Conditions

Low back pain is pain felt between the lower edge of the ribs and the creases of the buttocks. Most adults experience it at some point; it often eases within a few weeks, and when it lasts longer, pinpointing its source guides treatment.

A lumbar disc herniation occurs when the soft centre of a spinal disc pushes through a tear in its tougher outer ring and presses on, or irritates, a nearby nerve root. It can cause back pain and, more typically, pain, numbness or weakness down the leg; in many people symptoms ease over time without surgery.

Spinal stenosis is a narrowing of the spinal canal, or of the openings where nerve roots leave the spine, that puts pressure on the nerves. In the lower back it typically causes leg pain and numbness that come on with walking and ease when sitting or bending forward.

Sciatica is nerve pain that travels from the lower back into the buttock and down the back of the leg. It is a symptom rather than a disease, most often showing that a disc herniation or narrowing around a nerve root is affecting the nerve.

Neck pain is felt anywhere from the base of the skull to the shoulders and is very common, usually linked to muscle strain, posture or age-related changes. Most episodes ease within a few weeks; when pain persists, identifying its source becomes important.

A cervical disc herniation occurs when the soft centre of a disc in the neck pushes out and presses on a nerve root or the spinal cord. As well as neck pain, it can cause pain, numbness and weakness spreading into the arm and fingers.

Shoulder and arm pain can come from the shoulder joint itself, the surrounding muscles and tendons, or the nerves that run from the neck into the arm. Working out whether the pain starts in the shoulder or in the neck is the first step in treatment.

Upper back and chest wall pain is felt between the shoulder blades and around the rib cage, and usually comes from muscles, joints or nerves. With new chest pain, however, urgent causes such as heart and lung problems must be ruled out first.

Headache and facial pain cover a wide range of conditions, from migraine and tension-type headache to nerve pains such as trigeminal neuralgia and occipital neuralgia. Effective treatment begins with identifying the type of pain and any underlying cause.

Abdominal and pelvic pain can arise from the organs of the abdomen and pelvis, from nerves, or from the abdominal wall. When pain persists despite assessment by the relevant specialists, pain medicine can offer additional options to improve quality of life.

Neuropathic pain is caused by damage to, or disease of, the nerves that carry sensations such as touch, temperature and pain. It typically burns, shoots or tingles, and often responds poorly to standard painkillers.

Cancer pain can come from the tumour itself, from cancer treatment or from related problems, and it can occur at any stage of the illness. Treatment is planned together with the oncology team and aims to ease pain while protecting quality of life.

Fibromyalgia is a long-term condition in which widespread pain comes with tiredness, unrefreshing sleep and difficulty concentrating, linked to changes in the way the nervous system processes pain. It does not damage the muscles or joints, and exercise, good sleep habits and pain-coping skills form the basis of treatment.

Myofascial pain syndrome is a regional muscle pain caused by tender trigger points within the muscles. It most often affects the neck, shoulder and lower back muscles, and is treated by improving posture and working habits, physiotherapy and, when needed, trigger point injections.