Too many British people are living with chronic back pain, having given up on an accurate diagnosis and treatment, claims Harley Street Spinal consultant Mr Bob Chatterjee. He reports that according to the British Medical Journal, more than 25 million UK adults in the UK today are suffering from chronic pain that has lasted for three months or longer.
BMJ statistics show that women and older age-groups are most at risk. With almost two fifths of the UK population living with either moderately or severely disabling chronic pain, awareness of the potential causes need to be understood, not ignored.
Half of adults have chronic back pain
Mr Chatterjee, Consultant Spinal Surgeon at Harley Street Spine, says that Spinal Stenosis is a large contribution to the millions suffering from chronic pain. “Nick-named the silent epidemic, Spinal Stenosis is frequently misdiagnosed,” explains Mr Chatterjee who is also a spinal lead at the Royal Free Hospital NHS Trusts . “We see patients progressively get worse for years before they are finally referred to a spinal specialist. The patients we see have commonly been living with the condition for four or five years before they have achieved an accurate diagnosis. It is common that they merely attribute the pain to old age and natural deterioration. In many cases the pain can travel to a different part of the body, such as the shoulder or neck, so many patients are misdiagnosed and treated in the wrong area of the body – as the cause and the root of the problem have manifested themselves in different areas.”
Mr Chatterjee, Consultant Spinal Surgeon at Harley Street Spine, says that Spinal Stenosis is a large contribution to the millions suffering from chronic pain. “Nick-named the silent epidemic, Spinal Stenosis is frequently misdiagnosed,” explains Mr Chatterjee who is also a spinal lead at the Royal Free Hospital NHS Trusts . “We see patients progressively get worse for years before they are finally referred to a spinal specialist. The patients we see have commonly been living with the condition for four or five years before they have achieved an accurate diagnosis. It is common that they merely attribute the pain to old age and natural deterioration. In many cases the pain can travel to a different part of the body, such as the shoulder or neck, so many patients are misdiagnosed and treated in the wrong area of the body – as the cause and the root of the problem have manifested themselves in different areas.
Spinal stenosis is the term used to describe the narrowing of the spinal canal that causes pressure and compression of the spinal nerves and the spinal cord. Caused by ageing, arthritis, hereditability as well as injury and trauma, spinal stenosis can happen at any age although it commonly affects those over 50.
“While symptoms can cause a huge strain on daily life – they can include deterioration in walking, aching calves and hunching forward – awareness of the condition remains low outside of the spinal community,” Mr Chatterjee continues. “Because of this patients just aren’t getting the fast diagnosis and treatment needed to move forward from it. By the time these sufferers see a specialist their condition has deteriorated and it is a more complicated picture, yet treatment for this is extremely effective, giving back the sufferer the same level of fitness and mobility before the onset of this condition”.
Unfortunately most conservative treatments (manipulation, physiotherapy, medication or injections) are unlikely to be of much benefit and the symptoms rarely improve without surgery to take the pressure off the nerves (decompression).
When nerves are compressed they can produce symptoms of pain, numbness and tingling in the legs. In rare cases they can produce severe pain and even weakness. Most cases will produce pain in the legs when walking but the pain will be relieved by sitting. Symptoms may not progress for years and then difficulties with co-ordination may suddenly increase. Most patients first visit their doctor with symptoms of spinal stenosis at about the age of 60.
Treatment for spinal stenosis has been around for the last five years and can involve key-hole surgery if the condition isn’t severe. Surgery, generally involves removal of the enlarged bone and ‘thickened’ ligament from the back of the spinal canal giving the spinal nerves more room.
First, the skin incision is made in the midline of the back and the muscles are lifted off the bony arch (lamina). A high-speed burr (like a dentist’s drill) is used to gain entry through the bone into the spinal canal. Then a small amount of lamina bone and ligament is clipped away. The facet joints, which are directly over the nerve roots, may be undercut (trimmed), to relieve the pressure on the nerves. After surgery the majority of patients can expect to regain significant improvement in their ability to perform normal daily activities.
“As with any health condition, the sooner and the more accurate the diagnosis, the easier it is to treat and the better the outcomes are for patients. There are huge advantages of keyhole surgery compared with open surgery, with much faster recovery time for the patient, meaning they can be out of hospital and back to their lives sooner – which is what we all want,” Mr Bob Chatterjee concludes.
Harley Street Spine is led by Mr Bob Chatterjee alongside a medical team specialising in all forms of spinal surgery from skull to pelvis and minimally invasive ‘keyhole surgery’ and spinal treatment in the elderly. Mr Bob Chatterjee has undertaken a Royal College of Surgeons accredited spinal training programme in both Orthopaedics and Neurosurgery. He is also the spinal lead at The Royal Free Hospitals NHS Trust.
