Back and Limb Pain, Weakness

Abstract

This is common in the neck and lumbar regions; the two sites of maximal spinal movement. Low back pain (LBP) is responsible for 6.5% of all GP consultations. The thoracic spine is splinted by the ribs and much less often is a site for pain. The spine is very strong: anteriorly it is formed by the vertebral bodies, separated by the discs which are supported by the anterior and posterior longitudinal ligaments. The spinal canal is formed by the pedicles, laminae and spinous and transverse processes at the sides and back which are largely supported by the strong paraspinal muscles (Figure 16). The spinal cord is shorter than the canal ending at the lower border of L1; below that the cauda equina carries the lumbosacral roots to the exit foramina from the canal. Lumbosacral disc protrusions compress the nerve roots below the cord termination, but cervical disc protrusions may compress both roots and the spinal cord.