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

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.

Overdoing and Avoiding in Chronic Pain

Chronic pain can lead to significant levels of distress and disability as sufferers struggle to maintain their activity levels in the face of high levels of pain. People vary enormously in their responses to a chronic pain problem but the two most obvious approaches are avoiding and overdoing. Avoiding is much less common the person doing less and less with time, avoiding activities as they fear damage to their back. With time this evolves into an almost complete avoidance of activity as the person rests for the majority of the day, with others typically taking over all the domestic tasks and often many of the personal ones too. This leads to high levels of unfitness and deconditioning.

The other approach, more common overall, is to keep pushing on with activities because they have to be done, and then cope with the consequences afterwards. These people feel guilty at not being able to do the things they should and when they wake up to a better day than normal they go for it, doing all the things they have wanted to do until the pain increase stops them and then is much worse for several days, forcing them to rest.