Muscle pain in back and neck
by Nathan Wei, MD, FACP, FACR
Nathan Wei is a nationally known board-certified rheumatologist and author of the Second Opinion Arthritis Treatment Kit. It's available exclusively at this website... not available in stores.
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The spine is a complex structure and vulnerable to injury.
The spine must be both mobile and stable.
The spine consists of 33 vertebrae and features three natural curves, the cervical (neck) curve, the thoracic (middle back) curve, and the lumbar (lower back) curve. In a normal spine, the cervical and lumbar sections curve forward, while the thoracic section curves backward. The cervical spine is the top seven vertebrae in the neck area. These bones permit rotation fo the head. The thoracic spine is made up of the 12 vertebrae in the upper back, and each thoracic vertebrae is attached to a rib. The lumbar spine is made up of the next five vertebrae. The lower back usually receives the most stress and strain.
Joining each pair of vertebrae posteriorly is a facet joint. Functioning like hinges, the facet joints guide the movement of the spine, while also stabilizing the vertebral column. Between each pair of vertebrae lies a flat, circular intervertebral disc. The outer part of the disc, the annulus, is strong and tough. The inner portion, the nucleus pulposus, is soft and absorbs shocks.
Two long ligaments run the length of the spine and help hold the vertebrae together along with the smaller ligaments between each vertebra. The extensors and flexors are the two main muscle groups that affect the back. The extensors are muscles in the back that allow the body to straighten up and lift objects, while the flexor muscles, which include the abdominal muscles, in the front allow us to bend forward as well as provide back support.
The vertebrae surround and protect the spinal cord, a column of nerves running from the brain. Peripheral nerves branch off from the spinal cord.
In general, back pain is not the result of a single incident. Rather, the back deteriorates from repeated wear and tear.
Most back pain stems from either muscle strains or joint and ligament sprains. Strains and sprains can occur when you bend too far or too often, lift a heavy load or twist suddenly. Strains are an excessive pulling phenomenon and there is little soft tissue damage. Sprains are a more serious problem where the muscles and ligaments are severely damaged leading to edema and even bleeding into the soft tissues. When the damage heals, it creates scar tissue, which is weaker and less flexible than normal muscle and ligament. Over time the back becomes less flexible and strong and more prone to painful damage. Both the neck and the low back are common areas for strain and sprain to occur. When the muscles become injured they will go into painful spasm.
Other conditions that should be considered in the case of chronic neck and low back pain include hypothyroidism and fibromyalgia.
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