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Fluoroscopy-guided treatment

X-ray-guided spine procedures, planned with

precision.

Consultant-led spinal injections that use live X-ray imaging to guide treatment to the intended anatomical target, with careful assessment before the procedure and clear follow-up afterwards.

Diagnosis first. Treatment second.

01

Identify the likely pain source

02

Confirm the target with imaging

03

Guide treatment precisely

Consultant-led care

Live X-ray guidance

Sterile clinical technique

Individual treatment planning

What fluoroscopy adds

Not simply an injection. A precisely guided procedure.

Fluoroscopy is a form of real-time X-ray imaging. It allows the consultant to see the relevant bony anatomy while carefully guiding a fine needle towards a selected spinal, nerve or joint target.

Depending on the procedure, a small amount of contrast may be used to help confirm the needle position and the expected spread before treatment is delivered.

Diagnosis first. Treatment second.

Clear anatomical targeting

The intended area can be identified rather than relying on surface landmarks alone.

Controlled needle placement

The needle is advanced under live imaging with attention to surrounding structures.

A procedure with a purpose

The injection may be therapeutic, diagnostic, or both, depending on the clinical question.

We recommend a procedure only when there is an appropriate clinical indication and a sensible anatomical target.
Procedures we provide

Different procedures for different pain sources.

The correct procedure depends on your symptoms, examination and imaging. These injections are not interchangeable.

Caudal epidural injection

Medication is introduced into the epidural space through the sacrum to help selected lower back and leg pain linked to spinal nerve irritation.

  • Approached near the tailbone
  • Usually includes a local anaesthetic and corticosteroid
  • Clinical effect varies between patients

Sacroiliac joint injection

A targeted injection into the sacroiliac joint, where the lower spine connects with the pelvis. It can help test whether this joint is contributing to pain and may also provide therapeutic relief.

  • For selected lower back, buttock or pelvic-region pain
  • May be diagnostic, therapeutic, or both
  • Used as part of a wider management plan

Lumbar medial branch block

A small amount of local anaesthetic is placed near the medial branch nerves that carry pain signals from the facet joints. The response helps assess whether these joints are a source of pain.

  • Primarily a diagnostic procedure
  • Relief may be deliberately short-lived
  • A pain diary may be used to record the response

Selective nerve root injection

A targeted injection around a specific spinal nerve as it exits the spine. It may be used to investigate or treat selected nerve-related pain, such as symptoms travelling into the leg.

  • Requires a clear clinical and imaging target
  • May contain local anaesthetic and corticosteroid
  • Offered where clinically appropriate

Who may be suitable

The target must make sense before the procedure does.

An injection may be considered when your symptoms, clinical findings and relevant imaging point towards a structure that can be targeted safely and meaningfully.

It is not suitable for every type of back pain, and an abnormal scan alone is not a reason to perform a procedure.

 

Diagnosis comes first.
If an injection is unlikely to help, if more information is needed, or if rehabilitation or another specialist is the better next step, we will explain that clearly.

Leg pain with a suspected irritated spinal nerve

Lower back pain with a possible facet-joint source

Pain thought to arise from the sacroiliac joint

Pain thought to arise from the sacroiliac joint

Your patient pathway

A clear route from symptoms to a sensible plan.

Where appropriate, the key decisions are connected rather than divided between unrelated appointments.

1

Review

Identity, health changes, medicines and consent are checked.

2

Position

You are positioned carefully on the X-ray table.

3

Prepare

The skin is cleaned and local anaesthetic is used.

4

Guide

Live X-ray imaging guides the needle to the target.

5

Treat

Contrast and medication are used as appropriate.

6

Observe

You are monitored briefly and given aftercare advice.

Preparing safely

What we need to know before your procedure.

Good preparation is part of a safe procedure. Please read your appointment information carefully and tell the clinic if your health or medication has changed.

 
Important: do not stop blood thinners, antiplatelet medicines or any prescribed medication unless you have received clear, individual instructions from the clinician responsible for your care.

Medicines and allergies

Bring an up-to-date list, including anticoagulants, antiplatelets and any previous reaction to medicines or contrast.

Diabetes

Tell us if you have diabetes, particularly if corticosteroid may be used, as it can temporarily affect blood glucose.

Infection or recent illness

Contact the clinic if you have a fever, current infection, are taking antibiotics, or feel unwell before the appointment.

Pregnancy

Tell us if you are pregnant or there is any possibility that you may be pregnant because X-rays are used.

Travel and eating instructions

Follow the procedure-specific advice supplied by the clinic. Requirements can vary, particularly if sedation is planned.

Balanced information

Potential benefits, with realistic expectations.

The aim is to create a useful change in pain, function or diagnostic understanding. No injection can guarantee a particular result.

What a procedure may help with

Important limitations

Your consultant will discuss the purpose of the proposed procedure, reasonable alternatives and what would count as a useful response in your particular case.

 
Risks and consent

Careful technique reduces risk, but no procedure is risk-free.

The risks vary according to the injection, your health and your medication. Your consultant will explain the procedure-specific risks and answer questions before consent.

Serious complications are uncommon, but it is important that you know what to look out for.

Less pain

Soreness, bruising or a short-lived flare of pain.

Temporary effects

Numbness, weakness, dizziness or faintness can occur.

Steroid effects

Flushing, sleep disturbance or a temporary rise in blood glucose.

Less common risks

Bleeding, infection, allergic reaction or severe headache.

Rare but serious

Nerve injury or other neurological complication.

No benefit

The injection may not improve the symptoms.

Seek urgent medical help after a procedure if you develop
 

new or worsening weakness, new bladder or bowel difficulty, numbness around the saddle area, fever, increasing redness or swelling, or a severe persistent headache. Follow the emergency advice given by the clinic.

After the procedure

Recovery is part of the treatment plan.

You will be given advice matched to your procedure. Temporary soreness is possible, and the effect of an injection can take time to become clear.

For diagnostic blocks, recording the timing and degree of change in your usual pain can be particularly important. This information helps decide the next step.

 
 

Follow your written aftercare

Activity, driving and medication advice can differ between procedures.

Observe the response

Note changes in your familiar pain and what you can do more easily.

Continue the wider plan

Where advised, use the opportunity to progress rehabilitation.

Know when to contact us

Use the clinic or emergency contact advice supplied after treatment.

Consultant-led treatment

Assessment, imaging and intervention brought together.

Your procedure is planned in the context of your clinical problem, not treated as an isolated technical appointment.

Dr Laith Al-Obaidi

Consultant Radiologist and Interventional Pain Specialist

Dr Al-obaidi combines specialist expertise in spinal and musculoskeletal imaging with image-guided intervention. This allows scan findings, clinical assessment and precise procedural planning to be considered as one connected pathway.

Dr Khalid Alaib

Consultant in Pain Medicine and Anaesthesia

Dr Alaib assesses and manages spinal pain, nerve-related pain and other persistent pain presentations. He focuses on balanced non-surgical treatment planning and interventional procedures where these are appropriate.

Frequently asked questions

Questions, answered clearly.

These answers are general. Your consultant and appointment information will provide advice specific to your procedure.

a clear next step

Is an X-ray-guided procedure the right next step?

Start with a specialist consultation. We will review your symptoms, relevant imaging and previous treatment, then explain whether a procedure is appropriate and what it is intended to achieve.