Back and spine problems
Back and spine problems are becoming increasingly common. About 80% of the Dutch sometimes experience some kind of back problems at some point in their life. The back is made up of several parts. Your neck, upper back, lower back, and pelvis / SI joint. Voor meer informatie over nekklachten, kijk dan op de pagina over nek- en schouderklachten.
Anatomy
The human spine is made up of seven cervical vertebrae, twelve thoracic vertebrae, five lumbar vertebrae, five sacral bone vertebrae and the tailbone. The vertebrae are separated from each other by an intervertebral disc. In the center of your spine lies the spinal cord and nerves that control your arms, legs and torso.
The spine is shaped with an S-curve. This S shape gives the spine flexibility and stability. This S shape also absorbs shocks and forces. The degree to which the spine is curves is different for every person. The size of the S shape has little correlation with physical pain or problems.
However, the inability to actively influence the S shape, for example by extending your upper back, can lead to problems and pain.

Upper back problems
Upper back problems often manifest themselves in pain and stiffness between the shoulder blades and / or at the bottom of the neck. Coughing, sneezing or deep breathing can also become sensitive or even painful.
The underlying cause of most upper back problems is the inability to fully extend the thoracic spine. A rounded upper back without the ability to extend actively, can cause an array of issues…
For example, the joint between the spine and the ribs can become immobile. Immobile rib joints can hinder your breathing during exercise or rest.
Also, the position of your shoulder blades depends on the curve of your upper back. A rounded upper back forces the shoulderblades to slide up over your torso. This impaires the movement of your shoulderblades. This further impaires the movements in your shoulder joint and can cause problems in your shoulder.


Low back pain
Having some back pain every so often is nothing to worry about. After a day of moving, (too) heavy lifting or after long days in the same position, your lower back can start to hurt. It used to be called sciatica or lumbago. These days it is called nonspecific low back pain. Almost 80% of people sometimes have it and in most cases it disappears within 6 weeks, without treatment. However, if it happens more often it can quickly become problematic. More and more people live with chronic low back pain.
A human spine is very strong and can withstand enormous forces. How can it be that so many people suffer from back pain?
Besides bone and nerve, the back also has of a lot of connective tissue, muscles and joints.
These joints, connective tissue and muscles are built to move. Movement stimulates circulation and bloodflow so all tissues get adequate nutrients and oxigen.
If joints, connective tissue and muscles are left motionless for an extended periods of time, they become fibrotic, stiff and tight, which can lead to muscle pain or joint pain in the lower back. So it is important to move these muscles and joints more often throughout the day.
Pelvic pain
Back problems can also be caused or influenced by your pelvis. Pelvic pain is common and can have a huge impact on your life.
Your SI joint is the joint between your sacrum and your two pelvic bones. Both pelvic bones should move relative to each other. If your SI joint gets stuck, it can cause complaints around the dimples in your lower back, the rest of the lower back or in the bum and hamstring. Piriformis syndrome can also be caused by an SI joint that does not move properly.
Pelvic or SI joint problems can also radiate to the glutes and hamstring.


Common causes of lower back and pelvic pain
Also with pelvic and back problems, where you feel the pain is rarely the place where the pain is coming from.
The pelvis and lower back in particular often compensate for a lack of motion in surrounding areas like your hips, upper back or shoulders. But also an old sprained ankle or broken toe can cause pain or stiffness in your back or pelvis. With lower back and pelvic issues it is important to look beyond your sore back to find the underlying cause.
Back and pelvic complaints can also be caused by scars from abdominal surgery, like a c-section or appendix surgery. When your scar is still feeling tight and sensitive to the touch, it may be affecting your back and pelvic problem.
Radiating or referred pain
Sometimes back and / or pelvic pain can cause radiating pain to the glutes or hamstring. While this is very annoying, you shouldn’t worry too much. This radiating sensation disappears by itself most of the times. Sometimes the sciatic nerve can become entrapped between the muscles in your glutes or hamstring. This can also give some radiating pain down your leg. If you are worries or concerned, feel free to contact one of our therapists.
What is the best thing you can do when you have lower back or pelvic pain?
- Move your spine in all directions, within the pain free range of motion.
- Move the surrounding joints and areas through their full pain free range of motion. That means your hips, ankles, shoulders, upper back.
- Relax! Breathing exercises, stretching and a walking in nature can help you to relax.
Especially when you have acute back problems, it is more about THAT you move instead of HOW you move. Moving within the pain free range decreased pain and accelerates the recovery process. So go for a walk, dance, move around!
Our treatment
Physiotherapy can provide quick relief from back problems. Our treatment improves the way the connective tissue, muscles and joints are able to move and quickly reduces your pain. We also give you specific exercises you can do to improve your strenght and awareness.
Even if there is a nerve compression in the glutes or hamstring, we can quickly resolve it.
If you have any questions about your low back problem, please contact one of our therapists. Often we can already give you useful tips that immediately reduce your complaints.