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

Disc Pain

It is not possible to diagnose discogenic pain by clinical examination of a patient as there are no specific examination techniques for this condition. Various physiotherapy techniques, such as testing centralisation and peripheralisation, show some connections with having disc-related problems, but do not go as far as to solidly diagnose disc pain. The accepted way of diagnosing this type of problem is to attack the disc itself with techniques such as discography. Discography involves inserting a needle right into the disc and injecting a contrast material which will show up on x-ray examination. The most important point is that the test is only positive if it brings on the typical pain the patient is normally complaining of.

The injected material allows the shape of the nucleus to be seen inside the disc and whether there any problems with it. The discs nearby are also tested and they should be negative if there is to be sufficient confidence in the findings from the symptomatic disc. Internal disc disruption (IDD) is quoted as the underlying pathology responsible for lumbar pain of disc origin, where the internal structure of the disc is altered by fissures occurring radially from the centre towards the outside.

Common Causes of Disc Prolapse

Spinal surgeons know that most disc herniations they are required to operate on are mostly made up of nucleus pulposus and rarely consist of much of the annulus fibrosis, which never occurs alone in a prolapse. Typical actions which risk prolapse are lifting and carrying, imposing flexion, side bending and compression loads on the lumbar spine at the same time. Combinations of these forces are what make a prolapse more likely, such as falling on the bottom whilst the legs are straight out in front, combining compression and bending. Other combinations could include tripping and so bending forward whilst carrying, reaching forward to catch a heavy object or lifting something heavy after a period when the spine has been in flexion.

If the upper body is pulled forwards suddenly and a force applied this is the most risky posture as the back muscles are contracting most strongly to resist the forward movement at that time and so increasing the compression through the spine. Due to fact that the discs are tighter and more swollen with water in the morning, it seems that disc prolapse may be more likely to occur at this time. Repeated bending in heavy jobs could also cause prolapse with time.