Non-surgical treatments

Mr Hess will always look to offer the most conservative treatment that’s right for you and your individual condition. 

Often, patients that see Mr Hess have tried many treatments with little permanent success. If not, Mr Hess can offer all kinds of interventional pain procedures in the cervical, thoracic and lumbar spine and many patients will benefit from these non-surgical solutions.

If you’ve been experiencing significant back pain for a long time, you’ll most likely have tried options like pain medication, physiotherapy and even perhaps injection treatment before.

For patients that might not have tried these options yet, they can be all that you need for the resolution of your pain.

If you’re experiencing back pain that’s impacting your quality of life, the first step is to book an appointment to see Mr Hess, who will begin the process of helping to diagnose and treat your condition.


Physiotherapy plays an important role in the treatment of back pain. The general rule is, the more active the patient, the better. It’s all about training your core muscles, providing stability for your spine and at the same time remaining flexible. Not only are yoga, stretching and pilates valuable activities to help you avoid chronic back pain, but active movements like these are also incredibly helpful in post-treatment rehabilitation.

Of course, in many patients, back pain is too severe to do any exercise at all, and so reduction in pain is the first step before starting with exercise. This is where osteopathy and manual therapy (massage and manipulation), as well as Laser treatment or TENS, come into play.

Or an image-guided injection (see below) is necessary to reduce the inflammatory process causing the pain and allowing the patient to start with physiotherapy.

Mr Hess co-operates closely with his experienced therapist colleagues at the London Spine Clinic, allowing his patients to benefit from a team of experts, all focused on the resolution of your pain in the most conservative way possible. 

This includes fortnightly multidisciplinary team (MDT) meetings where more complex cases are discussed.

Injection therapy

Image-guided injections serve two purposes: To establish and prove a diagnosis and of course to act as a therapy, improving the pain.

Diagnostic injections work by blocking the suspected area of pain with an anaesthetic. If your pain goes away, then Mr Hess knows that’s the area that’s causing the problem. If not, further investigations can be done to locate an exact area of cause.

The likeliest structures to cause neck and back pain are the facet joints, but also the discs or the sacroiliac joint may be involved. Pain radiating into an arm or leg is very often nerve pain due to a disc herniation or narrowing of the spinal canal.

Mr Hess is Master instructor for the US-based Spine Intervention Society (SIS) and has safely performed well over 10,000 of these injections.

If he sees a chance that an injection might help you to improve significantly and with lasting benefit, he will certainly recommend it.

Injection therapy includes:

  • Facet joint injections or medial branch blocks (the latter diagnostic only)
  • Sacroiliac joint injections
  • Injections of the third occipital nerve for chronic cervicogenic headache
  • Epidural injections and transforaminal nerve blocks
  • Radiofrequency denervation of the facet joints

Any questions?

Feel free to get in touch or visit our Frequently Asked Questions page for more information.

If non-surgical treatments don’t work

Sometimes your condition will not be resolved with non-surgical solutions. Often, patients that see Mr Hess have tried many treatments with little permanent success. You may have even had previous surgery that was only temporarily effective.

If you’re in this position, then you may be a candidate for endoscopic spinal surgery. Click below to read more about the highly effective surgical solutions offered by Insight Spine.