Back and Neck Pain
Understanding Back and Neck Pain
Back and neck pain are among the most common reasons patients seek neurosurgical advice. While most episodes of spinal pain resolve with time and conservative treatment, persistent or severe pain — especially when accompanied by nerve-related symptoms — may indicate an underlying structural problem that requires specialist assessment.
Common causes of chronic back and neck pain include herniated discs, degenerative disc disease, spinal stenosis, facet joint arthropathy, nerve root compression (radiculopathy), and spinal instability. In some cases, patients present after failed previous treatments or surgery, requiring expert re-evaluation.
Symptoms that Warrant a Specialist Consultation
- Pain that persists for more than six weeks despite rest and medication
- Pain radiating into the arm (from the neck) or leg (from the lower back) — often called sciatica
- Numbness, tingling, or weakness in the arms, hands, legs, or feet
- Difficulty with fine motor tasks such as buttoning a shirt or writing
- Pain that wakes you from sleep or significantly limits your daily activities
- Loss of bladder or bowel control (seek urgent medical attention)
How Dr Radebe can Help
Dr Radebe takes a careful, step-by-step approach to back and neck pain. He begins with a thorough history and examination, reviews all available imaging, and explains the source of your pain in clear language. Treatment is always graduated — starting with the least invasive options and progressing to surgery only when conservative measures have been exhausted or when the clinical situation demands it.
Treatment Options
Conservative and Interventional
- Facet Joint Injections — targeted injections to the facet joints of the spine, delivering anti-inflammatory and local anaesthetic medication to relieve pain caused by arthritis or irritation of these small joints.
- Rhizotomy — a procedure to disrupt the specific nerves transmitting pain signals from the facet joints, providing medium- to long-term pain relief.
- Kyphoplasty — a minimally invasive treatment for vertebral compression fractures, often caused by osteoporosis, involving the injection of bone cement to stabilise and restore the shape of the collapsed vertebra.
Surgical Options
- Discectomy — surgical removal of the portion of a disc that is compressing a nerve, commonly performed for sciatica caused by a lumbar disc herniation.
- Laminectomy — removal of the lamina (part of the vertebral bone) to widen the spinal canal and relieve pressure on the spinal cord or nerves.
- Endoscopic and Laparoscopic Discectomy — a minimally invasive alternative to open discectomy, using tiny incisions and a camera for faster recovery.
- ACDF (Anterior Cervical Discectomy and Fusion) — for neck pain caused by cervical disc disease, this procedure removes the damaged disc and fuses the vertebrae through a small incision in the front of the neck.
- TLIF (Transforaminal Lumbar Interbody Fusion) — for chronic lower back pain caused by instability or disc degeneration, this fusion procedure stabilises the spine and relieves nerve compression.
- TLIF with Decompression and Discectomy — a comprehensive procedure combining fusion, nerve decompression, and disc removal for complex lower back conditions.
- Posterior Instrumentation and Fusion — stabilisation of the spine with screws and rods, used for instability, deformity correction, or after decompression surgery.
- Re-decompression, Instrumentation Removal and Posterior Instrumentation and Fusion — a revision procedure for patients who require further surgery after a previous spinal operation.
- Wound Debridement — surgical cleaning of a post-operative wound if infection occurs.
All Treatments
Meet your Neurosurgeon
FAQ
When should I see a neurosurgeon for back pain?
You should consider seeing a neurosurgeon if your back or neck pain has persisted for more than six weeks, is accompanied by radiating pain, numbness, tingling, or weakness in the limbs, or has not responded to treatment from your general practitioner or physiotherapist. Loss of bladder or bowel control requires urgent specialist assessment.
What is a sciatica?
Sciatica refers to pain that radiates along the path of the sciatic nerve — from the lower back through the buttock and down the back of the leg. It is usually caused by compression of a nerve root in the lumbar spine, often due to a herniated disc or spinal stenosis.
Will I need surgery for my back pain?
Most patients with back or neck pain do not need surgery. Dr Radebe will always explore conservative options first, including medication, physiotherapy, and targeted injections. Surgery is recommended only when conservative treatment has failed or when there are signs of significant nerve damage.
What is the difference between a facet joint injection and a rhizotomy?
A facet joint injection delivers medication directly to the painful joint for short- to medium-term relief and is also used as a diagnostic tool to confirm the pain source. A rhizotomy goes a step further by disrupting the nerve that carries pain signals from the joint, offering longer-lasting relief.
Will I be able to return to normal activities after spinal surgery?
Most patients return to their daily activities within weeks to months after surgery, depending on the procedure. Dr Radebe and his team will provide a clear rehabilitation plan, and physiotherapy is often recommended to support your recovery and help you regain strength and flexibility.
- Appointment