Physiotherapists in Chichester 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.

Bone and Ageing

Bone loss occurs much more rapidly than the equivalent process in muscle tissues, with reductions in hormone production and in activity playing a part. After the menopause, the reduction in hormone production in women can result in lowered bone density which is initially termed osteopoenia and then osteoporosis when the bone approaches the levels where it will fracture easily during normal activity. Bone loss affects the trabecular honeycomb bone more than the denser outer cortical bone and also the vertical struts more than the horizontal ones. Once one of the struts is broken it does not repair.

Because they are made up of large amounts of trabecular bones, the spinal bones are often badly affected by osteoporosis, with the process eventually allowing a buckling of the upper and lower surfaces of the vertebrae. The fronts of the vertebrae are more vulnerable to fracture as the trabeculae lose more mass in this area. Physiotherapists teach weight bearing exercises to counteract bone loss and drug therapies can halt breakdown and even increase bone mass. Getting our bone mass up to a high level during younger years so that the steady loss with age does not become important may be the best strategy.