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

Risk Factors for Low Back Pain

Studies of risk factors have not given clear indication of the risk factors for low back pain although about 70% of disc degeneration seems to be connected with genetic factors and around 60% of back pain overall. There is a strong association between genetic factors and osteoarthritis in the small facet joints which lie each side of the spine. General levels of fitness and the strength of back muscles seem to have little relevance as does differences in leg length. One study which was well conducted shows that a high risk of poor lumbar mobility and a long back exists in young people who work in health work and are encountering heavy work for the first time. This may be because taller people are exposed to higher mechanical forces to the longer limb and spinal levers they use when lifting weights.

Of little relevance seem to be height or weight, flexibility of the lumbar spine or straight leg raising, and fitness seems also to be not connected. X-ray and MRI examination findings have no connection to whether a person might suffer low back pain in the future. Overall the highest risk factor for future back pain is having had back pain in the past.

Intervertebral Discs and Ageing

Ageing starts early in the discs and proceeds through life. Initially a loss of proteoglycan occurs, and as these chemicals attract and hold water into the centre of the discs, a degree of loss of hydration steadily occurs. The collagenous tissues lose some of their suppleness and resistance, becoming more brittle and more likely to suffer injury. As the discs have no central blood supply and rely on nutrition and oxygen diffusing in, a limitation of this process will accelerate the degenerative process going on in the disc centres. The tops and bottoms of the vertebrae, the endplates, are cartilage but can become calcified, further reducing supplies to the nucleus inside.

The outer part of the disc, the annulus, has layers of collagen material and these thicken and can develop defects. Overall the central disc material becomes drier, fibrosed and stiffer with a smaller volume as it loses water, throwing compressive forces onto the back of the disc annulus. The annulus becomes both stiffer and weaker with age, the increased stiffness perhaps offset by the increase in defects in the disc wall with time. Studies of discs have shown that they do not generally decrease in height with age.