What Causes Neck and Back Pain?
Several factors could be leading to your discomfort. Our experts break down the roots of this common complaint.
If you have ever endured discomfort in your neck or back, you know how debilitating this type of pain can be. The spine provides rigidity, stability, and flexibility all at the same time so that you can complete all your daily tasks and activities. Using a series of ligaments, tendons, intervertebral discs, and facet joints, the spine provides the mechanical connection your body needs.
Low back pain becomes more common as people age, affecting more than half of people over 60. It is very costly in terms of health care payments, disability payments, and missed work.
The spine (spinal column) consists of back bones (vertebrae). There are shock-absorbing disks between each of the vertebrae. The disks have a tough, outer layer of fibrocartilage and a soft, jelly-like interior called the nucleus. Each of the vertebrae has two joints behind the disks. The joints are called facet joints. The facets of one vertebral body rest on the facets of the one below it, forming a joint. The facet joints and thus the spine is stabilized by ligaments and muscles, which include the following:
- Two iliopsoas muscles, which run along both sides of the spine
- Two erector spinal muscles, which run along the length of the spine behind it
- Many short paraspinal muscles, which run between the vertebrae
The abdominal muscles, which run from the bottom of the rib cage to the pelvis, also help stabilize the spine by supporting the abdominal contents. The muscles in the buttocks also help stabilize the spine. All together, these muscles are referred to as the core muscles.
Enclosed in the spine is the spinal cord. Along the length of the spinal cord, the spinal nerves emerge from the sides through spaces between the vertebrae to connect with nerves throughout the body. The part of the spinal nerve nearest the spinal cord is called the spinal nerve root. Because of their position, spinal nerve roots can be squeezed (compressed) when the spine is injured, resulting in pain.
The lower spine (lumbar spine) connects to the spine in the upper back (thoracic spine) above and to the pelvis through the sacrum below. The sacrum is the large triangular bone at the base of the spine, the lower part of which is the tailbone. The lumbar spine is flexible to allow turning, twisting, and bending and provides strength—for standing, walking, and lifting. Thus, the lower back is involved in almost all activities of daily living. Low back pain can limit many activities and reduce the quality of life.
Types of back pain
Common types of back pain include local, radiating, and referred pain.
Local pain occurs in a specific area of the lower back. It is the most common type of back pain. The cause is usually a small disk injury, joint arthritis, and muscle sprains and strains. The pain may be constant and aching or, at times, intermittent and sharp. Sudden pain may be felt when an injury is the cause. Local pain can be aggravated or relieved by changes in position. The lower back may be sore when touched. Muscle spasms may occur.
Radiating pain is pain that travels from the lower back down the leg. The pain can be a dull ache or be sharp and intense. It typically involves only the side or back of the leg and may travel to the foot or only to the knee. Radiating pain typically indicates compression of a nerve root caused by disorders such as a herniated disk, sciatica, osteoarthritis, or spinal stenosis. Coughing, sneezing, straining, or bending over while keeping the legs straight may trigger the pain. If there is pressure on the nerve root, the pain may be accompanied by muscle weakness in the leg, a pins-and-needles sensation, or even loss of sensation. Rarely, do people lose bladder control (urinary incontinence) or bowel control (fecal incontinence).
Referred pain is felt in a different location from the actual cause of the pain. For example, some people who have a heart attack feel pain in their left arm. Referred pain from internal organs to the lower back tends to be deep and aching, and its exact location is hard to pinpoint. Typically, movement does not worsen it, unlike pain from a musculoskeletal disorder.
In addition to eating a healthy diet, regular aerobic activity is recommended, like walking, jogging, or biking. Exercise helps you lose weight and strengthen your back.
Just be careful — if activity is causing more pain, talk to your physician. Anything that causes pain is bad. Pain is the body's natural, built-in mechanism to tell us that the body doesn't like what we're doing. You should never do something that's putting you in pain.