P.O. Box 6114 Coventry CV3 9GR
024 7661 2681
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Warwickshire Clinics P.O. Box 6114 Coventry CV3 9GR
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Conditions We Treat

CONDITIONS WE TREAT

Back pain
Occurs in the vast majority of people at some point in their life and in the over whelming majority of cases has no long term consequences.
Neck pain
Almost as common as back pain, occurring in the vast majority of people at some point in their life and in the over whelming majority of cases has no long term consequences.
Urgent spinal conditions
Certain spinal conditions require urgent treatment, if necessary via the Accident and Emergency department. The type of symptoms that could indicate that you need urgent consultation include:
  • Unrelenting severe pain which will not settle with rest including night pain
  • Altered bowel and bladder function
  • Loss of bowel and bladder control
  • Pain and numbness down both legs
  • Numbness between the legs
  • Back pain for the first time when under the age of 16 or over the age of 70
  • Difficulty walking
  • Loss of sexual function
  • Back or neck pain associated with history of cancer, weight loss or loss of appetite.

Spinal conditions of any kind can be difficult to diagnose, if in doubt consult your G.P.
Leg pain coming from the back
Medically termed as sciatica and most commonly due to a nerve being trapped by a narrowing of the spinal canal.
Sciatica (leg pain coming from the back)
Caused by a nerve being trapped in the back (lumbar spine), most commonly due to a narrowing of the spinal canal.
Radiculitis (limb pain coming from the spine)
Irritation of a nerve root as it leaves the spine resulting in pain to where the nerve goes, most commonly the legs or arms.
Arm pain coming from the neck
Same mechanism as sciatica, the nerve being trapped as it leaves the neck (cervical spine)
Brachalgia
Same mechanism as sciatica, the nerve being trapped as it leaves the neck (cervical spine)
Tumours of the Spine
Always has to be considered in unusual (atypical) back and neck pain. See urgent spinal conditions.
Infections of the Spine
Always has to be considered in unusual (atypical) back and neck pain. See urgent spinal conditions.
Fractures (breaks) of the Spine
Always has to be considered in unusual (atypical) back and neck pain. See urgent spinal conditions.
Osteoporosis of the Spine
Thin bones. Does not actually cause pain but leads to an increased chance of a break to the spine
Slipped (prolapsed, herniated, bulging) Disc
The disc of gristle that is found between each block of bone (vertebra) that makes up your spine. Sometimes the disc can be large enough to trap a spinal nerve, leading to pain in the area the nerve is going to (leg or arm).
Degenerative Disc Disease
Wear and tear of the spine that causes the vast majority of back and neck pain
Discitis
Irritation (inflammation) of the disc (the disc of gristle that is found between each block of bone that makes up your spine). It can be due to infection.
Spondylolisthesis
Slip of the spine. One block of bone that makes up your spine (vertebra) can lose its normal orientation to its neighbouring block. Most commonly due to a bony deficiency or excessive wear. Often seen in the young and old and does not necessarily require treatment.
Spondylitis
Inflammation of the spine. Usually applied to the inflammation that can be associated with wear and tear of the spine
Spondylosis
Wear and tear of the spine. Often called degeneration of the spine and commonly simply age related changes
Pars Fracture/defect (Spondylolysis)
This is a bony deficiency in the back of the spine that can sometimes lead to a spondylolisthesis. Can occur with or without injury. Can lead to pain particularly in young fit sports people.
Mechanical Back Pain
Non specific back pain usually attributable to the soft tissues (muscles and ligaments) of the spine after excluding any serious underlying cause.
Whiplash (neck sprain)
Non specific neck pain as result of injuries to the soft tissues (muscles and ligaments) around the neck and shoulders
Scoliosis (spinal curve)
Abnormal curvature of the spine that can occur in young and old people which can vary markedly in severity often with no underlying serious cause
Scheuermann's disease
Unusual development of the discs and vertebra which can sometimes result in an increase in the forward curve of the spine.
Degeneration of the Spine
Simply a term for the normal wear and tear of the structures of the spine which in some people can be a cause for pain
Spinal Stenosis
A common condition that develops in older people as a result of progressive wear and tear in the spine causing narrowing of the spinal canal
Sacro-Iliac Joint Injections

CONDITIONS WE TREAT

Hip and Knee osteoarthritis (mild, moderate, and severe)

A joint is where two or more bones meet. The joint allows the bones to move freely but within controlled limits. To facilitate this movement, the ends of the bones are coated with a layer of tough, slippery tissue called cartilage. This cartilage acts a bit like a shock absorber to spread the load more evenly across your joint.

 

When an individual develops osteoarthritis, formerly known as wear and tear or degenerative joint disease, the cartilage lining the joints becomes damaged so the joint doesn’t move as smoothly as it should.

 

Many factors can work alone or in combination contributing to the development of osteoarthritis. These include age, gender, obesity, previous joint injury, joint abnormalities, genetic factors and other types of joint disease such as rheumatoid arthritis or gout.

 

Although osteoarthritis can develop in any joint, hips and knees are among the most affected.

 

The most common symptoms of osteoarthritis are pain, stiffness, crepitus, swelling and not being able to use the joint normally. Crepitus is described as a grating or grinding sensation on moving the joint.

 

In the case of hip or knee osteoarthritis, these symptoms tend to have a significant impact on the patient’s ability to walk.

 

In the early stages measures such as activity modification, losing weight, using a cane, taking painkillers and anti-inflammatories, physiotherapy and the sensible administration of steroid joint or visco-supplementation injections can help to keep the symptoms under control.

 

When the pain fails to respond to the above measures, affects the ability to perform the normal activities of daily living and regularly interferes with night sleep the time for a joint replacement, and in some special circumstances a hip resurfacing, has come.

 

According to the National Joint Registry for England, Wales, Northern Ireland and the Isle of Man, every year over 100.000 hip replacements and an even greater number of knee replacements are being performed in these nations and dependency.

 

I am a high-volume hip and knee replacement surgeon year on year performing between 3 and 4 times the number of hip and knee replacements than the average UK based surgeon. Read More Here

Complications of hip and knee replacement, and hip resurfacing
The most common complications leading to the revision of a failing hip replacement, knee replacement, or a hip resurfacing, are the following
    • Mechanical (or aseptic) loosening. Usually caused by wear of the joint replacement components after many years of use resulting in them becoming loose and painful.
 
    • Dislocation. Usually applies to a hip replacement, and rarely to hip resurfacing. In this rather common complication, the ball repeatedly comes out of the socket with activities of daily living and very often the patient lives in fear of it happening again losing confidence in the new hip.
 
    • Infection. When a joint replacement gets infected, it usually becomes inflamed, tender, and painful. With the passage of time the components may also become loose, and if the infection is left untreated there is a risk of sepsis. A periprosthetic joint infection is a serious complication which might result in the loss of limb or life.
 
    • Peri-prosthetic Fracture. A fall or a blow can cause a fracture of the bone near the hip or knee replacement. In some cases, the prosthesis components were already loose, and the trauma required to cause the bone to fracture is minimal. If the joint replacement components were not loose before the fracture, they can become loose because of it.
 
  • Adverse reactions to metal debris in patients that carry a hip resurfacing, or a hip replacement with large metal on metal bearings, or a modular neck. These types of prostheses were broadly used until a decade ago. Many of the patients that carry these kinds of implants are found to have elevated metal ion levels in blood and serum, the significance of which is poorly understood. At local level, the metal particles released from either the bearings or the interfaces between the different components can cause an adverse reaction in the tissues that surround the prosthesis that can involve bone and/ or muscles. This latter complication can cause pain swelling, loosening of the implants, and fracture. In 2012, the MHRA (Medicine and Healthcare products Regulatory Agency) published a guideline recommending that the patients carrying these types of prostheses must be followed up at regular intervals in order to identify those likely to fail in the early stages so that they can be counselled and treated promptly.
Patients should be informed by their consultant of warning signs that there may be a problem with the replaced or resurfaced joint. Anyone with a joint replacement experiencing any of the following symptoms: pain, instability, swelling, inflammation, or a purulent discharge from either the surgical scar or a nearby area should see their doctor immediately. A revision joint replacement tends to be more complex than the initial operation and many surgeons that feel comfortable performing primary joint replacements will refer their patients to an expert in revision surgery. I am a high-volume revision surgeon that year on year performs between 3 and 4 times the number of revision hip and knee replacements than the average UK based surgeon. Read More Here