Spinal breakdown

There is usually a pattern to your spinal condition. Telling you the story of its breakdown will make sense of what you are experiencing.

Stiff spinal segment

Mobility of the 24 interconnected bones of our spine is essential. Should any stiffness arise for any reason, part of the chain seizes up and throws it off balance. At this stage there are usually no symptoms and we take no action. Stiffness between two vertebral bodies means that the movement is lost, causing reduced pumping action of fluid into the discs. This reduces the supply of needed nutrients into the disc which cushions the bodies and so the breakdown begins. Pain usually starts in the disc, coming from its outer layers. This is the simple pain of back ache in the early stages and should be a warning that something is amiss.

See notes on relief of increasing pain and stiffness in the neck under Fit for Living.

Facet joint disturbance

Undernourished discs start shrinking which throws greater strain on the structures around them, in particular the facet joints at the sides. There are four such joints at each level, two facing up and two down. These joints are like any other, and have cartilage surfaces, synovial fluid, capsules, ligaments, blood and nerve tissue. On injuring the facet joints through strain or a sudden uncontrolled  movement, the facet joints behave like any sprained joint. Congestion builds up and pain from the facet joints can be referred to the leg. It is sometimes mistaken for symptoms from a 'slipped disc'. The swelling can cause pressure on a nerve root passing the joint, which can also cause referred pain. These symptoms may settle as we continue to move around but there is usually a susceptibility to further strain if full mobility of the joints and nutrition of the discs is not restored.

Acute locked back

What is known as an 'acute locked back' may develop. This is an episode of acute pain on a seemingly innocent movement. The victim is unable to move and is stuck in the position that gave rise to it. It is very frightening and assistance is needed to a place where the victim can lie down. Some times it can require admission to A & E. Bed rest, possibly for 48 hours, with an anti-inflammatory and muscle-relaxant is required. Lying on the back with the knees and hips bent at right angles and the legs resting on a stool gives most relief. Gentle movements of the back every two hours are essential in order to free up the muscles causing a jamming of the spine. Movement of the facet joints is essential to relieve the congestion and restore normality.

First aid

If at anytime you are aware of ricking your back, to prevent a severe back ache developing, immediately take anti-inflammatory medication ( if safe to do so) lie on the floor and practise bridging, mobilising each part of the spine. Repeat the exercise several times, and again after a few hours. This prevents acute inflammation flaring up with its pain and congestion.

Prolapsed (slipped) disc

This is not as common as one would think and usually occurs after prolonged malfunction of the spine. The centre of the disc houses the jelly-like nuclear pulposa which can start to breakdown if undernourished. Cracks start appearing in the outer disc layers and with repeated pressure, the nucleus can start oozing out until it is outside of the disc. It is at this point that it may interfere with nervous tissue in the spinal canal or near the roots as they leave the spine. Should serious nerve irritation follow with severe pain, numbness and possibly weakness of leg muscles, the usual method of treatment is surgery to relieve compression of the nerve. It has been found that many people have extruding (slipping out) nuclear pulposa without developing any symptoms. It has also been found that the pulposa can be absorbed by the body with no further ill-effect. 

Segmental instability

After longstanding problems, the affected level of the spine can develop serious instability, predisposing it to repeated episodes of displacement with its ensuing pain and dysfunction.

Careful attention should be paid to caring for your spine, strengthening the muscles and avoiding poor posture and prolonged sitting.