Living with persistent back pain?
Back pain is one of the most common reasons people seek medical advice. Some people continue to experience pain that affects work, exercise, sleep and everyday activities.
As a Consultant in Pain Medicine, I assess patients with persistent back pain to identify the underlying cause and develop a personalised treatment plan. Depending on the diagnosis, treatment may include education, rehabilitation, medication, image-guided injections or radiofrequency ablation.
Common Causes
Facet Joint Pain
Often causes pain across the lower back, particularly when standing, twisting or extending the spine.
Sciatica
Pain travelling into the buttock or leg caused by irritation of a spinal nerve.
Disc-Related Pain
Pain arising from degeneration or injury to the intervertebral discs.
Sacroiliac Joint Pain
Pain around the buttock or lower back, often aggravated by standing, walking or climbing stairs.
Persistent Spinal Pain
Back pain that continues despite previous treatment or surgery.
When Should You See a Specialist?
A specialist assessment may be helpful if:
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Pain has lasted longer than 3 months
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Physiotherapy has not improved symptoms
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Pain keeps returning
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Medication provides only short term relief
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You have persistent leg pain or nerve symptoms
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You have previously had spinal surgery
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You want to explore alternatives before considering surgery
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You wish to understand whether injections or radiofrequency treatment may be appropriate
Treatment Options
Education and Self-Management
Understanding the cause of pain is often the first step towards recovery. Advice on pacing, activity and lifestyle can form an important part of treatment.
Physiotherapy and Rehabilitation
Improving strength, flexibility and confidence in movement can reduce pain and improve function.
Medication
Medication may help manage symptoms but is usually most effective when combined with rehabilitation and other treatments.
Image-Guided Injections
For selected patients, injections may help reduce pain or provide valuable diagnostic information.
Radiofrequency Ablation
For carefully selected patients with confirmed facet joint pain, radiofrequency ablation may provide longer-lasting pain relief than repeated injections.
Multidisciplinary Pain Management
Where pain persists despite treatment, a broader approach that combines physical, psychological and medical strategies may help improve quality of life and function
Frequently Asked Questions
Is all back pain caused by disc problems?
No.
Many cases arise from the facet joints, muscles, ligaments or sacroiliac joints, and some people have more than one contributing factor.
What is facet joint pain?
Facet joints are the small joints at the back of the spine that help guide movement. They can become painful due to arthritis, injury or age-related changes and are a common cause of persistent low back pain.
Do I need an MRI scan?
Not always.
Many patients can be assessed without further imaging. An MRI may be recommended if the findings are likely to influence treatment decisions or if there are symptoms suggesting nerve involvement.
Can injections cure back pain?
Injections are not a cure, but they can reduce pain, improve function and, in some cases, help identify the source of pain.
What is radiofrequency ablation?
Radiofrequency ablation uses controlled heat to interrupt pain signals from small nerves supplying the facet joints. It may provide longer-lasting relief for carefully selected patients with confirmed facet-mediated pain.
Can I avoid surgery?
Many people with persistent back pain do not require spinal surgery. A comprehensive assessment can help determine the most appropriate treatment options and whether surgery is likely to be beneficial.
