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

Repeated Loading of Lumbar Discs

Lower loads than the sudden compression loading which occurs seldom can cause a disc prolapse if the loading in a bent position is repeated in a cyclical manner. This can be caused in discs which are reasonably young and causes a large split in the rear of the disc wall to one side or another, allowing the central nuclear material to ooze out. In several examples the layers of the disc wall which were the most outer ones did not split and form a fissure and the nuclear material protruding through the fissure inside built up behind the remaining layers in a bulge. As the ligament overlying this has many nerve endings, such a bulge could cause pain.

Older discs were shown in some cases to have fissures which are already present before any experimental loading and these discs did not prolapse during the loading tests, perhaps because the fissures had healed or because discs in poorer condition are too stiff and fibrosed to prolapse. If twisting, side bending or compression is added to bending then prolapse can occur more easily with less bend of the back. In some cases the nucleus may protrude out but in others the outer disc walls can protrude themselves.

Neck Pain

Neck pain is very common indeed in the adult population and can be very troublesome in terms of personal distress and loss of functional ability. However, the underlying cause is very rarely serious and permanent injury or damage to the neck is rare. In acute pain (pain of recent onset) the typical course is for it to settle over a period of days or weeks, with minimal interruption in normal activities of daily living after the initial severe few days. Neck pain and neck ache can last for some day or settle down and then recur again at some unpredictable time.

Initial management of the acute pain is very important as resting for a day or so makes sense but any longer than this may delay recovery or increase the possibility of long term pain and disability. Our necks are designed to be moved and to recover from pain or injury they need to be moved regularly and through large movements. Staying as close to normal activity as possible is one of the most important strategies for recovery. The presence of pain inhibits our willingness to move but keeping the neck still may be counterproductive.