Medical Weblog

In the same way, infection, producing clumps of bacteria and pus, may allow stones to form as the salts are precipitated out of solution.

Obstruction to the free flow of urine always leads to infection and may cause stones. Changes in the pH of urine, making it more acid or alkaline, can also lead to the precipitation of salts.

Prolonged immobilisation, such as can occur with a person laid up in traction for a broken bone or in paraplegics and quadriplegics, can lead to the demineralisation of bone.

Calcium comes out of the bone and is excreted through the kidneys. This excess calcium can form stones.

Calculi may be made of different chemicals, sometimes from a combination of two or more substances.

Calcium oxalate stones are usually rough with sharp projections and, because these irritate the lining of the kidney and cause pain and bleeding, are usually detected while still small.

Calcium phosphate stones, on the other hand, are smooth and may grow to a large size without detection. They may fill the pelvis or collecting chamber of the kidney and project into pockets of the kidney substance.

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A lateral process projects from either side.

Between two vertebrae is the intervertebral disc and it is this structure which is believed to cause most back problems.

The disc consists of an inner core of thick fluid, surrounded by tough fibroelastic cartilage arranged with interwoven strands.

From the late teens, the disc starts to degenerate — the inner core loses its fluid and becomes smaller and firmer, and the elastic tissue is subject to strain and may develop splits.

Whether the backache is due to normal degeneration or to injury is important not only to the sufferer and his doctor, but also to industry, insurance companies and the law, as most severe back conditions result in workers’ compensation claims.

It is this lack of agreement and lack of full knowledge of the pathology underlying the condition which leads to disagreements about treatment.

Backache may be the result of muscle strain or tearing or may come from injury or strain to ligaments or joints but it is now believed most back problems stem from a disorder of the disc.

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