Common spinal conditions and disorders
Spinal degenerative disease is the most common cause of spinal problems in the UK. Please see below for more detail. Mark treats other spinal problems including sports injuries, trauma, tumour and infection. Anything that leads to neural compression or spinal instability may require surgical treatment.
Degenerative spinal disease
The spine is subject to significant wear and tear. Back pain and neck pain are very common and can be the result of degenerative changes that occur over your lifetime. These problems can be difficult to treat with surgery.
Good core muscle function and general muscle conditioning are essential to help support the spine and maintain normal function. The best treatments are to control pain and support patients to remain as active and conditioned as possible.
Treatment options that do not involve surgery are described as conservative. This may include medications, physiotherapy, acupuncture and injections. Appropriate referrals can be coordinated via a consultation.
An MRI scan is the gold standard investigation to make an accurate diagnosis, rule out other possible causes of back pain and neck pain, and get patients on the right treatment pathway.
Nerve roots exit the spinal cord in the neck at each level of bone (vertebra). If these nerves are compressed as a result of degenerative changes in the neck patients may suffer severe pain that radiates down the arm. This is known as brachialgia or cervical radiculopathy.
The majority of these cases resolve spontaneously over 3–6 months, and patients can be helped in the meantime with medication and sometimes injections. If symptoms persist or are very severe, surgical treatment may be necessary to decompress the nerve root.
Degenerative changes in the neck can cause spinal cord compression in some patients. This leads to a deterioration in manual dexterity, balance and walking. The medical term for this is cervical myelopathy. This is a serious condition that can lead to lifelong disability. Early surgical treatment is recommended to preserve function and quality of life.
Sciatica is leg pain as a result of irritation/compression of nerve roots as they exit the lumbar spine. This is typically caused by disc degeneration and herniation, that contacts the nerve root. This is also known as lumbar radiculopathy.
The majority of these cases resolve spontaneously over 3–6 months. Patients can be helped in the meantime with medication and sometimes injections. If symptoms persist or are very severe, surgical treatment may be indicated.
Foot drop and cauda equina syndrome
A rare complication of a lumbar disc herniation is associated with foot drop when patients have weakness in lifting the foot. This should be considered an emergency and requires urgent assessment.
Acute cauda equina syndrome is another rare complication of lumbar disc herniation. Patients develop acute onset bladder and bowel dysfunction and numbness in the saddle area. This is a spinal emergency and requires urgent assessment and treatment.
Lumbar canal stenosis
Lumbar canal stenosis occurs as a result of wear and tear in the lumbar spine. The diameter of the spinal canal is reduced by overgrowth of bone and ligament, and the nerves to the legs are compressed. Patients develop difficulty walking, with pins and needles and numbness in the legs and often walk with a stooped forward posture.
This condition does not respond well to conservative measures and tends to progress over time. Surgical treatment is indicated to relieve the compression of the nerve roots and improve symptoms.
Did you know about spinal conditions?
Lower back pain is the largest single cause of disability in the UK
80–90% of acute disc herniations resolve with non-operative treatment within 3–6 months
Degenerative cervical myelopathy is the most common cause of spinal cord dysfunction in adults worldwide