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

Degeneration of Intervertebral Discs

The terms degeneration and ageing when applied to intervertebral discs are not exactly the same thing, as degeneration implies damaging changes in disc structure while ageing changes may be incidental. However, degeneration is a lot more common in older rather than younger discs. Degeneration does involve things which ageing does not, such as larger structural changes in the annulus in the endplates. This structural change starts to occur in a person.s twenties and reaches its maximum in middle age. Because disc degeneration occurs more commonly in men and in the lower lumbar spine it is assumed to be related to mechanical stresses.

Changes which occur in the discs are tears in the annular fibres of various patterns, buckling of the inner annular fibres inwards towards the disc centre, greater bulging of the outer disc walls, loss of disc height, defects in the endplates which can include these bulging up into the vertebral body. Blood vessels and nerves can grow inwards along the annular tears as they are no longer opposed by the internal disc pressure. Degeneration may disrupt the disc.s ability to distribute the compression stresses evenly, leading to high levels of stress being applied to areas which are not designed to cope with this.

Sudden Loads On Lumbar Discs

In experiments on lumbar spines from cadavers the commonest way a disc will fail is if it is placed in significant bending and compressed quickly is to form a prolapse at the rear of the disc. Prolapse occurred most easily in discs which had not degenerated but were between forty and fifty years old. It was not possible to make a very degenerated disc prolapse. The angle of bend or the compressive forces do not need to be excessive as if one of them is over the normal limits it can generate a prolapse. Prolapses mirrored what people say as they occurred with an audible popping sound and occurred suddenly.

Typically a complete split appeared in the rear part of the disc wall and through this fissure the internal nuclear material prolapsed. The prolapse either occurred at one corner of the back of the disc (a common finding in people with disc problems) or more centrally where the nearby ligament prevented it from moving out further. Disc prolapse occurs mostly in discs with some weakening of the disc wall fibres yet a reasonably good nucleus which can respond to the forces by generating high pressures. Degenerated discs did not prolapse on testing.