Back Pain

Home » Back Pain » Overview, Anatomy, Incidence and Prevalence, Risk Factors

Overview

Neck and back pain, especially pain in the lower back, is one of the most common health problems in adults. Fortunately, most back and neck pain is temporary, resulting from short-term stress on the muscles or ligaments that support the spine rather than from a serious injury or medical condition such as nerve damage or kidney disease.

Anatomy
The back is an intricate structure of bones, ligaments, muscles, nerves, and tendons. The backbone, or spine, is made up of 33 bony segments called vertebrae:

• 7 cervical (neck) vertebrae
• 12 thoracic (middle back) vertebrae
• 5 lumbar (lower back) vertebrae
• 5 sacral (lowest area of the back) vertebrae
• 4 coccygeal (coccyx, or tailbone) vertebra (made up of several fused segments)

The vertebrae are arranged in a long vertical column and held together by ligaments, which are attached to muscles by tendons. Between each vertebra lies a gel-like cushion called an intervertebral disc, consisting of semifluid matter (nucleus pulposus) that is surrounded by a capsule of elastic fibers (annulus fibrosus).

The spinal cord is an extension of the brain that runs through a long, hollow canal in the column of vertebrae. The meninges, cerebrospinal fluid, fat, and a network of veins and arteries surround, nourish, and protect the spinal cord.

Thirty-one pairs of nerve roots emerge from the spinal cord through spaces in each vertebra. The spinal cord and peripheral nerves perform essential sensory and motor activities of the body. The peripheral nervous system conveys sensory information from the body to the brain and conveys motor signals from the brain to the body.

Incidence and Prevalence
In the United States, back pain is reported to occur at least once in 85% of adults below the age of 50. Nearly all of them will have at least one recurrence. It is the second most common illness-related reason given for a missed workday and the most common cause of disability. Work-related back injury is the number one occupational hazard.

Risk Factors
Aging produces wear and tear on the spine that may result in conditions (e.g., disc degeneration, spinal stenosis) that produce neck and back pain. Having a previous back injury puts one at risk for another injury.

Physically demanding occupations that require repetitive bending and lifting have a high incidence of back injury (e.g., construction worker, caregiver). Jobs that require long hours of standing without a break (e.g., hairdresser) or sitting in a chair (e.g., keyboard operator) that does not support the back well put a person at risk for neck and lower back injury.

Being sedentary (i.e., not exercising regularly or engaging in physical recreation) and being overweight, which increases stress on the lower back, are risk factors.

Poor posture, such as slouching in a chair, driving hunched over, standing incorrectly, and using poor body mechanics when lifting and carrying heavy loads are risk factors. Sleeping on a soft or sagging mattress also can lead to back pain.

Sports that involve twisting the back, like golf, can result in back injury or worsen existing lower back pain.

Joint and/or bone disease (e.g., osteoporosis, arthritis) and infectious disease (e.g., spinal meningitis) can lead to degeneration, inflammation, and compression.

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