The spine is one of the most complicated structures in the human body. As well as providing structural support for the body it acts as anchor point for the head and limbs and their associated tendons and ligaments; houses the spinal cord which is the extension of the central nervous system, and also contains the main branches of the peripheral nervous system which supplies the rest of the body.

Most of us, at some point in our lives will experience back pain. For the most part, this is often muscular and with appropriate rest, topical treatment and pain relief, should gradually fade after a couple of weeks. For others unfortunately, back pain can be a long term symptom and as well as costing business millions every year, can sometimes (in extreme cases) spell the end of a working career entirely.

For sufferers of acute back pain, it is often a frustrating situation as the condition itself is usually an "invisible" one, with no obvious external signs. Many people who have suffered temporary back pain will often assume that the pain being experienced is the same ache or throb that they have been able to put up with, without realising that chronic pain makes it virtually impossible to do much at all. Lastly, as the symptoms are so often similar for a range of potential causes, diagnosing and successfully treating back pain can be a long and difficult process.

So what are the main causes of back pain?

Mechanical injuries are ones that generally occur from a trauma, perhaps a sprain or tear in one of the muscles attached to the spine or, more seriously, to the structure of the spine itself. Sports are frequently responsible for over-flexing, over-extending or over-rotating the spine causing an injury to soft tissue structures. Although painful, most minor sprains will heal within a few weeks, more serious tears will require longer and severely restrict movement in order to rest the affected area.

It is not just violent movement that can result in problems however - incorrect posture, gait or problems with supporting musculature can cause postural weakness in the spine. This ranges from a growing ache or tingling, referred nervous pain (such as sciatica), to vulnerability to strenuous movements, lifting or jarring. Each vertebra is cushioned by a disc, and if the spinal column is misaligned, the probability rises that these discs can bulge or prolapse, causing a "slipped disc" and pressure on the spinal cord.

Direct impact on the spinal column risks fracture of the vertebrae. This can be fatal or result in permanent paralysis if not handled correctly, and you will see suspected spinal injuries treated using a specialist "spinal board" to immobilise casualties. This reduces the possibility of movement in the damaged area, and the spinal cord being cut by sharp bone surfaces.

There are several arthritic conditions also implicated in long term, severe back pain. Osteoarthritis is a degeneration of the skeletal joints in the body, and although relatively common in places such as the hips and shoulders which are heavily attached to the spine, can also affect the verterbral column directly. As replacement in these cases is impossible, surgical solutions often involve fusing affected discs. Rheumatoid arthritis also affects the spine, and there are a number of juvenile arthropathies that affect younger people from the ages of 20-30 years which are often difficult to spot, but can lead to joints in the spine fusing together or being degraded from being attacked by the immune system.

For rheumatoid sufferers, a number of medicines are available, (largely derived from anti-cancer treatments that had a noticeable side-effect of reducing back pain) but require users to undertake regular blood tests as they can have severe effects on the liver. A new range of anti-TNF (tumour necrosis factor) treatments are also now developed, but are extremely expensive and not suitable for all patient types.

In both cases, maintaining moderate amounts of exercise is key in both retaining flexibility and mobility. Although initially difficult to exercise during painful flare-ups, improving movement will reduce the severity and impact of the disease, and also strengthen up supporting areas of muscle which will help alleviate pain experienced by the damaged sections. Biomechanical analysis of your walking gait, Pilates, and low-impact exercises in hydrotherapy pools are excellent ways to positively address exercise concerns when suffering back problems.

Lastly there are sometime congenital malformations of the spinal cord that people have from birth. Although the more severely-disabling forms are rare, minor defects in the vertebral column closing around the spinal cord are surprisingly more common but don't tend to result in health problems unless aggravated by another factor.

Although surgery involving the spine is highly specialised and carries a risk as it involves the major nerves of the body, correctional procedures using splits and rods have been used to correct major postural defects and allow people lead a normal life.