Physiotherapists in High Wycombe treat many different conditions including the issues profiled below.

The Course of Low Back Pain

Low back pain is always described as being either acute, sub acute or chronic with acute pain lasting less than six weeks, sub acute pain from six weeks to twelve weeks and chronic pain lasting over the twelve week point. Most people were assumed to recover quickly and go back to normal with only a small number suffering longer term pain and disability. However, research has shown that it is an episodic and recurring condition and present for much longer than generally thought. 75% of patients with back pain in primary care still had symptoms a year later in one study, indicating back pain is more of a chronic picture overall.

Patients with chronic back pain are not uniformly severe or disabled but rather suffer a varying degree of pain and disability over time. Old views used to be that 80-90 percent of back episodes resolved completed but it is much more realistic to view it as a longer term grumbling problem. The main predictor for people having back pain in the future is having had it in the past and this supports the above idea of back pain as a continuing problem. For most people back pain is a common but limited irritation which recurs from time to time.

Back Pain and Pathology

It is difficult to connect back pain symptoms to causative factors but some pathological findings are easier to link. Disc herniation can be objectively observed on MRI scanning and is reliably connected with sciatica but MRI scans on normal subjects show disc herniations in people who do not have symptoms. Lumbar disc degeneration seems very common in people of middle age but it is difficult to clearly define so that it can be measured in a way relevant to clinical practice. Disc degeneration starts sooner and is more developed in the L4/5 and the L5/S1 disc levels than in higher lumbar levels.

Even 15 year old school children have been found to have a significant incidence of these disc changes, with the incidence rising to close to 100 percent in people who have reached 50 years of age. MRI findings are not well correlated with requirements for medical care for back pain or for the levels of disability which can result. Narrowing of disc spaces, bony outgrowths and increases in bone density are connected to a degree with levels of back pain. Eastern societies which depend a lot more on the squatting posture are reported to have lower levels of degeneration than western societies.