Back Pain
Glossary of osteopathic terms.
Lumbago – old term for back pain, derives from lumb (low back) ago (ache)
Spinal disc – flexible ‘spacers’ between your vertebrae made up of a central soft gel wrapped in layers of fibrous tissue (annular fibres) to facilitate spinal bending and twisting
Vertebra(e) – Individual spinal bone(s): at the front of the bone is the body, a thick disc-shaped bone and at the back a bony circle to contain and protect your spinal cord with 2 protruberances at each side and back for your spinal muscles to attach to
Spinous process – the protruberance of bone off the back of each vertebra which you can see as a line of bumps – your spine – that spinal muscles attach to
Lateral – to the side (either side)
Lateral processes – two outcrops of bone at each side of the vertebra (like two side fins) which your spinal muscles attach to
Posterior longitudinal ligament – long ligament that runs down the back of all the vertebrae and discs like a long piece of protective K-tape, limiting too much spinal flexion
Anterior longitudinal ligament – long ligament that runs down the front of all the vertebrae and discs like a long piece of protective K-tape, limiting too much spinal extension
Annular fibre tear – lesion in in the fibrous layers of the spinal disc usually at the back and side (posterolaterally) where the posterior longitudinal ligament doesn’t protect the disc
Prolapsed disc / herniated disc / slipped disc – A spinal disc whose soft central gel has protruded through the annular fibres (usually lateral to the posterior longitudinal ligament)
NSLBP – non-specific low back pain. Back pain described as musculoskeletal without nerve root pain, (motor) weakness or (sensory) paraesthesia
Inflammation – the process of repair of any tissue which brings lots of repair cells and fluids to the site causing swelling, redness and soreness
Strain – an injury caused to soft tissues in the body caused by overloading the tissues or overstretching causing injury to some of the fibres
Parasthaesia – any sensation related to a peripheral nerve: numbness, tingling, heaviness, deadness, pain
Peripheral nerve – 43 pairs of motor and sensory nerves that connect your central nervous system to the rest of your body (muscles, organs and everything)
Motor nerves – these are nerves that control actions (basically any movement eg. moving your eye, picking up a cup of tea, and swallowing your tea)
Sensory nerves – these convey sensation (how heavy your cup of tea is, how hot it is, how cool your breath feels blowing on your tea and hand)
Cervical – neck area of your spine from the base of your skull to the top of your shoulders; numbers 7 vertebrae (C1 – C7)
Thoracic / dorsal – main back area of your spine from your shoulders to your waist each vertebra of which has a pair of ribs attached; numbers 12 vertebrae (T1 – T12)
Lumbar – low back area of your spine from the back of your waist to the top of your pelvis; numbers 5 vertebra (L1-L5)
Sciatic nerve – the thick nerve made up of several nerve roots exiting your spinal cord in the lumbar region supplying your lower limb (from your butt to your toe) with motor and sensory fibres.
So, here’s a typical explanation your osteopath might give you for why you haven’t got a slipped disc or a prolapsed disc.
“Your back pain or lumbago is what we would now term non-specific low back pain. This means you’re not experiencing any sciatic nerve symptoms (such as foot or toe weakness or pins and needles). This doesn’t necessarily mean you don’t have an annular fibre tear or a disc prolapse, but because these would be likely to cause inflammation that compresses one of the nerve roots that forms the sciatic nerve, this is less likely. Therefore, we’ll assume that you’ve strained (or overstretched) a muscle (or ligament) in your low back which, although very painful in the first few days after the injury, will recover much more quickly than an annular fibre tear or strain or disc prolapse.”
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