How the Curves in Your Spine Cause Back Pain

By Dan Baumgard

Over 60% of us will suffer from lower back pain at some point in our lives. Without question, it’s the leading cause of disability across the globe.

Your spine is comprised of 33 bones known as vertebrae, which are stacked one on top of the other. The resulting column is divided into five segments: cervical (in the neck), thoracic (at the same level as the chest), lumbar (at the level of the abdomen) and sacral (connecting with the pelvis). The fifth, the coccyx, is located at the very bottom of the spine (the tailbone) – and is very painful when injured.

The vertebrae are connected by multiple joints, including discs which allow the spine to move in multiple directions. Though we might think the spine should appear straight, it naturally curves forward and backwards so it can perform all of its important functions.

But many conditions can cause the spine to curve more than it should. This can not only lead to pain, but potentially a whole host of other health troubles too.

Dowager’s Hump

The spine also supports the weight of the body, protects the spinal cord and helps the body to bend, flex and twist. The thoracic region attaches to the ribs and naturally curves backwards – this curve is known as the thoracic kyphosis.

But sometimes, the curve of the thoracic kyphosis becomes more accentuated and visible – often as a result of osteoporosis (where bones become weaker), age-related changes to the back muscles and vertebrae, or long-term poor posture.

The medical name for this condition is hyperkyphosis, though it’s sometimes referred to as “dowagers hump” as it’s around two to four times more common in women.

A stooped posture with rounded shoulders (or “hunchback” appearance) is typically a sign of hyperkyphosis.

In some cases, it may become so extreme as to impact breathing since the chest can’t inflate properly. It can also affect swallowing since the neck becomes more horizontal and the gullet potentially narrowed.

Dowager’s hump

And of course pain and stiffness typically arise. This is a common theme for most patients with abnormal curvature of the spine, as the vertebrae lose their ability to move, and nerves arising from the spinal cord can become compressed.

Scoliosis

Another type of deformity that can occur in the spinal column affects not only how it bends forward and backwards, but also side-to-side.

Scoliosis occurs when the vertebrae either curve sideways, rotate in relation to each other, or collapse. This produces a variety of different deformities, ranging in size and severity.

The underlying causes of scoliosis are widespread. Sometimes bones can become deformed as a result of trauma, cancer or an infection (such as tuberculosis).

Scoliosis can also be present from birth, or arise from neurological disorders in early years – such as cerebral palsy.

As well as back pain, patients may also notice postural signs as scoliosis evolves. Their shoulder blades or ribcage can stick out more, and clothes may fit differently on their body.

SCOLIOSOS

Slipped and Fused Spines

Individual vertebrae in any part of the spine can sometimes also become displaced as a result of trauma, wear and tear, or certain health conditions (such as osteoporosis).

This means that instead of standing in a regular stack, a vertebra slips forward, and out of line. This condition is given the long and practically unpronounceable name, spondylolisthesis.

In doing so, this displacement can trigger nerve compression. If the sciatic nerve – the largest in the human body – gets compressed, it can lead to symptoms of sciatica. These are namely pain, pins and needles, or numbness in the back of the leg or buttock.

The vertebrae in the lower back can sometimes also fuse abnormally together. A condition called ankylosing spondylitis can trigger inflammation in the spinal joints and discs, which then harden over time. Another name for the condition is bamboo spine, since the now rigid and inflexible column resembles a tough stalk of bamboo.

FUSED SPINE

Managing Back Pain

Managing these conditions – and the pain they cause – will depend largely on the size of the deformity and what has caused it in the first place. Even a small spinal deformity can be significant.

For scoliosis for instance, braces to correct the spine as it grows may work to manage small defects in younger patients. But corrective surgery is often required to fix larger deformities and those which don’t respond to bracing.

Taking account of posture and bone health can also help prevent developing a spinal problem later in life. Using exercise to build a strong back and shoulders and avoiding slouching are solid measures, too. Managing associated conditions such osteoporosis with diet, medication and resistance training can also help.

Surgical intervention may be required in other situations – for instance, to decompress nerves that have become trapped or squashed.

Your spine is truly an architectural wonder. It’s far from a straight and rigid column – and capable of more than you’d ever expect. But this unique structure can lend itself to problems, especially when natural curves become deformities. The age-old adage “strengthen your back, strengthen your life” is a motto we should all be regularly reminded of, and to seek medical advice accordingly should back pain arise.

Dan Baumgardt is a medically-qualified clinical neuroscientist and anatomist. He is Senior Lecturer in the School of Psychology and Neuroscience at the University of Bristol

This article originally appeared in The Conversation and is republished with permission.

How Going Gluten-Free Changed My Life

By Lisa Ayres, Guest Columnist

I would like to share with readers my life-changing experience after eliminating gluten from my diet.

I had spinal implant surgery for spondylolisthesis about 24 years ago. For those who don’t know, spondylolisthesis is a defect in the spine that causes vertebra to slip to one side of the body. You can have spondylolisthesis without even knowing it. Someone may experience little to no pain and not know they have a “back issue.”

In my case, it got progressively worse as time went on.

After the surgery, I had physical therapy and even became certified in personal training to learn how to care for myself. I also took hydrocodone for pain, up to 3 tablets a day depending on my activities.

About 10 years ago, I also started having arthritis in my hands. They would throb after a few hours of gardening or similar use. I was told it was erosive arthritis. My toes also were affected and caused me a great deal of pain when I was on my feet without thick soled shoes.

My 24-year old daughter suffered from intestinal problems most of her life. After having pizza with friends one day, she came home with stomach cramps and was basically ill. I do a lot of research on issues that crop up in our lives and gluten intolerance kept popping up online as a clear possibility.

As a declaration of solidarity, and to make meals and shopping easier, I joined my daughter in going gluten and casein free. I found out that if one has gluten intolerance, they almost always have casein intolerance also. Casein is found in dairy products. 

LISA AYRES

It wasn’t easy for us to rid our diets of both gluten and casein, but to find out if my daughter’s illness was caused by them we had to start somewhere. On April 21, 2015, we cleared our diets and house of all gluten and casein products.

The first initial change was that my daughter appeared to get sicker. Stopping gluten is similar to stopping opioids for some people -- you go through a type of withdrawal. There are many websites, such as MentalHealthDaily.com, where you can learn more about gluten intolerance, withdrawal, and what you can and cannot eat. 

For 8 days she had severe joint pain and flu like symptoms. She said her joints felt worse than the pain she experienced when she broke her foot years before. But, her stomach discomfort began to subside almost immediately after giving up gluten and casein. By the ninth day the withdrawal symptoms vanished and she was feeling wonderful.

I didn’t have stomach problems caused by gluten, but my daughter and I live together and it would be not only unkind to eat restricted foods in front of her, it would be difficult to prepare separate meals, separate work areas, etc. So I changed my diet when she did. 

I had an unanticipated reaction. I had no withdrawal symptoms, but within 48 hours I had what can only be described as miraculous changes.

Due to the arthritis, my hands had a limited range of motion. My fingers were thick with swelling and I hadn’t been able to make a fist with my left hand in at least two years. My right hand also was swollen. The throbbing at night, sometimes without any particularly heavy use, was not only painful but depressing. Activities I had enjoyed were quickly running from my life. I was only 58-years old but felt decades older. The ongoing ache in my back was like an unwelcome guest that I could only get to leave with hydrocodone. 

But 48 hours after going gluten and casein free, I awoke, stretched, and moved my hands freely. My ring felt loose on my finger, the clench of my hands strong and flexible. 

This dietary change is a game changer for me. Plans I had put aside and tried to forget are now possible again. The pain in my back is now mainly managed with Tylenol and then only a couple of times a month. I have only taken hydrocodone twice since dropping gluten from my diet. My depression also has lessened. 

The systemic inflammation caused by the allergic reaction to gluten should not be ignored. A two week elimination diet is the best and only way to see if gluten really is the culprit. Tests currently are not accurate. 

My daughter had an emergency appendectomy and bowel re-section. It was advised by a gastroenterologist that she also get tested for celiac disease. Mind you, this is an experienced doctor.  They did an endoscopy on my daughter and the results were negative. However, the test results page included a disclaimer that if the patient had already cleared their system of gluten and there was no inflammation, the test wouldn’t be accurate for celiac or gluten sensitivity. 

The doctor didn’t tell us that eliminating gluten would “hide” her sensitivity. We only happened to have read the results ourselves. So the test wasn’t needed for her to know to avoid gluten!

Eliminating gluten and casein from your diet is the most accurate way to find out if you have an allergy or sensitivity to them.  I think many people aren’t aware that gluten and casein can cause such reactions. They hear how people are getting tested and clearing them from their diets, but when the results are negative, it feeds into the belief that being gluten-free is just a fad

If you are in pain, remember that gluten causes systemic inflammation which is pressing on sore joints and everything else in your body. You owe it to yourself to be as pain free as possible.

Lisa Ayres lives in South Florida. She suffers from spondylolisthesis, arthritis, and is gluten and casein intolerant.

Pain News Network invites other readers to share their stories with us.  Send them to:  editor@PainNewsNetwork.org

The information in this column should not be considered as professional medical advice, diagnosis or treatment. It is for informational purposes only and represents the author’s opinions alone. It does not inherently express or reflect the views, opinions and/or positions of Pain News Network.