本指南有助于你理解：脊柱和腰椎的构成引起腰痛的原因以及常见的症状医生可能做的检查如何控制疼痛和预防未来的问题...

Low Back Pain

A Patient’s Guide to Low Back Pain

Introduction

Low back pain is one of the main reasons Americans visit their doctor. For adults over 40, it ranks third as a cause for doctor visits, after heart disease and arthritis.

腰痛是美国人找医生就诊的主要原因之一。40岁以上的成人，排在就诊原因的第三位，仅次于心脏病和关节炎。

Eighty percent of people will have low back pain at some point in their lives. And nearly everyone who has low back pain once will have it again.

80%的人在一生中的某段时间会发生腰痛。几乎每个曾经有过腰痛的人会再次腰痛。

Very few people who feel pain in their low back have a serious medical problem. Ninety percent of people who experience low back pain for the first time get better in two to six weeks. Only rarely do people with low back pain develop chronic back problems.

人们感到腰痛很少是由于得了严重的疾病。首次发生腰痛的人90%在2～6周内获得好转。只有很少的腰痛患者发展为慢性背部疾病。

With these facts in mind, you can be assured that back pain is common, that it usually only causes problems for a short period of time, and that you can take steps to ease symptoms and prevent future problems.

有了这些事实理念，你就能确信背痛很常见，通常只会短期内引起问题，而且你可以采取措施来减轻症状，预防今后的病变。

This guide will help you understand

本指南有助于你理解：

· which parts make up the spine and low back

· what causes low back pain, and what the most common symptoms are

· what tests your doctor may run

· how to manage your pain and prevent future problems

• 脊柱和腰椎的构成
• 引起腰痛的原因以及常见的症状
• 医生可能做的检查
• 如何控制疼痛和预防未来的问题

Anatomy

Which parts make up the lumbar spine, and how do they work?

腰椎的构成及运行



The human spine is made up of 24 spinal bones, called vertebrae Vertebrae are stacked on top of one another to create the spinal column. The spinal column gives the body its form. It is the body’s main upright support.

人体脊柱由24块称为脊椎骨的骨头上下相叠而构成。脊柱赋予体型，是身体上下方向的主要支撑。



From the side, the spine forms three curves. The neck, called the cervical spine, curves slightly inward. The mid back, or thoracic spine curves outward. The outward curve of the thoracic spine is called kyphosis. The low back, also called the lumbar spine, curves slightly inward. An inward curve of the spine is called lordosis.

从侧方看，脊柱形成三个弯曲。在颈部，称为颈椎，略向前凸，中段称为胸椎，凸向后方。胸椎凸向后方称为后凸。下背部称为腰椎，略向前凸。脊柱向前凸称为前凸。



The lumbar spine is made up of the lower five vertebrae. Doctors often refer to these vertebrae as L1 to L5. The lowest vertebra of the lumbar spine, L5, connects to the top of the sacrum, a triangular bone at the base of the spine that fits between the two pelvic bones. Some people have an extra, or sixth, lumbar vertebra. This condition doesn’t usually cause any particular problems.

腰椎由最下方的5块椎骨组成，医生通常把这些椎体称作L1~L5，腰椎最下面的L5椎体，与骶骨的上面相连。骶骨是嵌于两块盆骨之间的三角形骨，是脊柱的底座。有些人有额外的第6块腰椎，这种情况通常不会引起特别的疾病。



Each vertebra is formed by a round block of bone, called avertebral body. The lumbar vertebral bodies are taller and bulkier compared to the rest of the spine. This is partly because the low back has to withstand pressure from body weight and from daily actions like lifting, carrying, and twisting. Also, large and powerful muscles attaching on or near the lumbar spine place extra force on the lumbar vertebral bodies.

每一个脊椎骨都有一个圆形的骨块，称为椎体。腰椎的椎体与其他脊柱的椎体相比更高，体积更大。其部分原因是因为腰椎需要承受体重以及日常活动，比如举重、搬运、转动等。同时，在腰椎及其周围附着的粗大有力的肌肉给腰椎椎体额外负荷。



A bony ring attaches to the back of each vertebral body. When the vertebrae are stacked on top of each other, these rings form a hollow tube. This bony tube surrounds the spinal cord as it passes through the spine. Just as the skull protects the brain, the bones of the spinal column protect the spinal cord.

每个椎体的后方连有一个骨性的环，当椎骨上下重叠排列时，骨环形成一个中空的管道。当脊髓行经脊柱时，由此骨性管道环绕。就象颅骨保护大脑一样，骨性的脊柱保护脊髓。

The spinal cord extends down to the L2 vertebra. Below this level, the spinal canal encloses a bundle of nerves that goes to the lower limbs and pelvic organs.

脊髓延伸至腰2椎体，在此平面以下，脊椎管内为一束支配下肢和盆腔脏器的神经。



The Latin term for this bundle of nerves is cauda equina, meaning horse’s tail.

这一束神经在拉丁语术语中称为cauda equina(马尾神经），意思是马的尾巴。



As the spinal cord travels from the brain down through the spine, it sends out nerves on the sides of each vertebra called nerve roots. These nerve roots join together to form the nerves that travel throughout the body and form the body’s electrical system. The nerve roots that come out of the lumbar spine form the nerves that go to the lower limbs and pelvis. The thoracic spine nerves go to the abdomen and chest. The nerves coming out of the cervical spine go to the neck, shoulders, arms, and hands.

当脊髓从大脑向下行经脊柱时，在每节椎骨的两侧发出神经，称为神经根。神经根联接起来形成神经穿行全行，形成身体的电气系统。从腰椎发出的神经根分布于下肢和骨盆。胸椎的神经分布于腹部和胸部。颈椎分出的神经分布于颈部、肩部、胳膊和手。



It is sometimes easier to understand what happens in the spine by looking at a spinal segment. A spinal segment includes two vertebrae separated by an intervertebral disc, the nerves that leave the spinal cord at that level, and the small facet joints that link each level of the spinal column.

有时，观察一下脊柱节段就比较容易理解脊髓出了什么问题。一个脊柱节段包括两个椎体和其间的一个椎间盘，神经于此平面从脊髓发出，方小关节突关节连接每层脊柱。

The intervertebral disc normally works like a shock absorber. It protects the spine against the daily pull of gravity. It also protects the spine during heavy activities that put strong force on the spine, such as jumping, running, and lifting.

正常情况下椎间盘起到减震器的作用，在对抗日常牵拉重力中保护脊柱，同时也在剧烈活动时保护脊柱以减少作用于脊柱的强大作用力，例如跳跃、跑步和举重。

An intervertebral disc is made up of two parts. The center, called the nucleus, is spongy. It provides most of the disc’s ability to absorb shock. The nucleus is held in place by the annulus, a series of strong ligament rings surrounding it. Ligaments are strong connective tissues that attach bones to other bones.

椎间盘由两部分组成，中央是髓核，富有弹性，为椎间盘作为减震器起大部分作用。髓核周围有一系列的坚强的韧带包绕，称为纤维环。韧带是联结骨与骨之间的坚强的结缔组织。



Between the vertebrae of each spinal segment are twofacet joints. The facet joints are located on the back of the spinal column. There are two facet joints between each pair of vertebrae, one on each side of the spine. A facet joint is made of small, bony knobs that line up along the back of the spine. Where these knobs meet, they form a joint that connects the two vertebrae. The alignment of the facet joints of the lumbar spine allows freedom of movement as you bend forward and back.

每个脊柱节段相邻两椎骨之间有两个关节突关节。关节突关节位于脊柱的后方，每一对脊柱有两个关节突关节，在脊柱的两侧各一个。关节突关节由排列于脊柱后方的小骨性突起构成。当这些小突起相接触时，就形成连接两个椎体的关节。腰椎的小关节的排列允许你自由地前后伸屈活动。



The surfaces of the facet joints are covered by articular cartilage. Articular cartilage is a smooth, rubbery material that covers the ends of most joints. It allows the bone ends to move against each other smoothly, without pain.

关节突关节的表面覆盖着关节软骨。关节软骨是覆盖在大多数关节端的光滑有弹性的组织，它允许骨端之间相互间平滑无痛地活动。



Two spinal nerves exit the sides of each spinal segment, one on the left and one on the right. As the nerves leave the spinal cord, they pass through a small bony tunnel on each side of the vertebra, called a neural foramen. (The term used to describe more than one opening is neural foramina.)

每一脊髓节段两侧发出两根脊神经，左右各一。神经根离开脊髓时，穿过在椎骨两侧的小骨道，称为神经孔。



The lumbar spine is supported by ligaments and muscles. The ligaments are arranged in various layers and run in multiple directions. Thick ligaments connect the bones of the lumbar spine to the sacrum (the bone below L5) and pelvis.

腰椎由韧带和肌肉保护。韧带按不同的层次排列，有多种角度的走行。厚厚的韧带将腰椎与骶骨（腰5下面的骨头）和盆骨相连。

The muscles of the low back are also arranged in layers. Those closest to the surface are covered by a thick tissue called fascia.

腰部的肌肉也按层次分布，它们的表面覆盖着致密的组织，称为筋膜。



The middle layer, called the erector spinae, has strap-shaped muscles that run up and down over the lower ribs, chest, and low back. They blend in the lumbar spine to form a thick tendon that binds the bones of the low back, pelvis, and sacrum.

中间一层称为竖脊肌，是附着于下位肋骨、胸部和腰部的条形肌肉，在腰椎汇合成粗大的肌腱约束腰椎、骨盆和骶骨。

The deepest layer of muscles connects along the back surface of the spine bones. The muscles also connect the low back, pelvis, and sacrum. These deepest muscles coordinate their actions with the muscles of the abdomen to help hold the spine steady during activity.

最深层的肌肉附着于腰椎骨的后表面，也连接腰椎、骨盆和骶和。在活动时，这些深层的肌肉与腹部的肌肉协调，维持腰椎的稳定。

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