Back muscles layered arrangement of function. back muscles

12.05.202027.05.2017

To train your back more effectively, learn which muscles, bones, and joints work during exercise. Train your back with a scientific approach!

Often, people who are just starting out workouts pump large and spectacular looking muscles in the front of the body first. The muscles of the arms, chest, and abs look great in the mirror, which is why many beginner athletes neglect to work on the muscles of the back. However, the back is just as important as the front of the body when it comes to aesthetics, strength and performance.

People who are serious about building their physique know that broad back It will be advantageous to distinguish them from other athletes. Understanding the anatomy and movement system of your body will make your workouts more effective. I want to tell you everything you need to know to build a great back.

The back is made up of many muscles. We will not be able to talk about each separately, so I want to focus on those that play the most important role in the process of training. Here's what you need to know to build an amazing back.

Latissimus dorsi

Biomechanics of the latissimus dorsi. Full FAQ. Exercises, delusions, myths

The latissimus dorsi is perhaps the main muscle that most people start working on if they want to pump up their back. These muscles originate from the humerus (the bone of the upper arm) and run to the scapula, lower thoracic spine, and the thoracolumbar fascia, which is a membrane that covers deep muscles back. Since the latissimus dorsi occupy most of the upper back, they play an extremely important role in building a massive and broad musculature.

Trapezius muscles

The trapezius muscles are much larger than you might think. Trapezoids are divided into 3 parts. The upper part starts at the base of the skull, goes down and attaches to the collarbone. The middle one originates in the upper part of the spine and is attached to the shoulder blade. The lower one starts in the middle part of the spine and is also attached to the shoulder blade.

Rhomboid muscles

The rhomboids are deep muscles that are located under the trapezius. They are angled and run from the thoracic spine to the shoulder blades. Despite the fact that these muscles are not on the surface, you should work on them, as this will positively affect the proportions of your body.

What about the lower back?

This article will focus on the muscles of the upper back. We talk about many of the muscles in the lower back in our ab and core workout video.

Skeleton anatomy

The spine plays an important role in almost every movement of the body, but as you train your back, you must also be aware of other bones and joints.

Thoracic spine

The thoracic region is the upper part of the spine. It is made up of 12 bones and runs from the base of the neck to the lower back. A well-developed upper back is essential for safe and effective training.

shoulder blades

The shoulder blades are triangular bones that connect the humerus and collarbone. They participate in traction horizontal movements.

shoulder joint

The shoulder joint plays an important role in traction movements. This is a kind of hinge that allows the arm to be mobile. Due to the fact that it allows the hand to move and rotate so actively, this joint is quite fragile. Keep this in mind and be careful while training.

Functions of the muscles of the back

Once you learn more about muscles, bones, and joints, you will understand how they form movements. And movements, as you all understand, are the basis of training. Knowing how these movements arise, we can build a strong upper part back, as well as maintain the health of the shoulder joints.

Latissimus dorsi

The latissimus dorsi muscles are responsible for the movement of the shoulder joints. Thanks to them, you can move your shoulders back and forth, as well as rotate them. Strong lats are especially important when doing pull-ups, deadlifts, and other heavy lifting exercises.

Trapezius muscles

The trapezium is also involved in the movement of the shoulders. As you stretch your arms forward, the upper and lower trapezius and the serratus muscles work together to lift your shoulder blades up. The trapezius muscles are also involved in bringing the shoulder blades together and lowering them down. You also engage them when you shrug your shoulders.

Rhomboid muscles

The rhomboid muscles are responsible for retraction of the shoulder blades as well as for their rotation.

Basic back exercises

You should not train your back by performing jerky movements that cause it to bend or rotate. You must use your muscles, bones, and joints to move smoothly but effectively. These exercises will give a load to all the muscles of the back, providing them with maximum development.

It is also important to know how your body works with different movements. Each of these exercises will develop muscles in a different way, resulting in a balanced physique and improved overall fitness level.

Exercise #1 Pull-ups

Pull-ups work the latissimus dorsi. This seemingly simple exercise can take time to master. correct technique execution. Once you can do a high number of reps with own weight, complicate the exercise by adding weights.

When doing pull-ups, make sure that you move in the full range of motion. Increase the time spent in the lower phase to stretch the muscles, and in the upper phase, try to pull the chest to the bar. This technique will help to better pump the lower part of the trapezium and the middle of the back.

Exercise #2 Dumbbell Bent Over Row

Such horizontal thrust is an amazing exercise for working on the rhomboid muscles, the middle part of the trapezius, as well as for the proportional development of the muscles of the hands. This is a fairly simple exercise, but its effectiveness can be easily reduced to zero if you do not follow the technique and work with too much weight.

To perform bent over dumbbell rows, take any position that is comfortable for you and fix your upper back. Pull the dumbbell, bending your arm at the elbow and pressing the shoulder blade to your back. Don't do too many reps and don't use momentum.

Exercise number 3 Pullover with a dumbbell

This is a great exercise for isolating the lats. It will also help you develop core strength and shoulder mobility.

To get the most out of this exercise, lie on your back and take a deep breath. Keep your abs tight to better stretch your lats. Since you will be moving the dumbbell behind your head, you will have to work hard to keep correct position body. If you arch your back too much, you won't be able to stretch your lats. So remember to keep your core muscles tight.

Exercise number 4 Thrust block to the face

This exercise will take you out of the usual directions of movement, and also add some variety to your workouts. The pull of the block to the face is great way building muscles of the upper and middle parts of the back.

When performing the exercise, hold on to the rope so that your thumbs are on top of the handles. This grip is more comfortable for shoulder movement. If you take a regular grip, then the rotator cuff will not move actively enough. Lock the position of the upper back, follow the movements of the elbows and bring the shoulder blades together. Stop in the positive phase of the exercise when your elbows are in line with your body.

The best result with a scientific approach

The muscles of the back work as a single harmonious system. To train your back effectively, you must have a strong spine, strong shoulder blades, and healthy shoulder joints.

Before you go to the gym and start exercising, watch the training videos. Remember that you must combine the work of the muscles with the work of the mind in order to build a beautiful body.

http://www.bodybuilding.com/fun/built-by-science-back.html

According to human anatomy textbooks, back muscles are superficial and deep. All together they occupy a rather large area of the body: from the area of the sacrum to the very skull.

Each element muscular system plays a special role.

But at the same time, they all quite effectively “cooperate” with each other. Muscles lie in several layers.

The very first, external, is called superficial in anatomy.

What elements are included in its composition and what are their functions?

General information about muscles

The muscles lying closer to the surface of the back form a two-layer system. All elements are attached to shoulder girdle and directly on the bones of the shoulder.

The surface ones are:

trapezoid;
large diamond-shaped;
small rhomboid;
lifting the scapula.

Trapezoidal

Trapezoidal has the shape of a triangle. Its base is located in the region of the line that conditionally divides the back into two halves. She herself captures the top and back of the neck.

This muscle originates in several places:

protrusion of the back of the head;
one third of the occipital bone;
processes of the seventh cervical vertebra;
nuchal ligament;
vertebrae of the thoracic spine;
pushy link.

Fixing in these places of the human body, muscle fibers go down to the shoulder girdle. Each type of bundle is connected to a separate part of the skeletal system:

The upper ones are fixed on the back of the clavicle.
The lower ones are directed vertically upwards. They transform into a plate of tendons and are fixed on the scapula.
The middle ones lie horizontally and are also attached to the shoulder blade.

The widest part of the trapezius muscle is in the lower part of the neck. In the same place, her tendon is most strongly determined.

If you examine the region of the seventh cervical vertebra, you can see a small depression. This is a tendon pad formed by the muscle fibers of the two sides of the back.

This muscle is located in the surface layer throughout its entire length. Its upper and lower lateral edges are involved in the formation of the lateral cervical and auscultatory triangles, respectively.

What are the functions of the trapezius muscles?

With their full contraction, the scapular bone approaches the spine. The spine must be immobile.
The superior bundles may elevate the scapular bone.
Contracting at the same time, the fibers rotate the blade around its own axis.
If the scapula is motionless, and the muscle is contracted at this moment, you can tilt your head forward.
If the right or left-hand side, the head turns to the other side of them.

broadest

Another muscle of the back, lying in the surface layer, is the latissimus dorsi. Like the previous one, it is a flat triangle. It is located in the lower part of the back symmetrically on the right and left sides.

Almost all parts of this element of the muscular system lie at the top. The only exception is the top, which is closed by a trapezoid.

The lower edge of the widest is one of the sides of the lumbar triangle. It originates from the processes of a part of the thoracic and from all the lumbar vertebrae, the iliac and sacral crests.

All the fibers that form this muscle go in one direction - up. At the top, they connect with bundles that come from the lower ribs and the lower region of the scapula.

Where the angle of the scapula is located, the latissimus narrows and, as it were, “hugs” the round one. Near the armpit, a flat tendon appears, which is attached to the humerus.

This part of the muscular system has several functions:

Raises arms to body and helps them turn inward.
Promotes shoulder extension.
With motionless hands, pulls the body towards them. This is especially noticeable when swimming or.

Blade lifter

The muscle that lifts the scapular bone does not begin with muscle, but with tendon fibers. They start from the processes of several upper vertebrae of the neck and go down. Along the way, they join the edge of the shoulder blade.

The upper and lower sections are hidden by the sternocleidomastoid and trapezius muscles, respectively. From the front of this muscle, a nerve goes to the rhomboid elements. There is also a part of one of the important arteries.

This part of the muscular system performs only two functions:

Helps to elevate the scapular bone, allowing it to come closer to the center of the back.
With a fixed shoulder blade, the neck is allowed to tilt to one side or the other.

Small and large diamond-shaped

Both, according to the anatomical tables, are also considered elements of the surface layer. It happens that they grow together, forming a single system. They start from different parts of the skeleton:

Small comes from two ligaments (output and supraspinatus), from the seventh vertebra of the neck and the first chest. It is located obliquely and is attached to one of the edges of the scapula.
The large one originates from the processes of several vertebrae of the thoracic spine (from the second to the fifth) and is also attached to the scapula.

Both of these muscles are hidden, but are still considered superficial. They themselves cover the one that is responsible for straightening the spine. Both elements are responsible for moving the scapula up and towards the spine.

Conditions in which there is a feeling of stiffness, muscle spasms, pain, are easily treated if you immediately consult a doctor.

Superficial muscles, if it is not developed and strengthened (that is, not given sufficient physical activity), is very prone to painful manifestations. People complain: "pulled his back", "squeaked". It is important not to start the inflammatory or spasmodic process that has begun.

Basically, if only the back muscles closest to the surface of the body are affected, anti-inflammatory drugs and a complex of therapeutic exercises help.

The superficial muscles and skeleton make up a rather complex system. Basically, their functions are to set in motion the shoulder blades, neck and shoulders of a person. Each element has its own characteristics and differs from others in the structure and direction of muscle fibers.

If you'd like more information about this from Alexandra Bonina, check out the links below.

Denial of responsibility

The information in the articles is for general information purposes only and should not be used for self-diagnosis of health problems or for medicinal purposes. This article is not a substitute for medical advice from a doctor (neurologist, internist). Please consult your doctor first to know the exact cause of your health problem.

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The muscles of the back are located in several layers, so they are divided into deep and superficial, which, in turn, are also located in two layers.

The longitudinal furrow of the back (sulcus dorsi) runs along the midline of the back. Along it are located the spinous processes of the VII cervical and all underlying vertebrae, which are easily palpable during palpation. On the sides of the furrow of the back, the relief of the extensor of the spine is noticeable.

Rice. 101. Superficial back muscles:

1 - sternocleidomastoid muscle; 2 - belt muscle of the head; 3 - trapezius muscle; 4 - deltoid muscle; 5 - infraspinatus muscle of the shoulder; 6 - infraspinatus fascia; 7 - small round muscle; 8 - large round muscle; 9 - a large rhomboid muscle; 10 - triceps shoulder 11 - the latissimus dorsi muscle; 12 - thoracolumbar fascia; 13 - external oblique muscle of the abdomen; 14 - internal oblique muscle of the abdomen

Superficial muscles of the back Superficial muscles of the back of the first layer

The trapezius muscle (m. trapezius) (Fig. 90, 95, 96, 99, 100, 101, 104, 106) is so called because the muscles of both sides together form a trapezoid. Individually, each of these large flat muscles has the shape of a triangle, the base of which runs along the spinal column and is located in the upper back and occiput. The trapezius muscle is divided into three parts, each of which performs its own functions. The upper part of the muscle raises the shoulder girdle and scapula, the middle part pushes the scapula towards the spine, and the lower part moves the scapula down. The muscle begins at the superior occipital protuberance, the superior nuchal line, the nuchal ligament, and the supraspinous ligament of the thoracic vertebrae, and is attached to the brachial process, the acromial (lateral) part of the clavicle, and the spine of the scapula.

The latissimus dorsi muscle (m. latissimus dorsi) (Fig. 101, 102, 104, 105, 106, 111, 113), contracting, brings the shoulder closer to the body and shifts the upper limb back, while turning it inward. With a fixed position of the upper limb, the muscle brings the torso closer to it, and also helps to shift the lower ribs upward during respiratory movements. The muscle is located in the lower back; starting point is on the thoracolumbar fascia, posterior crest ilium and spinous processes of five or six lower thoracic vertebrae.

Superficial muscles of the back of the second layer

The splenius muscle of the head (m. splenius capitis) (Fig. 100, 101, 102, 105) with a unilateral contraction turns the head to its side, and with a bilateral contraction it pulls the head back. The muscle has an oblong shape, begins at the spinous processes of the III-VII cervical vertebrae, I-III thoracic vertebrae and the nuchal ligament, and is attached to the lateral sections of the superior nuchal line, reaching the mastoid process of the temporal bone.

The belt muscle of the neck (m. splenius cervicis) (Fig. 96, 100, 102) with bilateral contraction pulls the neck back, and with one-sided rotation of the cervical spine in its direction. The muscle is located under the splenius muscle of the head, the spinous processes of the III-V thoracic vertebrae serve as its point of origin, and the transverse processes of two or three upper cervical vertebrae serve as the attachment point.

The muscle that lifts the scapula (m. levator scapulae) (Fig. 96, 97, 100, 102, 105, 111), when contracted, raises the medial angle of the scapula, and with a fixed position of the scapula, tilts the cervical spine to its side and backwards. The muscle itself is located under the trapezius muscle, begins on the posterior tubercles of the transverse processes of the four upper cervical vertebrae and is attached to the medial edge and angle of the scapula.

Small rhomboid muscle (m. rhomboidei minor) (Fig. 102, 111) moves the scapula to the spine, slightly shifting it upward. Located under the trapezius muscle, it begins on the two lower cervical vertebrae and is attached to the vertebral (medial) edge of the scapula.

The large rhomboid muscle (m. rhomboidei major) (Fig. 101, 102, 111), as well as the small one, moves the scapula to the spine, slightly shifting it upward. Located under the trapezius muscle, it has a point of origin on the spinous processes of the four upper thoracic vertebrae, and the place of attachment, like the small one, is on the vertebral edge of the scapula.

The serratus posterior superior muscle (m. serratus posterior superior) displaces the upper ribs back and up, and also takes part in the act of inhalation. It is covered by rhomboid muscles, begins in the region of the lower part of the ligament, the spinous processes of the two upper thoracic vertebrae and the two lower cervical vertebrae, and is attached to the outer surface of the II–V ribs, to the side of their corners.

Serratus posterior inferior (m. serratus posterior inferior) (Fig. 102) displaces the lower ribs back and down and takes part in the act of exhalation. The muscle is covered by the broad muscle of the back; its point of origin is located on the surface layers of the thoracolumbar fascia at the level of the two upper lumbar vertebrae and the two upper thoracic vertebrae, and the attachment point is on the outer surface of the four lower ribs.

Back pain can occur for a variety of reasons, ranging from banal stretching of muscles and ligaments and ending with such serious diseases as malignant tumors. Pain in the back can talk about the pathology of the spine, intervertebral discs, spinal cord, nerves or blood vessels, as well as the skin. In some cases, the pain is the result of an acquired or congenital curvature of the spine. It is worth noting that according to the World Health Organization, back pain is the most common reason for seeking medical advice.

Anatomy of the back region

The back is formed by the spinal column, the back and sides of the ribs, and the muscles of the scapular and lumbar region. Very strong muscles the backs allow you to hold, tilt and rotate the entire body, and also participate in the movements of the upper limbs.

The upper border of the back runs along the spinous process ( unpaired process of a vertebra extending from the posterior surface of the vertebral arch along the midline) of the last seventh cervical vertebra, as well as along the acromial processes ( processes of the scapula). From below, the border is a line that is limited to the iliac crests ( superior iliac bone) and the sacrum. The lateral borders are the posterior axillary lines. In the back, a paired scapular, subscapular region and an unpaired vertebral region, which corresponds to the contours of the spinal column and the lumbar region, are distinguished.

The skin of the scapular region is thick and inactive. In men, this area is usually covered with hair. In some cases, it can lead to the appearance of boils ( purulent-necrotic lesion of the hair shaft and surrounding tissues). Also, a large number of sebaceous glands are located in the skin, which, when the lumen of the excretory cover is closed, can become inflamed ( atheroma). Following the skin is dense subcutaneous fat, which has a cellular structure. It is followed by the superficial fascia ( connective tissue sheath) of the scapular region and its own fascia, which serves as a case for the superficial muscles. In depth, directly near the scapula, there are two separate fascial cases - supraspinous and infraspinous.

The skin of the lumbar region is thick and can easily be folded. Behind it lies the hypodermis subcutaneous adipose tissue) and superficial fascia of the back. A little deeper is fatty tissue, which also extends to the buttock area, forming a lumbar-buttock pillow. In this area, two departments are conventionally distinguished - internal and external. The border between these departments runs along the muscle that straightens the spine.

It is worth considering separately the following structures that are part of the back:

ribs;
shoulder blades;
muscles;
nerves.

Spine

The spinal column is one of essential elements musculoskeletal system. There are five segments in the spine, including the cervical, thoracic, lumbar, sacral, and coccygeal. Since the back includes only the thoracic and lumbar segments, it is still more appropriate to consider the entire spinal column as a whole.

In the spine, movements can be carried out in all three planes. Flexion or extension occurs around the frontal axis, rotation of the body is carried out around the vertical axis, and torso tilts to the left and right around the sagittal axis. A springy movement of the spine is also possible due to the contraction and relaxation of a certain group of back muscles.

The spine at the time of birth has only one natural curve - thoracic kyphosis ( posterior thoracic flexion). In the future, during the first 3-4 months, when the child learns to support his head, cervical lordosis is formed ( anterior curvature of the spine). When the child begins to walk, the lumbar curves forward, which leads to the formation of lumbar lordosis. Also at the same time, sacral kyphosis is formed. It is thanks to these natural bends - kyphosis and lordosis - that the spine is able to withstand significant loads, being a kind of shock absorber. The spine, in addition to the supporting function, also performs a barrier function, protecting the spinal cord from various kinds of injuries. In addition, the spinal column is directly involved in the movements of the head and body.

In the human spine, on average, there are 32 - 34 vertebrae, which are separated from each other by intervertebral discs. There are 5 vertebrae in the lumbar and sacral regions cervical region there are 7, and in the chest - 12 vertebrae. In turn, the coccyx consists of 3 - 5 vertebrae. Depending on the segment of the spine, the size and shape of the vertebrae may vary somewhat.

The following segments are distinguished in the spine:

cervical is the highest and most mobile section of the entire spine. Good mobility allows you to perform various movements in the cervical region, and also allows you to tilt and turn your head. Due to the minimal loads on the cervical segment, the bodies of the cervical vertebrae are small. The first two vertebrae, which are called the atlas and the epistrophy, differ somewhat in shape from all other vertebrae. Unlike other vertebrae, the atlas does not have a vertebral body that performs a supporting function. Instead, the atlas has two arches ( back and front), which are connected by means of lateral bone thickenings. The first vertebra with the help of the condyles ( bony protrusions involved in the articulation of bones) is attached to the foramen magnum in the skull through which the spinal cord passes. The second vertebra, or epistrophy, has a bone process in the form of a tooth, which is fixed in the vertebral foramen of the atlas with the help of ligaments. It is thanks to this process that the first vertebra, together with the head, can perform a variety of high-amplitude movements. It is worth mentioning that the transverse processes ( lateral processes extending from the arch of the vertebra) cervical vertebrae have openings through which the vertebral vein and artery pass. The spinous processes of the cervical vertebrae, which extend back along the midline, have some difference. Most of them are bifurcated. The cervical segment is the most vulnerable part spine due to the fact that the size of the vertebrae is small, and muscle corset not as massive as in other departments.
Thoracic consists of 12 vertebrae, which are much more massive than the vertebrae of the cervical segment. The thoracic vertebrae posteriorly limit the chest. On the lateral surface of the thoracic vertebrae there are costal fossae, to which the heads of the ribs are attached. The long spinous processes of the thoracic vertebrae, which are inclined obliquely downward, overlap each other in the form of a tile.
Lumbar represented by 5 massive vertebrae. The bodies of the lumbar vertebrae are very large, since it is on the lumbar spine that the maximum load falls. The lumbar vertebrae have costal processes, which are essentially vestigial ribs ( ribs that have lost their meaning in the course of evolution and which are rudimentary). The spinous processes of the lumbar vertebrae, unlike the thoracic vertebrae, are directed backwards. The last vertebra is inclined somewhat forward, as it articulates with the sacral bone, which, heading back, forms a physiological kyphosis. It should be noted that, unlike the thoracic segment of the spine and the sacrum, the lumbar spine has increased mobility. It is the lumbar region that allows you to tilt the body to the right and left, bend and unbend the body, and also combine tilt and turn of the body. These high-amplitude movements are carried out thanks to strong muscles.
sacral department at the time of birth, it consists of 5 separate vertebrae, which by the age of 18–25 gradually form and form a single bone. The sacrum is a bone that is part of the pelvis and has a triangular shape. On the front surface of the sacrum there are four parallel horizontal lines, which, in fact, are the places of fusion of the vertebrae with each other. On the sides of these lines are small openings through which nerves and arteries pass. On the posterior surface of the sacrum there are 5 bony crests, which are the fusion of the spinous and transverse processes. Side surfaces The sacrum articulates with the ilium and is strengthened with strong ligaments.
coccygeal department represented by 3–5 vestigial vertebrae of small size fused with each other. The shape of the coccyx resembles a curved pyramid. The coccyx is more mobile in women, since during childbirth it is able to deviate somewhat backwards, thereby increasing the birth canal. Although the coccyx is a rudimentary segment of the spine, it still performs a number of rather important functions. Ligaments and muscles are attached to the coccyx, which are directly involved in the functioning of the large intestine and genitourinary apparatus. Also, the coccyx performs an important function in the distribution of physical activity. So, for example, if the body is tilted forward, then the ischial tubercles, as well as the lower branches of the ischial bones, are the support. In turn, if the body is tilted somewhat back, then the load is partially transferred to the coccyx.

Separate consideration requires the structure and function of the intervertebral discs. The intervertebral disc is a formation that consists of fibrous ( connective tissue) and cartilage and has the shape of a ring. In the center of the disc is the nucleus pulposus, which consists of a gel-like substance. On the periphery there is a dense fibrous ring. Intervertebral discs do not have their own vessels. They are nourished by the hyaline cartilage that covers the disc and is supplied with nutrients from the overlying and underlying vertebrae. The intervertebral discs act as a shock absorber during walking, running or jumping, and also increase the flexibility and mobility of the spinal column.

The vertebral column receives its blood supply from the branches of the aorta, which pass along the vertebral bodies or near them ( the cervical spine is supplied with blood by branches of the subclavian artery). The main arteries are the intercostal and lumbar arteries, which supply blood not only to the anterior and posterior parts of the vertebrae, but also to some muscles of the back. In addition, the posterior branches of these arteries enter the spinal canal ( spinal arteries where the spinal cord is located. In turn, the spinal arteries are divided into anterior and posterior, which communicate with each other and form a network of anastomoses ( fistula between vessels). This network supplies arterial blood to the spinal cord, vertebral bodies and cartilaginous tissue of the intervertebral discs.

The outflow of blood from the spine is carried out through four venous plexuses, which anastomose with each other ( connect). At the base of the skull, these plexuses communicate with the occipital venous sinus, which is one of ten venous collectors that collect blood from the veins of the brain. It is worth noting that the spinal veins do not have valves, and depending on the pressure, blood can move through them in both directions. This difference, however, significantly increases the likelihood of tumor metastasis ( penetration of cancer cells into other tissues) to the spine.

From the cervical spine, lymph outflow is carried out to the deep lymph nodes of the neck, in the upper part of the thoracic region - to the lymph nodes of the posterior mediastinum. In the lower thoracic segment, the outflow is carried out to the intercostal lymph nodes, and then to the thoracic lymphatic duct. The outflow of lymph from the lumbar and sacral segment is carried out in the lymph nodes of the same name.

Ribs

There are 12 pairs of ribs in the human chest. The number of ribs corresponds to the number of thoracic vertebrae. The rib is a pair flat bone, which has an arcuate shape. The large curvature of the ribs provides greater mobility. In turn, curvature depends on age and gender.

Each rib consists not only of the bony part, but also of the cartilage. The bony part of the rib has a body, neck and head. The body of the rib is the longest part and forms the angle of the rib approximately in the middle, deviating towards the sternum. On the posterior edge of the rib is the neck, as well as the head, which articulates with the corresponding thoracic vertebra. The anterior edge of the bony part of the rib has a small fossa, to which the cartilaginous part joins. It is worth noting that the upper 7 pairs of ribs are directly connected to the sternum, and they are called "true". The next 3 pairs of ribs are attached with their cartilaginous part to the overlying ribs and are not attached directly to the sternum. The anterior ends of the lower two ribs are located in the muscles of the abdominal cavity and are called "fluctuating". The lower edge of the ribs bears a groove in which the intercostal nerves and vessels pass ( under the lower edge of the rib is a vein, followed by an artery and a nerve). It should be noted that this neurovascular bundle is covered in front and behind by intercostal muscles.

The first two ribs are somewhat different in structure from the other ribs. The first rib is the shortest of all and the widest. On the upper surface of this rib there are grooves in which the subclavian artery and vein pass. Also next to the groove there is a tubercle of the anterior scalene muscle to which is attached given muscle. The tuberosity of the serratus anterior muscle is located on the second rib.

shoulder blades

The shoulder blade is a flat triangular bone that is part of the shoulder girdle ( along with clavicle and humerus). Three rather large formations are distinguished in the scapula - the scapular spine, acromion and coracoid process. The scapular spine is a triangular bony plate that runs along the posterior surface of the scapula and divides the scapula into the infraspinatus and supraspinatus fossa. The scapular spine ends with the acromion - the humeral process. The acromion is a massive triangular process that is located above the glenoid cavity of the scapula and connects to the clavicle. Also, part of the muscle bundles is attached to the acromion deltoid muscle. It should be noted that the scapula performs an important musculoskeletal function, since more than 15 different muscles are attached to it.

In total, the following surfaces are distinguished in the shoulder blade:

Front surface(ventral) directly adjacent to the ribs and is concave. This surface, in fact, is represented by the subscapular fossa. Inner part this fossa is striated with scallops, which are necessary for attaching the tendons of the subscapularis muscle. In turn, a small outer part of the subscapular fossa serves as a bed for the subscapularis muscle. In the upper part of the subscapular fossa, the bone is somewhat bent and forms a subscapular angle. It is thanks to this shape that the blade has good strength.
Back surface scapula is divided into two unequal parts by a large bone formation in the form of a ridge ( spine of scapula). Unlike the anterior surface, the posterior surface is convex. The part that is located below is called the infraspinatus fossa, and the one above is called the supraspinatus. The infraspinatus fossa is several times larger than the supraspinatus and is the site of attachment, as well as a bed for the infraspinatus muscle. The supraspinatus fossa serves as the site of attachment of the supraspinatus muscle.

muscles

The skeletal muscles of the back provide active movements not only in the thoracic and lumbar segments, but also participate in the turns and tilts of the entire body and neck, participate in the act of breathing by attaching muscle bundles to the ribs, penetrate into the pelvis, and allow movements in the shoulder girdle.

The following skeletal muscles are distinguished in the back:

trapezius muscle It is a flat and rather wide triangular muscle, which is located on the surface and occupies the back of the neck, as well as the upper back. This muscle, with its apex, is attached to the acromion of the scapula, while the base of the muscle faces the spinal column. Contraction of all bundles of the trapezius muscle brings the scapula closer to the spine. If only the upper muscle bundles contract, then the scapula rises, and if only the lower ones, it goes down. With fixed shoulder blades, contraction of both trapezius muscles leads to extension and deviation of the head back, and with unilateral contraction, it tilts the head to the corresponding side.
Latissimus dorsi back is a massive muscle that occupies almost the entire lower back. The muscle originates from the last five thoracic vertebrae, all lumbar and sacral vertebrae, from the upper part of the iliac crest, from the superficial sheet of the lumbar-thoracic fascia, and also from the lower four ribs and is attached to the humerus. The upper bundles of the muscle are directed sideways and form the back wall of the axillary cavity, while the lower bundles are directed sideways and upwards. The latissimus dorsi muscle is involved in the rotation of the arm inward. In the event that the upper limb is fixed, then the muscle brings the body closer to it and somewhat expands the chest.
rhomboid muscle passes directly under the trapezius muscle and has the shape of a rhombus. This muscle is located between the shoulder blades. The large rhomboid muscle originates from the spinous processes of the first four thoracic vertebrae, moving obliquely downwards, the muscle bundles are attached to the inner edge of the scapula. Contraction of the muscle brings the scapula to the midline. With the contraction of only the lower bundles of the muscle, the lower angle of the scapula rotates inward.
Minor rhomboid muscle, as well as the large rhomboid muscle, is located under the trapezius muscle ( second layer of muscle). This muscle plate in the form of a rhombus originates from the two lower cervical vertebrae. Going down obliquely, the muscle is attached to the inner edge of the scapula. The small rhomboid muscle brings the scapula closer to the spine.
Muscle that lifts the scapula is an oblong and thickened muscular plate, which is located under the trapezius muscle in the lateral part of the back of the neck. This muscle originates from the transverse processes of the first four cervical vertebrae and, heading obliquely down, is attached to the inner edge and upper corner of the scapula. The muscle raises the upper angle of the scapula, and also slightly rotates and displaces the lower angle of the scapula towards the spine. With a fixed shoulder blade, tilts the neck to the appropriate side.
Muscles that lift the ribs located only in the thoracic region. These muscles originate from the transverse processes of the thoracic vertebrae. These muscles are attached to the underlying ribs. It is worth noting that there are short muscles, lifting ribs that go directly to the underlying rib, as well as long ones that are thrown over one rib. During contraction, these muscles raise the ribs, which contributes to an increase in volume. chest (are one of the main muscles involved during inhalation).
Serratus posterior superior refers to the third layer of the superficial muscles of the back. This muscle starts from the two lower cervical and two upper thoracic vertebrae. Moving obliquely down, the serratus posterior superior muscle is attached to 2-5 ribs. Since the muscle is attached to the ribs, its main function is to participate in the act of breathing.
Serratus posterior inferior abdominis located on the border of the chest and lumbar back. This muscle begins from the spinous processes of the three upper lumbar vertebrae and the two lower thoracic vertebrae. The muscle bundles move obliquely upward and attach to the last four ribs. This muscle lowers the lower ribs down.
Muscle that straightens the spine- the longest and most powerful skeletal muscle in the entire back. The muscle lies in a groove, which is formed by the transverse and spinous processes of the vertebrae. One end of the muscle is attached to the sacrum, the spinous processes of the last two lumbar vertebrae, and the iliac crest. Heading vertically upward, this muscle divides into three separate muscle bundles - the spinous muscle, the longissimus muscle and the iliocostal muscle. If there is a bilateral contraction of the muscle that straightens the spine, then this leads to the extension of the entire spinal column and fixation of the entire body in a vertical position. With a unilateral contraction, the spinal column tilts to the corresponding side. In addition, due to the fact that several muscle bundles are attached to the ribs, this muscle can also take part in the act of breathing.
teres major muscle is a flat and elongated muscle that originates from the lower angle of the scapula, goes outward and is attached to the humerus. The large round muscle brings the shoulder to the body, and also pulls it back.
teres minor muscle is an oblong muscle that resembles a rounded cord in shape. The small round muscle originates from the outer edge of the scapula. Moving laterally, the muscle passes into the tendon, which is woven into the back surface of the shoulder capsule and attached to the humerus ( to the big bump). Teres minor muscle abducts ( supination) shoulder from the body and pulls the capsule shoulder joint.
infraspinatus muscle has a triangular shape and fills the entire infraspinatus fossa of the scapula. Heading sideways, the muscle bundles converge into a tendon that is attached to the humerus. The infraspinatus muscle rotates the shoulder outward, and also pulls back the articular capsule of the shoulder joint.
supraspinatus muscle is a triangular muscle that completely covers the supraspinous fossa of the scapula. Muscle fibers passing under the shoulder process ( acromion), are directed to the humerus. The muscle is attached to the back surface of the articular capsule of the shoulder joint. The contraction of the supraspinatus muscle leads to retraction of the joint capsule and prevents its infringement.
Subscapularis - a flat muscle of a triangular shape, which almost completely fills the subscapular fossa. The muscle is divided into separate muscle bundles by connective tissue layers. In the subscapularis muscle, a deep and superficial layer is distinguished. In the first layer, muscle bundles originate from the costal ( ventral) the surface of the scapula, in turn, the superficial bundles start from the subscapular fascia, which is attached to the edge of the subscapular fossa. The subscapularis attaches to the humerus ( to the crest of the lesser tubercle). It should be noted that this muscle, heading towards the humerus, passes into the tendon, which fuses with the articular capsule of the shoulder joint in its anterior part. Thanks to this, the muscle is able to bring the shoulder to the body.
Intertransverse muscles are deep short muscle bundles that are stretched between the transverse processes of two adjacent vertebrae. The transverse muscles are found in the cervical, thoracic and lumbar regions. The main function of these muscles is to hold the spine. Unilateral contraction leads to the inclination of the spinal column in the corresponding direction.
Interspinous muscles also located in close proximity to the spine. These short muscles are stretched between the spinous processes of neighboring vertebrae in the cervical, thoracic and lumbar regions. The interspinous muscles take part in the extension of the spine and its holding in a vertical position.
Square muscle of the lower back is a flat quadrangular muscle bundle. The quadratus lumborum originates from the transverse processes of all lumbar vertebrae, the iliac crest, and also from the iliopsoas ligament and attaches to the last rib and the transverse processes of the first and second lumbar vertebrae. Bilateral contraction of the square muscle of the lower back leads to extension of the spine, and unilateral - tilts the body in the corresponding direction.
psoas major is a long and fusiform muscle. The most superficial muscle bundles are attached to the lateral surfaces of the four upper lumbar vertebrae, as well as to the last thoracic vertebra. Moving down, the psoas major muscle narrows somewhat. In the pelvic cavity, this muscle is connected to the iliac muscle, which leads to the formation of a common iliopsoas muscle. This muscle is involved in flexion and rotation of the outside of the thigh. In addition, the psoas major muscle allows you to flex the lower back with a fixed position of the lower limb.
External oblique abdominal muscle located on the anterior and lateral surface of the abdomen, and also partially passes to the chest. The external oblique muscle of the abdomen originates from the outer surface of the seven lower ribs. This muscle is attached to the ilium, a connective tissue structure that runs along the midline of the abdomen ( white line) and to the articulation of two pubic bones ( pubic symphysis). Bilateral contraction of the external oblique muscle of the abdomen slightly flexes the spine and lowers the lower ribs. In turn, unilateral contraction leads to rotation of the body in the opposite direction.
Internal oblique abdominal muscle located directly under the external oblique muscle of the abdomen. This muscle is a muscular-tendon plate, which originates from the iliac crest, lumbothoracic fascia and inguinal ligament. Advancing in a fan-like manner, the internal oblique muscle of the abdomen attaches to the lower ribs and is woven into the linea alba. With a bilateral contraction, the spine flexes, and with a unilateral contraction, the body rotates in the corresponding direction. In the event that the chest is fixed, the internal oblique muscle of the abdomen raises the pelvic bones.

Nerves

The nerves of the back are represented by the spinal nerves. Each such nerve consists of motor and sensory nerve fibers. The first are centripetal fibers that carry impulses from the brain through the spinal cord to muscle tissues, some glands. While sensitive fibers are centrifugal. Taking impulses from peripheral tissues, as well as from organs, these nerve fibers ( nerve cells and their processes) conduct them to the central nervous system.

The spinal nerves are formed from the following nerve tissues:

front roots, essentially formed by the main processes of nerve cells ( axons), which are located in the anterior part of the spinal cord ( in the anterior horns). These processes, uniting, form threads, and those, in turn, form the anterior or motor root. The anterior roots contain nerve fibers that conduct motor impulses to smooth and skeletal muscles. It is worth noting that, leaving the spinal cord, the roots depart in different ways. In the cervical segment of the spinal cord, the roots depart from it almost horizontally, in the thoracic region they are directed obliquely and downward, and in the lumbar and sacral regions they depart downward.
back roots, unlike the anterior ones, are formed by axons of nerve cells that conduct sensitive impulses from various organs and tissues to the spinal cord, and then to the brain. It is worth noting that the posterior roots, connecting with the anterior roots, form the spinal ganglion. This node then gives off fibers to form the spinal nerve.

The spinal nerves emerge from the spinal cord in pairs. Each pair of spinal nerves belongs to one of the segments of the spinal cord. The cervical part of the spinal cord consists of 8 segments ( while the cervical spine - only 7 vertebrae), thoracic - from 12, lumbar - from 5, sacral - from 5 and coccygeal - from 1 - 3 segments. It is worth noting that the segments of the spinal cord do not correspond to the segments of the spinal column. Only the uppermost cervical segments are located opposite the corresponding cervical vertebrae, while the lower cervical and upper thoracic segments are located one vertebrae higher. Already in the middle of the thoracic region, the discrepancy is 2-3 vertebrae. In turn, the lumbar segments of the spinal cord are located at the level of the last two thoracic vertebrae, and the sacral and coccygeal segments are located at the level of the last thoracic and first lumbar vertebrae.

The spinal nerves of the thoracic segment have four separate branches. One of these branches is represented by the intercostal nerves.

The following branches are distinguished in the thoracic nerves:

Connecting nerves head to the node of the sympathetic trunk ( part of the autonomic nervous system, which is activated under the influence of stress) and connect with it ( anastomose).
shell branch enters the spinal canal and goes to the dura mater ( sheath of connective tissue that covers the top of the spinal cord and brain).
back branch, in turn, is divided into two branches - internal and external. The internal branch sends muscle branches to some chest muscles ( transversospinous muscle, semispinalis and rotator muscles), and the cutaneous branch innervates the skin, which is located above these muscles. The outer branch also has a muscular and dermal branch. The first branch innervates the iliocostal muscle, as well as some muscles of the chest and neck. The second branch penetrates the skin, which corresponds to these muscles.
anterior branch The thoracic spinal nerves are represented by the intercostal nerves. Their number fully corresponds to the number of ribs. The intercostal nerves enter the neurovascular bundle, which is also represented by an artery and a vein. The first six intercostal nerves reach the sternum, and the lower two go to the abdominal wall ( to the rectus abdominis).

The upper six intercostal nerves reach the outer edge of the sternum, while the lower ones go to the rectus abdominis. In the abdominal wall, these nerves are located between the internal oblique muscle and transverse muscle belly. The last intercostal nerve is located in close proximity to the pubic symphysis and ends in the lower third of the rectus abdominis and pyramidal muscles.

The intercostal nerves innervate ( carry out nervous regulation) muscles that are located in the wall of the abdominal and chest cavity ( transverse pectoral muscle, subclavian, levator ribs, external and internal intercostal muscles, and upper portions of some abdominal muscles), as well as some back muscles ( serratus posterior superior and inferior, as well as the levator ribs muscles). In addition, the intercostal nerves also innervate the peritoneum ( a transparent and thin connective tissue membrane that covers all the organs of the abdominal cavity from above) and pleura ( sheath of thin connective tissue that covers both lungs and lines the inner surface of the chest cavity). The first intercostal nerve also takes part in the formation of the brachial plexus. It should be noted that in addition to connecting and muscle tissue these nerves also penetrate the skin of the lateral and anterior surfaces of the abdomen and chest. In turn, in women, these nerves are involved in the innervation of the mammary glands.

What structures can become inflamed in the back?

It should be noted that back pain can occur not only with inflammation of the structures that are located directly in the back. So, for example, in some diseases of the chest and abdominal organs, pain occurs that can be reflected ( radiate) in the back.

In the back area, the following tissues and structures can become inflamed:

Skin covering back can be attacked by pyogenic bacteria such as staphylococci and streptococci, causing pyoderma ( purulent lesion of the skin). In addition to the skin, these microbes infect the hair shafts ( follicles), sweat, and sebaceous glands.
fatty tissue, located directly under the skin hypodermis) or in deeper layers, can also become inflamed and lead to phlegmon ( purulent fusion of fatty tissue). Phlegmon most often occurs against the background of purulent lesions of the kidneys, pancreas or other structures that are in the retroperitoneal space or in the abdominal cavity.
muscles, as a rule, they become inflamed due to traumatic damage, which can occur after excessive physical effort or with the direct impact of a traumatic factor on muscle tissue ( contusion, crush, sprain, compression or tear). Muscles can also become inflamed ( myositis) due to a long stay in an uncomfortable position or with local hypothermia.
Ligaments and tendons just like muscles tend to become inflamed after being damaged. Partial or complete ligament rupture is accompanied by local pain of varying severity ( from weak to extremely strong with a complete rupture of the ligament), tissue edema, as well as limited mobility in the nearby joint.
Thoracic and lumbar spinal roots most often they become inflamed when they are squeezed by the vertebrae, pathological bone growths ( osteophytes) or a tumor, causing sciatica. A special case of sciatica is inflammation of the intercostal nerves, which is manifested by pain along the course of these nerves of a different nature and intensity ( this pathology is also called - intercostal neuralgia).
Vertebrae may be involved in infectious and non-infectious inflammatory processes. In some cases, the spinal column may be affected by infections such as tuberculosis or brucellosis ( an infection transmitted from sick animals to humans that causes damage internal organs ). Also, the vertebrae can undergo purulent-necrotic inflammation of the bone tissue ( osteomyelitis), which is most often caused by pyogenic bacteria such as streptococci or staphylococci.
Spinal cord can become inflamed against the background of an existing infection. With myelitis ( inflammation of the white and gray matter of the spinal cord) there is a partial loss of motor and tactile sensitivity up to the development of limb paralysis ( lower and/or upper). Also, myelitis can be caused by a serious injury, in which infection attaches and one of the segments of the spinal cord is involved in the pathological process.

Causes of back pain

Back pain can be caused by a number of different conditions. In some cases, severe pain appears against the background of a banal physical overstrain, which leads to muscle spasm. Athletes most often injure the musculoskeletal system. In turn, in the elderly, in most cases, dystrophic-degenerative processes of the spine are found. These processes manifest themselves as back pain of varying intensity, limited mobility in the spine, muscle spasm, loss of motor and tactile sensitivity, and other symptoms.

Causes of back pain

Disease name	Mechanism of back pain	Other symptoms of the disease
Pain that occurs against the background of inflammation of the skin and subcutaneous fat
*Furuncle* *(purulent-necrotic inflammation of the hair shaft and tissues around it)*	Pain sensations appear due to excessive irritation or destruction of pain endings that are located near the hair shaft or follicle. It is worth noting that the most severe pain occurs 72 hours after the formation of the boil. It is on the 3rd - 4th day that purulent fusion of the boil stem occurs ( central part), in which pain endings are also destroyed.	The general condition, as a rule, is not changed. The only symptom besides local pain is fever. In this case, the body temperature can rise up to 38ºС, and sometimes even exceed 39ºС. During the period when the core of the boil has undergone melting and rejection, the pain gradually subsides. At the site of the boil, the skin heals by scarring within 2 to 5 days.
*Furunculosis* *(a pathological condition in which boils appear on the skin at various stages of development)*		Furunculosis is manifested by general malaise with the occurrence of headaches, dizziness, nausea and / or vomiting. In some cases, against the background of general weakness, loss of consciousness may occur. Also, with this purulent skin lesion, fever occurs, in which the body temperature rises to 38.5 - 39.5ºС.
*Carbuncle* *(acute purulent-necrotic inflammation of the skin and surrounding tissues around several hair follicles)*	The mechanism of pain is similar to that of a boil.	A carbuncle is a fusion of several affected hair shafts ( infiltrate). The size of the carbuncle can vary, in some cases it can reach 4 - 6 centimeters in diameter, and sometimes exceed 9 - 10 centimeters. It should be mentioned that for 8-12 days this pathological formation is extremely painful. Later, through several holes through the carbuncle, a purulent-necrotic mass is rejected ( skin is like a sieve). The skin at the site of the carbuncle exposes a rather deep ulcer, which is also quite painful. Over the next 15 to 20 days, the ulcer heals by scarring. The general condition for carbuncle is similar to that for furunculosis - an increase in body temperature ( 39.5 - 40ºС), chills, headaches, dizziness, nausea and vomiting.
*Ectima* *(skin disease in which there is a deep lesion)*	The pain is a consequence of the occurrence of a deep ulcer, which is formed at the site of a relatively small abscess or conflict. It is an open ulcer that serves as a source of pain. It should be noted that within 3-5 days this sore gradually begins to scar, which is manifested by a decrease in pain.	At the beginning of the disease, one or several small blisters with purulent contents may appear on the skin ( sometimes pus can be mixed with blood). In the future, this abscess is covered with a brown crust, which, opening up, exposes a painful and deep sore.
*Erysipelas* *(subcutaneous fat loss)*	Subcutaneous fat becomes inflamed and swells. In turn, tissue edema compresses the nerves and nerve endings located in nearby vessels and the subcutaneous fat itself. With the bullous form of erysipelas, blisters form with a colorless liquid, which then become covered with a crust. In the future, the crust disappears and often exposes painful ulcers and erosion.	During few hours ( 24 hours) after the onset of the disease, the affected skin becomes hot to the touch, swollen and painful. Emerging erythema ( reddened skin segment) has a red-purple color and is also raised compared to healthy skin ( due to tissue swelling). Also, this disease is characterized by damage to the lymphatic vessels and nodes ( lymphangitis and lymphadenitis).
Pain arising from inflammation of the muscles, ligaments and deep fatty tissue
*Myositis* *(inflammatory process that is localized in the muscles)*	The inflammatory process leads to swelling of the soft tissues. Ultimately, the enlarged muscles compress the nerve endings in the vessels, as well as nearby nerves that are located in the deeper and / or superficial layers.	Myositis is manifested by muscle pain, which is aggravated by touch and pressure on them. Also myalgia ( muscle pain) increases during movement or when the weather changes. Sometimes this pathology can lead to reddening of the skin over inflamed muscle tissue. With untimely treatment, myositis leads to a violation of the functional state of the muscles. Also, in rare cases, other nearby muscles may be involved in the pathological process.
*Tendinitis* *(inflammation of the connective tissue of the tendon)*	Tendinitis is characterized by the presence of a permanent rupture of a certain part of the tendon. Since a large number of pain receptors are located in the connective tissue of the tendon, depending on the amount of damage, the pain can be either minor or severe. As a rule, pain occurs when performing movements in the joint adjacent to the tendon.	The skin over the injured tendon may become red and hot to the touch. There may also be tissue swelling. Sometimes a crunch occurs at the site of inflammation of the connective tissue of the tendon ( crepitus). It should be noted that in some cases, the injured tendon heals with the formation of dense nodules of calcium ( calcifications).
*Retroperitoneal phlegmon* *(purulent fusion of retroperitoneal tissue, diffuse character)*	Retroperitoneal phlegmon leads to purulent fusion of fatty tissue located in the retroperitoneal space. Ultimately, a large accumulation of pus forms, which compresses various structures and tissues ( nerves, muscles, tendons, blood vessels), in which a large number of painful endings are located. Pain in this pathology, as a rule, pulling and pulsating.	In the first period of the disease, there is general weakness, loss of appetite, dizziness, headaches, chills. Body temperature can rise to 37.5 - 38ºС. The pain, localized in the lumbar region, gradually increases. In some cases, the process can spread beyond the retroperitoneal tissue, causing pain in the sacrum, buttock or abdomen.
Pain in the spine
*Osteochondrosis* *(dystrophic changes that occur in the intervertebral discs)*	With osteochondrosis, dystrophic changes occur in the intervertebral discs. Ultimately, they lose their elasticity, which leads to a decrease in the space between two nearby vertebrae and pinching of the spinal nerves. Compression of the nervous tissue leads to cramping and sharp pains. It should be noted that pain in osteochondrosis may increase against the background of increased mental or physical activity.	Often with osteochondrosis, there is increased sweating of the whole body or hands ( hyperhidrosis). Muscles innervated by pinched spinal nerves gradually lose their functionality and become lethargic and weak ( atrophy). Compression of the lower lumbar spinal nerves, as well as the upper sacral ( these nerves form the sciatic nerve) leads to sciatica ( inflammation sciatic nerve ).
*Intervertebral hernia*	When the peripheral part of the intervertebral disc is damaged, the nucleus of the disc protrudes outward. Ultimately, this nucleus is able to compress the spinal nerves, causing pain and inflammation of the nerve tissue. These pains may be constant or cramping in nature ( in the form of shots). It should be noted that intervertebral hernia is more often formed against the background of osteochondrosis in the lumbar segment of the spine.	Since a hernia occurs precisely in the lumbar spine ( more than 75 - 80% of all cases), this leads to compression of the sciatic nerve, which innervates the back of the thigh and lower leg, as well as the foot. Most often in the lower extremity ( as a rule, only one sciatic nerve is compressed) there may be such unpleasant sensations as "goosebumps", tingling, numbness. In addition, there is a weakening of the muscles of the legs, as well as a loss of sensitivity. In rare cases, there are violations of the act of urination and defecation. If an intervertebral hernia occurs in the cervical segment ( approximately 18 - 20% of all cases), it is possible to increase blood pressure, the occurrence of headaches and dizziness, as well as pain that is reflected in the shoulder and arm. In quite rare cases ( in 1 - 3%) a hernia occurs in the thoracic region. In this case, a typical symptom is constant pain in the thoracic segment while working in a forced position. It should be noted that sudden movements, coughing and sneezing often provoke new bouts of pain.
*Displacement of the vertebrae* *(subluxation of the vertebrae)*	When the vertebrae are displaced ( spondylolisthesis) can cause compression of the spinal nerves, as well as the spinal cord itself ( narrowing of the canal that houses the spinal cord). As a result, there is a pain syndrome of varying severity with the occurrence of various kinds of neurological symptoms.	With the displacement of one of the vertebrae of the lumbar spine ( occurs most frequently) there are symptoms characteristic of inflammation of the sciatic nerve. In this case, there is pain along the nerve fiber, loss of sensation in the back of the leg, the occurrence of paresthesia ( tingling sensation, numbness, "goosebumps" in the leg), amyotrophy. If there is a displacement of the vertebra in the cervical region, which occurs much less frequently, then in this case the main symptoms are headaches, dizziness, and in some cases a stable increase in blood pressure.
*Vertebral fracture*	The direct impact of a traumatic factor on the vertebrae can lead to compression of nerve tissues, spinal cord, blood vessels and other tissues, causing extremely severe pain.	In addition to the occurrence of acute pain in the area of damage, a vertebral fracture is also characterized by a complete limitation of active movements in the damaged segment, a sharp muscle tension, and when the spinal cord is compressed, serious neurological symptoms can occur, up to a violation of the cardiovascular and respiratory activity (if it is a fracture of the upper cervical vertebrae).
*spinal tumor* *(benign or malignant tumor of the spine or spinal cord)*	Tumor cells, and cancer cells in particular, are able to bind to pain receptors in various tissues ( nervous, connective tissue, muscle tissue, as well as the vascular wall) and stimulate them. The more cancer cells come into contact with pain endings, the more pronounced the pain syndrome. It is worth noting that it is pain that is the first symptom of a tumor of the spine and spinal cord. This pain is characterized by an increase in the night and / or morning period of time ( being in a horizontal position) and some subsidence when moving to a vertical position.	Pain that occurs against the background of neoplasia ( neoplasm) of the spine, often reflected in the upper or lower limbs. It is characteristic that the pain is practically not stopped by painkillers. In addition to pain, there is also a violation of the act of urination and defecation, muscle weakness and paresthesia ( burning sensation, goosebumps, numbness) in the lower and sometimes in the upper limbs, loss of motor function ( paralysis), gait disturbance. In some cases, coldness is felt in the lower extremities, the skin of the extremities becomes cold to the touch and sticky. A fairly large tumor can lead to spinal deformity, causing scoliosis.
*Bechterew's disease* *(inflammation of the spine of a non-infectious nature)*	The inflammatory reaction that occurs in the spinal column leads to the release of a large number of biologically active substances that are responsible for the increased pain syndrome. Inflammation is localized not in the vertebrae themselves, but in the intervertebral discs, causing dystrophic changes in them. Ultimately, the load on the muscles and ligaments of the spine increases, which leads to their pathological tension and pain.	At the beginning of the disease, pain can only disturb a few vertebrae of the lumbar or sacral spine. In the future, the process covers the entire spine, and in some cases passes to large joints ( hip, knee, ankle and/or elbow). Stiffness in the spine gradually increases, which disrupts normal motor function. In addition, Bechterew's disease ( ankylosing spondylitis) has extra-articular manifestations. These manifestations include inflammation of the iris of the eyeball ( iridocyclitis), inflammation of the heart bag ( pericarditis), acquired valvular insufficiency.
*Scoliosis* *(lateral curvature of the spinal column)*	Pain occurs due to compression of the spinal nerves by the vertebrae that have undergone scoliotic curvature. Also, scoliosis is a predisposing factor to the early development of osteochondrosis.	Depending on the magnitude of the curvature of the spinal column, 4 degrees of scoliosis are distinguished. In addition to a violation of posture, the normal position of the pelvic bones and organs located in the pelvic cavity sometimes changes ( bladder, rectum, uterus and appendages).
*Kyphosis* *(curvature of the spine in the anteroposterior direction)*	In kyphosis, there is a wedge-shaped deformity of the vertebrae in the thoracic spine along with a pathological replacement of cartilage tissue with connective tissue in the intervertebral discs. Ultimately, the musculoskeletal apparatus cannot cope with the load, which leads to overstrain and pain.	Kyphosis leads to a violation of the mobility of the spinal column. The long course of this pathological condition leads to stoop, and then to hunchback. It should also be noted that with kyphosis, the function of the respiratory muscles is impaired ( basically a diaphragm) due to a violation of the mobility of the chest.
*Scheuermann-Mau disease* *(kyphosis that occurs during puberty)*	Same as for kyphosis.	As a rule, there is increased fatigue, pain in the lumbar segment when performing moderate physical activity. Also, pain can appear with a long stay in a sitting position.
*Tuberculosis of the spine* *(tuberculous spinal injury)*	Tuberculosis can completely destroy the bone tissue of the vertebrae, leading to pinching of the spinal roots. In addition, tuberculosis can lead to abscess formation ( limited collection of pus), which, in turn, is also able to compress the spinal nerves.	Tuberculosis causes general malaise, muscle weakness and myalgia ( muscle pain ), subfebrile fever ( 37 - 37.5ºС). Pain at the beginning of the disease, as a rule, is insignificant, but as the disease progresses, they become more pronounced, and sometimes unbearable. In addition, tuberculous lesions of the spine cause a violation of posture and stiffness in movements both in the spinal column itself and in the hip joints ( gait disturbance occurs). Due to the fact that the load from the spinal column is transferred to the musculo-ligamentous apparatus, gradually the back muscles atrophy ( loss of functional state).
Brucellosis of the spine(damage to the spine caused by the penetration of the brucellosis pathogen into the body)	With brucellosis, one or two vertebrae are most often affected. In these affected vertebrae, a decrease in bone density is observed, which triggers a compensatory reaction, during which additional lateral bone outgrowths are formed ( osteophytes). It is osteophytes that most often compress the spinal roots emerging from the spinal cord.	Brucellosis is characterized by an increase in body temperature to 37.5 - 38ºС. Chills and general malaise also appear, which is manifested by headache, dizziness, joint pain, especially in the lower extremities. If you do not detect and start treatment in time, then the defeat of the spine with brucellosis can cause a purulent lesion of the spine ( osteomyelitis).
*Spinal osteomyelitis* *(purulent inflammation of the vertebrae with involvement in the pathological process of surrounding tissues)*	This rather rare pathology leads to purulent lesions of the vertebral bodies. As a result, an accumulation of pus is formed, which can compress the spinal cord, spinal nerves, blood vessels, soft tissues, fatty tissue, which contain a large number of pain receptors. The pain is often severe and permanent. It is worth noting that pus can melt tissues and penetrate into more superficial layers ( through fistulas).	Osteomyelitis proceeds rapidly. Body temperature rises to 39 - 40ºС, tachycardia occurs ( increase in the number of heartbeats) and hypotension ( lowering blood pressure). In addition, the general condition deteriorates sharply, leading to fainting and convulsions. The pain syndrome is most pronounced at night.
*Myelitis* *(inflammation of the spinal cord)*	The inflammatory process, localized in the structures of the spinal cord, leads to tissue edema. In turn, the edema compresses nearby blood vessels and nerves, contributing to the onset of pain. It is worth noting that back pain in myelitis is most often unexpressed. It is the neurological symptoms that come to the fore. When the spinal nerves are involved in the pathological process, diffuse pain appears along the course of these nerve fibers.	Depending on the affected segment of the spinal cord ( usually affects 1-2 segments), as well as from the clinical form of this inflammation, the symptoms of myelitis may differ slightly. Acute focal myelitis is characterized by general malaise, fever ( 38.5 - 39ºС), chills, muscle weakness, sometimes vomiting. Then there is a feeling of numbness and tingling in the legs ( paresthesia), which is quickly replaced by a complete loss of movement in the limbs. If the process is localized in the lumbar region, then in this case dysfunction of the pelvic organs occurs. In disseminated myelitis, in addition to the main focus, there are also secondary foci that are smaller in size. Irregularity of spinal cord lesions leads to varying degrees of motor, reflex and sensory disorders both on the left and on the right. There is also a form of myelitis ( opticomyelitis), in which there is a partial loss of visual areas, as well as a decrease in visual acuity. In children, myelitis often leads to seizures.
Pain in the ribs
*Shingles* *(a viral disease caused by herpes zoster, which is manifested by damage to the skin and nervous system)*	After the varicella-zoster virus ( herpes zoster) becomes active again ( after the first contact with him, a person becomes ill with chickenpox, and then the virus becomes inactive), it moves along the intercostal cells and causes inflammation of the overlying layers, namely the skin. There are characteristic rashes ( red blisters with colorless liquid), severe itching and severe pain. Pain is a consequence of strong irritation of pain receptors located in the subcutaneous fat, as well as nerve processes ( axons) intercostal nerves.	Most often, skin manifestations of herpes zoster are preceded by a general malaise of the body ( headache, dizziness, fever, muscle pain), itching, tingling and pain of a neurological nature at the site of future rashes. Rarely, the virus can infect the ophthalmic branch of the trigeminal nerve, leading to corneal destruction ( transparent and most superficial membrane of the eye) or cause pathological changes in the ear canal, causing partial or complete hearing loss.
*Tietze syndrome* *(inflammation of the cartilage of the ribs)*	This pathology leads to inflammation and swelling of the cartilaginous tissues of the ribs. The enlarged anterior segments of the ribs are able to compress the surrounding tissues, in which pain receptors are located. Pain is most often unilateral and is acute or progressive.	The cartilaginous segments of the first 5-6 ribs are usually affected. Sudden movements of the trunk, coughing or sneezing can increase the pain syndrome. Tietze's syndrome is characterized by the presence of constant pain in the sternum, which in some cases can bother patients for years. Often the pain is paroxysmal in nature. When feeling the cartilaginous part of the ribs, a painful swelling is detected. Sometimes pain can be reflected along the ribs in the anteroposterior ( sagittal) direction. It is worth noting that, apart from pain in the anterior part of the chest and sternum, there are no other symptoms of this disease.
*Intercostal neuralgia* *(pain caused by compression of the intercostal nerves)*	Pinching of the spinal roots of the thoracic spinal cord inevitably leads to pain along the intercostal nerves ( thoracalgia). The pain can be either dull and aching, or sharp and piercing. It should be noted that this pain syndrome has a paroxysmal character.	An attack of pain leads to difficulty in breathing, as a person reflexively stops using the affected side, assuming a forced position. In some cases, there is a twitching of the muscles innervated by the intercostal nerves, and the skin becomes red or, conversely, turns pale. There may also be heavy sweating and tingling in the chest. Sometimes there may be loss of sensation in some segments of the chest. An attack can cause or increase coughing, sneezing, sudden movements. In fact, intercostal neuralgia is not an independent pathology, but is a manifestation of osteochondrosis of the thoracic segment of the spine, scoliosis, and some infectious diseases ( herpes zoster, flu, tuberculosis), severe overwork, injury or other cause.
*rib fracture*	Pain is caused by exposure to various structures of the chest traumatic factor ( bruise, sprain, compression, crush or tear). In some cases, bone fragments of the ribs can damage the pleura ( thin connective tissue membrane that covers both lungs and lining the inner surface of the chest cavity), which contains a large number of nerve receptors.	The pain is most often severe and excruciating. Any movements made in the chest, deep breathing, coughing or sneezing can increase these pain sensations. That is why patients with rib fractures reflexively experience shallow breathing, which, in turn, increases the risk of pneumonia. When probing the fracture site, a crunch is often found ( crepitus), swelling and deformity of the chest ( sometimes bruising). The skin becomes pale or cyanotic. If there is a unilateral fracture of the rib or ribs, then there is a delay in breathing of the affected side of the chest. When the torso is tilted to the healthy side, as a rule, severe pain occurs.
*Osteosarcoma and osteochondroma of the ribs* *(malignant tumors of the ribs, in which the bone or cartilage tissue of the ribs is involved in the pathological process)*	Cancer cells are able to bind have tropism) with pain endings in different tissues ( connective tissue, muscle, nervous, as well as the wall of blood vessels) and cause them to be overstimulated. There is a direct relationship between the number of cancer cells and the severity of the pain syndrome ( the more cells, the more pain). One of the features of osteosarcoma is that the pain is most pronounced at night and in the morning, when the person is in a horizontal position.	The skin at the site of the lesion becomes swollen. In the future, a small network of dilated veins often appears on it ( phlebectasia). The progression of these oncological diseases leads to an increase in the size of the tumor, which, in turn, more and more compresses the surrounding tissues and increases pain. In addition, there is anemia ( anemia), muscle weakness, apathy, weight loss. It should be noted that the pain caused by osteosarcoma is practically not relieved ( localization and minimization).
Pain in the shoulder blades
*Pterygoid scapula syndrome* *(paralysis of the serratus anterior, which causes the scapula to bulge painfully backwards)*	Most often, this pathology develops against the background of an injury to the long thoracic nerve. Ultimately, this nerve is unable to send nerve impulses to the serratus anterior, causing paralysis. Against the background of a violation of the innervation of the anterior serratus muscle, muscle pain gradually arises. Sometimes damage to the cervical spinal nerves or the brachial plexus can also lead to this disease. Pain sensations are aching in nature.	As a rule, pain occurs after the onset of muscle weakness. This pain can be reflected in the shoulder or even in the forearm. Another symptom is a protrusion of the lower edge of the scapula. The presence of this manifestation is detected while the patient presses on the wall with straight arms.
*scapula fracture*	Pain can be caused by hematoma compression ( accumulation of blood from damaged vessels) surrounding tissues. In some cases, pain from a scapular fracture can be felt in the shoulder joint. This is due to the fact that with a fracture of the glenoid cavity of the scapula, all the blood flows into the cavity of the shoulder joint ( hemarthrosis).	In addition to pain in the shoulder blade area, swelling also occurs, which is a consequence of tissue edema. Often, during movements or when pressing in the area of a fracture of the scapula, a crunch can be heard ( friction of bone fragments). In some cases, the scapula is displaced, which ultimately leads to the drooping of the shoulder girdle. In addition, very often there is a limitation in the mobility of the shoulder joint.
*Osteomyelitis of the scapula* *(purulent lesion of the bone of the scapula)*	The accumulation of pus in the subscapular region can lead to compression of the underlying blood vessels and nerves. In some cases, this pathology causes purulent inflammation of the shoulder joint ( purulent shoulder arthritis). The pain can be both moderate and severe.	In addition to pain, there is an increase in body temperature ( up to 37 - 38ºС), chills, general weakness, loss of appetite. Sometimes there may be an increase in heart rate ( tachycardia). As a rule, the pain intensifies at night or in the morning, and gradually decreases during the day.
*Exostosis of the scapula* *(osteochondral growth that can compress surrounding tissues)*	In some cases, an osteochondral neoplasm of the scapula can reach a large size and, thereby, lead to compression of muscle tissue, blood vessels and nerves. Pain can also occur with malignant degeneration of exostosis ( cancer tumor).	If the exostosis reaches large and very large sizes, then in addition to pain, excessive pressure on the ribs may occur, which, in turn, can lead to their deformation.
*Tumor of the scapula* *(osteochondroma, chondroma, osteoblastoma, osteoma)*	Tumor cells have on their surface protein molecules that bind to pain receptors and cause their stimulation. Pain at the beginning of the disease may not be very disturbing, but as the tumor grows, the pain sensations increase significantly and are almost not amenable to relief with painkillers. This is due to the fact that there is a direct relationship between the size of the tumor and the severity of the pain syndrome ( the more cancer cells, the more pain).	The skin in the shoulder blade area is most often hot to the touch, thinned and edematous. If the tumor is located near the glenoid cavity of the scapula, then there is a violation of movements in the shoulder girdle. In some cases, pathological fractures may occur, which are associated with loss of bone strength. If the tumor reaches a large size, then it is able to compress the vessels and nerves of the chest, thereby causing severe pain and discomfort.

In addition to the above reasons, there are a number of pathologies associated with the cardiovascular system, gastrointestinal tract, respiratory system, which can lead to pain in various areas of the back. That is why, in the event of back pain, it is necessary to consult an experienced doctor who is able to conduct the correct differential diagnosis and accurately determine the disease.

The most common pathologies in which reflected back pain can occur

Name of the disease	Mechanism of pain	Other symptoms of the disease
Diseases gastrointestinal tract
*Ulcer of the stomach and duodenum*	Excessive exposure to gastric juices, bile, and stomach enzymes ( pepsin) on the mucous membrane of the stomach and duodenum leads to local ulceration ( an ulcer forms). As a rule, pain in these pathologies is localized in the upper abdomen, but sometimes they radiate ( reflected) in the lumbar and / or thoracic segment of the spine, as well as in left side loins. The intensity of pain can be different - from slightly aching, up to "dagger".	A stomach ulcer quite often leads to heartburn and belching. A quickly emerging feeling of fullness with food is often replaced by nausea and even vomiting. After eating, there may be heaviness in the abdomen. In half of the cases there is a violation of the table ( constipation). With a duodenal ulcer, "hunger pains" are observed that appear on an empty stomach and stop only after eating or when using medications or substances that reduce acidity ( antacids, antisecretory drugs, soda). In addition, duodenal ulcers are characterized by symptoms such as belching, nausea and vomiting, bloating and intestines, night pains.
*pancreatitis* *(inflammation of the pancreas)*	Normally, pancreatic enzymes enter the duodenum and only there they become active. In some cases, premature activation of these enzymes in the pancreas itself occurs, which in turn leads to inflammation and severe pain. Depending on the affected area, pain may occur in the left or right hypochondrium, in the epigastrium ( the upper part of the abdomen below the sternum), and when the entire pancreas is involved in the pathological process, it has a shingles character ( gives pain, including in the lower back).	General malaise, fever ( up to 38 - 38.5ºС), palpitations, shortness of breath, nausea, bloating, stool disorder ( diarrhea or constipation). The face of a patient with pancreatitis acquires pointed features and also becomes pale. The body is covered with sticky sweat, the mucous membranes become dry. In some cases, the skin around the navel and on the lower back becomes bluish, covered with dark blue spots. This is due to the fact that blood in pancreatitis can accumulate under the skin and lead to the formation of these spots ( Mondor's sign).
*Intestinal obstruction*	Painful sensations arise due to compression of the mesentery by the intestines, in which the nerve trunks and blood vessels are located. The nature of the pain depends on the type of intestinal obstruction ( dynamic, mechanical or mixed). Most often there is constant and arching pain or cramping and severe.	The main symptom of intestinal obstruction is pain, which is localized in the abdomen and can be reflected in the lumbar region. In the future, pain may subside, which indicates inhibition of intestinal motility and peristalsis. Often the feeling of nausea is replaced by indomitable and repeated vomiting. Obstruction is accompanied by gas and stool retention, as well as bloating.
Diseases of cardio-vascular system
*myocardial infarction* *(one of the manifestations of coronary heart disease)*	Death of heart tissue necrosis) leads to severe and persistent pain. With myocardial infarction, pain persists for more than 15 minutes ( up to 60 - 70 minutes) and stop either after the use of narcotic painkillers, or on their own within a few hours.	The pain is localized behind the sternum, but in some cases it can radiate ( give away) in the shoulder, arm, shoulder blade, abdomen, or throat. Also quite often there are various arrhythmias. In addition to pain and heart rhythm disturbances, shortness of breath, as well as a dry cough, may occur. In some cases, a heart attack is asymptomatic, and sometimes the only sign of a heart attack is cardiac arrest.
*angina pectoris* *(a disease that causes short-term pain or discomfort in the region of the heart)*	Pain occurs due to impaired blood supply in the coronary vessels that feed the heart. Unlike myocardial infarction in angina pectoris, pain lasts no more than 15 minutes and responds well to treatment with nitrates ( nitroglycerine).	Pain and discomfort with angina pectoris are pressing or burning in nature. Very often the pain is reflected in the shoulder and left hand, neck, lower jaw, in the upper abdomen or in the interscapular region. Sometimes there is shortness of breath, nausea or vomiting.
Respiratory system diseases
*Pleurisy* *(inflammation of the pleura that surrounds each lung)*	Accumulation of abnormal fluid in the pleural cavity exudate) leads to overstretching of the pleural sheets, which contain a large number of nerve endings. Also, the pain occurs due to the friction of the inflamed and rough pleura sheets against each other. Pain in the chest in some cases may radiate to the area of the scapula.	Often pleurisy is accompanied by an increase in body temperature ( 38 - 39ºС) and chills. The pain is aggravated by coughing, during breathing, shortness of breath appears. The affected half of the chest during breathing may lag behind the healthy one. The accumulation of a large amount of pathological fluid in the pleural cavity can lead to compression of the lung.
*Pneumonia* *(inflammation of the lung tissue)*	Pain in pneumonia indicates that not only lung tissue is involved in the pathological process ( no pain receptors in the lungs), but also the pleura. Intensity pain depends on the degree of involvement of the pleura in this inflammatory process. If pneumonia affects only one lung, then the pain is localized in the right or left hypochondrium. With bilateral pneumonia, not only the chest hurts, but also in the area of the shoulder blades.	Pneumonia with pleurisy usually begins with chills followed by fever ( up to 39 - 40ºС). Then there is a wet cough with sputum. In addition, there is a general malaise, muscle pain, headache, loss of appetite, drowsiness. In some cases, sputum may contain streaks of blood, which indicates the exit of red blood cells from the bloodstream and their entry into the lungs ( occurs in the second stage of croupous pneumonia).
*Lungs' cancer*	Growing, a cancerous tumor is able to penetrate into the bronchi, pleura and nerve tissues, which causes severe pain. The faster the tumor progresses, the stronger the pain.	A dry or wet cough may appear, which is accompanied by sputum or blood. In some cases, cancerous pneumonia occurs, which is manifested by fever, chills, general weakness, and shortness of breath. When the tumor grows into the heart sac, heart pain occurs, and if nerves are involved in this pathological process, then neurological symptoms appear ( muscle paralysis, pain along the nerve, etc.).
kidney disease
*Pyelonephritis* *(inflammation of the kidney and pelvis)*	The penetration of pathogens into the kidney leads to its inflammation. In the future, there is a focal lesion of the kidney with the involvement of the intercellular substance in the pathological process. Pyelonephritis leads to tissue destruction ( including nerve endings) and replacing them with connective tissue ( fibrosis). Against the background of a banal infection, the pain may be aching or dull, and if pyelonephritis is the result of blockage with a calculus ( stone) of the pelvis or ureter, then there is a pronounced pain syndrome, which is paroxysmal in nature.	Acute pyelonephritis is manifested by an increase in body temperature up to 39 - 40ºС, chills, general weakness, malaise, loss of appetite, headache, sleep disturbance. Quite often there is nausea and vomiting. An increase in the frequency of the urge to urinate is combined with unpleasant sensations during this process. Urine often becomes cloudy the presence of protein and bacteria in the urine). Exacerbation of chronic pyelonephritis is also manifested by the above symptoms, but this pathological condition is more dangerous. The thing is that chronic pyelonephritis leads to chronic renal failure ( violation of all functions of the renal tissue), and can also cause arterial hypertension of renal origin ( increased blood pressure).
*Renal colic*	Increased pressure in the renal pelvis ( cavity that connects the ureter to the kidney) leads to an acute violation of the renal blood supply and the appearance of a pronounced pain syndrome. The onset of pain comes on suddenly. The pain is usually felt most strongly in the lower back ( at the projection site of the left or right kidney). It is worth noting that an attack of renal colic lasts from a few seconds and minutes to several hours.	The pain syndrome often spreads to the lower abdomen, groin and perineum, as well as to the thighs. Sharp movements can provoke renal colic. Sometimes there is nausea and vomiting, bloating, stool disorder ( diarrhea). If renal colic occurs against the background of blockage of the ureter with a stone, then there is an increase in the frequency of the urge to urinate. There is also a cessation of urine output.

Why does the back hurt in the lumbar region?

Back pain can occur due to a variety of reasons. Lower back pain can be caused by trauma to the lumbar region, a long stay in a very uncomfortable position, physical overstrain, stressful situations, sprains of muscles and ligaments, acquired or congenital curvature of the spinal column, etc. Below is a list of the most common diseases that can cause pain in lumbar region.

Pathologies that can lead to pain in the lumbar region are as follows:

Purulent lesion of the skin ( pyoderma). With a local decrease in the protective properties of the skin, pyogenic bacteria such as streptococci and staphylococci can penetrate into it. In this case, a purulent-inflammatory process develops, which leads to the appearance of painful ulcers. different sizes. These diseases are most often accompanied by general malaise, fever, weakness.
Stretching of the muscles and ligaments of the lower back usually occurs in professional athletes or in untrained people after excessive physical activity. In addition to pain, inflammation and local tissue swelling also occur.
Osteocondritis of the spine is a degenerative disease in which the cartilage covering the intervertebral discs is gradually destroyed. Ultimately, the distance between the vertebrae gradually decreases, leading to compression ( squeezing) roots of the spinal cord, which are located on the sides of the vertebral bodies. It is the compression of the spinal roots that is manifested by severe pain ( radiculitis).
Scoliosis is a lateral curvature of the spine ( curvature along the frontal axis). This pathology leads to an uneven distribution of the load on the spinal column. Ultimately, the skeletal muscles and ligamentous apparatus of the lower back are constantly overstrained, which causes pain.

Why does my back hurt during pregnancy?

Women during pregnancy quite often experience back pain and, in particular, in the lower back. The thing is that during pregnancy, some changes occur in the musculoskeletal apparatus of the back. In order to ensure the normal passage of the fetus through the birth canal ( pelvic bones), under the influence of a special hormone ( relaxin), ligaments and muscles become looser and less elastic. And this, in turn, increases the load on the spine and intervertebral discs. In addition, during pregnancy there is a shift in the center of gravity, which is manifested by a strong displacement of the lumbar anteriorly. In this case, the muscles of the lower back are constantly overstrained, which ultimately leads to microtrauma and pain.

Pain during pregnancy can occur at various times. Quite often, this symptom occurs at 4 - 5 months of pregnancy. As the child grows, the center of gravity in a pregnant woman shifts more and more, which increases the pain. That is why back pain is the most severe on last month pregnancy. Increased pain also occurs due to the fact that the child begins to squeeze the lower back from the inside.

If before pregnancy a woman was diagnosed with osteochondrosis of the spinal column ( dystrophic changes in the intervertebral discs), then the likelihood that when carrying a child she will experience back pain increases many times over. These pains can also be observed in pregnant women with curvature of the spinal column ( scoliosis or kyphosis), in obese women or overweight and in women with weak back muscle development.

In some cases, back pain may radiate to the back of the thigh, lower leg, or foot. This symptomatology, as a rule, indicates compression and inflammation of the sciatic nerve ( sciatica). In addition to pain, paresthesia also occurs ( burning, tingling, or crawling sensation), impaired sensation and muscle weakness in the leg.

The anatomy of the back muscles is described, each muscle is shown in detail with a photo, find out what our back consists of, to strengthen it and create relief-muscular muscles.

- a huge, wide back always distinguishes ordinary people from bodybuilders, the famous "triangular frame" is achieved only through the development of this muscle group, and for a girl, a beautiful, slender posture, the standard and main advantage of her gait.

Powerful and strong back muscles are used in almost all sports, as they take part in all pushing, pulling and twisting movements, also with strong back muscles, our spine supports the living shield of "flesh and meat". Especially strong lower back muscles will allow you to get rid of the feeling of pain when bending over or lifting moderately heavy things.

What muscles are

The upper part of the body is formed by 80% of the muscle fibers of the back (20% is occupied by the shoulders, arms and neck) and it is this part that creates the impression of a physically powerful person when looking at a person from behind.

We do not notice in what movements and when the muscles of the back take part, but as soon as we stretch this muscle group, then immediately when turning, tilting, raising a leg or arm, a feeling of discomfort is given to the back.

To get out of the state of "hibernation" and create beautiful powerful back muscles, let's see below what exercises you need to do and what muscle groups it consists of:

The muscles of the back, as can be seen from the figure, is not the presence of one large muscle group, it consists of many large and small muscle fibers, for which you need to do a load, which you need to train in a variety of ways.

The belt muscle of the head, although shown in the figure, belongs to the neck muscles section, it is mentioned in the anatomy and descriptions of the neck muscles section, so that we don’t repeat ourselves, let’s go further and start from top to bottom:

- as you already understood, it is located in the upper back and covers its entire upper part with a wide array, on the one hand it looks like a triangle, but if you look at both sides of this muscle, it resembles the shape of a trapezoid, which gave it its original name.

It starts from the very top of the back, in contact with the muscle fibers of the neck and ends in the inner section of the center of the back just below the shoulder blades. Thanks to this musclethe blades move back and forth and up and down.

- the name comes from the fact that the muscle resembles a rhombus, is located under the trapezium and performs practicalki the same functions. The small one is smaller than the large one and is located above it.

Large and small round muscle - located under the widest on their outermost side, therefore, "swinging" this muscle, it swells and bulges in violation of the widest, expanding the very edge of the back. Her task is to lower the raised hand down and take it back. The small round muscle is on top of the large one.

- located deep under all the muscles of the back, located along the entire length of the spine from the coccyx to the beginning of the head, plays an important role in the operation of the spine, ensures its maintenance, and along with it, the spine holds many small muscles.

The muscle is loaded when bending and bending the back.

Serratus posterior inferior - located in the thickness of the muscles under the latissimus in the lower part of the ribs, or rather in the area of \u200b\u200bthe last 4 ribs, that is, between the 9th and 12th (ribs are considered from top to bottom).

The main task is to lower the ribs down and back, despite the resistance of the diaphragm.

- a large muscle of the back, it is thanks to it that the back expands, located in its lower part from the bottom of the trapezium (the lower part of the trapezoid, cover the latissimus dorsi) to the waist, covering the rest of the muscle fibers with a large layer, it is she who looks out from under the muscle cavities when looking at torso in front, lifting triceps and biceps.

Also, this muscle has a different name among athletes - “wings”.

The task of the broadest - pulling, raising, lowering and rotating the arms, brings the shoulders and arms to the body, helps the respiratory muscle to lift the chest for inspiration.

thoracic fascia- the muscles of this lower section are responsible for maintaining the lumbar vertebrae. External fascia - covers the latissimus dorsi and trapezius muscle until the onset of the large gluteal muscle, internal fascia - lumbar region.

Warming up the back muscles

1) Stand straight, feet shoulder-width apart, raise your elbows to chest level, forearms parallel to the floor, take your elbows back while unbending them, then bring your hands forward while touching your right side with your left hand, and your left with your right;

2) Stand straight, legs wider than shoulders, arms spread apart and straightened at the elbows, bend forward so that the body is parallel to the floor, then turning the torso, begin to reach the sock with the fingers of the left hand right foot, then vice versa with fingers right hand toe of the left foot;

3) Go to the barbell, simulator or other base where you can put the palms of your hands at waist level, kneel on one knee, and put your straightened arms on the base and holding on to it, bend down, thus stretching your back.

Number of repetitions

1) For relief and fat burning - the weight should be such that in 1 approach you do a maximum of 14-12 repetitions;

2) For dialing muscle mass - set the weight so that no more than 10-8 repetitions are done in 1 approach without violating the technique;

3) For the growth of strength indicators - have to take big weights, there is a serious load here, if necessary, use wrist straps and an athletic belt, the weight should be so large that no more than 6-4 repetitions are done in 1 approach.

Latissimus dorsi

Trapezius muscles

Rhomboid muscles

What about the lower back?

Skeleton anatomy

Thoracic spine

shoulder blades

shoulder joint

Functions of the muscles of the back

Latissimus dorsi

Trapezius muscles

Rhomboid muscles

Basic back exercises

Exercise #1 Pull-ups

Exercise #2 Dumbbell Bent Over Row

Exercise number 3 Pullover with a dumbbell

Exercise number 4 Thrust block to the face

The best result with a scientific approach

General information about muscles

Trapezoidal

broadest

Blade lifter

Small and large diamond-shaped

Denial of responsibility

Superficial muscles of the back Superficial muscles of the back of the first layer

Superficial muscles of the back of the second layer

Anatomy of the back region

Spine

Ribs

shoulder blades

muscles

Nerves

What structures can become inflamed in the back?

Causes of back pain

Why does the back hurt in the lumbar region?

Why does my back hurt during pregnancy?

What muscles are

Warming up the back muscles

Number of repetitions

How to run to lose weight?

Kettlebell Exercises: Ballistics and Strength

Stretching, its types and significance for us