Conditions

It’s important to remember that, in the vast majority of cases, neck pain is unlikely to be caused by anything serious. Most often, it’s just a strained muscle or the result of bad posture. However, if your neck pain doesn’t respond to painkillers and rest, then Mr Casey may be able to help you get to the root of the problem.

As well as the causes mentioned above (muscle strain, bad posture), it could be the result of your neck locking in a twisted position. This is known as acute torticollis and can be caused by injury or persistent bad posture.

In some cases, the cause is wear and tear to your neck bones and joints (known as cervical spondylosis) or sudden injuries such as whiplash.  

At your consultation, Mr Casey will discuss your symptoms with you. If necessary, he may refer you for further tests to establish exactly the underlying cause.

These can include:

• Imaging tests (X-ray, CT scan or MRI scan)
• A physical examination (to test strength and reflexes)
• Blood tests to check for inflammation or infection
• Electromyography (EMG) (to assess nerve function through the spinal cord)

Depending on the cause of the pain, your options could include anything from physiotherapy to a course of painkillers or steroid injections to help with the pain.

If the cause is to do with spinal cord or nerve compression, then surgery could be the best option. Mr Casey specialises in these procedures, and will involve you at every stage of the decision-making process to ensure you’re completely happy with your treatment pathway.

While most cases of lower back pain resolve themselves without active treatment, the recurrence rate is high, and the effects can be debilitating.

Typically, patients will experience pain between the lower ribcage and the top of the buttocks. Stiffness in the back is also common, along with pain, numbness or weakness in one or both legs.

A very common symptom that affects people from all age groups, it can be difficult to find a specific cause of lower back pain. However, for some, there will be an identifiable cause that can be treated successfully. So, if your back pain is persistent and stopping you from living your life in the way you want to, get in contact and find out how Mr Casey can help you regain your mobility and live pain-free.

As mentioned above, lower back pain is a symptom, and the cause can be difficult to ascertain.

While most cases will be down to bad posture or muscle strain, causes can be more serious, including infection, cancer, inflammation and fractures.

This means that, while most cases will require simple, non-invasive treatments, others require early identification and highly specialised treatment.

If you’re worried about persistent or debilitating back pain, a consultation with Mr Casey can help you to get peace of mind or a fast-track to the care you need. Get in touch to find out more.

Your treatment options are wide-ranging and dependent on the underlying cause of the pain. In most cases, physiotherapy, painkillers or perhaps steroid injections to help with the pain will be all you need.

If you do require surgery, your treatment options will include a number of options including a lumbar disc microdiscectomy or a lumbar spine fusion.

You’ll find more information on some of the procedures Mr Casey offers in the treatments section. Feel free to get in touch if you have any other questions or to book a consultation. We’ll be happy to help in whatever way we can.

Sciatica is a very common condition in which the sciatic nerve, which runs from the lower back and down the legs, becomes pinched, irritated or compressed.

Although painful, most people will find that the condition will clear up over time. For others, however, it can become a chronic and disabling condition that requires surgical treatment.

The main symptom is pain. Sufferers typically experience mild to severe pain anywhere from the lower back and hips through to the buttocks or legs. In some cases, pain can present in the feet and toes.

Other symptoms include tingling/pins and needles (paresthesia), and numbness, while some people may experience more serious symptoms, such as muscle weakness and incontinence.

At your consultation, Mr Casey will review your medical history and ask you about your symptoms. He’ll also carry out a physical examination including flexibility and strength tests.

If necessary, you’ll also have access to a range of imaging tests, including, but not limited to:

• MRI (magnetic resonance imaging) scans
• X-ray
• CT (computerised tomography) scans

For most people, treating sciatica effectively involves pain management and increasing mobility. This can be done with nonsteroidal anti-inflammatory drugs, which should reduce the pain and reduce any inflammation, and regular, low-impact exercise such as walking or swimming.

If the pain persists, further treatment options include prescription painkillers and muscle-relaxing drugs, or corticosteroid injections into the spine.

In severe cases, surgery, such as a lumbar disc microdiscectomy, can be the best option to help with, or prevent, possible nerve damage. The procedure is used to alleviate chronic pain and numbness stemming from pinched nerves in the lower spine.

If you’d like to find out more about this condition, or any of the others listed here, please feel free to get in touch. A member of our team will be more than happy to help.

Cervical myelopathy, or stenosis, is a common condition that tends to affect older patients, in which the spinal cord in the neck is compressed. This part of the spine has eight nerve roots that branch out and control function in your shoulders, arms and hands, so patients suffering from cervical myelopathy can experience a significant neurological impact.

Most often associated with wear and tear of the spine over time, cervical myelopathy can also be caused by the gradual hardening of the ligaments around the spinal cord, rheumatoid arthritis, trauma (such as impact injury to the neck), spinal infections or tumours.

As well as experiencing symptoms in the neck at the site of the compression, you may also have symptoms elsewhere in your body.

These can include, but are not necessarily limited to:

• A reduced range of motion
• Clumsiness and poor coordination of the hands
• Neck pain (this can travel down the spine as the condition progresses)
• Numbness or tingling in your arms and hands
• Poor balance
• Problems with fine motor skills
• Stiffness in the neck and spine

It is important to remember, however, that most patients presenting with neck pain won’t have cervical myelopathy, and will be experiencing a muscular issue rather than a neurological one. Similarly, some people suffering from the condition may not experience neck pain.

If you’re suffering from chronic neck pain and medication and physio isn’t helping, feel free to get in touch to find out how Mr Casey can help you.

Because the symptoms associated with cervical myelopathy are common to other conditions, it can go undiagnosed for long periods of time.

Among the methods used to diagnose cervical myelopathy are:

• A physical examination (to test strength and reflexes)
• Electrical tests (to assess nerve function through the spinal cord)
• Imaging tests (X-ray, CT myelogram or MRI)

Typically, however, Mr Casey will arrange for you to have an MRI scan at the earliest possible date to see whether you’re suffering from cervical myelopathy.

In most cases, keyhole spine decompression surgery is the best option. Find out more about the procedure here. Nonsurgical pathways, such as physiotherapy are not recommended to treat cervical myelopathy. 

Mr Casey will talk to you at length about your options, making sure you’re involved at every stage of the decision-making process and completely happy with your treatment plan.

If you have any questions on anything you’ve read here, please feel free to get in touch. A member of our team will be more than happy to help. You can also find more information in this booklet from the British Association of Spine Surgeons.  

“Stenosis” simply means narrowing. Lumbar spinal stenosis is a condition in which the spinal canal narrows, causing pressure on the spinal cord and the nerves within it, which carry crucial information from your brain to your muscles.

Spinal stenosis is most common in the lumbar area – the lower back where the spine meets the pelvis.

The majority of patients presenting with the condition tend to be over the age of 50. This is because, most often, it’s the result of osteoarthritis, or wear and tear on your spine over time.

You may not notice any symptoms early on. However, they can develop over time and can include:

• Difficulty walking over short distances (a few hundred metres)
• Back pain
• Numbness/a loss of sensation in the feet or legs
• Sciatica
• Weakness in the legs

On very rare occasions spinal stenosis can lead to a condition called Cauda Equina Syndrome. So, should you experience any of the following symptoms, you should seek immediate medical attention:

• Loss of bladder control
• Loss of bowel control
• Loss of sexual function
• Numbness or loss of sensations around your buttocks or anus
• Severe pain in one or both legs
• Severe/increasing numbness or loss of sensations in your genitals or inner thighs

In order to diagnose lumbar spinal stenosis, Mr Casey will first ask you a series of questions about your symptoms and do a complete physical exam during your consultation. He’ll look for a range of indicators, including loss of sensation, weakness, and reflex problems.

Depending on his findings, he may then send you for one or more of the following:

• Scans (X-ray or MRI)
• Electrical tests (to assess nerve function through the spinal cord)

Treatment for lumbar spinal stenosis tends to fall into three categories.

Physical therapy including exercises that help strengthen your core, back, and leg muscles, as well as supports and walking aids if necessary.

Medicines including anti-inflammatories, or steroid injections to relieve pain and reduce swelling.

Surgery including spinal stabilisation and widening the space between vertebrae. If you’d like to find out more about how Mr Casey could help you, please get in touch. One of our team will be more than happy to help, whether that’s providing more information, or booking a consultation.

Because the condition is most often the result of wear and tear, you can’t prevent lumbar spinal stenosis. What you can do, however, is to significantly lower your risk.

Watch your posture. Make sure you sit well, especially if you have a job that requires a lot of work at a desk, and make sure your chair has good support. Similarly, you should make sure your mattress is firm and comfortable.

Watch your weight. When we carry extra weight, we’re putting extra stress on our back. This, in turn, can exacerbate the onset of lumbar spinal stenosis.

Exercise regularly. By making sure the muscles that support your lower back are strong, you’ll protect your spine. Walking, swimming, cycling are all good for your back, while weight training is good for muscle development.

If you have any questions on anything you’ve read here, please feel free to get in touch. A member of our team will be more than happy to help. You can also find more information in this booklet from the British Association of Spine Surgeons. 

While osteoarthritis is a result of wear and tear on your joints, rheumatoid arthritis (RA) is an autoimmune condition in which your joints become inflamed. It is the most common cause of inflammation in the spine, and tends to appear more often in the cranio-cervical spine.

While some people may have no symptoms at all, pain is a common symptom. This tends to be worse first thing in the morning or after extended periods of low activity.

Other symptoms of rheumatoid arthritis in the cervical spine can include:

• A crunching sensation/clicking noise when turning your head
• An ache at the base of the skull
• Balance issues/dizziness
• Headaches
• Muscle spasms in either the neck or shoulder
• Swelling or stiffness in the neck
• Weakness in the hands or legs

If you’re experiencing any of the above symptoms and are worried about the cause, get in touch and book a consultation with Mr Casey. Our team will do everything they can to help.

At your consultation, Mr Casey will ask you about your medical history and symptoms to get a clear picture of the problem. Depending on the outcome, there are a number of tests that are used to diagnose rheumatoid arthritis.

These include:

• A physical examination (to test range of motion and feeling)
• Electromyography  (EMG) (to assess nerve function through the spinal cord)
• Imaging tests (X-ray, CT scan or MRI scan)
• Blood tests to check for inflammation or infection

There are many treatment pathways you may be offered. These include physiotherapy, massage or medication, such as non-steroidal anti-inflammatory drugs, and corticosteroids (both to relieve pain and reduce swelling).

If these treatments aren’t enough to effectively treat your arthritis, then a procedure such as decompression surgery may be the best option, particularly if you’re experiencing problems with the nerves or spinal cord.

In the meantime, there are steps you can take to minimise the impact of rheumatoid arthritis on your spine, such as:

• Hot and cold compresses (to help with aching muscles and swelling)
• Regular light exercise, such as walking
• Stopping smoking
• Therapeutic supports for example, neck pillows
• Using a chair that gives proper support to the back and neck both at work and at home

If you’d like to find out more, please feel free to get in touch. A member of our team will be more than happy to help.

A synovial cyst is the result of a fluid build-up on the tendons or joints along the spine. They are benign and can go unnoticed, unless they’re pressing against a nerve or affecting joint movement.

While the cause is unknown, they are most often found in older patients (50+), in the lumbar area (lower back). They may be the result of wear and tear of the spine over time, and can be indicative of other conditions of the spine, such as arthritis or degenerative disk disease.

Your symptoms will depend on the size and location of the cyst, and can include:

• Backache
• Changes in bowel or bladder function
• Impaired movement
• Impaired reflexes
• Numbness

These are similar to those experienced by patients presenting with spinal stenosis. If you’re suffering with any of these symptoms and worried about the cause, you can get in touch here to arrange a consultation with Mr Casey.

At your consultation, Mr Casey will ask you about your medical history and symptoms. Depending on the outcome, he may suggest an X-ray or an MRI (magnetic resonance imaging) scan. These will help him to identify the size and location of the cyst which will, in turn, help to inform your treatment plan.

Among the options open to you are straightforward treatments such as rest, anti-inflammatory drugs, painkillers and steroid injections. While these are good options to relieve pain and other symptoms, the cysts can return.

If you do suffer from persistent cysts, then surgery could be the best option. Mr Casey specialises in this area, and will discuss all these options with you, informing and involving you at every stage of the decision-making process so you’re completely comfortable with your treatment plan.

For an overview of some of the treatments Mr Casey offers, click here. And booking a consultation couldn’t be easier, simply click below.

Tarlov cysts are a rare condition and occur at the base of the spine in an area called the sacrum, around spinal root nerve fibres. The cysts are abnormal sacs of spinal fluid, which are more likely to occur in women than in men.

In many cases, people with Tarlov cysts don’t have any symptoms. However, if they result in nerve root compression, you may experience:

• Sitting intolerance
• Perineum pain (pain around the private parts)
• Loss of bladder control
• Loss of bowel control
• Loss of sexual function
• Lower back pain
• Persistent genital arousal syndrome
• Sciatica
• Weakness in the legs, feet or buttocks

As with spinal cysts (above), Mr Casey will ask you about your medical history and symptoms.

In most cases, SPECT-CT and detailed neurophysiological testing will be required. These will help to identify the size and location of the cyst which will, in turn, help to inform your treatment plan.

If appropriate, your test results will be reviewed by our wider multidisciplinary team (MDT), including urologists, gynaecologists and colorectal specialists.

Your potential treatments are similar as to those offered for spinal cysts: pain relief or corticosteroid injections to help alleviate any pain, drainage of the cysts, or surgery, to remove them completely.

For an overview of treatments Mr Casey offers, click here. To book a consultation, simply click below.

Put simply, spinal tumours are tumours located on the spine. As with tumours in other parts of the body, they can be benign (non-cancerous) or malignant (cancerous). Often, cancers found in the spine have metastasised (spread) from other parts of the body. Whether benign or malignant, spinal cancers can cause symptoms that require treatment.

It's important to note that many of the symptoms associated with spinal tumours can also be the result of other, less serious conditions. If in doubt, a consultation is often the best course of action to get either peace of mind, or a fast-track to the care and treatment you need.

Those symptoms can include:

• A change in bowel or bladder habits
• Back or neck pain that doesn’t improve with rest
• Feeling nauseas, vomiting
• Loss of appetite
• Numbness, tingling or weakness in the arms or legs
• Unexpected weight loss

Again, if you’re experiencing these symptoms, it could be the result of another condition. If you’re in doubt, or worried, get in touch to book a consultation.

• MRI (magnetic resonance imaging) scan
• X-ray
• CT (computerised tomography) scan

The best treatment option for you will depend on a number of factors, including your age, health, the position and size of the tumour and whether it’s cancerous or benign.

Your case will also be reviewed by our wider multidisciplinary team (MDT). This means you’ll benefit from the expertise of oncologists, radiologists, and other surgeons as well as our spine nurse specialists.

Your treatment options may include:

• Excision surgery: Mr Casey will attempt to remove the entire tumour, or as much of it as possible.
• Radiotherapy: This can be used following surgery, or in place of, if surgery isn’t viable.
• Chemotherapy
• Steroids to help alleviate the symptoms

You’ll find more information on some of the procedures Mr Casey offers in the treatments section. Feel free to get in touch if you have any questions you can’t find an answer to here, or to book a consultation. We’ll be happy to help in whatever way we can.

Syringomyelia is a condition in which a fluid-filled cyst (syrinx) develops within the spinal cord. As the cyst enlarges over time, it can distort the spinal cord leading to a range of symptoms from pain to neurological conditions.

There are several possible causes of syringomyelia. The most common of these is known as a Chiari malformation, where brain tissue protrudes into the cervical spine.

Other causes of syringomyelia include:

• Inflammation-related damage (for example from meningitis)
• Spinal cord injury
• Spinal cord tumours

The surgical treatment of syringomyelia is one of Mr Casey’s specialist areas.

The symptoms can include:

• A loss of sensitivity to pain and temperature
• Headaches
• Muscle wasting
• Neurological problems
• Pain in the neck arms and back
• Scoliosis (curvature of the spine)
• Stiffness across the back and through the shoulders, arms and legs
• Weakness in the arms and legs

If you’re not suffering from any problematic symptoms, you may just need to have the condition monitored. However if the symptoms are having an adverse impact on your quality of life, then you may want to look at treatment.

The type of treatment open to you will depend on the underlying cause of the syringomyelia. Spinal decompression surgery is one possible route that could be used to treat syringomyelia caused by Chiari malformation.

Mr Casey will talk to you about the best treatment options for you, making sure you’re involved at every stage of the decision-making process and are completely happy with your proposed treatment pathway.