Joints are the place where two bones meet and are held together by the ligaments. Muscles attach to bones by tendons, and nerves branch out from the spinal chord on each side of the vertebrae. Disks, which have a gelatin-like center, act as cushions and shock absorbers between vertebrae. The source of back pain may originate in the nerves themselves, in the muscles, disks or joints of adjacent vertebrae rubbing against each other, according to Gaughan. Muscle spasms cause pain because the spasm decreases the space between nerve roots.
Bone spurs bony outgrowths on vertebrae can cause pain and stiffness.
Compression of disks up and down the spine decrease the space between vertebrae, which can also cause pain, Gaughan explains. Most back pain is either neuropathic or musculoskeletal. Symptoms of neuropathic pain include a burning, electrical or prickly sensation, whereas musculoskeletal is an aching or twisting pain, according to Gaughan. During an initial exam, Gaughan does both a neurological and musculoskeletal exam to determine the source of pain. First, she assesses the integrity of the nerves and spinal column by testing reflexes, tone, strength and sensation.