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

Bone and Ageing

Bone loss occurs much more rapidly than the equivalent process in muscle tissues, with reductions in hormone production and in activity playing a part. After the menopause, the reduction in hormone production in women can result in lowered bone density which is initially termed osteopoenia and then osteoporosis when the bone approaches the levels where it will fracture easily during normal activity. Bone loss affects the trabecular honeycomb bone more than the denser outer cortical bone and also the vertical struts more than the horizontal ones. Once one of the struts is broken it does not repair.

Because they are made up of large amounts of trabecular bones, the spinal bones are often badly affected by osteoporosis, with the process eventually allowing a buckling of the upper and lower surfaces of the vertebrae. The fronts of the vertebrae are more vulnerable to fracture as the trabeculae lose more mass in this area. Physiotherapists teach weight bearing exercises to counteract bone loss and drug therapies can halt breakdown and even increase bone mass. Getting our bone mass up to a high level during younger years so that the steady loss with age does not become important may be the best strategy.

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.