The Spinal Clinic

The spinal clinic was set up in 1996 and was known at the time as ‘The Back Pain Clinic’ a few years later ‘The Neck Pain Clinic’ was developed alongside the Back Pain Clinic and these two clinics were amalgamated to the combined ‘Spinal Clinic’ in 2004 although the name ‘The Back Pain Clinic’ has always continued to exists and is interchangeable with the Spinal Clinic.

Who Will I see?

The Spinal clinic is led by Orthopaedic Physiotherapy Practitioners (OPP) who are highly skilled Physiotherapists and are specialised in the assessment and treatment of spinal conditions. Often patients or referrers express concern about seeing a Physiotherapist as often our patients already had Physiotherapy treatment without success. This clinic appointment is not about Physiotherapy treatment although if after assessment it would seem that Physiotherapy is the best treatment, the OPP can refer to the nearest Physiotherapy Department.

Click here to meet the Musculoskeletal Medicine Team

What can I expect when I attend my appointment?

We have an automated booking in system which will give you a call number. Once you have booked in you can take a seat and you will be called through to the clinic rooms. There is always a receptionist to help you should you require assistance. If you had previous investigations such as X-ray’s or MRI scans and your GP has made us aware of this, we will always endeavour to obtain both the report and the images prior to your appointment to help with clinical decision making.

The OPP will ask a number of questions and will perform a clinical assessment. If you require undressing we have hospital gowns to change into. Following the assessment the OPP will give you a diagnosis and explanation about your condition and will discuss the various treatment options, if investigations are required the OPP will arrange this. Follow-up appointments will be arranged following investigations, however in some instances telephone follow up can be arranged if preferred.  If we need to do an X-ray we can usually arrange this on the day however waiting times for this can vary and some patients choose to book an X-ray for a different day. Blood test can also be done on the same day however MRI scans do have a waiting time of about 4-6 weeks. We do have urgent slots available to take place within one week. If you are referred to our day ward for an injection our nurses will do a brief assessment and will complete the relevant paperwork before you are listed for the procedure. The day ward (ADCU unit) will send you an appointment and you will be reviewed by your OPP 6/52 after your injection.

What investigations can I be referred for?

Orthopaedic Physiotherapy Practitioners can refer for a range of investigations such as MRI scans, X-rays, Nerve Conductions Studies, Ultra Sound Scans and Blood tests and will arrange this as required depending on your symptoms and clinical assessment.

What treatments can I be referred for?

There are usually a number of treatment options available and the OPP will discuss this with you and will explain in detail what the risks and benefits are of different treatment options. The non-surgical treatment options are; referral for spinal injections such as epidural injections, nerve root block injections and facet joint injections and vertebroplasty.Some OPP’s are trained in injection treatment and this might be offered if appropriate at your clinic appointment, however any injections into the spine will take place on our day ward.   Other treatments could be referral to Physiotherapy which could either take place locally or in this Hospital if preferred. We have our specialised Functional Restoration Program and the Back Class. We have generous time slots in our clinic and advice, education and reassurance also plays an important part of treatment offered in clinic.

I have been told I need surgery; do I still need to be assessed in the Spinal clinic?

Yes! The OPP’s have worked with our Spinal Surgeons for many years and will be able to give you more detailed information about the role of surgery, what surgery might entail and which of your symptoms might improve following surgery. The OPP will also be able to explain to you what sort of risks and benefits there are with surgery and you can decide if you want to consider surgical treatment. We will do a ‘work up ‘for surgery which means that the Surgeon will get a detailed report about your condition, your clinical presentation, your general medical health and any relevant up-to-date investigations. Click here for more patient information.

Can I be referred to other departments?

Yes, we have well established referral pathways to our Orthopaedic Surgeons, if for example if on assessment it appears that you have a hip problem rather than a back problem we will arrange a hip X-ray and if required we can refer directly to a Hip Surgeon. We can also refer outside our Trust to Neurologists, Pain Clinics or Vascular Surgeons. We are fortunate that we also have a Rheumatology Consultant and a Metabolic Bone Specialist Professor Bowman and Dr Gittoes respectively,  who have clinics at the Royal Orthopaedic Hospital and are based at the QEH. Therefore in our clinic you will have a comprehensive assessment with access to a variety of treatment options or onward referrals.

Which conditions do we see?

The list below is an indication of the type of conditions that we will accept in our clinic however is not exhaustive.

  • LBP and /or leg pain of probable spinal origin and non-progressive weakness.
  • Neck pain with or without arm pain of probable spinal origin and non-progressive weakness
  • No less than 4/5 power on myotomal testing and not clinically deteriorating
  • Clinical picture of spinal stenosis/neurogenic claudication with radiological evidence indicating non-critical spinal stenosis (if available)
  • History of spinal surgery > 12/12 at discretion of consultant spinal surgeon
  • Thoracic pain in the absence of other red flags
  • H/o any cancer believed to be in remission
  • Osteoporosis/ osteoporotic collapse

We also see patients with acute sciatica (severe nerve pain down the leg) and we have dedicated acute appointment slots available for this condition and the GP can book directly into these slots via Choose and Book. Please click here for more detail about this service.

How do you measure your service?

We aim to see acute or urgent patient within 2/52 and routine appointments within 4-6/52 and we audit our service against these standards on a regular basis. We also do an annual patient satisfaction questionnaire and GP satisfaction questionnaire to get feedback of what we do well and what we can improve on.

Contact the spinal clinic

Please call Secretary, Anita Dhorajia on 0121 685 4296