Avoid stoop, Always sit with straight back.

Spine Health

  • Basics of Spine
  • Spinal Diseases and Spinal Care
  • Ergonomics
We have total 33 Vertebras in our vertebral-Spinal column.
Basic four regions in Vertebral column.
[A] Cervical Spine has 7 Vertebrae.
[B] Thoracic Spine has 12 Vertebrae.
[C] Lumbar Spine has 5 Vertebrae.
[D] Sacrococygeal region has 5+4 vertebral segments

Thoracic and sacrococcygeal curves are primary Curves. Lumbar and Cervical curves develop later in life, they are called secondary curves. Lordotic curvature is maintained by the tensin band, paraspinal muscles which are present at the back of cervical and lumbar spine.
Cervical and lumbar curves are dynamic and maximally mobile. These qualities make them more prone for degeneration, early wear and tear, spondylosis and injuries. Commoner cervical levels to get injured are C5-6 and 8-7. Commoner Lumbar levels to get injured or to develop pathology are L 4-5 and L5-51

In between 2 vertebras there is inter vertebral Disc.
  • Annulus Fibrosus
  • Nucleus Pulposus
  • Annulus fibrosus is outer tough layer.
  • Nucleus pulposus is a jelly like material.
  • Which is present at centre of disc. Nucleus pulposus along with tougher outer layer, annulus fitness acts like a cushion in between 2 vertebras.
  • Intervertebral disc functions as cushion, buffer, spring, shock absorbers; broadly we say that it bears all the load and protects the neural structures from getting injured.

Three major functions of intervertebral Disc.
  • Maintains lordtic posture of lumbar and cervical spine.
  • Acts like a buffer in between 2 vertebras and prevents forces getting transmitted to spinal cord and spinal nerves.
  • Maintains the height of foramen and passage of nerve roots is kept clear.

Nutrition of Disc
Intervertebral Disc gets nutrition through diffusion across vertebral end plates.

End plate sclerosis, degeneration, smoking affects the diffusion across end plates and in turn nutrition of the disc is altered.

Above mechanism is responsible for dehydration of intervertebral disc. Thus develops – dehydrated disc. Degenerative disc Disease (DDD) or Black Disc disease.

DDD is one of the major causes of mechanical back pain.

Indirect Causes of Back Pain
  • Stress related to back pain.
  • Herpetic shingles (Herpes Zoster).
  • Pancreatitis. Pancreatic diseases.
  • Hepatic Diseases.

Management of Back Pain
  • Precautions and care to reduce the pain or to present severity.
  • Give relaxation to body part/back area.
  • Sleeping is the best position to give rest to back. Sitting for long time will hurt back more.
  • Sleeping on firm/hard bed is preferable.
  • Sleeping on side in case of acute back pain is relaxing.
  • Sleeping straight on back with 2 Pillows under knee joints is advisable.
  • Hot packs in case of chronic back pain.
  • Ice pack fomentation in case of acute injury.

Success of Any Treatment is Accurate Diagnosis
  • Getting the injured area checked by an qualified Doctor, Orthopedic Surgeon or Spine Specialist is always advisable.
  • Making the diagnosis is first step in treating the problem.
  • Investigations in form of radiography (X-ray) of lumbar or cervical spine are always advisable.
  • X-rays speak about bony injuries, muscle spasm, decrease in the disc spaces.
  • MRI Scan Magnetic Resonance imaging is gold standard. Investigation in assessing back Pathologies. MRI Scan Assess statues of

  • Intervertebral Discs.
  • Spinal cord and Spinal nerves.
  • Bone marrow oedema Vertebral bodies.
  • CSF flows.
  • MRI will tell about disc herniation’s (slipped Disc), their compression over spinal used and spinal nerves.
  • MRI is advisable – when there is intractable back pain and leg pain.

When to Get MRI Scan Done
  • Back pain more than 3 months which is not responding to medicines.
  • Radiating leg pain, which is and progressing despite of medical treatment.
  • Neurological deficit such as toe drop/foot drop.
  • Numbness / tingling and leg pain which is altering or restricting activities of daily living (ADL).
  • Back pain + leg pain + Evening rise fever. Once the diagnosis is made; the important part is treatment of specific disease.

[1] 80% individuals of back pain get better with conservative Care, which acts as a specific treatment.
[2] 10% individuals who are not getting better with medical treatment has severe intensing of leg pain and back pain without neurological deficits are ideal candidate for root block/pain block.
[3] 10% individuals are subjected to surgery.
  • Who have not responded to medical Rx. In last 10 to 12 years.
  • No relief with pain block / root block.
  • Worsening homological deficit.
  • Intraceable leg and back pain.
  • Toe drop and foot drop.
  • Urinary / bladder and bones problems.