelvis (hips) weaken with sitting, and what do most people do all day but move from one sitting position to another. I would estimate that in my practice, more than half of all back pain problems start with weak hip muscles. After all, the spine sits on the hips. I have good success in dealing with back pain by strengthening the hips. There are some excellent hip exercises in my video archives, with more to come.

If you have to sit, try to sit with a straight back, and periodically (every 15 minutes or so) get up and stretch. The PC video in my archives is a three-stretch routine that has really helped me, and it only takes about a minute. Learning to bend correctly, lift correctly, and move as much as possible are vital to spine health. If you take the proactive approach to caring for your spine, you’ll have a minimum of pain symptoms.

Stay well, John R Blilie, M.S.