Physiotherapy Department Tel: 01473 703312 Information for patients Understanding Your Spine The spine is a flexible column linking the pelvis, thorax (rib cage) and head. It is made up of a working arrangement of bones, joints, discs, ligaments, muscles, spinal cord and nerves. Together these structures enable the spine to twist and turn, bend and stretch. Bones These provide ‘scaffolding’ to support the weight of the body. The spine is made from 24 vertebrae; seven form the neck, 12 support the rib cage and five form the lower back. However, the spine is one continuous structure which supports the skull and finishes with the pelvis. The position or posture that your spine rests in can affect how well your spine moves and how comfortable you are. Joints These are formed when two vertebrae meet and move on one another. These joints are either side of the spine at each level and are called facet joints. When the spine moves, these joints open and close. Your posture affects the position of these joints. There are also two joints at the bottom of the spine where it meets the pelvis. These are the sacroiliac joints. Joints can become strained through poor posture, repetitive loading or poor muscle control. Discs Facet joints DPS ref: 06099-14(RP) Vertebra Nerves Ô Discs These separate the vertebrae and are located between each vertebra. Each disc is made up of a gel‑like centre which is surrounded by rings of strong cartilage. The discs act as shock absorbers and allow movement between the vertebrae. Discs can bulge or become torn under excessive, prolonged or repetitive pressure. Ligaments These support the bones and joints. They help to stabilise the spine and prevent excess movement. Ligaments can become strained through poor posture or repetitive loading. Muscles These create movement at the spine. They also play a very important role in stabilising the spine. Muscles affecting the spine can be large powerful muscles affecting several joints or much smaller muscles affecting one joint. They can extend from the skull down to the pelvis. Muscles can be torn through injury, go into spasm (as a reaction to pain) or be inhibited (prevented from working properly, either due to pain, weakness or poor posture). Nerves Between each pair of vertebrae there is a small opening for a nerve. The nerve carries messages to and from the brain and other parts of the body via the spinal cord. The nerves supply our muscles with power and our skin with sensation, such as feeling temperature, pressure and pain. Nerves can become inflamed or pinched. This may cause a feeling of pain, pins and needles or numbness. It can also cause a muscle to become weak. If this occurs in the lower back, this may be felt in the buttock, hips or legs. In the neck this may be felt in the shoulders or arms. In the spine nearest the rib cage this may be felt in the arms or around the rib cage. If one or more of the above structures is injured or strained the body’s natural response is to become inflamed. In the majority of cases the body will heal itself and any pain or discomfort will resolve. Occasionally the body reacts differently to the injury or strain, which can lead to chronic pain. Sometimes the cause of the problem is obvious, if you have had an accident for example. Often the cause is less clear and is a combination of events over weeks, months, or even years. Posture is often at fault. The way we sit at home, at work or when driving, the way we stand, walk or even lie, can put excessive strain on the spine. This can be because of poor habits learnt over a lifetime, badly designed furniture, or muscles not supporting the spine properly. Some activities and movements can put your back at risk. Many factors can place strain on the back and lead to injury, including being in a poor working position, repetitive movements, or if you are not strong or flexible enough for the task. In order to ensure good recovery and prevent a recurrence of the problem, it is important that you know how to look after your back and how to reduce the risk of injury. Your physiotherapist will discuss this with you during your physiotherapy session. Produced by: The Ipswich Hospital NHS Trust Heath Road, Ipswich, Suffolk IP4 5PD Hospital switchboard: 01473 712233 www.ipswichhospital.nhs.uk Issue 3: January 2015 Review date: December 2017 © The Ipswich Hospital NHS Trust, 2007-2015. All rights reserved. Not to be reproduced in whole, or in part, without the permission of the copyright owner.