The most common cause of back pain is skeletal problems -problems affecting all the tissues of the spine other than muscles or nerves. If, like many people, you are not as fit as you could be, you run more risk of injury because your muscles will not be able to provide support when it is most needed.
Facet Joint Problems
Even normal everyday activities can force your back to work under great strain, putting extra pressure on your intervertebral discs. Injuries to the facet joints can occur in any part of the spine but they are more common in the lower back and neck regions where the facet joints have to withstand more twisting force, and possible strain, than elsewhere.
This type of injury is more common in middle and old age when the discs separating the vertebrae are beginning to dry out and become thinner. As a result, the spine becomes shorter, causing the ligaments that hold the vertebrae together to slacken. This can allow a facet joint to slip out of alignment under pressure. A misaligned facet joint can cause acute back pain, because irritation and bleeding within the joint cause the joint capsule to swell and press on a nerve.
The sacroiliac region, where the bottom of the spine joins the pelvis is a common problem site. The joints in this part of the back can be strained or pushed out of alignment by a sudden jolt – such as missing a step unexpectedly or sitting down too hard, especially on a seat that is too low. A violent, twisting motion may have a similar result.
Effects of Misalignment
If the problem is in your lower back you may also feel pain in your buttocks, hips and thighs. A facet joint problem in the neck will cause pain and restrict the amount of movement you can make. This is one of the causes of the condition known as wry neck. Facet joint problems may respond to rest, manipulation by an osteopath, chiropractor or physiotherapist. After the acute pain has subsided, exercise may help.
Many people with neck problems find that placing a soft collar or rolled-up towel around the neck helps provide support and eases the pain, allowing them to sleep better.
Ligament Problems
Ligament problems as well as slackening as a result of the normal ageing processes, ligaments -although pliable enough to allow movement around the joints – can become strained or, in extreme cases, torn. This is mainly due to the fact that ligaments in adults have very little elasticity. Torn or damaged ligaments take a long time to heal – even longer than bone. When they finally do heal, scar tissue often restricts the movement of the ligament across the surface of the bone, which may be a source of long-term inflammation and pain.
Disc Problems
The main sections of the vertebrae are joined to each other by the intervertebral discs. Although they are tough and their structure allows them to change shape temporarily under pressure, they can still be damaged.
The discs can absorb a great deal of vertical pressure, but they are vulnerable to sudden, twisting movements. This sort of movement can occur during some sports or through lifting heavy objects incorrectly. Damage is more likely to occur if the upper body is bent forward at the time, since in this position the facet joints are less able to prevent excessive rotation. If the vertebrae above and below a disc are suddenly forced to rotate in different directions, the outer casing, the anmilus, can split – allowing the nucleus of the disc to bulge outward.
