Pain can affect any partof the body, but it is particularly common around the spine and in the joints. We, at the London Interventional Clinic, offer rapid expert assessment of acute and chronic cases of painful spinal disordersin order diagnose and treat underlying causes and prevent deterioration of the pain or the underlying condition.
Our spine stretches from the base of the skull to the coccyx, and is of vital importance for supporting the weight of the upper body and the head, enabling movement and flexibility, and protecting the spinal cord within.
Spinal pain is possibly the most common condition that patients seek help for and it can vary significantly from patient to patient. From an intermittent and mildly aching back to acute,stabbing pains, back pain presents in many different ways and can affect all ages. Some conditions or previous surgery can be the cause of back pain, although more commonly spinal pain is as a result of strain to the muscles and ligaments that support the spine. Sometimes, spinal pain can even be an indicator of other conditions such as stomach, kidney or gynaecological problems so it is important to seek help from a medical professional who will be able to help determine the cause for you.
Pain can be felt in the cervical spine (neck), thoracic spine (upper to mid back), lumbar spine (lower back), sacral spine (around the pelvis and hips) and coccyx (tailbone), and typically makes patients feel stiff, sore and generally very unwell. Pain from the lower back can radiate into the buttocks or legs and pain in the upper back can radiate into the shoulders and arms. Good posture is critical for everybody to help to prevent spinal pain and it is essential that consideration of the back is taken when lifting heavy items.
Injections (of steroid and local anaesthetic) to the spinal facet joints and radiofrequency procedures are simple and highly effective procedures usually carried out as a daycase procedure under a light sedation if required. They can dramatically reduce pain and many people who undergo these can find that the benefits last for months, if not years.
Radiofrequency heats the nerve that is transmitting the pain and in doing so, disrupts the route so that the nerve signals are no longer transmitted. Once the spine has healed the pain should be reduced and the benefits felt for a good length of time.
Injections work by administering a long-acting local anaesthetic and steroid to the facet joints to anaesthetise the facet joint and block pain, enabling physical therapy and the return to an active lifestyle.
Epidural steroid injections are injections made into the spine in order to treat pain from a slipped disc or compressed nerve with pinpoint accuracy. They can be extremely beneficial in treating the conditions which can lead to sciatic nerve pain. The injections consist of both a steroid and a local anaesthetic and this combination helps to reduce the inflammation of the nerve adjacent to the intervertebral disc. Pain relief can vary from patient to patient but many will see many years relief after such a procedure.
Joints provide the connectivity between bones, supporting the body and enabling mobility. Damage to the joints from illness or injury can impact movement and cause pain. Joint pain can affect anyone, old or young and can have many causes; injury or illness, and can affect a single joint or multiple joints. Knee joint pain is particularly common as these joints support your entire body mass, making them vulnerable to strain, impact and injury. Joint pain can reveal itself in different ways such as a sharp or aching pain.
You should seek medical advice to investigate the cause of joint pain, particularly if it is ongoing or if it developed suddenly as a result of trauma. It is critical to determine whether the pain is in a single joint or whether it is affecting multiple joints. Causes can include fracture or dislocation, various forms of arthritis, a connective tissue disorder, bleeding in the joint space (haemarthrosis), inflammation of the joint lining, gout or cartilage damage, amongst other causes.
At the London Interventional Clinic we can perform targeted injections to jointswith either a steroid to relieve the inflammatory pain or with hyaluronic acid (with or without the addition of steroid), which replaces any lost joint fluid to improve the movement of the joint and provide better absorption of impacts.Osteoarthritis of the knee is usually treated in the first instance with knee joint injections and pain relieving medication, or in severe cases surgery the knee can be surgically replaced – but this is what we want to avoid, if possible.
Treatment… What can be done?
The treatments available for pain are vast and will depend on the cause. Investigations such as an MRI may be required as part of the assessment process to look more closely at the cause. Our approach is interventional; by name and nature, we treat pain by interventional means with injections, topical patches and radiofrequency so that our patients can avoid open or major surgery (where appropriate) and avoid the use of ongoing or lifelong medication. There are times and cases of course where medication is appropriate, possibly in conjunction with interventional procedures. Treatment may entail a combination of the following depending on clinical indication:
Injection therapy with:
Long-acting local anaesthetic
Viscosupplementation(hyaluronic acid), with or without the addition of steroid
Botulinum Toxin A and steroid combined
Qutenza patch treatment:
Capsaicin patches (applied to the skin under close medical supervision within a specialised clinic)
Physical therapy-based rehabilitation:
Manual therapy and home exercise programmes
Movement based therapies such as yoga or Pilates
Chiropractic and osteopathic methods
NSAIDs (non-steroidal anti-inflammatory drugs i.e. Ibuprofen)
Some anti-depressant and anti-epileptic drugs
Stronger medications such as opioids
Topical gels and creams (applied to the area affected area)
Your Treatment Pathway
At the London Interventional Clinic, we have a holistic approach to treating your pain. Dr Humble will first see you for an initial consultation at any of our clinics across London to assess your medical history and examine you in order to make recommendations as to a treatment plan. Your bespoke plan may include investigations, minimally invasive pain management techniques, physical therapy based rehabilitation, medication or onward referrals to allied healthcare providers (such as a shoulder specialist). We will take care of the arrangements for any stage of your treatment plan; arranging private prescriptions, MRIs, treatments (outpatient therapy and daycase procedures) and referrals for physical therapy and other expert input.
You will be assessed and treated, taking into account all clinical and significant lifestyle factors that may be affecting or impacting on your condition. Usually Dr Humble will want to review you periodically but this will be outlined as part of your plan.
Please contact us on 0208 185 7273 or email@example.com to book a consultation or with any enquiries you may have.
- Make an appointment
- Email confirmation of your appointment location and a pain questionnaire to complete
- Assessment and consultation
- Formulation of a multi-stage treatment plan, outlining all recommended options
- Any investigations required
- Booking and undergoing your procedure
- Physical therapy where appropriate
- Follow up review 4-6 weeks post procedure