OVERVIEW

Back pain is personal.

Each ache and pain is different, that's why Goodpath takes a personalized approach to creating back pain plans. Each plan is designed to get you on the path back to better health.

Our algorithm builds well-rounded plans based on your symptoms, lifestyle details, and medical history. Click below to take a 3-4 minute assessment.

This page has been reviewed by the GoodPath medical team. Medical Writer: Beth Holloway, RN, M. Ed; Medical Reviewer: Stephanie Gianoukos, MD, MPH; Updated: February 2020.

## The Back’s StructureThe back’s structure is complex. It is made of the spine, discs, nerves, muscles, tendons, ligaments, and other structures. Each of these parts are individual structures, which function or work together. Here’s how:

The __spine__ is made up of bones called vertebrae. __Ligaments__ hold the vertebrae together. Between each vertebrae, __discs__ provide cushioning. __Nerves__ extend through small holes in the vertebrae to different parts of the body. __Tendons__ attach the __muscles__ to the vertebrae. These muscles support the spine and allow for movement.

### MusclesThe back’s muscles start at the top of the back (called the cervical vertebrae) and go to the tailbone (also called the coccyx).

Some of these muscles are quite large and cover broad areas. Other muscles are small and cover much less space. Certain back muscles extend to other areas, like the shoulders, upper arms, and thighs.

### Types of Back MusclesThere are three different types of muscles in the body: the heart muscle, smooth muscles, and skeletal muscles.

The back muscles are skeletal muscles. They support bones, in this case, the vertebrae. By tightening and relaxing, the skeletal muscles create movement.

### Parts of the MuscleEvery skeletal muscle has three main parts: *the origin, insertion, and belly.*

A muscle’s origin is where a tendon attaches it to the *less* movable bone. On the other hand, the insertion is where a tendon attaches that muscle to the *more* movable bone. The fleshy, thick part of the muscle is called its belly.

### Tendons

In the back and elsewhere in the body, tendons attach muscles to bones. They help support particular bones and make them move.

Learn the basics of back anatomy.

Bones (called vertebrae), discs, supporting muscles, tendons, ligaments, and other structures make up the back. Any combination of these may be involved in back pain.

When specific areas of the back are involved in back pain, they are named for the spine in those same areas. 

  • Neck pain may be called cervical pain, like the cervical spine.

  • Upper back pain may be called thoracic pain, like the thoracic spine.

  • Lower back pain may be called lumbar pain, like the lumbar spine. It is also known as lumbago.

## Types of Back InjuriesMuscle or tendon injuries can occur anywhere in the body. But, they are common in the back and can cause pain.

One type of injury – a strain – means that a muscle or tendon has stretched or torn. Sometimes, muscles and tendons are strained at the same time.

### Muscle InjuriesMany people have experienced or heard of a strained muscle (also called a pulled muscle). These terms describe a stretched or torn muscle. Strained muscles can occur anywhere in the back, but often affect the low back (lumbar area).

What could cause a muscle strain? Recovering from quick movements like a loss of balance.

Tendon Injuries

Like with muscles, tendon stretches and tears are also called strains. 

What could cause a tendon strain? Overusing a tendon without allowing for rest.

Muscle and Tendon Injuries

There are tendons at the ends of the muscles, which attach to the bone. So, activities that cause a strain could injure both the muscle and tendon at the same time. 

What could cause a muscle and tendon strain? Bending and lifting a heavy package.

Learn the basics of back anatomy.

Bones (called vertebrae), discs, supporting muscles, tendons, ligaments, and other structures make up the back. Any combination of these may be involved in back pain.

When specific areas of the back are involved in back pain, they are named for the spine in those same areas. 

  • Neck pain may be called cervical pain, like the cervical spine.

  • Upper back pain may be called thoracic pain, like the thoracic spine.

  • Lower back pain may be called lumbar pain, like the lumbar spine. It is also known as lumbago.

Muscle Groups in the Back

As with other parts of the body, the back has several layers of muscles. Some are closer to the surface (called superficial muscles). Moving deeper into the body, there are intermediate muscles and deep muscles.

The back has different muscle groups that work together to allow movement. There are groups of muscles that move the:

Other muscles beyond the back also help move the head, shoulders, arms, and legs. For example, some muscles located in the chest also help move the shoulders. Likewise, there are muscles in other parts of the body that help support and move the spine.

The Muscles that Move the Head

The Sternocleidomastoids

These strong, large muscles are located on either side of the neck. Individually, they rotate the head left or right. Together, they flex or bend the head towards the chest.

A person who complains of a stiff neck may have a problem with one of their sternocleidomastoids.

The semispinalis capitis, splenius capitis, and longissimus capitis

These muscles all help the head extend toward the back. They also work with sternocleidomastoid muscles to rotate the head left and right.

After working on the computer with their head bent forward, a person might feel soreness in these muscles.

Label: The semispinalis capitis, splenius capitis, and longissimus capitis

The Muscles that Move the Shoulders

There are seven pairs of muscles that move the shoulders. Three of these pairs are chest muscles, not back muscles. The four back muscle pairs are: 

The trapezius 

These large muscles – sometimes called traps – are shaped like trapezoids or diamonds. They move the shoulder bones (also called scapulae). In addition, they help move the collar bones. 

The levator scapulae

These muscles raise the shoulder bones. “Levator” means raise.

The rhomboideus major and rhomboideus minor (also called rhomboid major and rhomboid minor)

These two pairs of muscles also help move the shoulder bones.

The Muscles that Move the Upper Arms

Five pairs of back muscles that help move the upper arms. These are: 

The latissimus dorsi

These large wing-shaped muscles extend from the upper to the lower back. Sometimes known as the lats, they help move the arms and shoulders. 

The supraspinatus and infraspinatus

Together with the deltoid muscles, the supraspinatus muscles move the upper arms. The infraspinatus muscles help rotate or turn the arms.

The teres major and teres minor

These muscles help move the arms in many ways. For instance, the teres minor muscles aid in rotating or turning the arms.

The Muscles that Move the Spine

There are several sets of muscles that help move the spine. In the back, these muscles include: 

The sacrospinalis (also called the erector spinae)

There are three groups of muscles that make up the sacrospinalis. These extend from the neck area to the lower back.

The spinalis

These muscles are closest to the spine. There is a set of muscles in the 

upper back (called the thoracic area) called the spinalis thoracis. 

The iliocostalis

These muscles are furthest from the spine. There are three sets of iliocostalis muscles: 1) in the cervical area (iliocostalis cervicis), 2) in the upper back or thoracic area (iliocostalis thoracis), and 3) in the lumbar area (iliocostalis lumborum).

The longissimus

These muscles are located between spinalis and the iliocostalis muscles. There are three sets of longissimus muscles: 1) above the cervical area (longissimus capitis), 2) in the cervical area (longissimus cervicis), and 3) in the upper back or thoracic area (longissimus thoracis).

Label: The spinalis, longissimus, and iliocostalis muscles

The quadratus lumborum

These muscles are found in the lower back (also called the lumbar area). They help to bend the back to one side or the other.

Label: Quadratus lumborum muscles

The Muscles that Move the Upper Legs (Thigh)

There are many muscles that move the large bone of the thigh. These include: 

The iliopsoas

The psoas major and iliacus muscles make up the iliopsoas. These go from the lumbar spine to each of the thigh bones (also called femurs). In addition to moving the thigh, these muscles help bend the back. 

The psoas minor

A smaller muscle, called the psoas minor, is located in front of the iliopsoas.

Learn the basics of back anatomy.

Bones (called vertebrae), discs, supporting muscles, tendons, ligaments, and other structures make up the back. Any combination of these may be involved in back pain.

When specific areas of the back are involved in back pain, they are named for the spine in those same areas. 

  • Neck pain may be called cervical pain, like the cervical spine.

  • Upper back pain may be called thoracic pain, like the thoracic spine.

  • Lower back pain may be called lumbar pain, like the lumbar spine. It is also known as lumbago.

PREVENTION

Some back pain is preventable.


How can back pain be prevented?

When an individual has back pain or has had it in the past, they may be wondering how to prevent it in the future. GoodPath is here to help them treat current symptoms and/or prevent future pain.

POSITIONING

Individuals can help prevent back pain by paying attention to their back throughout the day. If it begins to hurt, they should change positions. 

For example: If they experience discomfort while sitting on the sofa, they should, stand up and walk around, or move to another seat.

STRENGTHENING

The muscles in the abdomen or belly (sometimes called core muscles) help to support the lower back. Strengthening these muscles can help prevent pain.

PROTECTING

Individuals can protect the back by keeping the spine straight. When lifting or moving heavy objects, it’s helpful to use the largest muscles and hold items close to the body.

STRETCHING

Doctors recommend doing gentle back stretching exercises every day. These can even be performed while sitting in a chair.

POSTURE

Good posture is helpful for back pain prevention. As much as possible, individuals should stand tall and sit up straight.

MAINTAINING ACTIVITY

Doctors recommend staying as active as possible for back prevention and to increase overall health.  The U.S. Department of Health and Human Services (HHS) recommends "Once approved by their doctors, adults should have at least 2½ hours of medium-paced aerobic activity (for example, walking quickly), 1½ hours of intense aerobic activity (for example, jogging), or a combination of both every week. Aerobic activity strengthens the heart and lungs."


When should I see my doctor?

In most cases, back pain does not mean a person has a serious condition. However, there are situations when one should see a doctor right away. Individuals should see a doctor when they have back pain and any of the following:


How is back pain diagnosed?

Individuals may or may not need to see a doctor when they’re experiencing back pain. If they decide to see a doctor, the doctor will ask questions and perform a physical exam. They may also order tests or suggest seeing a specialist.

QUESTIONS

The doctor might ask questions like: How long has the pain been present? Where is the pain located? Do certain things make the pain better or worse?

They will likely ask about the patient’s medical history, which helps diagnose the reason(s) for back pain. The physician might also ask about work, daily habits, and exercise level. For example, doctors will try to determine if someone’s medical history might include a previous diagnosis of osteoarthritis of the spine. Or, for instance, if their patient works on a computer every day and then developed pain.

EXAMS

As with other medical problems, the doctor might complete an exam. The exam may include putting the person through certain movements and checking their reflexes.

TESTS

Many times, tests are not needed when someone is experiencing back pain. Yet some symptoms of back pain are cause for concern. In these cases, doctors may order imaging tests like X-rays and scans. In some situations, they may also order lab tests.

REFERRALS

The doctor may advise a patient to see a specialist or therapist for further evaluation or testing. Medical specialists are professionals like orthopedists or neurologists. Therapists include physical therapists (PTs) and occupational therapists (OTs). 

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Summary

The back is made of the spine, discs, nerves, muscles, tendons, ligaments, and other structures. Injuries – such as a muscle or tendon strain – are common and can lead to pain.

GoodPath’s personalized approach to care helps provide relief faster. Take our assessment for a well-rounded back pain kit in 4 minutes or less.

Learn the basics of back anatomy.

Bones (called vertebrae), discs, supporting muscles, tendons, ligaments, and other structures make up the back. Any combination of these may be involved in back pain.

When specific areas of the back are involved in back pain, they are named for the spine in those same areas. 

  • Neck pain may be called cervical pain, like the cervical spine.

  • Upper back pain may be called thoracic pain, like the thoracic spine.

  • Lower back pain may be called lumbar pain, like the lumbar spine. It is also known as lumbago.