1. What is the cause of my back pain/neck pain?
The spine is made up of a stack of bones (vertebrae), from the pelvis, up to the skull. They are cushioned by the tissue between them called discs. The vertebrae are held together by tissue bands or straps called ligaments movement between each bone as facilitated by joints (facets). This whole spinal unit is then supported by a group of muscles commonly referred to as the “core”. The spine itself houses and protects the spinal cord and nerves that transmit electrical signals between the brain and the rest of the body.
Pain can be generated from any one of these structures but is often referred onwards to other structures (e.g. a slipped disc, compressing a nerve generating leg pain). A careful consultation, taking a thorough medical history and a clinical examination will help narrow down the cause. For most patients an MRI of the spine is requested to help confirm the diagnosis. Modern day imaging is so sensitive that a number of common but irrelevant abnormalities will be in the report and patients understandably find this daunting!
I will then review the actual images and show them to you, explain the findings and determine which findings fit with your signs and symptoms.
Most other practices require you to pay for an initial review, then a scan followed by the second consultation to discuss the findings and treatment options
I offer a diagnostic package, which is a one stop clinic. This involves a free telephone consultation, where I attain some details of your history in order to request the appropriate scan. After you have had the scan, I see you in my clinic for a formal history and examination and then me go over the scan findings to formulate a plan. This gets to your diagnosis and plan in a faster and more cost effective manor. If you have already had a scan, we arrange transfer of the images (once you have informed my PA) so the images (not just the report) can be reviewed before the consultation.
2. How can it be treated?
The majority of patients I see will not require surgery. Most problems in the spine relate to poor posture, weakness of the core and therefore secondary strain on the joints, ligaments and discs. This can then cause pain from the joints that is referred to the adjacent attached muscles. Tears in the discs can cause nerve compression and result in leg pain (sciatica) or shoulder/arm pain (brachalgia).
In the context of pain localised in the back with no nerve compression, this can mostly be managed by strengthening the core muscles and some manipulations. I work with physiotherapists and osteopaths in Kent and Essex, who will tailor the treatment to your ability, scan findings and recommendations I make. Most patients usually require 3 sessions with the physiotherapist or osteopath and if they carry out these exercises and continue them in their own time significant improvement is noticed. I personally offer a follow up after this treatment to ensure it is working and confirm that nothing more invasive is required. The therapists and I communicate about your progress thoughout your care.
These are some of the scenarios where either an injection or surgery may be required.
i. Patients with worsening leg pain (beyond 6 weeks), with confirmed nerve compression on imaging that clinically fits with the pain distribution.
ii. Patients with progressive neurological deficits (weakness), surgery may be recommended sooner.
iii. Confirmed misalignment of spinal bones (spondylolisthesis) with instability, that has failed conservative measures.
With the range of procedures I have been trained in, my goal is to find the least invasive procedure that is still able to offer the longest lasting result.
3. How much will this cost me to treat privately?
In the current economic climate, this is one of the most concerning questions for most patients. Especially if you are uninsured. Many patients I see, have paid to see numerous different professionals (physiotherapists, osteopaths, chiropractors, pain specialists and other surgeons) before they have even got to the diagnosis.
My one stop clinic approach consists of a free telephone consultation, followed by a one-price scan and face-to-face consultation. This diagnostic package helps get to the root of the problem and formulate a plan with fewer visits and therefore at a reduced cost.
My unique practice model is all of the above professionals working together in one organisation, led by me, a spinal neurosurgeon. For the majority of patients who have been seen in my one-stop clinic, our tailored spine therapy package (usually 3 sessions with either an osteopath, physiotherapist, then a follow up with me) leads to a significant improvement.
If surgery is required, the cost depends on the type of procedure. If a type of operation has been suggested to you elsewhere you can request a price or a second opinion from me. Please note that opinions can sometimes vary between surgeons and I would need to review you and any scans you have had first.
For any further information please feel free to make an enquiry and we will contact you.
BMI - Chelsfield Park Hospital
Private Consultations and Surgery
Bucks Cross Rd, Chelsfield,
Orpington BR6 7RG
Call: 01689 877855
Spire - Hartswood - Brentwood
Private Consultations and Surgery
Eagle Way, Warley,
Brentwood CM13 3LE
Call: 01277 508161
BMI - London Independent Hospital
1 Beaumont Square,
London E1 4NL
Whilst surgery is carried out here for complex cases no consultations are held here.
The video consultation platforms (MS Teams and Zoom) have been set up by the hospitals to ensure your security and ease of use. The appointment staff will help you in setting up these consultations.