Book An Appointment

Starting your recovery is as simple as answering a few questions.

Learn How To Get Started

Learn all you will need to know about your first visit right here.

Frequently Asked Questions

Answers to the your most common questions are one click away.
  • Facebook
  • Twitter
Labeled human anatomy diagram of man’s neck and back muscles from a posterior view on a white background.

When many of us experience neck pain or low back pain we often take to the internet to search for the answers. In order to comprehend the source of low back pain, neck pain, or sciatica one must first appreciate the relevant anatomy of the spine. Spinal anatomy is very intricate and gradually changes from level to level. Knowing some of the basics can help to demystify common conditions. Below is a list frequently referenced anatomical landmarks and terms to help you better understand how your back and neck work.

Similarly, we often seek information on-line when we need to decipher the meanings of our physicians reports and X-ray / MRI reports. Having a quick reference for

Cervical Spine The cervical spine is the neck portion of the spine and is made up of 7 vertebrae. They are labeled C1-C7 from top to bottom and they run from the base of the skull to the mid-back (thoracic spine) around shoulder level. The cervical spine possesses a large degree of mobility, which allows us to freely scan our environment. Nerves branching out of this area innervate the muscles of the neck, arms and hands. Sensory information from the hands, arms, neck and portions of the head also enter the spinal cord here. Neck pain, arm pain (brachialgia), numbness, and tingling, and pain into the shoulder blades (scapula), are common complaints related to injuries at this spinal level. It is estimated that 36% of all spine pain is “neck pain”.
Thoracic Spine The thoracic spine is mid-back portion of the spine and is made up of 12 vertebrae. These bones are labeled T1-T12 from top to bottom and run from the cervical spine down to the low back (lumbar spine). The ribs attach to the thoracic vertebra at several points which helps contribute to this regions stability. Nerves branching from this area of the spine control core muscles, internal organs and carry sensory information from the trunk to the brain. Injuries to this level are experienced as regional mid back pain as well as back pain, numbness, and tingling from the back extending forward around the ribs. Compression fractures are most common at this spinal level. It is estimated that 2% of all back pain is “mid back pain”.
Lumbar Spine The lumbar spine is the low back portion of the spine and is made up 5 vertebrae. These bones are labeled L1-L5 from top to bottom and they run from the thoracic spine down to the sacrum (pelvis). Spinal nerves branching out of this region control the muscles of the legs and feet. Sensory information from the legs and feet also enter the spinal cord in the lumbar spine. Low back pain, sciatica, lower extremity numbness, tingling, and weakness are frequently reported complaints related to injuries at this level. Lumbar disc herniation and lumbar stenosis are common disorders here. It is estimated that 62% of all spine pain is “low back pain”
Sacrum The sacrum is a wedge shaped bone at the base of the spine that is made up of 5 fused bones. The sacrum sits below the last lumbar vertebra and between two pelvic bones known as the illium. The sacrum has 4 pairs of sacral foramina or holes where nerve roots exit the spinal cord. These nerve roots control the muscles of the buttocks (glutes), pelvic floor, hamstrings and calves. Lumbosacral region dysfunction and sacroiliac joint (SI joint) injury (also referred to as posterior pelvic pain) is implicated in 14% to 20% of all cases where low back pain is reported.
Coccyx This is the lowest spinal level and rests beneath the sacrum. It is often referred to as the “tailbone” and is comprised of 4 small bones. Nerves do not exit from this spinal level as is the case at the levels above it. It is rarely implicated as a source of back pain but can be problematic in cases involving trauma where blunt force is experienced through this region (ex: falling into seated postures or upon the back). Coccyydynia and coccyxalgia are terms used to refer to injuries at this spinal level.
Articular Disc

 

The articular disc refers to the soft tissue between each vertebra. There are two parts to the articular disc. The annular fibers make up the stronger outer perimeter of the disc and are comprised of layers of ligaments giving the disc shape and stability. Held within the annular fibers is a jelly like substance that gives the disc cushioning and allows from freedom of spinal movement. It is formally termed the nucleus pulposus.
Annular Fibers The annular fibers are the outer portion of the articular disc that is strong, fibrous and maintains the integrity of the whole disc. This is the portion that is damaged when a disc is “herniated”. Loss of integrity to these annular fibers can lead to neck pain and low back pain depending on where the injury occurs.
Nucleus Pulposus The nucleus pulposus is the inner portion of the articular disc. It is a jelly like material that is contained within the annulus and provides the cushioning between vertebrae. When there is damage to the annular fibers the nucleus conforms to the area of injury and in extreme cases can actually be pushed out of the disc.
Vertebra A vertebra is the term for the bones of the spine. There are 7 cervical, 12 thoracic, and 5 lumbar vertebrae as well as 5 fused sacral vertebra and 4 coccygeal segments.
Vertebral Body The vertebral body is the cylindrical shaped portion of the vertebra designed to bear most of the compressive weight of the spine. This is the front (anterior) portion of the bone that is stacked on top of one another. Between each vertebral body is a disc that provides cushioning between these hard bones. This is the portion of the vertebra injured with compression fractures.
Intervertebral foramen The intervertebral foramen is a term for the paired holes to the left and right between two vertebra through which nerves exit from and return back to the spinal cord. In older adults decreased disc height can make this foramen progressively more narrow, which eventually compresses these nerves. The pinching of these nerves as they exit the intervertebral foramen is known as lateral stenosis and is one of the most common sources of low back pain and neck pain in seniors.
Facet Joint These are the joints on the back (posterior) portion of the vertebra. They are paired-up to left and right sides and provide stability to the spine. The orientation of these joints varies gradually but substantially at various spinal levels and is a primary determinant in the mobility at each spinal level. When we bend backwards these joints glide downward and compress upon each other. When we flex forward these joints open up and are decompressed.
Spinal Cord The spinal cord is the bundle of nerves that comes from the brain to reach the different parts of the body. The spinal cord is protected within the spinal canal. Narrowing of the spinal canal that compressed the spinal cord is known as central stenosis and can cause local neck pain or low back pain as well as pain, numbness, tingling and weakness extending into our extremities.
Thecal Sac The thecal sac is the membrane that encloses the spinal cord and keeps the cord saturated in cerebral spinal fluid. Compression of the thecal membrane is commonly caused by a disc herniation and can be seen on an MRI. Any compression of the spinal cord can cause low back pain, neck pain or sciatica depending on the severity and area of compression.
Nerve Roots A nerve root is the term used to describe a branch of nerves off the spinal cord. These roots enter and exit the spinal cord between the vertebrae through the intervertebral foramen. At each level these nerve roots carry motor information away from the spine while bringing sensory information back to it.
Lordosis Lordosis is the term for the concave curve naturally found in the cervical and lumbar spine. When this curve is either flattened or present in excess it can be a source of low back pain or neck pain.
Kyphosis Kyphosis is the term for the convex curve naturally found in the thoracic spine and sacrum. This curve is completely normal but is commonly present in excess at the thoracic spine leading to “hyperkyphosis”. If unaddressed it can be a common cause of back pain and increase our risk for compression fracture.
Scoliosis This term refers to an abnormal lateral curvature of the spine. This can occur for many different reasons. In more advanced cases this can lead to neck pain as well as back pain. Some causes include difference in the length of one leg compared to the other, misalignment of the pelvis, or trauma. A majority of all scoliosis is idiopathic (arising without clear cause).
Spinal Ligaments Ligaments are short bands of strong connective tissue that hold bones to other bones. In the spine they provide stability between vertebrae and limit excessive motion.

Works Cited:

http://www.mayfieldclinic.com/PE-AnatSpine.htm

http://www.tarlovcystfoundation.org/our_library0.aspx

 

1 Comment

  1. 4I6GlUie

    141659 967812A quite exciting go by way of, I could not agree completely, but you do make some genuinely legitimate factors. 105791

    Reply

Submit a Comment

Your email address will not be published.

Pin It on Pinterest

Share This

Share this post with your friends!