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

Slipped Disc

Slipped disc is the term used in normal speech to describe a severe back problem, particularly one which involves severe leg pain. However, it is a misnomer in that the disc is unable to slip anywhere so a slipped disc indicates a different kind of pathology. The disc outer covering (annulus fibrosus) is made up of multiple overlapping levels of tough material which encloses a more gel-like interior (nucleus pulposus). With time the layers of the annulus can become fewer or split along certain lines, leading in some cases to the material of the nucleus protruding to the outside of the disc.

This protrusion of part of internal gel through the outer layers of the disc is the so-called slipped disc, known more technically as a disc prolapse or disc protrusion. The protrusion may aggravate the nearby nerve root by compressing it or chemically irritating it, leading to pain in the part of the body supplied by that nerve. The commonest syndrome is sciatica, a severe leg pain usually below the knee which is caused by pressure on the one the lower lumbar nerves. Most attacks of sciatica resolve on their own but if not then discectomy is a highly successful operation.

Lumbar Posture and Muscles

The abdominal and back muscles are affected in three main ways by changes in the posture of the spine: how long the muscles are; what angle they pull against the spine; how powerful they can be due to their changing leverage. Muscle length is important is the application of power and they develop most tension when they are stretches to about 10% above their normal resting length. If the muscle is shortened by contraction then the available strength of contraction is reduced. The fibrous elements in a muscle have their tension increased a lot by stretching, storing energy which can be released as part of enhanced contraction.

In normal standing the back muscles are shortened slightly so they develop more power when the spine is flexed, i.e. bent over to some degree. This means it may be best to bend the back somewhat to lift a heavy weight as this allows increased muscle power to be generated. Stretching of the passive fibrous structures and back muscles whilst lifting can be coupled with a lack of high tension forces on the ligaments and discs by flexing the spine at the time to most of its range.