Let's get started: what is really the back pain?

Back pain is a very common symptom in the general population, and specifically in many musicians and guitarists. It's usually reported in the lower parts of the spine, in the so-called lumbar region. But what are the underlying causes?

They vary, a lot, depending on the age of the patient, and this allows us to divide it into two main groups: young and old people. 

In fact, the younger musicians have a much higher resistance to the pain, because of two factors: they're not completely developed (from a muscular and skeletal point of view) and for this reason they're much more elastic; the second one is the level of activity and energy they have, that gives them more phisical resistence and ability to play a lot of hours without pauses.

An other interesting factor (more related to the general incidence of this injuries) is that younger subjects have a much higher incidence of lumbar hernia, which is well described by the following image:

Essentially, the central part, called "Nucleus Pulposus", breaks the fibers of the anulus (made of collagen and other proteic substances) and can cause compression of nerves and spinal cord. 

This kind of traumi are caused mainly by sudden weight lifting with uncorrect posture, which causes non-physiological angles in the spine: this can cause compression of the intervertebral disk and the fissuration of the anulus.

This happens mainly in young subjects because of the fact that the nucleus is well hydrated: in older patients it becomes less rich in water, and can be, for this reason, too small to push against the anulus fibers.

Other kinds of injuries are the chronic ones, caused by wrong postures repeated over and over.

A very useful example of it is this chart: it explains how the posture influences the forces that work on our anatomical structures.

As you can see, this is a more holistic approach to the problem. In case of musicians, and guitarists in particular, the problems can be referred in specific parts of the back.

Moreover, there's also the problem of doing some of this movements adding torsion or doing them with a flabby attitude. We must keep our back straight and solid, expecially during physical efforts (but we'll see the solutions in the next articles).

The main factors involved are:

• Asymmetrical distribution of weight on the chair we sit on every time we practice. This is very common in guitarists, because of the large (past?) use of the footstool. 
• 
  Non-physiological curves we mantain to get our hands on the strings; this can lead to:
• prolonged contraction (and asymmetrical as well) of the back muscles: this can add muscular pain and fatigue;
• rigidity of the back;
• compression of the nerves. In fact, they are almost always in between many other structures: if these structures are too tense, or have inappropriate angles, the nerve can be compressed and damaged.
  

• Displacing of the center of gravity: when we sit properly, the weight is distributed evenly on each vertebra and intervertebral disk, gradually increasing from the top to the bottom (the bottom vertebrae are much bigger for this reason). But, when we assume a wrong position (for example we lean forward or toward one side) the center of gravity moves from its position of equilibrium: now the weight can't be well distributed, and some parts of the spine will be more solicited than others. 
• The spine works better when we alternate compression and distention: expecially during distention, the intervertebral disk can rehydrate himself and restore his elasticity. If we sit for too long, we're putting too much load on the lumbar vertebrae, which explains the higher incidence of pain in this region.

To sum up, we can easily see how back problems can be caused by many factors, and in the musicians' case, they have strict connections with the posture and the way they conduct their practice. Also, we've seen how injuries can be acute or chronic, and affect both young and older musicians. 

Next time, we'll go in depth on some of these issues, and we'll try to propose some solutions! I hope you liked this content, feel free to share it, comment and subscribe to my web channels✌