Unfortunately, it’s a fact of life – just about all of us will suffer from it at some point, and not surprisingly, the older we get, the more likely it is. As a rule of thumb, it affects 30 per cent of 30-year-olds, 40 per cent of 40-year-olds, and so on, increasing with each decade.
Over-the-counter pain relief with Paracetamol or Ibuprofen can often help with mild back pain. Doing more exercise and trying Pilates or yoga can help. If you’re overweight, losing a few pounds is also a good idea. If you try these steps and feel little or no improvement, the next stage is supervised rehabilitation with a spinal physiotherapist.
If you have any leg pain – often called sciatica – linked to the discomfort in your back, then it’s best not to try the physiotherapy but to see a specialist instead.
This is pain you’ve had for a while and hasn’t been helped by the first-step treatments of pain relief, exercise, weight loss and spinal physiotherapy.
If you’ve had little success with the first-stage approaches of painkillers, exercise, losing weight and spinal physiotherapy, then a course of steroid injections may be offered as a non-surgical step.
Known as facet blocks, they target the small facet joints in each affected segment of your spine. The procedure involves injecting a small amount of anaesthetic and anti-inflammatory steroid to try to block the pain.
If this works for a short time, rather than repeat the injections, the next option for potentially longer pain relief is facet joint ablation, also called rhizolysis and radiofrequency ablation.
Under an anaesthetic, the nerves carrying pain signals to the brain from the affected joints are neutralised using a heated, needle-like probe.
We offer a new non-surgical, pre-cursor stem cell treatment that harnesses your body’s own natural ability to repair itself. Fat from your belly is processed using an innovative technique called Lipogems® that cleans and purifies the cells before they are injected, with x-ray guidance, into the affected joint.
There’s more information on this therapy below, and for greater detail, click here.
After the non-surgical approaches have been tried, there are several operations that may help, though it does depend on what parts of your back are causing the pain, and if it’s linked to discomfort in your buttocks and legs, often called sciatica.
While surgery for leg pain/sciatica is a very successful and routinely performed, surgery for back pain is generally considered a last resort and needs careful consideration in consultation with a specialist.
If just one area of your spine is affected, then fusion could be an option. The procedure uses cages or rods and screws to stabilise a segment of your back to reduce pain.
If you have pain or weakness in your legs triggered by a back problem, like a bulging or damaged disc that puts pressure on a nerve, then a possible next step would be a decompression operation or a discectomy.
Decompression is a general term for surgical procedures that aim to free up the trapped nerve in your lower back. In a similar way, a discectomy gives the nerve more room by removing part of a disc.
Steroid injections are essentially risk-free, but are only successful for about half of patients. The benefits can be quite short-lived, providing relief for months rather than years.
Facet joint ablation, which knocks out the nerves carrying pain messages to the brain, has about a 65 per cent success rate, though results do vary. Some patients enjoy less pain for up to two to three years, with others see little improvement. It can be quite sore for a week or so afterwards and the procedure carries a very small risk to damage to nearby nerves.
The spinal fusion, decompression and discectomy have the same risks as any surgery plus a one per cent possibility of infection and around a one-in-a-thousand chance of nerve injuries.
With fusion, however, even in the best scenario, only around 60 per cent of patients experience any relief afterwards. Your outlook is much better, though, if you have an operation for leg pain – around 75 per cent are helped by decompression and up to 90 per cent from a discectomy. As always, correct diagnosis for surgical options is essential to gaining the benefit and accepting the risks.
The pioneering Lipogems® adipose tissue therapy is less invasive than surgery and has provided some very positive outcomes. The procedure is very safe and the risks are minimal, though all procedures including an injection do come with risks. Some patients experience mild bruising from the fat harvest site and slight swelling on the joint. We maintain the importance of measuring outcomes and the on-going assessment of our patients to determine the medium and long-term benefits.
Looking for the source of pain in a large single joint like a knee or hip is fairly straightforward, but not so with your back. It’s made up of bones, discs and facet joints all snugly laced together with tendons, muscles and nerves. It’s not quite a needle in a haystack, but tracking down exactly which part is generating your discomfort takes considerable expertise, especially when there can be more than one source for your pain. A problem in one area can also cause an issue somewhere else, for example a damaged disc or joint could be putting pressure on a nerve that makes your leg or buttock painful, as in sciatica.
Our innovative range of treatments goes beyond what’s available on the NHS. As well as providing a full opinion on your spine that includes all the traditional non-surgical and surgical options, our experienced consultants will also assess your suitability for our alternative biological therapies.
You’ll see one of our expert spine consultants, Mr. Shahid Khan or Mr. Arun Ranganathan, for around 30 minutes. Either before or on the day, we’ll arrange for you to have an MRI scan so that an imaging report is ready for your appointment.
As well as reviewing this, our specialist will take your medical history, discuss your symptoms and carry out an examination. They will also discuss all the treatment options with you, along with their potential benefits and risks.
Our expert team works as part of a collaborative partnership of surgeons, sports medicine doctors and physiotherapists to provide the perfect patient pathway to get you quickly on the road to recovery. Whether you require conventional treatment or if you are a candidate for our regenerative treatments, you can be sure that you will get the best advice.
Our renowned medical team provides a range of treatments, from the traditional to the innovative:
Also called facet or nerve root blocks, they are recommended if you’ve not had much success with the first-step approaches of painkillers, exercise, losing weight and spinal physiotherapy.
This is an effective and well-researched procedure that’s a potential alternative to surgery. It takes advantage of the blood’s natural healing properties to reduce pain and improve joint function. It uses a specially concentrated dosage of platelets prepared from your own blood to repair damaged cartilage, tendons, ligaments, muscle and bone. Patients usually see their symptoms improve in one to two weeks of having the injections. Read more clinical evidence supporting PRP here.
A pioneering new treatment using your body’s own stem cells to treat pain and inflammation. The minimally invasive procedure is a possible alternative to having an operation or can be used after surgery to help healing. It harnesses natural repair cells removed from your body fat to target problems affecting discs, joints, tendons, ligaments and muscles. The procedure takes around an hour and early results suggest an improvement for 75 per cent of suitable patients.
Autologous means ‘from the same person’ rather than from a donor. Essentially, your own cells are used to encourage healing. With this type of treatment, there’s no chance of the rejection, infection or contamination risks that come with using material from someone else. The innovative therapies we offer are based on this idea. If you’ve found traditional treatments aren’t helping your pain, of if you’re looking for a possible alternative to surgery, then this approach is one to consider.
Fluoroscopy-guided infiltrations of intervertebral discs and facet joints with Endoret® (PRGF®) in patients with chronic lower back pain resulted in significant pain reduction assessed by VAS. Read full paper.