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

Back Pain and Pathology

It is difficult to connect back pain symptoms to causative factors but some pathological findings are easier to link. Disc herniation can be objectively observed on MRI scanning and is reliably connected with sciatica but MRI scans on normal subjects show disc herniations in people who do not have symptoms. Lumbar disc degeneration seems very common in people of middle age but it is difficult to clearly define so that it can be measured in a way relevant to clinical practice. Disc degeneration starts sooner and is more developed in the L4/5 and the L5/S1 disc levels than in higher lumbar levels.

Even 15 year old school children have been found to have a significant incidence of these disc changes, with the incidence rising to close to 100 percent in people who have reached 50 years of age. MRI findings are not well correlated with requirements for medical care for back pain or for the levels of disability which can result. Narrowing of disc spaces, bony outgrowths and increases in bone density are connected to a degree with levels of back pain. Eastern societies which depend a lot more on the squatting posture are reported to have lower levels of degeneration than western societies.

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.