Back or spine is one of the most important parts of your body. It protects the spinal cord, provides structural balance to the head, shoulders and chest, and helps balance and distribute the weight of your body. Your back also helps you bend, stretch and even rotate so swiftly and smoothly that it makes one wonder what life would be like without this flexibility.

But, this convenience comes with its share of baggage. Problems of the back are all too common, sometimes resulting from your lifestyle habits, sometimes caused by illnesses and injuries, and at other times due to other reasons. Treatment options for back pain range from conventional methods to surgical means. Read more about treatment options at Healthbase .

Anatomy of the spine

Your back and neck contain the spinal column or vertebral column which is made up of 33 individual bones called vertebrae and runs down from your skull to your pelvis. Between the vertebrae are circular pads of cartilage (connective tissue) called discs that are responsible for cushioning the vertebrae when you jump or run.

The spinal column can be divided into four regions (from top to bottom):

• The 7 vertebrae at the top constitute the neck region or cervical spine

• The next 12 vertebrae make the upper back or the thoracic region

• The next 5 vertebrae are the lower back or lumbar vertebrae

• The last group of bones at the base of the spine are fused together into what is known as the sacrum and coccyx

The lumbar region (low back) is where most of the pain is felt as it supports the weight of the upper body.

Types of back pain

When you have a backache, the pain may originate from the muscles, nerves, bones, vertebral joints, discs or other structures in the spine or the spinal column.

Most back pains are temporary and can be managed with rest and / or medication. Your physician may also prescribe therapy and regular back exercises to keep the pain at bay and your back in shape. However, there are some cases of back pain that are severe or chronic and require surgical invervention.

Spinal osteoarthritis

One cause of such a chronic long-term back pain is spinal arthritis or osteoarthritis of the spine. It is the mechanical breakdown of the cartilage between the vertebral joints in the back portion of the spine leading to mechanically induced pain.

In spinal osteoarthritis, the joints become inflamed and pain may be felt when performing even the simplest of activities like standing, sitting or walking. Over time, bone spurs i.e. small irregular growths on the bone, also called osteophytes, typically form on the vertebral joints and around the spinal vertebrae which may become so large as to cause irritation or entrapment of nerves passing through spinal structures and result in spinal stenosis (diminished room for the nerves to pass).

Classification of spinal osteoarthritis

When stiffness and pain are in the lower spine (lumbar spine) and sacroiliac joint (between the spine and the pelvis), it is classified as lower back osteoarthritis or lumbosacral arthritis. When the stiffness and pain are in the upper spine, neck, shoulders, arms and head, it is classified as neck (cervical spine) osteoarthritis or cervical spondylosis.

Causes of spinal osteoarthritis

The most common causes of spinal osteoarthritis are repetitive trauma to the spine from repetitive strains caused by accidents, surgery, sports injuries and poor posture. Other risk factors include aging, gender (more common in post-menopausal women), excess body weight, genetics, and associated diseases (like infections, diabetes, rheumatoid arthritis, etc.).

Spine fusion surgery

For spinal arthritis, the only effective surgical treatment is spine fusion surgery which stops motion at the painful joint. In fusion, one or more of the vertebrae of the spine are united (fused together) using bone grafts so that motion no longer occurs between them.

Spinal fusion surgery is used to treat:

• a fractured (broken) vertebra e.g. spondylolisthesis

• deformity e.g. scoliosis or kyphosis (spinal curves or slippages)

• pain from painful motion

• instability

• some cervical disc herniations (fusion together with discectomy)

• weak or unstable spine caused by infections or tumors

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