Disc herniation, stenosis and instability
I assess cervical and lumbar conditions including disc herniation, narrowing of the spinal canal and instability. These may be associated with neck or back pain, pain radiating into an arm or leg, altered sensation or weakness.
Cervical spine: neck, arms and neurological function
Cervical conditions may cause neck pain or pain radiating into an arm. When the spinal cord is affected, difficulties with hand dexterity or walking may also develop. The examination helps distinguish these situations and assess the priority of treatment.
Lumbar spine: back pain, sciatica and walking
In the lumbar region, I distinguish local pain from pain related to a nerve root. With stenosis, leg symptoms may limit walking distance. We review how symptoms vary with activity, how they have developed and which treatments have been tried.
Relating your symptoms to your tests
I want to understand how the problem started, how it is developing and what it limits: walking, sleeping, working or physical activity. We review your imaging in this context. If further tests are needed, I explain what information each is intended to provide.
The role of investigations
MRI helps assess discs and nerve structures. Other tests may provide information about bone, alignment, stability or nerve function when needed. The aim is to request investigations that can clarify the diagnosis or change the plan.
Choosing treatment and reviewing progress
Depending on the diagnosis, we may consider non-surgical treatment, rehabilitation, monitoring or an operation. The decision takes account of neurological function, the impact of symptoms and response to treatment. An MRI finding alone does not determine treatment.
When we consider surgery
We consider an operation when there is a surgically treatable problem and the expected benefit justifies it. Relevant factors include strength and neurological function, the severity and persistence of symptoms and response to other treatments. I explain which symptom the operation aims to improve and which difficulties may persist.
