Back & Spinal Pain Conditions We Treat
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Disc Prolapse (IVDP)
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Radiculopathy (Sciatica / Cervical)
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Facet Joint Pain
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Sacroiliac Joint Pain
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Failed Back Surgery Syndrome (FBSS)
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Coccygeal Pain
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Autonomic Dysfunction–Related Pain
Disc Prolapse (IVDP)
Overview
A herniated or prolapsed disc occurs when the soft core of an intervertebral disc bulges out and irritates nearby nerves. This leads to pain in the lower back, neck, or limbs. Without timely management, it can restrict movement and cause chronic nerve irritation.
Symptoms
- Localised low-back or neck pain
- Radiating pain down the leg (sciatica) or arm
- Tingling, numbness, or muscle weakness
- Pain worsening on bending, coughing, or sneezing
Diagnosis
- Physical and neurological examination
- MRI or CT scan to identify disc herniation and nerve compression
- Electromyography (EMG) for nerve-function evaluation
- Diagnostic selective nerve-root block to confirm pain origin
Treatment
- Medical Management: Anti-inflammatory medications, muscle relaxants, and
short-term neuropathic pain modulators. - Interventional Procedures: Epidural steroid injections or selective nerve-root
blocks for reducing inflammation and pain. - Rehabilitation: Physiotherapy, posture correction, and core-strengthening
programs. - Surgical Referral: Reserved for cases with neurological deficits or unrelenting
pain.
Radiculopathy (Sciatica / Cervical Nerve Pain)
Overview
Radiculopathy occurs when nerve roots exiting the spinal cord are compressed or inflamed, often due to disc herniation or degenerative changes. Depending on the location, symptoms may affect the legs (lumbar) or arms (cervical).
Symptoms
- Shooting or burning pain radiating along a nerve path
- Tingling, pins-and-needles sensation
- Muscle weakness or altered reflexes
- Pain aggravated by movement or coughing
Diagnosis
- Neurological assessment of reflexes, sensation, and strength
- MRI spine to identify the affected level
- Nerve conduction studies to assess damage
- Diagnostic nerve-root block for confirmation
Treatment
- Conservative Care: Analgesics, rest, and physiotherapy for posture and muscle
balance. - Interventional Therapy: Transforaminal nerve-root block or epidural
injections for precise relief. - Advanced Techniques: Radiofrequency ablation or pulsed RF for long-term
modulation of pain transmission. - Rehabilitation: Gradual stretching, ergonomic correction, and guided exercise
to prevent recurrence.
Facet Joint Pain
Overview
Facet joints connect the vertebrae and provide stability to the spine. Degeneration, arthritis, or injury can inflame these joints, resulting in chronic localised back or neck pain.
Symptoms
- Localised dull pain and stiffness in the back or neck
- Pain worse on extension, twisting, or standing
- Morning stiffness and restricted mobility
- Tenderness over the affected joints
Diagnosis
- Physical examination and movement tests
- MRI or CT scan to assess joint degeneration
- Diagnostic medial-branch block to confirm the facet as the pain source
Treatment
- Medications: Anti-inflammatory drugs and muscle relaxants.
- Interventional Procedures: Facet joint injections or medial branch nerve blocks; radiofrequency ablation for long-term relief.
- Rehabilitation: Physiotherapy for posture correction and spinal stabilisation.
- Lifestyle: Ergonomic adjustments and weight management to reduce recurrence.
Sacroiliac Joint Pain
Overview
The sacroiliac (SI) joint connects the spine to the pelvis and can be a major source of lower back or buttock pain. Dysfunction or inflammation of this joint may mimic disc or hip disorders, making precise diagnosis crucial.
Symptoms
- Deep pain in the lower back, buttocks, or thighs
- Pain aggravated by standing, walking, or stair climbing
- Stiffness after sitting for long periods
- Pain on turning in bed or bending forward
Diagnosis
- Clinical provocative tests (FABER, Gaenslenʼs test)
- Diagnostic SI joint block under fluoroscopic or ultrasound guidance
- MRI or CT for joint inflammation assessment
Treatment
- Medical: Anti-inflammatory medications and muscle relaxants.
- Interventional: SI joint injections with corticosteroids; radiofrequency denervation for chronic pain.
Physiotherapy: Pelvic stabilisation, stretching, and strengthening exercises.
Lifestyle: Posture correction, activity modification, and core strengthening.
Failed Back Surgery Syndrome (FBSS)
Overview
FBSS describes persistent or recurring back or leg pain even after spinal surgery. It may result from residual nerve compression, scar tissue, altered biomechanics, or psychological stress.
Symptoms
- Continued back or leg pain after surgery
- Numbness, weakness, or tingling
- Pain on movement or prolonged sitting
- Emotional distress or frustration from poor recovery
Diagnosis
- Detailed surgical history and imaging (MRI, CT, X-ray)
- Nerve conduction and electromyography tests
- Diagnostic blocks to differentiate scar vs. nerve pain
- Psychosocial evaluation for coping and rehabilitation needs
Treatment
- Medication: Neuropathic pain agents and anti-inflammatory therapy.
- Interventions: Epidural adhesiolysis, nerve-root blocks, or spinal cord stimulation (SCS) for refractory pain.
- Rehabilitation: Targeted physiotherapy and ergonomic retraining.
- Counselling: Support for post-surgical anxiety and adaptation.
Coccygeal Pain
Overview
Coccygeal (tailbone) pain, or coccydynia, is discomfort at the lower tip of the spine, often after a fall, prolonged sitting, or childbirth. The pain can be sharp and worsens when sitting or leaning back.
Symptoms
- Pain and tenderness at the tailbone
- Discomfort when sitting or standing up
- Pain radiating to buttocks or lower back
- Swelling or bruising (in acute cases)
Diagnosis
- Clinical evaluation and local palpation
- X-ray or MRI to exclude fractures or dislocation
- Diagnostic ganglion impar block to confirm source
Treatment
- Conservative: Cushioned seating, posture correction, and mild analgesics.
- Interventional: Ganglion impar block under imaging guidance for targeted relief; radiofrequency ablation for persistent pain.
- Rehabilitation: Pelvic floor exercises and physiotherapy.
Autonomic Dysfunction–Related Pain
Overview
The autonomic nervous system regulates involuntary body functions. When affected by injury or disease, it can lead to persistent pain syndromes like Complex Regional Pain Syndrome (CRPS) or vascular-related discomfort.
Symptoms
- Burning or deep aching pain
- Colour or temperature changes in limbs
- Swelling and sweating abnormalities
- Skin sensitivity or trophic changes
Diagnosis
- Clinical and sensory examination
Autonomic testing (thermoregulatory or sweat evaluation) - Imaging to rule out vascular or structural causes
- Diagnostic sympathetic nerve block
Treatment
- Medications: Neuropathic and vasodilator drugs to regulate nerve activity.
- Interventional: Sympathetic nerve blocks (lumbar, stellate) for diagnostic and
therapeutic benefit. - Physiotherapy: Desensitisation and graded movement therapy.
- Psychological Support: CBT and relaxation training to manage autonomic
flares.
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FAQs
What causes spine and back pain?
Spine pain can be caused by disc problems, nerve compression, joint inflammation, injury, or previous surgery.
Do all spine problems require surgery?
No. Most spine conditions improve with medications, injections, and physiotherapy. Surgery is needed only in selected cases.
What are spine injections, and are they safe?
Spine injections are image-guided procedures that reduce pain and inflammation. They are safe and commonly used for long-lasting relief.
When should I see a spine pain specialist?
If pain lasts more than a few weeks, radiates to the arms or legs, or affects daily activities, you should consult a specialist.
Can pain continue even after spine surgery?
Yes. Some patients may have ongoing pain after surgery, but specialised treatments can effectively manage it.