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

The Curves of the Spine

A quick look at anyone's spine from the side clearly indicates that the spine is not a dead straight structure but has a series of curve. There are four spinal curves, the cervical, thoracic, lumbar and sacral. The neck curve begins to develop when the young child starts to try and lift the head up to look around, while the lumbar curve may be secondary to an upright gait. During walking the curves vary in regular amounts and this may be so that the spine can absorb and release energy, allowing the curves to be increased and decreased rather than the spine just suffers compression. This makes the curve system a form of shock absorber.

During the gait cycles the large muscles of the abdomen and back are working hard to stop large changes in the spinal curves occurring as this would adversely affect stability, and it is these tendons that the energy is stored which would otherwise just be applied to the spine. Walking involves jarring up and down movements which could be harmful if they were transmitted up through the spine and arrived at the head. These forces are lessened by the absorption of forces which the curves provide.

Lumbar Stenosis

There are many painful syndromes which involve the lumbar spine, with the discs, ligaments, joints, muscles and nerves all implicated in pain production. Older people can present with symptoms which indicate a stenosis of their vertebral canal. The vertebral or spinal canal runs down the back and carries the spinal cord, allowing the nerve roots to exit to the body at each spinal level (each disc level). The spinal canal can be congenitally narrow which increases the chances of developing spinal stenosis with age. As degenerative changes occur in the spinal structures the spinal canal can become narrowed and tight.

The symptoms of spinal stenosis typically do not include back pain but rather leg pain, often bilateral, and worsened by walking but better with sitting. Typically presenting in people of 65 years or older, spinal stenosis can also present as a nerve root irritation of a sciatic type due to stenosis of the exit for the spinal nerve root. Physiotherapy is not usually very useful and little is found on examination apart from a reduction in spinal extension and many people manage their symptoms over time as best they can, although surgical spinal decompression can be very successful in relieving the symptoms.