11 October 2018
Health statistics show that one in three adults in the UK will be affected by back pain at some stage in their life.
For some, treatment can be a simple as a course of anti-inflammatory medication or even a period of rest and gentle exercises, but for others the problem can be debilitating leading to long-term absences from work, depression or even permanent disability. In the vast majority of cases, the pain can be handled without taking the ‘last resort’ option of spinal surgery.
Patients can get stuck in a Catch 22 situation where the pain prevents effective physiotherapy and the problems simply gets worse. Interventions and injections can produce very effective pain relief which will then allow the patient to move on to physiotherapy and, hopefully, a return to full or almost full fitness.
1: What is the most common cause?
The most common cause is muscular pain or non-specific back pain. Degenerative spine is the second most common cause.
2: What are other major causes?
The other major causes are nerve root compromise (sciatica) and post spinal surgery pain.
3: How long do people tend to suffer before they seek medical help?
This tends to vary significantly. Patients who could be helped the most are usually the ones who, for professional or lifestyle reasons, delay seeking attention. The priority is to get them back to health as soon as possible so that they can return to their cherished activities.
4: Are there any particular age groups most affected?
Although back and neck pain is more common in older adults, very fit and active patients in their 20s and 30s have successfully been treated. Unfortunately no-one is immune to developing back problems.
5: What first steps should you take to help you decide treatment options?
Even if your pain issue may seem obvious and you've already seen your doctor or other specialist, an initial consultation with one of our consultants will always start with a basic history of your health.
Consultants prefer to hear everything you have to say in an unhurried and detailed manner. They will go through each issue in detail and rule out any sinister causes first. These are called red flag symptoms. Once the consultant is reassured that they have reliably excluded any red flag symptoms, they would proceed to a physical examination and medication review.
6: What sort of options are available?
The available options depend on the cause of the back pain. The options can include pain relieving medications, injections, TENS therapy (Transcutaneous Electrical Nerve Stimulation) or sometimes even acupuncture can be very beneficial.
7: Once you have managed to relieve the pain what is the next step?
The goal is to recondition the back - which is achieved by very specific and targeted strengthening of the back muscles.
8: Why are targeted injections so efficient?
Injections deliver therapeutic substances directly to the affected area of the body. This avoids the need to prescribe pain-relieving medications, which usually affect other parts of the body as well.
9: What other interventions are available?
Certain other interventions like spinal cord stimulators, dorsal root stimulators, intrathecal pumps (a medical device which delivers medication directly into the spinal canal) and deep brain stimulation are available but these are usually for complex pain syndromes.
10: Are there many cases when you decide that surgery is the best option?
As mentioned above there are certain “red flag” situations where spinal surgery may be the most suitable option. Having said that, the percentage of patients who go on to need spinal surgery is actually much lower than you might think.
Spinal consultants at Spire Cheshire Hospital
To book an appointment with one of our consultants ring 01925 26500 or send an enquiry.