Physiotherapists in Nottingham 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.

Disc Prolapses

In a disc prolapse the internal material of the disc becomes displaced in relation to the outer annulus. The annular rings should be around the disc and the water retaining nucleus at the centre of the disc should remain there. In one kind of protrusion the disc bulges the annular fibres outwards but the nuclear material remains inside the disc. If the annular fibres rupture right through their thickness then part of the nucleus can extrude outside the confines of the disc but it still remains in contact with the rest of the nucleus inside the disc.

A third type of disc prolapse can occur where the disc tissue is extruded from the disc but then is separated from the nucleus and exists as an independent fragment outside the disc walls. Disc prolapses or herniations do not seem to be well connected with age or changes of degeneration of the discs even though it is again most common at lower lumbar levels which are subject to both degeneration and stresses more than other spinal regions. Even though disc prolapses are often called .slipped discs., the disc cannot slip as it is tightly bound to the vertebrae above and below.