Spine & Back

Woman Stretching Back

Spine & Back Care

Table of Contents

spinal column icon

What are the Causes of Back Pain?

Your back consists of a complex arrangement of muscles, ligaments, tendons, discs and bones along the spine. Issues with any of these components can lead to strain or structural problems resulting in back pain.

Strain

The most common cause of back pain is a strain. Simply lifting an object the wrong way, lifting an object that’s too heavy or an abrupt or awkward movement can cause strain to the muscles in the back. While this may seem like a minor injury, the back pain can be severe.

Back pain can be caused by many structural problems, including ruptured discs, bulging discs, Sciatica, arthritis, abnormal curvature of the spine and osteoporosis.

Why Does My Lower Back Hurt?

Pain in the lower back can range from mild discomfort to debilitating pain that can cause you to miss work and other regular activities. Lower back pain can be caused by:

  • lumbar spine (the discs between the vertebrae)
  • ligaments that are around the spine and discs
  • spinal cord nerves
  • lower back muscles
  • abdomen and pelvic internal organs
  • the skin around the lumbar and surrounding area
  • complex regional pain syndrome

How can you avoid lower back pain? There are many ways to prevent lower back pain – from maintaining a proper diet, to good posture and staying active (through exercise such as yoga).

Why Does My Upper Back Hurt?

Like lower back pain, pain in the upper back can cause a lot of issues and discomfort. Major causes of upper back pain include:

  • disorders of the aorta
  • tumors in the chest
  • spine inflammation

What are the Four Major Regions of the Spine?

The spine, or what’s commonly known as the backbone, is comprised of 33 interlocking bones called vertebrae. Each of the vertebral bodies are separated by intervertebral discs that act as shock absorbers for your spine. These discs are composed of two regions the inner or nucleus pulposus and the outer or annulus fibrosis. The nucleus pulposus is a jelly-like solution while the annulus fibrosis has a fibrous-like composition.

These bones are segmented into four regions:

The Cervical Spine (Neck)

The cervical or neck region is made up of seven vertebrae. The neck supports the weight of the head as well as protects the nerves that run from the brain to the rest of the body. A lot of neck pain can be caused by strain or sprain to the muscles, ligaments or tendons in the neck.

The issues that cause neck pain usually heal on their own. However, pain that lasts longer than two to twelve weeks or has caused pain in the arm is likely a skeletal (spine) issue.  If the pain continues down the arm to the hand and fingers, it could be caused by a cervical herniated disc or foraminal stenosis, which is a pinched nerve in the neck.

The thoracic or upper-mid back region is made up of 12 vertebrae. The thoracic spine can be understood as a strong cage which is designed to protect vital organs like the heart and lungs. The upper back is not designed to move, so there is less chance of injury to this major region of the spine. However, there can be back pain in the upper back if it becomes irritated by a spinal compression fracture, strained muscles or joint issues in the shoulders. A less common cause of spine pain is a thoracic herniated disc.

The lumbar region or lower back is made up of five vertebrae. The lower back can move much more than the upper back and is the region of the spine most commonly affected by back pain. The lumbar region carries the weight of the torso. The different motions that can be caused by the lumbar spine are at the L3-L4 and L4-L5 areas. These regions get a lot of wear and tear that can cause conditions like osteoarthritis or degenerative disc disease.

The lower discs of the spine (L4-L5 and L5-S1) take on even more strain. This is most likely to herniate and can cause lower back pain and even numbness that can shoot down the leg to the foot. This condition is called sciatica.

The sacrum (or pelvic region) and coccyx (or tailbone) complete the lowest part of the spine. This bone is shaped like a triangle and fits between the two sides of the pelvis. This then connects the spine to the lower body. When pain occurs in this area of the spine, it’s often called sacroiliac joint dysfunction.

What are the Five Major Reasons for Severe Spine Pain?

Injuries, abnormalities and wear and tear can all lead to conditions that cause severe spine pain. When the pain cannot be helped by nonsurgical methods and interferes with your everyday activities, your provider may suggest spine surgery. Spine surgery can help ease the spine pain and get you back to living life on your own terms.

The five different conditions that can cause severe spine pain include:

Sacroiliac Joint Dysfunction

Occurs when one of the joints in the lower back becomes inflamed due to injuries, arthritis or wear and tear.

Occurs when the sciatic nerve (which runs through the lower back, hip, bottom and leg) becomes inflamed from a herniated disc, bone spur or condition that pinches the sciatic nerve.

Occurs when the open space in the spine becomes narrowed due to a herniated disc, spinal injuries or bone overgrowth.

Occur when one or more spinal bones break due to trauma or a condition that weakens the bones, such as osteoarthritis.

Occurs when a spinal bone pushes forward and puts pressure on the bone below it.

What is the Importance of the Spine?

Over time, or by acute or sudden injury, an intervertebral disc can become herniated and cause a great deal of pain. Pain from your spine can translate to other areas of the body. For instance, an injury to your lower back can cause severe leg pain. The spine is a major factor in all the body’s movements. The spine provides balance, absorbs shock, protects the spinal cord and nerves, and allows for bending and twisting movements.

Procedures

  • Lumbar transforaminal epidural steroid injections, which deliver medication directly to the affected nerve root to reduce inflammation and leg or lower-back pain.
  • Cervical and lumbar interlaminar epidural steroid injections, designed to relieve neck, arm, and lower-back pain caused by disc herniation, spinal stenosis, or nerve compression.
  • Lumbar, cervical, and thoracic facet medial branch blocks and radiofrequency ablation, used to diagnose and treat pain originating from the facet joints by temporarily blocking or interrupting pain signals.
  • Caudal epidural steroid injections, which provide broader anti-inflammatory relief for lower-spine conditions, especially when multiple nerve levels are involved.
  • Intercostal nerve blocks, which target nerve-related pain in the chest or upper abdomen that may be associated with thoracic spine conditions.

These procedures are performed by Lauren Terranova, D.O., M.S., a fellowship-trained pain management specialist at Coastal Orthopedics.

Learn more about Dr. Terranova

What Is Minimally Invasive Spine Surgery?

Minimally invasive spine surgery (MISS) is a surgical technique that uses smaller incisions and specialized instruments to treat spinal conditions. This approach minimizes damage to the surrounding muscles and tissues, allowing for quicker recovery, less post-operative pain, and reduced scarring. Minimally invasive surgery can be used for a variety of spinal procedures, including decompression surgeries and spinal fusions.