The human back, also called the dorsum (pl.: dorsa), is the large posterior area of the human body, rising from the top of the buttocks to the back of the neck. It is the surface of the body opposite from the chest and the abdomen. The vertebral column runs the length of the back and creates a central area of recession. The breadth of the back is created by the shoulders at the top and the pelvis at the bottom. Back pain is a common medical condition, generally benign in origin.
Structure The central feature of the human back is the vertebral column, specifically the length from the top of the thoracic vertebrae to the bottom of the lumbar vertebrae, which houses the spinal cord in its spinal canal, and which generally has some curvature that gives shape to the back. The ribcage extends from the spine at the top of the back (with the top of the ribcage corresponding to the T1 vertebra), more than halfway down the length of the back, leaving an area with less protection between the bottom of the ribcage and the hips. The width of the back at the top is defined by the scapula, the broad, flat bones of the shoulders.
Muscles
The muscles of the back can be divided into three distinct groups; a superficial group, an intermediate group and a deep group.
Superficial group The superficial group, also known as the appendicular group, is primarily associated with movement of the appendicular skeleton. It is composed of trapezius, latissimus dorsi, rhomboid major, rhomboid minor and levator scapulae. It is innervated by anterior rami of spinal nerves, reflecting its embryological origin outside the back.
Intermediate group The intermediate group is also known as respiratory group as it may serve a respiratory function. It is composed of serratus posterior superior and serratus posterior inferior. Like the superficial group, it is innervated by anterior rami of spinal nerves.
Deep group The deep group, also known as the intrinsic group due to its embryological origin in the back, can be further subdivided into four groups:
Spinotransversales – composed of splenius capitis and splenius cervicis. Erector spinae – composed of iliocostalis, longissismus and spinalis Transversospinales – composed of semispinalis, multifidus and rotatores Segmental muscles – composed of levatores costarum, interspinales and intertransversarii The deep group is innervated by the posterior rami of spinal nerves.
Organs near the back The lungs are within the ribcage, and extend to the back of the ribcage making it possible for them to be listened into through the back. The kidneys are situated beneath the muscles in the area below the end of the ribcage, loosely connected to the peritoneum. A strike to the lower back can damage the kidneys of the person being hit.
Surface of the back The skin of the human back is thicker and has fewer nerve endings than the skin on any other part of the torso. With some notable exceptions (see, e.g., George "the Animal" Steele), it tends to have less hair than the chest on men. The upper-middle back is also the one area of the body which a typical human under normal conditions might be unable to physically touch. The skin of the back is innervated by the dorsal cutaneous branches, as well as the lateral abdominal cutaneous branches of intercostal nerves.
Movement The intricate anatomy of the back provides support for the head and trunk of the body, strength in the trunk of the body, as well as a great deal of flexibility and movement. The upper back has the most structural support, with the ribs attached firmly to each level of the thoracic spine and very limited movement. The lower back (lumbar vertebrae) allows for flexibility and movement in back bending (extension) and forward bending (flexion). It does not permit twisting.
Clinical significance
Back pain
The back comprises interconnecting nerves, bones, muscles, ligaments, and tendons, all of which can be a source of pain. Back pain is the second most common type of pain in adults (the most common being headaches). By far the most common cause of back pain is muscle strain. The back muscles can usually heal themselves within a couple of weeks, but the pain can be intense and debilitating. Other common sources of back pain include disc problems, such as degenerative disc disease or a lumbar disc herniation, many types of fractures, such as spondylolisthesis or an osteoporotic fracture, or osteoarthritis.
Society and culture
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