The spinal column has also a protection function in addition to the support function for the spinal cord and the large nerves. However, its special vicinity to the nerve structures can have an unfavorable effect.

The main nerves, which exit the spinal column between vertebral bodies in pairs to the left and to the right, enter the foraminal holes between the vertebrae into the body. In this area smaller nerves for the supervision of the movement of facet joints and the control of the back musculature emerge from the main nerves. For the emerging nerves the available space is relatively small. The spinal cord and these nerves send active decisions for corresponding movements to the muscle groups assigned to them and enable the desired movement.

In addition all sensory information from body like contact, pressure, warmth and cold as well as information about joint positions are relayed through these nerves and the spinal cord to the brain. Without these nerve fibers, the muscles would not know what to do and we would not know what the muscles are doing. Not only are the arms and legs driven in this manner, but also the back musculature is controlled over this mechanism and enables us to make decisions about standing, stooping, seats, turning.

Wear, degeneration and injuries of vertebral bodies and especially the intervertebral discs can cause irritation or entrapment of the nerves and in extreme cases tearing. Pain, movement restrictions and paralysis are the consequences. Often a muscle bracing as a response to pain exerts pressure on a nerve.

Psychological stress also relates to nerve compression. Over the centuries it has been known that psychological strain has an effect on the body. The spine is an especially sensitive organ to this stress. Depression often leads to poor posture. For example, someone who has lost his job, may slouch or let his head hang down, which can lead to back pain.

Headache, shoulder, arm and low back pain can develop when people are over strained, when the possibility to relax is insufficient. Problems in the family and in the job, social isolation, loss of friends and relatives, or outstanding debts are all stresses that result in back pain. Suffice it to say, that back pain may initially have no physical background.

This is what doctors describe as psychosomatic problems (psyche=soul, soma= body). If these problems persist for years, the could be changes in the body. Conversely, chronic painful disorders can affect the psyche. In both cases a vicious downward circle can develop where the psyche, nerves and organism interact and the situation deteriorates.

Based on thousands of surveys doctors of the University of Washington have compiled a list of psychological stressors. These different stressors have been ranked on a point scale. They discovered that the state of health in test persons with more than 200 points declined in the last two years in most of the cases. It is apparent that the stressors are very often involved in back pain

Of course, there is variation between people and how they experience stress. No two humans are exactly alike, even identical twins. Pain is a subjective perception. There are individuals that cope well with physical and psychological problems/stress. Others suffer badly and worsen their condition. In general tough individuals deal with pain better than more sensitive ones.