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A herniated disc is caused when the fibro cartilage disc, which is situated between each vertebra ruptures and the soft spongy filling is pushed out and the presses on the nerves running through the spine. A herniated disc is often mistakenly called a slipped disc. This can come on slowly or suddenly and can be caused by improper lifting, sudden pressure or repetitive strenuous activity. However, like so many injuries, I believe that this is an injury waiting to happen; in that the back is already weakened and it is only a matter of time before something gives. There are some very good websites on the subject including www.spineuniverse.com

Disease can occur through such things as osteoarthritis which is a degenerative disease of the vertebra and rheumatoid arthritis which is an inflammatory disease of the joints or a tumour, which is an abnormal growth of tissue; a tumour can be benign (will not spread to other tissues) or malignant (will spread to other tissues). Arthritis is the commonest of all and causes millions of people reduced mobility and pain.

Posture is an important consideration when thinking about back pain and it is a very big subject. Back pain can occur for any number of reasons:

Slouching is something which often occurs in childhood and could be the result of inherited demeanour and/or poor self image, however it can take many years before a slouched posture can have any impact on the spine causing problems. The body is good at making adjustments when posture is out of alignment but bad posture will ultimately tighten certain muscles and weaken others and this is a recipe for things to go wrong. The body is designed to work most functionally and efficiently when the spine carries its weight evenly over the mid-line. Any bad alignment will put pressure on certain joints, ligaments and muscles. If you slouch i.e. your shoulders hang forward, your head will also be forward and so your upper body weight will be pulled forward past the mid-line. Apparently your head weighs between 4.5 - 5 kg. That is a lot of weight not to be properly positioned on your spine. When you slouch, a lot of pressure is put on the spine, supporting muscles, buttock and leg muscles in order to stabilise the body. Overweight – obese. When a person is overweight, most of the excess weight is carried at the front of the person, especially around the gut and so will put the centre of mass forward of their midline. This will put stress on the spine and supporting muscles and may well cause back problems and of course back pain.

Large breasts. Again it is the same situation of carrying a large amount of weight forward of the midline, however the problem can be helped by wearing a correct fitting bra. Apparently many women wear poorly fitting bras which do not properly support their breasts.

Sedentary lifestyle. The best thing you can do for your posture is to exercise regularly, carrying out exercises which encourage a strong and healthy spine. However, if you lead a sedentary lifestyle doing little exercise with a lot of sitting around, maybe slouching around, your body will weaken and not be able to fight the forces of gravity which impact on us all.

Carrying a heavy shoulder bag or a laptop computer over one shoulder will make one group of muscles on the weight baring side tense up to support the weight. If the extra weight is carried repeatedly over one shoulder, the supporting muscles will start to remain in a constant tense state. This group of muscles will put extra strain on opposing muscles and imbalance will occur. It is possible the body will adjust to accommodate this and the person will develop a pronounced higher shoulder. However, stress will put extra strain on the body’s muscles and may well result in the person developing a bad back,

Spinal abnormalities. It is possible for the spine to unnaturally bend to the left or the right, which is called scoliosis. “The causes of scoliosis are many, and although we well understand the consequences, the origins of this condition remain complex and obscure. There are two main types of scoliosis—namely, idiopathic (no known cause) and syndromic (the curvature is part of a recognised disease pattern, such as Marfan's syndrome). Idiopathic scoliosis accounts for most spinal curvatures and they may either be of early onset, before age seven years, or late onset, after that age and usually in adolescence. There is a definite genetic connection, with around 25% of those with a scoliosis have a direct relative with a curvature. 80% of adolescence idiopathic scoliosis arises in girls, and 80% of these girls have their rib prominence on the right side. The spine can bend towards either side of the body at any place, in the chest area (thoracic scoliosis), in the lower part of the back (lumbar), or above and below these areas (thoracolumbar). It can even bend twice, causing an S-shaped curve. When the curve is S-shaped (double curvature) it is often not noticeable and the person can appear quite straight because the two curves counteract each other. If the curve is low down in the spine, the ribs will not be affected but one hip may be higher than the other.”

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Spinal abnormalities. It is possible for the spine to unnaturally bend to the left or the right, which is called scoliosis. “The causes of scoliosis are many, and although we well understand the consequences, the origins of this condition remain complex and obscure. There are two main types of scoliosis—namely, idiopathic (no known cause) and syndromic (the curvature is part of a recognised disease pattern, such as Marfan's syndrome). Idiopathic scoliosis accounts for most spinal curvatures and they may either be of early onset, before age seven years, or late onset, after that age and usually in adolescence. There is a definite genetic connection, with around 25% of those with a scoliosis have a direct relative with a curvature. 80% of adolescence idiopathic scoliosis arises in girls, and 80% of these girls have their rib prominence on the right side. The spine can bend towards either side of the body at any place, in the chest area (thoracic scoliosis), in the lower part of the back (lumbar), or above and below these areas (thoracolumbar). It can even bend twice, causing an S-shaped curve. When the curve is S-shaped (double curvature) it is often not noticeable and the person can appear quite straight because the two curves counteract each other. If the curve is low down in the spine, the ribs will not be affected but one hip may be higher than the other.” www.sauk.org.uk/scoliosis.htm
It is also possible for the spine to be curved too much posterioraly making the individual bend unnaturally backwards. This is sometimes known as sway back but is termed as lordosis. However, if the spin bends forward creating an unnaturally round-back (sometimes referred to as hunchback), it is called kyphosis.

Sitting incorrectly Many people today spend most of their working day sitting at a desk, working at a computer and so often they sit badly and/or the chair they sit on is not good for them. Firstly, sitting for long hours, especially without stretching breaks) is not a good thing and secondly sitting incorrectly will weaken certain muscles and stretch others; also sitting behind the wheel of a vehicle for many hours and then in the evening sitting on some soft sofa or chair watching TV will weaken the back. There is only one correct way to sit and that is with an erect spine, any other way will not only put stress on the spine but will stretch certain muscles and so weakening them; this will create muscle imbalance. Sitting badly is like slouching and will ultimately cause problems with the spine and the back. Many badly designed chairs are responsible for creating weak backs.

Lifting incorrectly There is a right way and wrong way to lift but I am not going to explain here what this is right and wrong but if you visit http://famchiro.users.lantic.net/html/body_back.html , you fill find some good descriptions. There is no doubt that putting undue pressures on the spine by lifting heavy objects incorrectly is likely to cause problems to the spine. If your back muscles are weak or have been injured before, it is highly likely the spine will give way under the pressure and you over stress muscles and consequently suffer discomfort and back pain.

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Muscle imbalance Overly tight muscles will always put pressure on other groups of muscles which are not so tight. This may seem a strange reason for causing back pain but tight hamstrings will place a great deal of stress on the lower back. Tight hamstrings can cause the hips and pelvis to rotate back flattening the lower back and causing back problems. Tight hamstrings are caused by a number of reasons. Some people naturally have short hamstrings and so lack natural flexibility but for others it is caused by not enough stretching and sedentary lifestyle, especially a lot of sitting. “Although there are many causes of low back pain, it is thought that muscle imbalance plays a major factor.  Weak or inhibited abdominals alongside tight hip flexors, hamstrings or back muscles can cause poor alignment of the spinal column, pelvis and limbs. Over time this places unnecessary strain on the tissues and joints.  The spine becomes sore, stiff and inflexible and in some cases nerve symptoms such as pins and needles or numbness are experienced.” http://www.onesteppilates.co.uk

Tense muscles I have already spoken about some of the reasons why we get tense or tight muscles but there are other reasons too. Cold muscles are not relaxed muscles, they are tense (note how when you get cold, you tense up your shoulders), so if you suddenly start exercising with cold muscles, you are at risk of straining muscle tissue. Poor training techniques – over strengthening certain muscles. Over exercising will put pressure on the body, especially if you are not getting the proper rest and recovery. Stress will exacerbate this. Sometimes people wonder why they have suddenly developed a bad back and are suffering back pain. The truth is that bad backs don't just happen but are often the result of neglect and tight/tense muscles applying undue stresses over a long period of time until weakened muscles give way under the pressure and hey presto, a bad back! Muscle Facts

I have already spoken about some of the reasons why we get tense or tight muscles but there are other reasons too. Cold muscles are not relaxed muscles, they are tense (note how when you get cold, you tense up your shoulders), so if you suddenly start exercising with cold muscles, you are at risk of straining muscle tissue. Poor training techniques – over strengthening certain muscles. Over exercising will put pressure on the body, especially if you are not getting the proper rest and recovery. Stress will exacerbate this.

Facet restrictions The bony protrusion at each side of the disc is called a facet. These are connection points were muscle attach to the vertebra. Whenever you bend, each vertebra should follow in line with all the others; the discs compressing to allow the vertebra to rotate and slide. The interesting thing about the lumbar vertebra is that in sideways bending, they don’t move as you would expect them too; in fact they do the opposite of what you expect. When you stand erect and sideways bend to the right, the lumbar vertebra rotate to the left and when you bend the left, vice-versa. It is all part of how this amazing structure works in order for us to bend in so many directions. However, things can go wrong due to muscles being too tight or too weak and a vertebra can actually get stuck either in partial rotation or be unable to rotate fully. This will not necessarily cause any pain or discomfort but could well lead to troubles later on. It is however relatively easy for an experience body worker to release the fixed facet but the overall health of the spine is key to preventing problems reoccurring. Referred pain is an interesting and very complex subject. It is where pain is experienced in one part of the body but the cause is actually in another part. This can be because of a trapped or damaged nerve sending signals to another area, or it can be caused through something like cervical spondylosis transmitting pain to the shoulder. See:- http://www.bbc.co.uk/health/ask_the_doctor/cervicalspondylosis.shtml I also consider it quite probable that an injury, say to the knee, albeit an old injury can lead to problems being experienced maybe in the hip or lower back. Consider a car whose shock absorber at one wheel is not working well; the car can still be driven but the breakdown might well occur in the differential or the driveshaft because of the additional vibrations transmitted to these parts. Many people carry old injuries not realising the stresses these place on other parts of the body. So it is clear there are many causes to back pain but there are certain golden rules which will help a person avoid back problems and back pain.

NOTE: massage should not be sought until back pain has ceased.

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“Some back pain sufferers have discovered that a change in lifestyle, especially where stresses are greatly reduced, find that their back pain and discomfort disappear!”