Welcome to Momentum Health's patient resource about Lumbar Spine problems.
Knowing the main parts of your low back and how these parts work is important as you learn to care for your back problem.
Two common anatomic terms are useful as they relate to the low back. The term anterior refers to the front of the spine. The term posterior refers to the back of the spine. The section of the spine that makes up the low back is called the lumbar spine. The front of the low back is therefore called the anterior lumbar area. The back of the lower spine is called the posterior lumbar area.
This article gives a general overview of the anatomy of the low back. It should help you understand:
what parts make up the low back
how these parts work
Hear from some of our patients who we treated for Back Pain
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I was in chronic hip pain for 3.5 long years. I tried every treatment known to man including chiropractic,physio, massage, acupuncture, and even spinal decompression. Everyone who treated me came to... ”
“ I was in chronic hip pain for 3.5 long years. I tried every treatment known to man including chiropractic,physio, massage, acupuncture, and even spinal decompression. Everyone who treated me came to quick conclusions as to what my issue was with no formal assessment, and everyone claimed they could help me. Needless to say they were unsuccessful.
Thank God for Jocelyn! I went to see her for a massage one day and she genuinely cared about my pain and she did a casual assessment to try to locate the cause of my pain. She is the strongest and best massage therapist I have ever got. She urged me to try chiropractic care again with Dr Brad. In my first session with him he did a full assessment with proper diagnostic testing and he confirmed what Jocelyn thought it was. With regular appointments with Dr Brad my pain was close to gone in 3 weeks.
I have continued to see the physiotherapy team which includes Alexis and Ankit. With trying diligently to do my exercises, I am pain free.
Thank you momentum health creekside! I will forever refer to you as my dream team!
Oh, and the reception team is excellent! ”
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I had been attending this location since January for a bad lower back injury and Mark had been phenomenal. I was fortunate it was not a more severe injury but it was very quick before I was walking... ”
“ I had been attending this location since January for a bad lower back injury and Mark had been phenomenal. I was fortunate it was not a more severe injury but it was very quick before I was walking without pain again. Highly recommended! ”
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I can't say enough good things about Dr. Simons. I injured my back again and had trouble sleeping and my movement was quite impaired. Immediately after the adjustment I already felt a massive... ”
“ I can't say enough good things about Dr. Simons. I injured my back again and had trouble sleeping and my movement was quite impaired. Immediately after the adjustment I already felt a massive improvement. never will I ever go to another Chiropractor, he is the reason why I drive all across town to see him ”
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I recently had the pleasure of visiting Dr Carpino and Physiotherapist Russ Gothard for some back and hip pain I was experiencing. I can't say enough good things about the care I received. Both... ”
“ I recently had the pleasure of visiting Dr Carpino and Physiotherapist Russ Gothard for some back and hip pain I was experiencing. I can't say enough good things about the care I received. Both professionals were incredibly knowledgeable, attentive, and skilled. They took the time to listen to my concerns and tailored their treatments to my specific needs which also included the GLAD Back program. After just a few sessions, I felt a significant improvement in my pain levels, overall mobility and pain management. I highly recommend Dr Carpino and Pysiotherapist Russ Gothard to anyone in need of chiropractic or physiotherapy services at Momentum Health. Also a big thanks to massage therapist Meagan Fishly who also played an important role in dealing with my injuries. ”
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Excellent experience! The front desk staff are are always very friendly and ready to help. I worked with Nmeshivi and Leah to recover from a back injury. They listened to what I had to say and... ”
“ Excellent experience! The front desk staff are are always very friendly and ready to help. I worked with Nmeshivi and Leah to recover from a back injury. They listened to what I had to say and customized a recovery program for me, modifying it as I progressed. Overall very happy with the treatment and care throughout the process. ”
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First I want to say Anthony at the desk is an absolute super star! I ended up pinching a nerve in my lower back in December and calling in pain and he got me in to see Adam right away and Adam helped... ”
“ First I want to say Anthony at the desk is an absolute super star! I ended up pinching a nerve in my lower back in December and calling in pain and he got me in to see Adam right away and Adam helped with so much relief and support right away. Then recently I hurt my neck and I called and need more help but explained to Anthony I struggled to sit for a long period of time (or at all in that moment) without being in pain and was dealing with dizziness as well. I arrived 15 mins early due to my ride being early and Anthony helped accommodate me by letting Adam know and getting me an empty bed in the back so I could lay down (that helped me the most) and Anthony walked me to the back so I could lay down and be comfortable before my initial appointment even started and offering me a heat pack. Just absolutely amazing and dealing with me awkwardness because I am someone who would just deal with pain probably as well haha. So thank you so so much. I will recommend to everyone I know. And thankyou to Adam to helping me so much and dealing with my sass. Without these two, I don’t think I would even have progressed as much I have with these aches and pains. ”
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I’ve been seeing Heather for just over two months now and she has made a HUGE difference in my life. I have chronic pain in my back and hip that has been plaguing me for over 10 years. I’ve been... ”
“ I’ve been seeing Heather for just over two months now and she has made a HUGE difference in my life. I have chronic pain in my back and hip that has been plaguing me for over 10 years. I’ve been countless doctor, physios and trainers for my pain and for the first time I feel like I have someone who is determined to get to the bottom of my issue, teamed up with the knowledge and experience to do so. The red cord/ dry needle system that she uses is so smart I honestly can’t understand why I’ve never heard of it before, it doesn’t make sense why more physios aren’t using it! If you’re like me and have feel like you have tried everything for you pain and nothing is making a real difference I cannot recommend Heather enough, she has over 35 years of experience and genuinely cares about helping you get better. ”
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I'd like to express my appreciation to Momentum Health Physiotherapy. I had been suffering from lower back pain for three months until I received 3 times treatment (once per week) provided by Jason,... ”
“ I'd like to express my appreciation to Momentum Health Physiotherapy. I had been suffering from lower back pain for three months until I received 3 times treatment (once per week) provided by Jason, then I recovered. Jason is very nice person and very professional. The exercise therapy is helpful for strengthen the muscle of my lower back. I would highly recommend Momentum Health West Springs. ”
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I had back pain for 2 weeks, and after massage, chiropractic and medication a friend indicated Eli. I was there for an hour, He did different types of methodology, showing knowledge and skills, and... ”
“ I had back pain for 2 weeks, and after massage, chiropractic and medication a friend indicated Eli. I was there for an hour, He did different types of methodology, showing knowledge and skills, and the pain was gone. Today, if the pain show up, Eli is my first option. Thanks for the great service! ”
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Over the past few years I have suffered from back, neck, arm and hand ailments. I sought treatment by going to Momentum Health at Deerfoot City and have done so for some time now. All the staff have... ”
“ Over the past few years I have suffered from back, neck, arm and hand ailments. I sought treatment by going to Momentum Health at Deerfoot City and have done so for some time now. All the staff have been welcoming, courteous and professional. Mark Taylor has been my physiotherapist for the past year. He is very professional, friendly and skilled at his job. He has been successful at treating a number of my physical ailments and relieving the pain. I would highly recommend him to anyone seeking a physiotherapist. ”
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Thank you so much for your excellent acupuncturist service Dr. Adam and receptionists for accommodating my last minute appointment. To my lower back and glutes. Great suggestion for the exercise too. ”
“ Thank you so much for your excellent acupuncturist service Dr. Adam and receptionists for accommodating my last minute appointment. To my lower back and glutes. Great suggestion for the exercise too. ”
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I seen Carlee and her team for direction to help with my piriformis muscle and back disc issues. They were helpful, friendly and got me on track to manage my symptoms. I would highly recommend this... ”
“ I seen Carlee and her team for direction to help with my piriformis muscle and back disc issues. They were helpful, friendly and got me on track to manage my symptoms. I would highly recommend this team to help you out. Thanks ladies! ”
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My first visit was excellent (following all of my other visits remained a good experience). My physiotherapist, Anne, helped me understand what was happening with my lower back. She educated me on... ”
“ My first visit was excellent (following all of my other visits remained a good experience). My physiotherapist, Anne, helped me understand what was happening with my lower back. She educated me on what causes the pain, and we did some exercises during my first visit, which I found helpful. I like my physiotherapist, Anne, who makes me feel respected. ”
“
My first visit was excellent (following all of my other visits remained a good experience). My physiotherapist, Anne, helped me understand what was happening with my lower back. She educated me on... ”
“ My first visit was excellent (following all of my other visits remained a good experience). My physiotherapist, Anne, helped me understand what was happening with my lower back. She educated me on what causes the pain, and we did some exercises during my first visit, which I found helpful. I like my physiotherapist, Anne, who makes me feel respected. ”
This section highlights important structures in each category.
Bones and Joints
The human spine is made up of 24 spinal bones, called vertebrae. Vertebrae are stacked on top of one another to form the spinal column. The spinal column is the body's main upright support.
From the side, the spine forms three curves. The neck, called the cervical spine, curves slightly inward. The middle back, or thoracic spine, curves outward. The outward curve of the thoracic spine is called kyphosis. The low back, also called the lumbar spine, curves slightly inward. An inward curve of the spine is called lordosis.
Three Curves in Spine
The lumbar spine is made up of the lower five vertebrae. Doctors often refer to these vertebrae as L1 to L5. The lowest vertebra of the lumbar spine, L5, connects to the top of the sacrum, a triangular bone at the base of the spine that fits between the two pelvic bones. Some people have an extra, or sixth, lumbar vertebra. This condition doesn't usually cause any particular problems.
Lower Vertebrae
Each vertebra is formed by a round block of bone, called a vertebral body. The lumbar vertebral bodies are taller and bulkier compared to the rest of the spine. This is partly because the low back has to withstand pressure from body weight and from movements such as lifting, carrying, and twisting. Also, large and powerful muscles attaching on or near the lumbar spine place extra force on the lumbar vertebral bodies.
A bony ring attaches to the back of each vertebral body. This ring has two parts. Two pedicle bones connect directly to the back of the vertebral body. Two lamina bones join the pedicles to complete the ring. The lamina bones form the outer rim of the bony ring. When the vertebrae are stacked on top of each other, the bony rings form a hollow tube that surrounds the spinal cord and nerves. The laminae provide a protective roof over these nerve tissues.
Bony Ring
A bony knob projects out at the point where the two lamina bones join together at the back of the spine. These projections, called spinous processes, can be felt as you rub your fingers up and down the back of your spine. Each vertebra also has two bony knobs that point out to the side, one on the left and one on the right. These bony projections are called transverse processes. The projections in the low back are broader than in other areas of the spine because many large back muscles attach and impart powerful forces on them.
Between the vertebrae of each spinal segment are two facet joints. The facet joints are located on the back of the spinal column. There are two facet joints between each pair of vertebrae, one on each side of the spine. A facet joint is made of small, bony knobs that line up along the back of the spine. Where these knobs meet, they form a joint that connects the two vertebrae. The alignment of the facet joints of the lumbar spine allows freedom of movement as you bend forward and back.
Facet Joints
The surfaces of the facet joints are covered by articular cartilage. Articular cartilage is a smooth, rubbery material that covers the ends of most joints. It allows the ends of bones to move against each other smoothly, without friction.
Articular Cartilage
On the left and right side of each vertebra is a small tunnel called a neural foramen. (Foramina is the plural term.) The two nerves that leave the spine at each vertebra go through the foramina, one on the left and one on the right. The intervertebral disc (described later) sits directly in front of the opening. A bulged or herniated disc can narrow the opening and put pressure on the nerve. A facet joint sits in back of the foramen. Bone spurs that form on the facet joint can project into the tunnel, narrowing the hole and pinching the nerve.
Neural Foramen
Nerves
The hollow tube formed by the bony rings on the back of the spinal column surrounds the spinal cord. The spinal cord is like a long wire made up of millions of nerve fibers. Just as the skull protects the brain, the bones of the spinal column protect the spinal cord.
Spinal Cord
The spinal cord extends down to the L2 vertebra. Below this level, the spinal canal encloses a bundle of nerves that goes to the lower limbs and pelvic organs. The Latin term for this bundle of nerves is cauda equina, meaning horse's tail.
Between vertebrae, two large nerves branch off the spinal cord, one on the left and one on the right. The nerves pass through the neural foramina of each vertebra. These spinal nerves group together to form the main nerves that go to the organs and limbs. The nerves of the lumbar spine (cauda equina) go to the pelvic organs and lower limbs.
Connective Tissues
Connective tissues are networks of fiber that hold the cells of the body together. Ligaments are strong connective tissues that attach bones to other bones. Several long ligaments connect on the front and back sections of the vertebrae. The anterior longitudinal ligament runs lengthwise down the front of the vertebral bodies. Two other ligaments run full-length within the spinal canal. The posterior longitudinal ligament attaches on the back of the vertebral bodies. The ligamentum flavum is a long elastic band that connects to the front surface of the lamina bones (just behind the spinal cord). Thick ligaments also connect the bones of the lumbar spine to the sacrum (the bone below L5) and pelvis.
Ligaments
A special type of structure in the spine called an intervertebral disc is also made of connective tissue. The fibers of the disc are formed by special cells, called collagen cells. The fibers may be lined up like strands of nylon rope or crisscrossed like a net.
An intervertebral disc is made of two parts. The center, called the nucleus, is spongy. It provides most of the shock absorption in the spine. The nucleus is held in place by the annulus, a series of strong ligament rings surrounding it.
Two Parts of Intervertebral Disc
Muscles
The muscles of the low back are arranged in layers. Those closest to the skin's surface, the superficial layer, are covered by a thick tissue called fascia. The middle layer, called the erector spinae, has strap-shaped muscles that run up and down over the lower ribs, chest, and low back. They join in the lumbar spine to form a thick tendon that binds the bones of the low back, pelvis, and sacrum. The deepest layer of muscles attaches along the back surface of the spine bones, connecting the low back, pelvis, and sacrum. These deepest muscles coordinate their actions with the muscles of the abdomen to help hold the spine steady during activity.
Low Back Muscles
Spinal Segment
A good way to understand the anatomy of the lumbar spine is by looking at a spinal segment. Each spinal segment includes two vertebrae separated by an intervertebral disc, the nerves that leave the spinal column at each vertebra, and the small facet joints that link each level of the spinal column.
The intervertebral disc separates the two vertebral bodies of the spinal segment. The disc normally works like a shock absorber. It protects the spine against the daily pull of gravity. It also protects the spine during heavy activities that put strong force on the spine, such as jumping, running, and lifting.
The spinal segment is connected by two facet joints, described earlier. When the facet joints of the lumbar spine move together, they bend and turn the low back.
Summary
Many important parts make up the anatomy of the back. Understanding the regions and structures of the lumbar spine can help you be more involved in your health care and better able to care for your back problem.
The important parts of the lumbar spine include:
