Category Archives: Spinal Health

Structures of the Spine and Causes of Back Pain
16 Nov

Structures of the Spine and Causes of Back Pain

Welcome back to Part 2 of the Restoration Blog! In Part 1 we discussed Keeping Your Spine Healthy in the Office and in this issue, we will start to consider the root causes of pain in Structures of the Spine and Causes of Back Pain.

The spine is a complex network of structures and any injury, irritation or problem with these can cause low back pain. This includes the musculoskeletal spinal muscles, ligaments, the bones, intervertebral discs, joints and the nerves which exit the spine. BUT this is where it gets a little confusing ….! It is important to emphasise that structural abnormality is not always indicative of pain and that structures actually causing back pain is a controversial topic. The term can should therefore be used carefully. The symptoms and severity of back pain vary greatly; a simple muscle strain can cause severe acute pain, while a degenerating disc may present with milder intermittent symptoms. Studies have shown that one individual may have a disc bulge on an MRI scan and have no pain, whereas another person may have no abnormality found on an MRI but are in 10/10 pain.

The pain you feel is therefore unique to you and is not necessarily coincidental to the type of structures involved or indicative of scan results. In this blog, we attempt to summarise the most commonstructural causes of back pain but we must always remember that our bodies and pain itself are complex and there are a wide range of variables to consider. Back problems can be connected; tight muscles can irritate the underlying nerves, which may or may not be interrelated with underlying disc or joint problems. The body can compensate in terms of posture and muscle imbalances and can be exacerbated by stress, inactivity, poor general health and nutrition. We focus below on looking at spinal structures, however we must also ask ourselves is the source of pain from or correlated with other variables rather than any structural abnormality …….

Muscular/ Soft tissue Problems

This is the most common cause of acute back pain and ranges from symptoms of a mild ache to sudden severe pain. Muscular and/or ligament (bands of tissue connecting vertebra to vertebra) problems can be caused by different mechanisms such as muscular strains from heavy lifting, repetitive overuse through sitting or bending activities, sports injuries, underlying muscle weakness, postural problems and subsequent compensations. Either the muscles or ligaments become over stretched or torn, placing undue stress on the lower back. Symptoms normally include the following: localised lower back pain, tendernesspasm and nerve problems.s, muscle pain,

Lumbar Disc Problems

Your intervertebral discs are the spongy pads between your vertebrae which act to cushion the spine as it moves. Herniated discs can occur gradually due to wear and tear of the spine, or suddenly due to injury such as heavy lifting. A prolapsed disc is whereby the disc becomes compressed and bulges outwards or ruptures. Alternatively, degenerative disc disease, which is degeneration of the disc itself can also be a source of pain. As the discs deteriorate they lose their shock absorbing ability during bending and torsion of the back.

Sacroiliac Dysfunction

The sacroiliac joint connects to the bottom of your spine (lumbar), to the tailbone and pelvis. Any dysfunction to this joint, such as too little or too much movement, can cause lower back pain and/or referred pain.

Lumbar Stenosis

This is a less common cause of back pain whereby there is narrowing of the spinal canal or nerve root canals exiting the spinal column. This can result in nerve end compression with neurological type symptoms; leg pain, tingling, weakness and numbness.


General wear and tear of the spine (arthritis), and of the cartilage surrounding the facet joints of the spine, can be a source of pain and limitation of movement.


The sciatic nerve extends from the lower back into the leg and to the foot. It can become impinged or irritated anywhere in its’ course and from any of the above conditions/ problems. The most common symptoms of sciatica are: burning type pain and/or tingling at the back and/or buttock, back of the leg and sometimes into the foot. Piriformis Syndrome is a problem whereby the piriformis muscle, a small muscle located in the buttock, becomes tight or spasms. The piriformis muscle can be irritated alone or because of a nearby structure such as the sacroiliac joint (see sacroiliac dysfunction). This can cause pain into the buttock area and can also irritate the underlying sciatic nerve.

Remember that if you experience low back pain, you are not alone. 80% of people will suffer with low back pain at some point in their lifetime. Most low back pain will resolve in days to a few weeks with correct self management and/or temporary treatment, but we must also get to the root cause, whether it be due to structural abnormalities, other factors, or a combination of both. A holistic approach is usually necessary to choose the best strategies and treatments to move forwards with for longer term management and prevention of reoccurrence. In Part 3 we will be focusing on treatment methods for the different causes of back pain, with an emphasis on re-gaining confidence with your back and getting you back to your best. See you in Part 3; Breaking the Vicious Cycle of Back Pain.

Total Restore. Your Manchester Physio Clinic.

Getting you back to your best.

Keeping your spine healthy in the Office
10 Oct

Keeping your spine healthy in the Office

Muscular Skeletal Pain and Musculoskeletal PhysiotherapistsWelcome to the Restoration Blog! In this first series we will be focusing on back pain, a common complaint which unfortunately most of us will suffer with at some stage of our lives. First up, in part 1, Keeping The Spine Healthy in the Office.

At the clinic we often find that people experiencing low back pain, whether it be a new onset or a recurring episode, are at a loss as to how and why it has happened. People will often say: I don’t understand, I was absolutely fine and woke up one morning with the pain, is it my mattress? Have I slept in a funny position? Have I pulled something whilst exercising the day before?

The spine and the pain we feel is complex and in Part 2 we will think more about the Structures of the Spine and Causes of Pain, but foremost let’s go back to basics on a practical level; where do many of us spend a considerable amount of our time? At the office. Work is essential in keeping us physically and mentally healthy but we must look after ourselves, particularly if we spend hours either sitting still or completing repetitive tasks. These activities can lead to poor posture which in turn can cause tight and weakened spinal muscles. Unfortunately, this could also mean that stressors on other structures have occurred; for example, stretched spinal ligaments, nerve and disc irritation, weak gluteal and core muscles, stiff and mal-aligned vertebrae. We must therefore attempt to unload the spine to counteract these negative effects, to reduce strain, fatigue, tension and to restore circulation, mobility and posture to the spinal column.

Here are some simple tips to a healthier and happier spine at the office:

  1. Keep moving! Aim to stand up from your desk every 30 minutes; get yourself a drink, go to the photocopier, check out the lovely view out of your office window if you are fortunate to have one, or just walk to the other end of the room in a pointless manner and back… your spine will thank you later.
  2. Take your breaks; this can be micro breaks for a couple of minutes every hour (see examples above or be creative and think of your own!), tea breaks, lunch breaks and rotating your tasks to combine sitting and standing activities if possible. No eating your lunch at the desk please unless you really have no other option.
  3. Look at the ergonomics of your work station and your posture. Most work places offer a work station assessment of some kind; make the most of this if they do. If not, ensure your lower back (lumbar spine) is supported ideally with a built in lumbar chair support, or a rolled up towel or pillow is better than nothing at all. Keep your hips slightly above your knees, feet firmly on the floor or on a foot rest, your monitor at arms’ length and at or slightly below eye level.
  4. Stretch the contracted lower back muscles. Here are three you can do at work to get you started:

Exercise #1 Hip and Spine Release:

Sit in an upright posture in your office chair (see point 3). Cross your left leg over your right knee. Lengthen your spine. Inhale and on the exhale, slowly bend forwards, bringing your chest and torso towards your folded legs. Allow your arms to drop down to the floor and hold this position for 5 deep breaths. Slowly curl the spine back up to an upright posture. Repeat 3 times on each side.

Exercise #2 Spinal Chair Twist

Sit slightly forward in your chair with an upright posture. Turn your head and trunk to the right. Cross your left arm over your body and rest this on the right arm rest or the side of your right leg. Place your right hand on the top of the back of your chair. Hold this stretch for up to 30 seconds, repeat 3 times on each side.

Exercise #3 Spinal Reach

Sit tall and upright. Clasp your hands and face the palms outwards. Reach above your head with clasped hands, stretching through the spine. Inhale and keeping your weight even through both hips, exhale as you reach up and over to the right. Hold up to 30 seconds, breathing normally. Return to centre and repeat 3 times on each side.

Often it is the small changes to our daily lives which make the most difference to our health and these office tips are easy to do, effective and will empower you to get back to your best. See you in part 2 for Structures of the Spine and Causes of Pain.

Total Restore. Your Manchester Physiotherapy Clinic. Getting you back to your best.