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

Good and Bad Lumbar Posture

Good and bad lumbar posture has often been decided on grounds that are not sufficiently scientific and future recommendations need to be based on solid research. Early research on the effects of different spinal postures indicated that maintaining a lumbar lordosis reduced the pressures inside the disc nucleus. This seemed fine until it was realised that these pressures were being transferred to the rear disc walls and the facet joints. As the facet joints are known to be frequent causes of low back pain and the nucleus of the disc is not a source of pain the idea that a lordosis is desirable in all circumstances does not stand up to examination.

Overall having some flexion in the spine is better in static positions whilst a slight lordotic posture is better when walking. Too much flexion interferes with the ability of the muscles of the back to protect the spine, so a moderate position should be taken between too much flexion and too much extension. The benefits of slight flexion are mirrored in the typical habits of people in postures, such as crossing the legs or putting a leg up on something at a bar, both actions which increase the flexion of the lumbar spine.

Repeated Loading of Lumbar Discs

Lower loads than the sudden compression loading which occurs seldom can cause a disc prolapse if the loading in a bent position is repeated in a cyclical manner. This can be caused in discs which are reasonably young and causes a large split in the rear of the disc wall to one side or another, allowing the central nuclear material to ooze out. In several examples the layers of the disc wall which were the most outer ones did not split and form a fissure and the nuclear material protruding through the fissure inside built up behind the remaining layers in a bulge. As the ligament overlying this has many nerve endings, such a bulge could cause pain.

Older discs were shown in some cases to have fissures which are already present before any experimental loading and these discs did not prolapse during the loading tests, perhaps because the fissures had healed or because discs in poorer condition are too stiff and fibrosed to prolapse. If twisting, side bending or compression is added to bending then prolapse can occur more easily with less bend of the back. In some cases the nucleus may protrude out but in others the outer disc walls can protrude themselves.