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Your spine is made of 24 bone blocks called vertebrae,
stacked on top of each other, resting on the wide basin of the
pelvis (your hips) and topped by the skull. Sandwiched between
each vertebra are spongy but tough cushions called discs, which
act as shock absorbers for the vertebrae and give the spine its
flexibility.
Strong elastic ligaments hold all the vertebrae and discs
firmly together in a column. Muscles are attached to the
vertebrae by rubbery connections called tendons - and the
contractions and expansions of the complex layers of back
muscles produce the movements of your back and your upper body.
The spine also provides a protective case for the spinal
cord, which runs from the base of the brain into a hollow canal
down the vertebrae. This is the main communications cable
between the brain and the rest of the body, and nerves from the
spinal cord branch out and leave the spine through spaces
between the vertebrae.
Doctors divide the back into the five regions shown in the
diagram. It is the lumbar region, right at the bottom of the
flexible part of the back, and just above the pelvis, where back
pain strikes most often. This is because the lower part of the
back bears the entire weight of the upper body, plus any weight
the person is carrying. It also twists and bends more than the
upper part of the back
The spine is the central pillar of the body. It supports the
weight of the head and the trunk and provides a protective
passage for nerves to travel through. Anything that weakens or
puts pressure on it affects its shape and consequently how
effectively it works.
The normal back
Our spine is made up of twenty-six bones called vertebrae
that are stacked like building blocks on top of each other.
There are seven cervical, twelve thoracic, five lumbar, one
sacral (made up of five bones fused together), and the coccyx
(made up of four bone fused together). In between these
vertebrae are discs filled with soft material that act as shock
absorbers.
Looked at from behind the normal spine is straight and
stretches vertically from the head down to roughly the top of
the cleft between the buttocks. Looked at from the side the
spine has two curves. One is at the top of the back and bends
outwards, the other is in the small of the lower back and curves
inwards.
Excessive curves
When the curve of the upper spine becomes excessive the back
may appear hunched and more rounded than usual. This is called a
kyphosis. Poor posture may contribute to it developing over the
years. However, more commonly it's diseases affecting the spine
that are responsible, such as osteoarthritis or osteoporosis.
Children too can have a kyphosis although when this is the case
it is usually not known what has caused it.
Excessive inward curving of the lower back makes it appear
deeper and more hollow. This is known as a lordosis and being
overweight is a common cause. Having a large belly causes
imbalance and to compensate for this and to prevent toppling
forwards a person will lean backwards. Weak abdominal muscles
may also be partly responsible for lordosis developing, as may
having a poor posture.
In fact, having a kyphosis may contribute to a lordosis
developing as well. Once again it's about trying to correct the
imbalance created by the excessive outer curve.
Both these excessive curves of the spine can cause muscular
strain and muscle aches. Physiotherapy helps to strengthen the
supporting muscles of the spine and correct poor posture. Where
there is an underlying cause, for example osteoporosis, then
this needs to be treated. Maintaining an ideal weight is also
advisable if further problems are to be avoided.
The side-ways curve
In the normal spine there is no sideways curve. When the
spine does curve to the side then this is called a scoliosis.
It's more common for women to develop it and it can run in
families. A scoliosis most often appears in the upper chest area
or in the lower back and usually there is no obvious cause for
it. Some babies are born with a scoliosis and this is known as a
congenital scoliosis. Rarely diseases causing muscle weakness
around the spine may be responsible, for example, poliomyelitis.
If the legs are not the same length then the spine will curve
because of this.
If the scoliosis isn't obvious from birth then it tends to
develop during childhood and teenage years, and gradually it
becomes more visible. Bending forwards makes it more obvious.
The gait of someone with a scoliosis may be abnormal
contributing to the back pain that may be experienced
intermittently.
It's important not to ignore the emotional effects the
appearance of a scoliosis has on someone, particularly since it
tends to appear at the often-difficult time of puberty when many
other body changes are also taking place.
Treatment of a scoliosis involves physiotherapy to strengthen
the supporting muscles of the spine and where a cause is known
this must be corrected. For example, wearing appropriately
raised shoes to make the legs of equal length.
When the scoliosis is severe or getting worse quickly then it
may be necessary for a spinal brace to be worn to prevent
further curvature developing or to have spinal surgery.
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