Back pain in Enfield

The spinal column protects the spinal cord, which communicates with your brain. The backbone or spine consists of 24 bones called vertebrae, each with an intervertebral disc to cushion them as you move, like shock absorbers. The facet joints are small connections between each vertebra.

Your orthopaedic and spinal surgeon, consultant orthopaedic surgeon or consultant physician in rheumatology in Enfield may talk to you about one of the five sections of the spine when they examine you. These sections are the cervical (upper), thoracic (middle) and lumbar (lower back), the sacrum and the coccyx (also known as the coccygeal area).

Most back pain is felt in the lower back or lumbar area labelled L1-L5. The lumbar region takes most of the weight of the spinal column.

Then there are ligaments, muscles and nerves surrounding the spine to keep it stable and mobile.

Nearly 12 million days at work are lost annually in the UK due to back pain, primarily because of sprains, strains, postural problems and other non-specific or ‘mechanical’ back pain.

The patients who come to The Cavell Hospital with back pain will have typical symptoms such as aching muscles, shooting pains, or a sharp, burning sensation that radiates along the leg (sciatica).

We offer consultations for back pain from a range of conditions, including slipped or prolapsed disc, sciatica, and spinal stenosis.

Most of the time, back pain improves and isn’t anything to worry about. The most common type of back pain, lower back pain, usually goes away after a few days or weeks.

However, several red flags are concerning. They include tingling, weakness or numbness in the legs or groin (saddle anaesthesia), inability to control the bowel or bladder, a fever, and unexplained weight loss. If these describe your symptoms, you should see a doctor immediately.

You should also see a healthcare professional as soon as you can if you have back pain following a fall or an injury.

If you’re seeing one of Circle Health Group’s pain management or orthopaedic consultants or a consultant rheumatologist in Enfield, they will distinguish between acute and chronic back pain.

Acute back pain

Acute pain means that your pain begins suddenly after lifting something incorrectly at work or twisting during sports or an activity like gardening.

The pain usually goes away after 72 hours with self-help, such as applying ice or heat to it and taking over-the-counter painkillers.

Chronic back pain

If your back pain lasts for three months and shows no signs of going away, it’s called ‘chronic’, and you should see a healthcare professional.

Although lower back pain is where most people feel back pain, it’s also possible to get it in different parts of the back, anywhere from the neck to the waist. Facet joint syndrome, for example, from ageing or an accident or trauma, is typically felt in the low back, but you can also feel it in the middle and the neck.

Lower back pain

The primary reasons for non-specific lower back pain (sometimes called lumbago) are pulled muscles, injured ligaments and joints, and issues with the intervertebral discs.

Indeed, low back pain is the most common reason for people coming to The Cavell Hospital and Circle Health Group for relief from back pain.

Middle back pain

You may wonder, ‘what is middle back pain a symptom of?’. It’s difficult to answer as back pain is usually a symptom of something else.

Mid-back or thoracic pain could be down to poor posture from sitting at a desk, overdoing a specific, repetitive motion, or an injury or accident.

It could also be due to a slipped or herniated disc putting pressure on the nerves in the spine or osteoarthritis (also called wear and tear arthritis).

If it’s a vertebra fracture, it requires immediate medical attention.

Upper back pain

The causes of upper back pain between the shoulder blades or your neck are the same as middle back pain. They include poor posture, repetitive movements, carrying a shoulder bag for too long, or an accident or injury.

Like lower and middle back pain, osteoarthritis, osteoporosis, ankylosing spondylitis and other conditions can also cause upper back pain.

Neck pain

The spinal column starts at the neck, and neck pain is widespread. Like the other parts of your spine, poor posture is often the cause of muscle ache in the neck, which can impact your mobility and quality of life.

There are many other causes, such as herniated discs caused by osteoarthritis. The Cavell Hospital provides a variety of treatments ranging from medication and physical therapy to surgery to help with neck pain.

Back pain can be due to various issues, from poor posture to lack of exercise and muscle and ligament strains and sprains from sports. There are also many typical conditions where back pain is felt.

Postural and movement problems

When the movement of the spine and the muscles around it is disrupted through sprains (torn ligaments) and strains (pulled muscles), poor posture, or sitting down too much, it can lead to back pain and discomfort.

It is essential to keep moving. Postural advice and physical therapy from a physiotherapist or an osteopath can help relieve and manage such pain if self-help methods such as heat, ice and anti-inflammatory painkillers haven’t helped.

Structural problems

Structural problems mean issues with the structures of the back, such as a trapped nerve, narrowing of the spine (spinal stenosis), a herniated or ruptured disk, or broken bones and fractured vertebrae.

Degenerative and age-related problems

If a consultant at The Cavell Hospital tells you that your back problem is degenerative, they mean it’s caused by the degeneration of the discs or spine, often due to ageing.

Typical problems include osteoarthritis and rheumatoid arthritis, ankylosing spondylosis (a form of arthritis) and disc wear and tear.

As we age, we can also lose bone strength and density from osteoporosis and are more likely to experience spinal stenosis (narrowing of the spinal column).

Lack of fitness

If you do not do enough exercise or suddenly decide to get fit after weeks of inactivity, you are more likely to suffer from back pain.

The back likes movement, particularly daily stretches and low-impact exercises such as yoga or Pilates that do not put too much impact on the joints.

Being overweight

Extra body weight can cause stress in the lower back. Losing even a few pounds or kilos can help to alleviate pressure on the joints.

Several organs can radiate pain to the lower back but are unrelated to the spine. An infection of the kidneys or bladder and kidney stones are examples of non-spine sources of referred pain.

Women may also feel low-back pain from uterine fibroids or endometriosis. Of course, pregnancy is another common cause of low-back pain in women. However, women almost always feel relief from back pain once the baby is born.

Referred pain can also be caused by other conditions that affect organs such as the lungs, stomach or gall bladder. In rare cases, a tumour can press on the spine.

Standing or sitting all day, lifting something incorrectly, twisting to pick up a toddler, or carrying a heavy backpack — activities like these are often the cause of back pain.

Here are some lifestyle changes that can help to prevent back pain:

• Exercise. The best way to prevent back pain is to get up and keep moving. Regular exercise, mainly walking, swimming, yoga and Pilates, help to keep the body supple and mobile. They support the muscles and ligaments, which can help prevent back pain.
• Avoid weight gain. Keeping an ideal body weight is another way to keep your back healthy. Weight gain stresses the joints, mainly if the weight is distributed around your tummy.
• Eat healthily. Lean meat and plenty of fresh fruit, vegetables, whole grains, nuts and seeds, plus two portions of oily fish each week, aid digestion and reduce inflammation, which can cause pain. Lower back pain can sometimes be traced to bowel problems like IBS and constipation.
• Take screen breaks. Sitting at a PC for eight hours or more usually means slouching. Get up to make a tea or coffee and stretch regularly — set the alarm so you remember to do it.
• Sleep on your side. Get a supportive mattress and sleep on your side in the foetal position, not your back or stomach.

Your consultant can give you further guidance on preventing or managing back pain depending on the underlying cause and any other factors.

You may have come to Circle Health Group from a GP without having had any diagnostic investigations for your back pain or been referred by a physiotherapist.

Your consultant at The Cavell Hospital will want to talk to you about your symptoms and medical history and examine you. They will typically send you for imaging, such as an x-ray, ultrasound, CT or MRI scan if you have not had tests already.

The hospital’s imaging department provides a wide range of diagnostic services. Many are also available at our sister hospital, The King’s Oak in Enfield, which also has bone densitometry (DEXA) scanning to check for the signs of osteoporosis.

The neurology department at The Cavell Hospital can also refer you for investigations into nerve damage and the electrical activity in the brain.

You can make an appointment to see an experienced expert in back pain at The Cavell Hospital, including physiotherapists, pain consultants, orthopaedic surgeons and spinal neurosurgeons.

Physiotherapy and pain relief are often the first treatments for spinal complaints. Then there are invasive treatments such as injections performed by a radiologist and surgery performed by an orthopaedic consultant, spinal surgeon or consultant neurosurgeon.

If your consultant examines you and thinks another expert could help, they can also refer you to specific specialists. For example, your orthopaedic surgeon might refer you to the physiotherapy team’s rehabilitation service for some chronic spinal conditions. Or physiotherapy may refer you to a consultant orthopaedic surgeon for keyhole joint surgery or ligament repair.

Physiotherapy

Most back pain is non-operative, so physiotherapy is often the first port of call for patients with lower back pain.

A physiotherapist at The Cavell Hospital will assess how you move once they have taken a detailed medical history, provide treatment, suggest exercises, and give you advice.

Pain medicine

Fibromyalgia, osteoarthritis and spinal pain are three of the most common conditions seen by our pain management experts at The Cavell. They can assess and diagnose whether your back pain is musculoskeletal (it comes from the joints or muscles) or it’s to do with nerve pain.

They can then refer you for the proper treatment or suggest you see another specialist.

Neurology

Our highly experienced consultant neurologists at Enfield deal with neurological problems with the spine, spinal cord, brain, and nervous system.

Typical neurology treatments cover compromised nerves, conditions like stenosis, and misalignment that causes pressure on a nerve. They can help determine the cause of difficulties with walking, bladder or bowel control and loss of coordination.

Rheumatology

Consultant rheumatologists investigate, diagnose and manage musculoskeletal conditions such as osteoporosis, arthritis and spinal pain.

Our consultant spinal surgeons at The Cavell Hospital are experienced in diagnosing and treating lower and back pain and sciatica with non-surgical and surgical options.

Non-surgical treatments usually mean spinal injections to relieve sciatica, facet injections, and medial branch blocks to ease ongoing acute lower back pain.

If non-surgical therapy does not work, the broad spinal surgery options include:

Cervical discectomy

In a cervical discectomy, the surgeon removes prolapsed disc tissue to relieve spinal cord or nerve root pressure.

Lumbar laminectomy

Lumbar laminectomy is designed to ease the pain of lumbar spinal stenosis and prevent worsening symptoms. The surgeon removes bone and ligament tissue that’s narrowing the canal.

Spinal fusion

is used to counter spinal instability and prevent the need for further surgery in future. Your surgeon may suggest a spinal fusion to remove and replace a disc with a bone graft.

Facet joint denervation

Injury, structural problems and age-related change can all lead to inflammation of the facet joints and pain. Facet joint denervation kills the nerves supplying the facet joints.

Lumbar spinal decompression surgery

Lumbar spinal decompression surgery is a treatment for spinal stenosis that takes the pressure off the spinal cord and nerves and relieves sciatica.

Vertebroplasty

In kyphoplasty or vertebroplasty, medical cement is injected into the vertebral body, usually stabilising fractures due to osteoporosis.

You can pay for private healthcare at our hospital in Enfield through self-pay methods or private medical insurance.

At The Cavell Hospital, we offer fixed-price packages that include a first consultation, treatment, and aftercare. We also offer accessible flexible payment options, or you can use your private health insurance to pay for care.

Find out about individual treatment prices at The Cavell Hospital.

With consultations available at our private hospital in Enfield six days a week, we can help you access the expert-led care you need without delay.

The Cavell Hospital is just outside of Enfield town centre. It is easily accessible to those living in Enfield, North London, by train, bus, or car. The hospital is located at Cavell Drive, Uplands Park Road, Enfield, London, EN2 7PR. For instructions on how to get to us, click here.

It is easy to book a private consultation at The Cavell Hospital with a back specialist of your choice. You can either book your appointment online or phone us on 020 8366 2122.