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

Good and Bad Lumbar Posture

Good and bad lumbar posture has often been decided on grounds that are not sufficiently scientific and future recommendations need to be based on solid research. Early research on the effects of different spinal postures indicated that maintaining a lumbar lordosis reduced the pressures inside the disc nucleus. This seemed fine until it was realised that these pressures were being transferred to the rear disc walls and the facet joints. As the facet joints are known to be frequent causes of low back pain and the nucleus of the disc is not a source of pain the idea that a lordosis is desirable in all circumstances does not stand up to examination.

Overall having some flexion in the spine is better in static positions whilst a slight lordotic posture is better when walking. Too much flexion interferes with the ability of the muscles of the back to protect the spine, so a moderate position should be taken between too much flexion and too much extension. The benefits of slight flexion are mirrored in the typical habits of people in postures, such as crossing the legs or putting a leg up on something at a bar, both actions which increase the flexion of the lumbar spine.

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.