The most important thing to remember is that back pain is usually the result of a structural problem, and until the structure of your spine is addressed the pain will persist.
Your spine is composed of several bones called vertebrae, and between each vertebrae is a fibrous structure with a soft inner core called the disc. The outer portion of the disc is called the annulus fibrosis and the soft inner structure is called the nucleus pulposus. This structure provides flexibility and cushioning to the spine. It also creates space between thevertebrae so that the delicate spinal nerves can pass through the openings called foramen to reach their target destination. If the discs become damaged in any way, a cycle of pain begins with the start of progressive problems which can culminate in a Herniated disc or ruptured disc.
How are discs damaged?
Overall, discs are very tough and resilient; however they are very susceptible to injury with repetitive activity and loading.
For example when you lift incorrectly or sit in one position for long periods of time the fibers in the disc begin to weaken. An example of this is a common paper clip. If you bend the paper clip one time it doesn’t break, but do it over and over again it just snaps in half.
The fibers of the outer portion of a disc, the annulus fibrosis behave in much the same way. As the stresses on the disc are repeated (such as repetitive lifting or even sitting in one position for long periods of time) the fibers break down. This creates small cracks and fissures in the discs creating a pathway for the softer inner nucleus to slowly leak out. This is the beginning of a disc bulge or herniation.
What is a Herniated disc?
When your disc is injured or torn, the nucleus — the soft jelly like substance inside the disc, can leak out. If it leaks out completely, it’s called a herniated disc. If the outer material is not torn, discs can bulge without herniating. It’s like if you step on a balloon and it doesn’t pop. The balloon bulges out to one side or the other without the rubber breaking.
When a disc bulges or herniates it is a major cause of back pain. It can also pinch the delicate nerves that pass by as they come out of the spine. That’s what can cause radiating pain. In other words, pain, tingling and numbness going down your leg or arm and possibly into your toes or fingers!
This radiating pain is often referred to as sciatica in the leg, or cervical radiculopathy in the arm.
As the outer portion of the disc weakens, the pressure on the discs causes the inner nucleus to migrate through the small cracks and fissures that have been created. This pressure changes with various activities and an activity such as lifting incorrectly can dramatically increase the pressure inside the disc.
When the pressure in the disc increases, the forces push the inner material outward. And if there are small cracks or tears in the outer fibers of the disc this material can literally “squeeze out.”