This Is What's Causing Your Back Pain（原声文稿）

experience some form of back pain at some point in our lives.

how bad it hurts, how long it lasts, and of course is.

So in today's video where we take a look at the back, surrounding muscles, essentially looking at all these places you can better understand why you might be experiencing that back pain. So let's jump right into it.

So as I mentioned there are multiple in therefore pain.

So it probably makes sense for us to go over some of the basic be used interchangeably and we can see that the spine is made up of a little bit more closely, let's break this down take a look at some of these structural features so that we can apply Now remember we said there's five individual regions is our first region referred to as the cervical region.

Now, the cervical region or cervical translates to neck.

bones or cervical vertebrae that make up this region.

Here's cervical vertebra number one, cervical vertebra number two. You can see how annoying that would be.

So instead, we choose to abbreviate C1, C2, all the way down to C7 here.

The next two rows represent the next region, which is the thoracic region. You can see the bones are also getting larger.

chest anatomy, and there are 12 individual thoracic vertebrae.

Here's T1 all the way down to T12 here.

The next region is the lumbar region represented by this row. Lumbar translates to loin.

Now we're not really referring to loin stirring or a wrestling in your loins or nether regions here.

In anatomy, loin refers to this region between the lower rib and the pelvis here, vertebrae occupy.

But there are five individual lumbar L5 here.

Now I want to just pause for a second here, vertebral column meaning you can get movement between the individual and that is great in all because we get mobility increased risk for injury, damage, pain and that's going the fourth one being here let me get this into focus in between my fingers called the sacral region.

The sacral region started as five individual sacral bones.

five, but around age 14 to 16, these bones start to fuse together.

fusion takes place and it is one solid bone that we refer to as the sacrum. The fifth region does something similar.

was individual little bones that you can see here that fuse together.

And one of those four fused together, we call it the coccyx, or many of us just refer to it as the tailbone.

to hone into some of these origins of back pain.

functions or demands that we place upon the back these holes and this hole is referred to as the vertebral a canal called the vertebral canal and that's where the spinal cord will run through the central skeleton.

This large region that you see on the majority transmit forces and weight.

Now this little hole that's in these vertebral just wanted to mention that but the vertebral body is all of the spine is to move in all three planes of space.

transverse processes.

The ones coming off the back are bones to move a side to side, front to back, and even rotate.

Transmit all this weight.

And then move in all three planes of will have back pain because of all the demands that we place upon example, the intervertebral disc that we already mentioned.

help decompress or take some of the pressure off your disc is sleep, we're going to utilize Cornelius, the fake skeleton, he's a real skeleton, he's a fake skeleton, but Jeffrey doesn't have we're going to take a look at the sagittal cut through this cadaver and you these amazing intervertebral discs.

So you can see the disc in between the bones, disc bones on either side neck or in the cervical region and discs go from that last disc being between L5 and S1 here that I'm pointing at the probe there.

actually are narrowing on the back in the front or posteriorly and anteriorly, starting to degenerate a little bit.

And if we move up, that degeneration got even worse in the thoracic region.

the vertebral bodies, the bone, started to actually narrow and degenerate.

cadaver, the body in the front started to narrow and create more of a wedge shape rather than this nice boxy vertebral body that we should have.

from the bones degenerating as well as the disc.

disc problems is just aging and degeneration.

something really heavy or just really bad luck and twisting it as a herniated or bulging disc and luckily show us kind of this example of what a bulging disc that damage to the disc in and of itself would cause pain.

would cause pain. Bones degenerating would cause pain.

other category of pain is essentially potential irritation And some of these close by structures are your spinal foramen or foramina for pleural.

And this is the pathway narrowed that intervertebral foramen, maybe the actual vertebral disc got degenerated and got thinner, you could see perspective of putting two vertebrae together without a disc, and cause a problem for that nerve trying to come have a herniated or bulging disc, especially if it goes posterior-laterally compressing, irritating or damaging that nerve.

So this nerves. Again we said from C2 down to the actual sacrum.

And when we pain that I kept harping over earlier in the video.

But that nerve things like numbness, entangling in the skin, and even potential weakness as to mention about discs and nerves before we talk about other commonplace where you often hear about herniated discs and around the sciatic nerve and sciatica. So let me show you the sciatic nerve.

hamstrings coming down this direction.

And you can see this large nerve, of the lower leg and into the foot.

But what sciatic nerve gets contributions from five different spinal nerves or five different spinal levels.

If you look at Cornelius here, we've got L4, L5 there, the sciatic nerve.

So those five different lateral kind of just backwards posterior and more medial, which would go into the spinal canal.

canal and could get pushed on by a herniated disc that's going posteriorly.

tingling, and even potentially muscle weakness.

Another potential cause of back pain is a form of arthritis called osteoarthritis.

hip arthritis, maybe even arthritis in the joints of the fingers.

that are forming the joints starts to break down or degenerate.

and eventually can cause pain within the joint.

tiny small little joints going the entire length that have cartilage within.

of those joints here, here, here, here, and all the way up on both sides cervical down to lumbar And they're referred to as facet joints most like to say facet because it sounds more lumbar vertebrae Let's zoom into one of them so I can really drive this point home but here would be an area covered with cartilage on this lumbar vertebra. Here it'd be another area and these would form facet joints.

could be anywhere within the length of the spine, and it does tend to localize close to the area where the arthritis is.

example, who get whiplash, are more likely to develop that tear can cause it.

You can even talk about improper spine might put more pressure or more wear and tear than others. And of course, aging is a risk factor.

this is the type of back pain that people will often say things like, re-injured like an old disc injury but most are referring to this muscular type this cadaver dissection, you might not recognize a lot of these muscles here.

pictures are like the trapezius or traps here, the latissimus that we removed those is because those muscles, even though they are on the back, like the shoulder joint and even the scapulae here.

move our spine are underneath, and that's what you're looking at here.

So we had to remove all those more superficial back muscles.

So for example, here's a group of muscles called the erector spiny muscles.

iliocostalis here, the longissimus here, and the spinalis.

FYI, people have a nice little mnemonic to remember those muscles. It's called I Love School.

Other people like, no, no, no, no, I remember it better this way.

I'm just the messenger here, just FYI, they say something like I love sex. They are the erectors after all.

side, like the multifidus and even the semi-spinalus.

could be involved in some muscular back pain. Not all of them, but some potential major contributors.

And so what's happening with this type of pain is that the muscles can be strained.

pulled just like you can strain or pull a hamstring.

can get tears in those muscle fibers and that can obviously vary in severity.

as they feel tight and they don't want to move because that will aggravate the pain.

you have more than one thing going on at the same time? And the answer is yes.

that area also spasmed and created tension and pain on top of the disc injury.

arthritis in the same area, and the muscles were spasming.

obviously didn't cover every single type of back pain.

We mostly focused on these those closely related structures like the nerves and the surrounding the spine even pathological fractures from certain problem. There's also viscerogenic back pain. Viscero just means internal organs.

inflamed, can refer to the back and cause that back pain.

But when we're in this video, you might think, well, how do we deal with this?

Well, luckily and supportive therapies.

And when we're talking about supportive like possibly applying heat, massage, exercise, and even physical therapy.

lidocaine patches, NSAIDs which are things like ibuprofen to help manage the pain.

necessary if we've got some muscles that are spasming like crazy.

you can step up even further to things like injections.

nerve or even an inflamed facet joint.

There's this really cool facet joints where they inject this needle with radiofrequency and nerves that we saw on Cornelius, those big nerves, but a tiny tiny things with a ruptured or bulging disc to help Obviously there's so much more information that we could go into that the love to hear from you guys.

So if you want us to go into any forms of back pain, throw those in the comments.

And if you like what you learned here, proper mechanics, mobilize the spine properly, and strengthen those surrounding muscles. And we'll see you next time.