Spinal anatomy is a remarkable combination of strong bones, flexible ligaments and tendons, large muscles and highly sensitive nerves. Most of us take spine anatomy -- specifically, this juxtaposition of strength, structure and flexibility -- for granted in our everyday lives -- until something goes wrong. Once we're in pain, we're driven to know what's wrong and what it will take to relieve the back pain and/or neck pain and prevent a recurrence.
The Neck Is Susceptible to Strain or Injury
The neck supports the weight of your head and protects the nerves that come from your brain to the rest of the body. This section of the spine is called the cervical spine and has seven vertebral bodies (bones) that get smaller as they get closer to the base of the skull. Only the top two segments rotate (so you can turn your head).
Acute neck pain is most often caused by a muscle, ligament or tendon strain (such as from a sudden force or straining the neck), and will usually heal with time and nonsurgical treatments to alleviate the pain (such as ice/heat, medications, chiropractic or osteopathic manipulation, etc).
For patients with neck pain that lasts longer than two weeks to three months, or with mainly arm pain, numbness or tingling, there is often a specific anatomic problem. For example, pain that radiates down the arm, and possibly into the hands and fingers, is usually caused by a cervical herniated disc or foraminal stenosis pinching a nerve in the neck. Treatment options will differ depending on the specific diagnosis. For more information, see the following article:
The Upper Back Is Not Usually a Source of Pain
The 12 vertebral bodies in the upper back make up the thoracic spine. The firm attachment of the rib cage at each level of the thoracic spine provides stability and structural support and allows very little motion, which means that thoracic disc injuries are rare. However, irritation of the large back and shoulder muscles or joint dysfunction in this area can be very painful. For more information, see the following article:
The Lower Back Is the Most Prone to Injury
The lower back (lumbar spine) has the least structural support and endures the most strain, making it the most frequently injured area of the spine.
The motion in the lower spine is divided between five motion segments, although a disproportionate amount of the motion is in the lower segments (L4-L5 and L5-S1). Consequently, these two segments are the most likely to be injured. For example, a herniated disc in this area can cause pain and possibly numbness that radiates through the leg and down to the foot.
Most episodes of lower back pain are caused by muscle strain. Even though this doesn't sound like a serious injury, pain in the low back can be severe.
- Learn more about Lumbar Spine Anatomy
The Bottom of the Spine Can Cause Pain Too
Below the lumbar spine is a bone called the sacrum, which makes up the back part of the pelvis. This bone is shaped like a triangle that fits between the two halves of the pelvis, connecting the spine to the lower half of the body.
The sacrum is connected to part of the pelvis (the iliac bones) by the sacroiliac joints. Pain here is often called sacroiliac joint dysfunction, and is more common in women than men.
The coccyx--or the tailbone--is at the very bottom of the spine. Pain here is called coccydynia and is more common in women than men. For more information, see: