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Spine Assessment Tool

A leading UK authority in spine care

Keeping people moving

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How far can you walk before you have to stop?

Does your back or leg pain come on when you stand and walk?
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Have you been told it’s part of ageing?
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Have you had other treatments for your back that haven’t worked?
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Are your back problems preventing you from doing the things you enjoy?
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Has your scan been poorly explained to you?
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Are you worried about the risks of surgery?
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A particular focus of my practice

When the scan doesn't explain the pain

Some of the most difficult back pain I treat comes not from the disc or the nerves, but from the vertebral end plates — a cause that is visible on a standard MRI scan, has a specific and minimally invasive treatment, and is often overlooked.
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What people say

 
  
 
 EXCELLENT Google star 1Google star 2Google star 3Google star 4Google star 5
I was seen by Mr Ghosh at Chelsfield Park hospital earlier this year after physio following an accident. My physio said that although treatment had helped, she felt I needed an MRI to make sure that there was no other damage, which I agreed to. I was subsequently referred to Mr Ghosh at Chelsfield Park hospital. I could not have chosen a better consultant – right from the beginning Mr Ghosh was friendly, gave me a very thorough report on the scan, answering all my questions and detailed how I could be treated.
Pat Gaywood
I would like to put on record my thanks to Mr Anthony Gosh and his PA Nikki Zelkin for their outstanding support both before, during and after my recent spinal procedures. Their professionalism and clarity has made the whole experience less demanding, and has enabled me to approach the recovery process in a very positive mindset due to this. Many thanks
Marcus Tobin
I was seen by Mr Ghosh at Chelsfield Park Hospital and underwent lumbar decompression surgery on 20th February. Mr Ghosh was extremely thorough in his explanation of what the surgery would entail. I asked lots of questions, and he was more than happy to explain everything in detail. The surgery went well and the pain was very minimal. I’m very glad that I chose him as my surgeon.
Anne Taylor
I went to the KIMS Hospital on 31st March. It is a very nice Hospital and everything went very well . The nurses were very kind and I was soon ready for Mr Ghosh’s Nerve Block procedure. I was soon back in my lovely room and very quickly eating a deliciouscold lunch.The nurses tested the strength in my legs every 30 minutes and at 815 pm I was told I could go home. I had a very good Consultant in Mr Ghosh and I am now waiting patiently for the nerve block to really take hold.
Eileen Booer
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Conditions and treatments

Assessment and treatment for a range of conditions including:

  • General neck pain
  • Spondylosis & Spondylolisthesis
  • Piriformis syndrome

Care is tailored to the individual, with a focus on clear diagnosis, thoughtful decision-making, and the most appropriate treatment pathway, whether surgical or non-surgical.

Treatments range from targeted injections and minimally invasive procedures to coordinated non-surgical care through a surgeon-led Clinical Direction approach.

Explore the conditions treated, treatment options available, and the approach to patient care.

Read more about conditions and treatments

Downloadable guides

Lumbar Spinal Stenosis

Cervical Radiculopathy

Cervical Myelopathy

View and download all of the guides

Primary clinics

Harley Street, London

World-class spine care in Central London providing a comprehensive, bespoke consultation service for both UK and international private patients.

Chelsfield Park Hospital

This Kent-based clinic is a popular location providing access to a range of cutting-edge diagnostic, treatment, and surgical solutions.

Sevenoaks Medical Centre

Our new Sevenoaks clinic brings specialist care closer to patients across Kent, East Sussex, and the surrounding areas.

Spire Hartswood Hospital

This modern, discrete clinic is conveniently located at the acclaimed Spire Hartswood Hospital at Brentwood, Essex.

Take the next step towards understanding your spine problem

Whether you are dealing with persistent pain, confusing scan results, or considering surgery, expert advice can help you better understand your condition and treatment options. Book a consultation for a clear assessment, thoughtful guidance, and a personalised approach to your spine care.
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Does your back or leg pain come on when you stand and walk?

If you can manage a certain distance and then have to stop — because your legs become heavy, achy, weak or numb — and sitting down or leaning forward on a trolley settles it within a few minutes, that is a specific pattern with a specific cause.

It is called neurogenic claudication, and it usually means the space around the nerves in your lower spine has narrowed. Often the symptoms are in both legs. Many people find they can cycle or push a supermarket trolley far further than they can walk upright, because leaning forward temporarily opens the space up.

The distance tends to shorten gradually, over years rather than weeks. Most people adapt without quite noticing — they park closer, they stop at the bench halfway, they decline the walk after lunch. By the time they mention it to anyone, a good deal of ground has already been lost.

Other patterns matter too

Pain travelling down one leg is more likely to be a trapped nerve from a disc. Pain in the arm or hand points to the neck. Clumsiness, dropping things, changes in handwriting or a feeling of unsteadiness on your feet can indicate pressure on the spinal cord itself, which needs prompt assessment.

Establishing which of these is responsible for your particular symptoms is the first and most important step, and it is where I concentrate most of my attention.

Read about Lumbar Spinal Stenosis
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Have you been told it's part of ageing?

It is the most common thing my patients have been told, and it is usually said kindly. It is also, very often, wrong.

Spinal narrowing does become more common with age. That is true. But “common with age” is not the same as “untreatable”, and the two get confused constantly — by patients, and sometimes by clinicians who have run out of things to offer.

Losing your walking distance is not an inevitable feature of being seventy. It is usually the result of a specific, identifiable narrowing at one or two levels of the lower spine, and in a great many people something can be done about it.

I see patients in their seventies and eighties who have spent years managing a condition that was treatable throughout. What they lost in that time — the walking, the travelling, the confidence, the independence — they did not need to lose.

If you have been told this is just age, it is worth having that view tested properly before you accept it. I have written in detail about what this condition is, what can be done about it, and how the decision is made.

Read about Lumbar Spinal Stenosis
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Have you had other treatments for your back that haven't worked?

Failed treatment is demoralising, particularly when you have given it time, money and hope.

In my experience it almost always comes down to one of two things: either the wrong structure is being targeted, or the right structure is being targeted in the wrong way.

This happens often with spinal narrowing. The symptoms are felt in the legs and the pain is often in the back, so treatment gets aimed at the back — manual therapy, core strengthening, facet joint injections. If the problem is compression of the nerves within the canal, none of those addresses it. The therapist may be excellent and you may have followed the programme faithfully, and it will still not resolve.

It is also worth knowing that most people over fifty have several abnormalities on a spinal MRI, the majority of which cause no symptoms at all. So identifying a finding on a scan is not the same as identifying the cause. The task is to work out which finding, if any, explains what you are actually experiencing — and that takes a careful correlation of your history, your examination and your imaging rather than a reading of the report alone.

I would rather start from the beginning than continue from where the last clinician left off.

And where treatment continues, it matters that whoever is delivering it knows precisely what they are treating. Depending on the case, I can record a video explaining your imaging for your therapist, or speak to them directly and agree the target with them before they begin.

Personalised clinical direction
Read about lumbar spinal stenosis
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Are your back problems preventing you from doing the things you enjoy?

Most people do not arrive telling me about pain. They tell me what they have stopped doing.

The golf that became nine holes and then none. The holiday that was cancelled because of the airport. The garden that became too much. The walk with the dog that someone else now does. The growing calculation before any outing about how far it is from the car, and whether there will be somewhere to sit.

These adjustments happen so gradually that they become normal, and it is often a spouse or a son or daughter who notices how much has quietly gone.

I take a goal-led approach to this. Before anything else, I want to know what you want to be able to do again — specifically, not in general terms. Those become the objectives, and the plan is built to reach them by the least invasive route that gives a durable result.

The aim is not simply to reduce your pain. It is to get you back the things you have given up.

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Has your scan been poorly explained to you?

You may have been told your imaging shows wear and tear, or changes consistent with your age, or that there is nothing there that clearly accounts for your symptoms. You may have been handed a report full of terms nobody translated.

A patient who does not understand their diagnosis cannot make a confident decision about their own care. I regard that as one of the significant failures in how spinal problems are managed.

When I review your case I go through your imaging with you personally and in plain language — what each finding means, whether it is clinically significant, and how it relates to the symptoms you actually have.

For patients who would like it, I can record a video walkthrough of your own scan. You can keep it, watch it again when the consultation has faded, share it with your family, and send it to your physiotherapist so that they can see exactly what I am seeing.

Where the picture is complex, I will discuss your case with colleagues — physiotherapists, pain specialists, rheumatologists or other surgeons as appropriate — so that what you are told reflects more than a single point of view.

You should leave knowing what is wrong, why it is causing your symptoms, and what your options are.

See how I explain your scan
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Are you worried about the risks of surgery?

These are the right questions to ask, and they deserve a straight answer rather than reassurance.

Age on its own is not what determines whether surgery is sensible. What matters is your general health, your other medical conditions, how much function you have lost, and what the specific operation involves. I have operated on patients in their eighties who have done very well, and I have advised against surgery in patients twenty years younger.

It is also worth knowing that the operation for spinal narrowing is often smaller than people expect. A decompression relieves the pressure on the nerves without fusing anything, without metalwork, and in most cases without destabilising the spine. It is usually a short procedure with a considerably quicker recovery than the major surgery people tend to imagine when they hear the words “spinal operation”.

I will not recommend an operation unless the diagnosis is unambiguous, the target is clearly identified, and I believe the benefit to you outweighs the risk. I will not recommend anything I would not recommend to a member of my own family.

And if I think surgery is the wrong answer in your case, I will tell you so, and tell you what I think the right course is instead.

I have set out the risks, the recovery and how the decision is actually made in detail — including what happens if you choose to do nothing.

Download the full guide
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