The theoretical part of back school helps patients understand how the back is structured and functions. Components of the theory include information about the:
- Spine
- Vertebrae
- Transverse processes and spinous processes
- Vertebral joints, intervertebral discs
- Ligaments and musculature, connective tissue
- Nerves
The spine (Latin : Columna vertebralis, Greek rhachis) is in its entirety the central load-bearing element of the human body. It forms the bony center of the body and connects all other parts of the skeleton. Furthermore, the spinal column encloses the spinal cord, which lies in the vertebral canal. The spinal column is composed of:
- Cervical spine with seven vertebrae, has a bend forward.
- Thoracic spine with twelve vertebrae, curves backwards
- Lumbar spine with five vertebrae, curves forward
- Sacrum with five bony fused vertebrae and the coccyx with four to five fused vertebral rudiments (varies from individual to individual), curves backwards
VertebraeEach vertebra consists of a compact vertebral body, adjoined by the bony vertebral arch. The only exception is the atlas (C1; first cervical vertebra), which does not have a compact vertebral body. A cavity results in the middle of the vertebral bone, and the totality of these cavities forms the vertebral canal, which provides protection for the spinal cord and its membranes located therein.The spinal cord extends from the exit of the first cervical nerve to the so-called medullary cone (conus medullaris), which in adults ends at the level of the first lumbar vertebra. The vertebral arches of two adjacent vertebrae leave the intervertebral hole as an interspace on each side, through which a spinal nerve (spinal cord nerve) emerges from the vertebral canal on each floor.Transverse process and spinous processA transverse process arises on each side of the vertebral arch, which has an articular surface in the thoracic region (chest region), to which the ribs attach, and the spinous process on the back. These bony projections serve as attachment points for ligaments and muscles. To ensure stable contact of each vertebra with its neighboring vertebrae, they are interconnected by the small vertebral joints. These vertebral joints also take their origin from the vertebral arches. Beyond their purely stabilizing effect, the vertebral bodies also perform another important task by forming blood cells in their bone marrow located inside.Vertebral jointsWith the exception of the first and second cervical vertebrae and the sacral and coccygeal vertebrae, which are fused together, two adjacent vertebrae are always connected by an intervertebral disc (discus intervertebralis). This is located between the two vertebral bodies and consists of fibrous cartilage with a relatively firm, outer, connective tissue ring and a soft, inner core (nucleus pulposus – centrally located portion of the intervertebral disc (discus intervertebralis); this consists of a gelatinous mass and has a high water content).Tasks of the intervertebral discs are the damping of vibrations and shocks and the mobile connection of the individual vertebrae with each other. The intervertebral discs form unreal joints (symphysis). In addition, there are real joints (called vertebral arch joints) between the individual vertebrae. Ligaments and musculature
The stability of the spine is provided mainly by strong ligaments:
- Anterior longitudinal ligament (ligamentum longitudinale anterius) – runs across the front of the vertebral bodies; it represents a stabilizing boundary of the spine in the direction of the abdominal cavity (abdomen).
- Posterior longitudinal ligament (ligamentum longitudinale posterius) – runs across all posterior surfaces of the vertebral bodies; it lines the vertebral canal in its anterior region.
- Yellow ligaments (Ligamenta flava) – occupy the space between each vertebral arch.
- Intertransverse ligaments (Ligamenta intertransversaria) – connect the transverse processes of the individual vertebrae.
- Interspinous process ligaments (Ligamenta interspinalia) – move from spinous process to spinous process and connect the backs of the individual vertebrae together.
- Supraspinous ligament (Ligamentum supraspinale) – a ligament pulling over all spinous processes; represents the most posterior stabilizing ligament of the spine.
These six ligaments or ligament systems are very important for the stability of the spine.They are supported by the numerous back muscles.ligaments give the spine support and mobility. The stabilizing and elastic structures of the spine enable numerous movements. Considered alone, the spine would not be particularly stable. It is only through the numerous muscles and ligaments that support it that it becomes a stable element that can withstand the stresses of everyday life. Often, the back is subjected to non-physiological (unnatural) stress. While some muscles are overused, others are hardly used.Incorrect sitting and high stresses put strain on the intervertebral discs, which are sometimes severely squeezed. This can lead to a herniated disc, which is often associated with severe pain. If you have knowledge about the back and how it works, you can specifically reduce and avoid incorrect movement and stress patterns. In the theoretical part of the back school, you will learn to understand how a healthy back is structured and what can unbalance this system of bones, muscles and ligaments. Only those who know what causes back problems can also take specific preventive measures.