For appointments or confidential discussion call
London Clinic 07776 511824
Norwich Clinic 01603 505063

The London Norwich Spine Clinic is based at
Hospital of St Johns & St Elizabeth, St Johns Wood, London
and the Spire Norwich Hospital, Norwich.

Information for GPs

Your spine is one of the most important and complex parts of your body - keeping it healthy is vital if you want to lead an active and pain free life.

Treatment types

Mr. Rai specializes in the evaluation of spinal problems with an emphasis on non invasive procedures and suitable management of your condition, referring to surgery only when other options have been explored.

The vast majority of spinal conditions can be treated without an operation and surgery is only required in 5-10% of patients who are seen routinely.

Often all that is required is assurance that there is no sinister cause of pain, a diagnosis based on detailed imaging and a better understanding of your condition to help you manage your own symptoms with conservative treatment.

Conservative treatment


Physiotherapy is a professional and reliable treatment option that is science based and well researched. The main focus is to restore normal function to your body, easing the pain while also promoting healing and well being.

Physiotherapy can involve hands-on therapy, exercises (including Pilates), acupuncture and advice. Hands-on therapy includes muscle spasm release, manipulation and other localized stretching techniques (mobilization) that help to restore normal movement in the area.

Our physiotherapists work in coordination with other treatment methods to provide a synchronized approach to resolving your back pain. They also offer advice on prevention and how to take care of your back and neck to try and stop deterioration over time.


The benefits of injections are very safe and have a very low complication rate.

The procedure takes about 5 - 10 minutes and is mostly done as a day case with the patient awake in the operating theatre. Anaesthetists usually give some short acting painkillers through a vein in the hand, to make the procedure virtually pain free.

Injections can help reduce inflammation and pain from compressed nerves, caused by a disc herniation (prolapse). About 70% of patients get relief from the pain but the length of relief is variable.

Injection are often used in conjunction with physiotherapy - reducing the pain gives a window of opportunity for a physiotherapist can then rehabilitate the patient.


An operation is usually the last resort for the treatment of your symptoms, aside from emergency situations.

If your back pain is due to a deformity, if other non-surgical treatments have failed, the pain persists, or there are neurological changes, then surgery may be needed.

Often the main aims of surgery are to take pressure of the nerves and occasional realign the position of the spine into a more normal position.

Common surgical procedures

Spinal fusion

This involves putting titanium screws into the spine with rods to prevent movement of that segment. The metal screws can be used to realign the spine into a normal physiological shape to normalise fuction.


This is usually done through a small incision and involves trimming the disc and making more space for the nerves

Disc replacement

Mr Rai performs cervical disc replacement so that normal motion is maintained in the neck. It is done through a minimal invasive way allowing early rehabitation and hospital discharge.

(cervical and lumbar)

This involves removing bone and abnormal ligaments thereby creating more room for the delicate spinal nerves.

Insertion of interspinous spacers

This is a minimally invasive technique which relieves the pressure from the nerves without having to remove bone or ligaments. It is useful in some selected patients.

Deformity correction

This is becoming more common with a increasing elderely population. It is usually done for scoliosis, kyphosis, tumour and trauma reconstructions. It involves the insertion of several metal screws and rods to build a scaffold to realign the spine.