No other collection of bones has been more insulted than the spine. There is always something creeping up it, chilling it, tingling it – not to mention the accusation that it’s not there at all. It has alignment issues, curvature problems, and a habit of slipping bits of itself into awkward positions – usually without warning.

That is because it is shy. It never likes to be in the front of things. The spine likes to contribute quietly through two main rear-guard actions for purposes of support, either vertically or horizontally, with more than occasional sitting or bending, or even diving off the edge of something.

Nevertheless, without it we would become decidedly unsteady. So getting to know your spine is vital to improving your relationship with this mostly unobtrusive but very important set of bones. After all, it holds up your head, shoulders, and upper body. It gives you support to stand up straight, the flexibility to bend and twist, and the ability to duck when necessary. Understanding your spine and how it works can certainly help you to better appreciate problems that can occur from aging or injury.

The spine

  • Your spine is made up of small bones, called vertebrae, which are stacked on top of one another and create the natural curves of your back.
  • These bones connect to create a canal that protects the spinal cord and nerve roots. Nerves branch out from the spinal cord through openings in the vertebrae and carry messages between the brain and muscles.
  • The muscles and ligaments provide support and stability for your spine and upper body. Strong ligaments connect your vertebrae and help keep the spinal column in position.
  • Intervertebral disks sit neatly between the vertebrae. They are flat and round, and about a half inch thick, and made up of two components:
  • The nucleus pulposus (another reason the spine is so shy). This jelly-like substance makes up the centre of the disk and provides flexibility and strength.
  • The annulus fibrosus which makes up the flexible outer ring of the disk. In effect, disks act as shock absorbers for the spine. Many nerve endings supply the annulus and as a result, an injured annulus can cause pain.
  • Facet joints lie between the back of the vertebrae and help your spine move, working much like hip or knee joints. The facet joints rotate the spine but may develop arthritis, causing low back or neck pain.
  • The cervical spine is made up of seven small vertebrae that begin at the base of the skull and end at the upper chest.
  • The thoracic spine is made up of 12 vertebrae that start from the upper chest to the middle back and connect to the rib cage.
  • The lumbar vertebra consists of five larger vertebrae. These vertebrae are larger because they carry more of your body’s weight.

Osteoporosis and the spine

What happens to the structure of the spine as people age?

  • Firstly, the nucleus of the disk may begin to “dry up”, thus reducing the much-needed shock-absorbing quality. As you continue to move daily, activities wear down the vertebrae, causing jagged edges to develop. These bony spurs can bring pressure to the spinal cord and nerves, and considerable pain.
  • Osteoporosis can cause compression fractures of the spine. These fractures can be very painful because the collapsed vertebrae may pinch the nerves that radiate from the spinal cord. As the disks collapse, they cause a curving of the upper back, known as kyphosis.
  • Osteoporosis is the loss of bone density, making the bones fragile and easily breakable. The spinal vertebrae are no different, and can fracture like any other bones in the body. Breaking one or more bones in the spine can cause sharp back pain that does not go away, or there might be no pain at all.
  • When there is no pain, many people do not know they have broken a bone in the spine, only realising something is wrong when they lose height, and clothes begin to fit poorly. As more bones break in the spine, the spine will become more curved; a condition sometimes referred to as the ‘dowager’s hump’.
  • Scoliosis is another type of spinal deformity. Scoliosis is a sideways curvature that takes on the shape of an ‘S’ or a ‘C’.

So there’s a lot to think about. Take care of your spine – because it takes care of all the rest. Never mention the word ‘pulposus’ in front of your spine. And if over 50, never dance on tables or attempt the fandango for fear of injuring your annulus. Love your bones!

NOFSA (National Osteoporosis Foundation South Africa)

NOFSA is the only non-profit, voluntary health organisation dedicated to promoting lifelong bone health. We focus on reducing the widespread prevalence of osteoporosis while working to find a cure for the disease, and by supporting research and developing programmes of education and advocacy.

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