By taking on an upright position, on two feet, the human species gained many benefits, while at the same time putting much greater loads on our spine. Spine as a segment of our skeleton is connected with both the head, through the neck, and to lower extremities through the pelvis and hips. Therefore it is one of the most important, but also one of the most problematic areas of the human locomotor apparatus. The spine acts as a bony column that enables our vertical stance. There are 7 cervical, 12 thoracic, 5 lumbar, the sacrum which has one big (5 fused smaller) vertebrae and the coccygeal bone that has 4 to 6 fused vertebrae. The spine has, as an answer to our upright position, developed 3 curves that in her sagittal section leave an impression of a double S letter. There is the cervical lordosis, thoracic kyphosis and the lumbar lordosis. Bad posture, lack of physical activity and long periods of sitting can lead to an increase or decrease in the range of motion of these spinal curves (hiper or hypolordosis, hiper or hypokyphosis, scoliosis) and in that way the load on the spine as a whole or on certain parts of it grows significantly. Between vertebrae there are softer parts called intervertebral discs with the purpose of decreasing the friction, in other words the discs serve as shock absorbers and help decrease the load on the vertebrae. The discs have a fibrose ring called anulus fibrosus and a soft core called nucleus pulposus. Two connecting discs and their belonging intervertebral disc make a so called dynamic vertebral segment, a place where degenerative changes or pain occur most often because it acts as a joint, a place where the movement occurs in the spine.
The reasons why pain appears in human back are many, from a sedentary way of life with a deficiency of physical activity, the aging process, genetic factors, trauma, etc. There is statistical data claiming that up to 80% of the overall population has or will experience some form of back pain. Degenerative changes first start developing on discs, their elasticity decreases, their form changes, the fibers of annulus fibrosus can develope small tears or fissures, intervertebral space can get narrowed, discs can slide out of their placement and even the nucleus pulposus can leak out of them if the annulus breaks. All of these changes put a much bigger load on the vertebrae itself and in the end on the spine as a whole. Spine deformations are caused by changes and wearing away of its parts and by sliding of vertebrae out of proper position which can lead to pressure on the nerves in the near vicinity of said vertabrae. They can also be caused by weak paravertebral musculature responsible for proper posture, by lack of physical activity and by longterm unnatural positioning of the spine. Deformations and pain in the back or spine can lead to a series of difficulties in other parts of the human body such as, migraine, tingling of the hands, feet or legs, chest pain, changes in hip positioning, loss or decrease of senses, etc. The pain can be acute, caused by a trauma or sudden movements that go beyond the range of motion of our back, or chronic, a result of a longlasting wear and tear of the integral parts in our spine and last through a longer period of time with varrying pain levels. Pain most often occurs in parts of our spine where a more mobile part of the spine connects to a part that is less mobile (lumbar spine, eg. L4-L5 or L5-S1).
As stated, there can be an array of degenerative changes in the spine region and its segments, with some of the prevailing ones being cervical pain syndrome (neck pain), cervico-brachial pain syndrome (neck pain that spreads in the shoulder and arm region), cervicocephalic pain syndrome (neck pain that spreads into the base of the head), lumbago, sciatica, spondylolisthesis, disc prolapse, disc protrusion or extrusion.