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You and your Spine

Understanding how your spine works can help you better understand some of the problems that occur from injury or the effects of ageing.

The Curves
Your spine is made up of three regions when viewed from the side, these regions form three natural curves. The "c-shaped" curves of the neck (cervical spine) and lower back (lumbar spine) are called lordosis. The "reverse c-shaped" curve of the chest (thoracic spine) is called kyphosis.

These curves are important to balance and they help you to stand upright. If any one of the curves becomes too large or small, it becomes difficult to stand up straight and our posture appears abnormal.

The Vertebrae
The spine consists of 24 individual bones called vertebrae which are stacked on top of each other. The cervical spine is made up of seven small vertebrae that begin at the base of the skull and end at the upper chest. The thoracic spine has 12 vertebrae that start from the upper chest to the middle back and connect to the rib cage. The lumbar vertebra consists of five larger vertebrae. These vertebrae are larger because they carry more of your body's weight.

The Muscles and Ligaments
These provide support and stability for your spine and upper body. Strong ligaments connect your vertebrae and help keep the spinal column in position.

The Facet Joints
Between the back of the vertebrae are small joints that also help your spine move. These facet joints have a cartilage surface, very much like a hip or a knee joint does. The facet joints are important for allowing rotation of the spine but may develop arthritis and become a source for low back or neck pain.

Slipped Discs
The condition commonly called a slipped is actually a ruptured, or herniated disk and is one of the most common causes of low back pain, as well as leg pain (sciatica). For most people with a slipped disc, low back pain is the initial symptom - although not all patients will experience pain as a disk degenerates.

A disk begins to herniate when its gel-like nucleus pushes against its outer ring due to wear and tear or a sudden injury. This pressure against the outer ring may cause lower back pain. If the disk is very worn or injured, the jelly-like centre may squeeze all the way through.Once the nucleus breaks or herniates through the outer ring, pain in the lower back may improve. Sciatic leg pain, however, increases. This is because the jelly-like material inflames the spinal nerves. It may also put pressure on these sensitive spinal nerves, causing pain, numbness, or weakness in one or both legs.
The Discs
In between each vertebra there are protective, circular pads called discs. They are flat and round, and about a half inch thick. Intervertebral disks are made up of two components.

Nucleus pulposus. A jelly-like substance that makes up the center of the disk. The gel is partly made of water and gives the disk flexibility and strength.

Annulus fibrosus. This is the flexible outer ring of the disk. It is made up of several layers, similar to elastic bands.

When you are standing or moving, weight is put onto the nucleus. In response, the nucleus expands. In effect, disks act as shock absorbers for the spine. The intervertebral disk is a very important structure. Many nerve endings supply the annulus and, as a result, an injured annulus can cause pain.

The Spinal Cord and Nerves
The spinal cord extends from the skull to your lower back and travels through the middle part of each stacked vertebra, called the central canal. Nerves branch out from the spinal cord through openings in the vertebrae and carry messages between the brain and muscles.

The spinal cord ends around the first and second lumbar vertebrae in the lower back and continues as nerve roots. This bundle of nerve roots is called the cauda equina. They exit the spinal canal through openings in the vertebrae (foramen), just like other nerve roots.

Trapped nerves
Trapped nerves occur when a nerve coming out from the spinal cord is irritated or pressed on. You feel pain along the course of the nerve. This condition is known as sciatica. Typically pain is felt down a leg, sometimes as far as to the calf or foot. The irritation or pressure on the nerve may also cause pins and needles, numbness or weakness in part of a buttock, leg or foot. About 9 in 10 cases of nerve root back pain are due to a slipped disc when part of the disc can press on a nerve nearby.

Sciatica
If you suddenly start feeling pain in your lower back or hip that radiates to the back of your thigh and into your leg. This condition is known as sciatica. The cause may be that have a protruding (herniated) disk in your spinal column that is pressing on the roots of the sciatic nerve which may also get inflamed and irritated by chemicals from the disk's nucleus.

Sciatic pain may also result from a condition known as Pyriformis Syndrome. This may occur as the sciatic nerve runs close to the Pyriformis muscle, located deep in the buttock, which may spasm due to a number of reasons and can lead to a trapped nerve.
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A Note of Caution
In very rare cases, a disorder affecting the bundle of nerve roots (cauda equina) at the lower (lumbar) end of the spinal cord is impacted by a herniated disk and could cause you to lose control of your bladder or bowel or have numbness or tingling in your groin or genital area .

If this happens it should be treated as an emergency situation and you should contact a doctor immediately.

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