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

Sciatica - Physiotherapy Examination

Sciatica is also known as nerve root pain, nerve root irritation, nerve root entrapment and slipped disc pain in the leg. True sciatica occurs when one of the nerve roots exiting the spinal canal is compromised, usually by a disc protrusion. The pain is typically severe, radiates down the leg beyond the knee, is worse in the lower leg or foot, has a surging quality and is worse with sitting or bending and better lying down. Physiotherapy examination starts with a history of the pain location and aggravating or easing factors and what were the precipitating factors for the pain problem.

The physio will examine the patient carefully as it is easy to aggravate the pain. Muscle power (as able), sensibility and reflexes will be tested to check the conduction of the nerve root involved and this should fit in with the area of pain reported. With the patient lying supine the affected leg will be raised with the leg straight to stretch the nerve and evaluate any changes in the pain reported. This neural tension test must provoke the typical pain to be positive. Palpation of the patient's spine may be performed in prone to evaluate the mobility or stiffness of the spinal segments.

Disc Nutrition and Posture

The supply of nutritional substances to the inner parts of the discs is in general poor and a lack of this supply is connected with degenerative disc changes. Large differences in the compression forces inside an intervertebral disc can be generated by relatively small changes in posture. These changes have correspondingly large effects on fluid flow out of and into discs and on diffusion of metabolic agents into the disc. The effectiveness of the transport of these materials depends on how far they have to travel from the nearest blood vessel which is usually in the vertebral endplate (top or bottom of the disc).

When bending, the back of the disc walls is stretched and the fronts are compressed, with stretching making the wall thinner and therefore more easily crossed by nutrients. This brings more food supply into the central area of the rear of the disc, the area which receives least nutrition. Compression from movement also squeezes water from the disc and as it returns when the pressure is relieved the incoming water brings nutrients along with it. Changes from a lordosis to a flexed position regularly increase the fluid flow in and out of the disc, encouraging the transport of nutrients.