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

Degeneration of Intervertebral Discs

The terms degeneration and ageing when applied to intervertebral discs are not exactly the same thing, as degeneration implies damaging changes in disc structure while ageing changes may be incidental. However, degeneration is a lot more common in older rather than younger discs. Degeneration does involve things which ageing does not, such as larger structural changes in the annulus in the endplates. This structural change starts to occur in a person.s twenties and reaches its maximum in middle age. Because disc degeneration occurs more commonly in men and in the lower lumbar spine it is assumed to be related to mechanical stresses.

Changes which occur in the discs are tears in the annular fibres of various patterns, buckling of the inner annular fibres inwards towards the disc centre, greater bulging of the outer disc walls, loss of disc height, defects in the endplates which can include these bulging up into the vertebral body. Blood vessels and nerves can grow inwards along the annular tears as they are no longer opposed by the internal disc pressure. Degeneration may disrupt the disc.s ability to distribute the compression stresses evenly, leading to high levels of stress being applied to areas which are not designed to cope with this.

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.