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

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.

Lumbar Stenosis

There are many painful syndromes which involve the lumbar spine, with the discs, ligaments, joints, muscles and nerves all implicated in pain production. Older people can present with symptoms which indicate a stenosis of their vertebral canal. The vertebral or spinal canal runs down the back and carries the spinal cord, allowing the nerve roots to exit to the body at each spinal level (each disc level). The spinal canal can be congenitally narrow which increases the chances of developing spinal stenosis with age. As degenerative changes occur in the spinal structures the spinal canal can become narrowed and tight.

The symptoms of spinal stenosis typically do not include back pain but rather leg pain, often bilateral, and worsened by walking but better with sitting. Typically presenting in people of 65 years or older, spinal stenosis can also present as a nerve root irritation of a sciatic type due to stenosis of the exit for the spinal nerve root. Physiotherapy is not usually very useful and little is found on examination apart from a reduction in spinal extension and many people manage their symptoms over time as best they can, although surgical spinal decompression can be very successful in relieving the symptoms.