KNOW YOUR SPINE?
You have successfully answered the question of what is hurting and now are probably wondering why it is hurting. But before we move on to the complex mechanisms of nerve pinching and radiculopathy, we should know some basics about the spinal column. The Spinal Column is a group of 33 bones which are called vertebrae. These bones are irregular in shape and have elastic disks present between them to help them support weight.
The whole spinal column is divided 5 parts : Cervical (7 bones in the neck region), Thoracic (12 bones in the upper back region), Lumbar (5 bones in the lower back region), Sacral (5 fused bones) and Coccyx, (4 bones in the tail region). There is a forward curve called lordosis in the neck region and the lower back region and a backward curve in the upper back and sacral region. In general, the spine is a straight structure and this alignment is three dimensionally altered in scoliosis and other deformity conditions. This alters the general anatomy of the body and might pose pressure on the nerves and therefore cause excessive back pain.
WHAT IS SCOLIOSIS?
Scoliosis refers to a condition which presents with an underlying deformity in the anatomy of the spine. A side wards curve is present on the spinal column. An anterior-posterior radiograph (front view) shows either a C- shaped or an S-shaped curve while the lateral (from the side) X-ray shows a mild outer roundness in the upper back (kyphosis) and a mild inner roundness (lordosis) in the lower back. It is important to understand that scoliosis is a 3-dimensional alteration in the spine anatomy which means that there is also a twist in the spine about the vertical axis. The symptoms of this disease vary with age and may present as cosmetic problems, back pain of unknown source and leg pain and weakness. The cause of scoliosis has not been determined yet but is presumed to be a combination of genetic and environmental factors. Scoliosis can either develop in an infant or even develop due to age-related degenerative changes in an older patient.
KYPHOSIS
Kyphosis refers to a condition in which there is excess outward curve of the spine in the neck, upper back and sacral regions. It is also known as round-back. The most common cause of this condition is a vertebral fracture due to osteoporosis, i.e. a decrease in the density and strength of the bone.
The front of the vertebrae collapses and loses its height but the back of the vertebrae remains stable and maintains its height. Therefore the spine, at the segments starts arching forward. Other causes include congenital (i.e. from birth), due to age-associated degenerative changes, or even due to iatrogenic causes, i.e. development of kyphosis as a complication of a previous spinal surgery. Another form of kyphosis is the Sheurmann’s disease in which patients develop kyphosis due to abnormal growth of the vertebrae and the spinal disks.