- Back Pain
- Nerve Pain
- Regional Pain (CRPS)
- Myofascial Pain
Simple or mechanical low back pain is pain felt in the back alone. It is important to treat this early and effectively, and exclude sinister causes such as infection, spine instability and tumours. Bed rest and immobility are not recommended for more than 2 to 3 days. Continuation of a normal life style using regular over-the-counter painkillers, careful goal-targeted exercises suffice, and physiotherapy suffice, for the majority. Patients with low back pain with referred symptoms, may have prolapsed discs compressing nerves, inflammation in the joints between the bones of the vertebral bodies, (facet joints), arthritis, or degeneration in the same bones with resulting nerve compression, and referred pain. This nerve compression results in sciatica, that is shooting pains in the legs, this is referred pain.
The Sacro-iliac joints are also a common origin of low back pain. These are relatively immobile joints and can become inflamed and cause pain with sitting or walking. They are often involved with Rheumatoid-like illnesses.
The precise diagnosis of any individual’s low back pain is, I believe, impossible to make on the back of the history and examination alone. An MRI is helpful to look at structures but in pain medicine, it’s about steroid injections and whether they will work or not. The best investigation for inflammation is a SPECT CT scan.
SPECT CT scans show up the inflamed discs and facet joints – the yellow colours above illustrate this. Steroid injections can be performed to these areas and the facet joints can be radiofrequency denervated to provide many years of relief from the affected joints.
The risks involved depend on the treatment being performed, you can view our treatments pages here.
Follow up treatment by me is rarely required after such intensive investigation. If a surgical opinion is necessary, then I will recommend one. Physiotherapy is always helpful after my treatments, but this is voluntary.
Sometimes injections are not possible and pain killing medication changes are necessary.
There is no need to suffer with debilitating low back pain; help is at hand! If you are suffering with low back pain and it will not go away despite the passage of time and using simple pain relieving medications, physiotherapy etc., then I can see you for a comprehensive evaluation of your problem.
Sometimes I alone cannot help you and I work closely with colleagues – surgeons, physiotherapists and psychologists which is important in such care – the multidisciplinary team.
Email firstname.lastname@example.org or call us on 020 7060 5109 for an appointment. Leave a message if you get through to a voicemail and you will be called back.
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