Back Pain
Most back pain is mechanical — from muscle, joint, disc and ligament — and resolves over weeks with structured rehabilitation. A minority is driven by a specific pain generator (lumbar facet joints, sacroiliac joint, discogenic, radicular) that responds to targeted treatment. Red-flag presentations (cauda equina, infection, fracture, malignancy) are screened for at every visit and referred urgently where needed.
What it is
Most back pain is mechanical — from muscle, joint, disc and ligament — and resolves over weeks with structured rehabilitation. A minority is driven by a specific pain generator (lumbar facet joints, sacroiliac joint, discogenic, radicular) that responds to targeted treatment. Red-flag presentations (cauda equina, infection, fracture, malignancy) are screened for at every visit and referred urgently where needed.
Symptoms and signs
- Mid-line lower back pain worse with sitting, standing or lifting.
- Pain radiating to one or both legs (sciatica) with or without numbness.
- Pain worse with extension and rotation (facet-mediated).
- Buttock pain worse with sitting and stair-climbing (sacroiliac joint).
- Red flags — saddle anaesthesia, new bladder / bowel disturbance, progressive leg weakness, unexplained weight loss, fever — call us urgently or attend A&E.
How we investigate
Structured pain history, neurological examination and red-flag screen. Same-week MRI lumbar spine through partner imaging centres where indicated. Targeted X-ray for suspected mechanical instability. Blood tests where inflammatory or malignant cause is in the differential.
Treatment options at The Vesey
- Structured physiotherapy referral — first-line for almost every patient, coordinated with our partner physio teams.
- Image-guided facet joint, medial branch and sacroiliac injections — diagnostic and therapeutic, performed by Dr Arul James.
- Epidural and transforaminal nerve root injections — for nerve-root-driven radicular pain.
- Radiofrequency denervation — durable analgesia after positive diagnostic block.
- Medication optimisation — including supported deprescribing of long-term opioid or gabapentinoid therapy.
- Onward spinal-surgery referral — direct consultant pathway for cauda equina, progressive neurology or failed conservative management.
When to see a specialist
- Back pain persisting beyond 6 weeks without improvement
- Pain radiating into one or both legs (sciatica)
- Pain not explained by a previous scan or consultation
- Inability to work, sleep or exercise due to back pain
- Bladder or bowel symptoms alongside back pain — attend A&E urgently
See a pain medicine specialist within 7 days. No GP referral required. Learn more →
Frequently asked questions
Do I need a GP referral for back pain at The Vesey? +
No. You can self-refer to The Vesey for pain medicine consultations. We will write to your GP with your consent.
How much does the initial consultation cost? +
Initial pain medicine consultation £260. MRI lumbar spine via partner from £390. Image-guided injections from £680. Self-pay and insurance accepted (BUPA, Vitality, AXA, WPA, Cigna, Aviva, Healix).
How quickly can I be seen? +
Same-week appointments typical, including Sundays. Urgent presentations are prioritised for next-available consultant review.
Will my health insurance cover this? +
BUPA, Vitality, AXA, WPA, Cigna, Aviva and Healix policies typically cover consultant pain medicine consultations and indicated investigations. We pre-authorise at booking.
When is back pain serious? +
Red flags: pain with bladder/bowel problems, pain after trauma, night pain that wakes you, unexplained weight loss — see a doctor urgently.
What is sciatica? +
Pain radiating from the lower back down the leg, caused by compression of the sciatic nerve (usually L4–S1 disc). Confirmed by straight-leg raise test; MRI if persistent.
How much does private back pain assessment cost? +
£260 with Dr Arul James (Consultant in Pain Medicine). Includes examination and injection plan if appropriate.
What treatments are available for chronic back pain? +
Facet joint injections, nerve blocks, radiofrequency ablation, TENS, structured exercise, pain psychology.
Book an appointment
When to see a specialist
Book if your back pain has persisted beyond 6 weeks, is interfering with work or sleep, has not been clearly explained, or you have radicular leg symptoms that haven't been investigated.
Cost and pathway
Initial pain medicine consultation £260. MRI lumbar spine via partner from £390. Image-guided injections from £680. Self-pay and insurance accepted (BUPA, Vitality, AXA, WPA, Cigna, Aviva, Healix).
- Open 7 days including Sundays — 8am to 8pm, no weekend surcharge
- No GP referral required — book directly with our pain medicine team
- Sutton Coldfield location — serving Birmingham, Walsall, Tamworth, Lichfield and the West Midlands
- CQC-regulated — rated 4.87/5 on Doctify from 350+ verified reviews
View our pain medicine services →
Sutton Coldfield · Birmingham · Walsall · Tamworth · Lichfield · West Midlands · Open 7 days 8am–8pm
Open 7 days · 8am–8pm · 0121 387 3727