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Spine Assessment Tool

A leading UK authority in spine care

Keeping people moving

Immediate access to world-class spine care

A leading consultant spinal neurosurgeon working with:
  • Physiotherapists
  • Osteopaths
  • Pain Specialists
  • Rheumatologists

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.
Learn more

Reduce your pain, restore your function.

Are you troubled by ongoing back pain, neck pain, sciatica, or pain radiating down your arm?
Have you seen multiple healthcare professionals about your spine without a working solution?
Have you had physiotherapy, injections, or other treatments that simply haven’t worked?
Is your spine problem stopping you living the life you want to live?
Has your condition been poorly explained and left you with unanswered questions?
Are you worried about surgery or whether any treatment will actually work?

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.
Learn more

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 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.
Susan Surtees
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
Read more reviews and testimonials

Conditions and treatments

Assessment and treatment for a range of conditions including:

  • General back pain
  • Sciatica / leg pain
  • Slipped / herniated disc
  • Spinal fractures
  • Cervical radiculopathy
  • Spinal cord compression
  • General neck pain
  • Brachalgia / arm pain
  • Spondylosis & Spondylolisthesis
  • Spinal stenosis
  • Spinal tumours
  • 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

Cervical Radiculopathy

Cervical Myelopathy

Lumbar Spinal Stenosis

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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Back pain may arise from inflammation at the vertebral end plates, from a degenerate or torn disc, from instability such as spondylolisthesis, or from the small facet joints at the back of the spine.

Neck pain follows similar patterns, often with the added complexity of referred pain into the shoulder or between the shoulder blades.

Sciatica — pain travelling down the leg — is usually caused by pressure or irritation of a nerve root in the lower back, most often from a disc herniation or narrowing of the space the nerve travels through.

Pain radiating down the arm is the equivalent problem in the neck, where a nerve root is compressed or inflamed, sometimes accompanied by numbness, tingling, or weakness in the hand.

Are you troubled by ongoing back pain, neck pain, sciatica, or pain radiating down your arm?

These are the symptoms I treat every day — and behind each of them sits a specific, identifiable cause.

Less commonly, but importantly, symptoms in the arms or legs can reflect pressure on the spinal cord itself — a condition called myelopathy — which may present as clumsiness, altered balance, or a subtle loss of dexterity. This requires prompt and expert assessment.

There is one cause of lower back pain I want to draw particular attention to, because it is the one I find most often missed. In a significant group of patients the pain does not come from the disc, the joints or the muscles at all — it comes from the bone itself, from the vertebral end plates immediately above and below a worn disc. It is visible on a standard MRI, it has a specific treatment, and it is routinely overlooked. If you have been told your scan does not explain your pain, this is worth reading. Back pain your scan doesn’t explain →

Identifying which of these mechanisms is responsible for your particular symptoms is the single most important step in treating them successfully — and it is where I focus the greatest part of my attention.

How I approach it

My aim is always to find the least invasive solution that delivers the quickest and longest-lasting result. Surgery is one tool among several, and it is the right tool only when the diagnosis clearly points to it.

To achieve that, I work as the clinical lead of a multidisciplinary team. Depending on what your diagnosis demands, that may involve physiotherapists, pain specialists, osteopaths, or rheumatologists — each contributing their expertise, and all of them working to a plan I have designed and continue to direct. I review your imaging with your therapist personally so that we are agreed on the mechanism and the target before treatment begins. I stay involved as your treatment progresses, and I adjust the plan as your condition responds.

The result is a treatment strategy built around the specific cause of your symptoms, delivered by the right practitioners, with one surgeon accountable for the outcome throughout.

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Have you seen multiple healthcare professionals about your spine without a working solution?

If you have been passed from chiropractor to physiotherapist to specialist and back again and you are still in pain, still without a clear explanation, and still no closer to a solution. I want you to know that this is not inevitable. It is, in my experience, almost always the result of an incomplete diagnosis.

The spine is one of the most complex structures in the human body to diagnose accurately. Many of the mechanisms that cause genuine, debilitating pain are not immediately obvious on a standard scan report. Also the majority of common findings on the scan are also seen in people without pain. Pain can arise from end plate inflammation, from subtle instability, from nerve sensitisation, or from a combination of structural and non-structural factors that require careful, systematic analysis to untangle. A radiologist’s report alone, or a brief review of imaging in a busy clinic, is rarely sufficient to identify these mechanisms with the precision that effective treatment requires.

Rather than begin from where the last clinician left off, I like to start from the beginning. I personally review any imaging you have had, correlate it with your full clinical history and examination findings, and work methodically to identify the precise mechanism driving your symptoms. I will often identify something that has been overlooked, not because previous clinicians were careless, but because this level of diagnostic scrutiny takes time, experience, and a specific commitment to finding the answer rather than managing the uncertainty. One diagnosis accounts for a disproportionate share of the patients who reach me this way. Read about vertebrogenic back pain →

I will not tell you the cause of your pain is unknown until I have exhausted every reasonable avenue to find it. In the majority of cases, there is an answer. My job is to find it.
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Have you had physiotherapy, injections, or other treatments that simply haven't worked?

Failed treatment is one of the most demoralising experiences a patient can have, particularly when they have committed time, money, and hope to a course of therapy that ultimately changes nothing. In my experience, treatment almost always fails for one of two reasons: either the wrong structure or mechanism is being targeted, or the right structure is being targeted in the wrong way.

Physiotherapy or any treatment that is not directed at the precise source/mechanism of your pain will not resolve it, regardless of how skilled the physiotherapist is or how diligently you follow the programme. Injections that target the wrong level, or that are performed without a clear understanding of the pain mechanism, provide temporary relief at best. Even surgery, if performed without an unambiguous surgical target, can fail to deliver the result both patient and surgeon hoped for. This is because most people will actually have multiple abnormalities on their spine MRI even if they have no symptoms. It is our job to treat the patient not the test result. So I offer a slightly different approach.

The clearest example I see of this is vertebrogenic pain — pain arising from the vertebral end plates rather than from the disc or the facet joints. These patients have often had physiotherapy aimed at the disc, injections aimed at the facet joints, and years of treatment directed at structures that were never the problem. The pain was coming from bone the whole time. Treatment only works when it is aimed at the right mechanism, and this is the mechanism most often missed. Read about vertebrogenic back pain →

Personalised Clinical Direction

When on your care, I do not simply refer you to a physiotherapist and step back. Personalised clinical direction is a service where I personally liaise with your therapist directly, reviewing your imaging with them in a dedicated video meeting so that we are both looking at the same scan, understanding the same mechanism, and agreed on the same target. I show them exactly what I am seeing and why it matters for their treatment approach. Together we agree on the strategy before a single session begins.

I then remain actively involved throughout. I check in on your progress regularly. I communicate with your therapist as your programme evolves. If something is not working, I want to know and I will adjust the approach. If a flare-up occurs or you have a concern, you can contact me directly. Your therapist can contact me directly too. Nobody is left to figure it out alone.

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Is your spine problem stopping you living the life you want to live?

Chronic spine pain does not just cause physical discomfort. It takes things from you – your ability to travel, to perform at your best professionally, to play sport, to be fully present for your family, to do the things that give your life meaning. Over time, the adjustments become so normalised that you forget what life felt like without them.

I believe in a patient goal-orientated approach. Let’s identify what you would both like and need to be able to do again, then I work with you to find the fastest and least invasive path to your goals that also gives the longest lasting result.

Under my personalised clinical direction programme, your treatment is built around your goals, your schedule, and your life, not a generic protocol. If the exercises your therapist has prescribed are too painful to perform, I will intervene. I can again liaise with your physiotherapist or even help with minor targeted procedures to give you a window of pain alleviation that will allow the physiotherapy exercise programme to take effect.

I also make myself accountable to you. I check in. I remind you. I am present throughout your treatment.
Spine Assessment Tool
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Has your condition been poorly explained and left you with unanswered questions?

You have had scans. You may have been told the results are age-related, or within normal limits, or that what is visible may or may not be the cause of your symptoms. You have left consultations without a clear understanding of what is actually happening in your spine and without the information you need to make a confident decision about your care.

I believe this is one of the most significant failures in modern spine care. A patient who does not understand their diagnosis cannot make a genuinely informed decision. And a patient who feels confused, dismissed, or uncertain is a patient who loses confidence in the entire process.

When I review your case, I personally explain your imaging to you in plain language, what each finding means, why it is or isn’t clinically significant, and how it correlates with the symptoms you are experiencing. I have a scan review service where I produce a personal video walkthrough of your own scan, explaining every relevant finding in language that requires no medical background to understand.

This cuts both ways. Most findings on a spinal MRI appear just as often in people with no pain at all, which is why so many patients are correctly told their scan is unremarkable. But occasionally the finding that matters is present and has simply not been connected to the symptoms. End plate changes — Modic changes — are the clearest example. They frequently appear in radiology reports without anyone flagging that they may be the cause of the pain. Back pain your scan doesn’t explain →

Where the clinical picture is complex, I discuss your case in a multidisciplinary setting, with physiotherapists, pain specialists, rheumatologists, or other surgeons as appropriate, so that the explanation and the plan you receive reflects the full breadth of specialist input, not a single point of view.

I want you to leave the consultation with either a clear understanding of the cause of your symptoms or the next steps and a clear plan.
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Are you worried about surgery or whether any treatment will actually work?

Your concerns about surgery are not irrational. They are exactly the right questions to ask and they deserve direct, honest answers rather than reassurance designed to move you toward a decision.

I will never recommend surgery unless three things are true: the diagnosis is unambiguous, the surgical target is clearly identified on imaging and confirmed by clinical examination, and the expected benefit in your specific case outweighs the risk. I will not recommend an operation I would not be confident recommending to a member of my own family.

Where surgery is the right answer, I use minimally invasive microsurgical techniques, refined through neurovascular training at one of London’s foremost neurosurgical centres, that minimise tissue disruption, reduce recovery time, and lower the risk of complications. Your pre-operative preparation, your procedure, and your post-operative rehabilitation are all personally directed by me. I am not handing you to a team and stepping back. I am present and accountable throughout.

For one particular cause of chronic lower back pain, there is now a minimally invasive day-case alternative to fusion surgery. Read about vertebrogenic back pain →

Where surgery is not yet indicated, or where you wish to exhaust non-surgical options first, My Personalised Clinical Direction programme means I am directly involved in overseeing your physiotherapy or other treatment, liaising personally with your therapist, reviewing your progress, and adjusting the approach as your condition evolves. You can contact me directly if concerns arise. Your therapist can contact me directly too. Clear milestones are set, and at each review point we assess together whether the non-surgical pathway is delivering the results we expect or whether the decision about surgery needs to be revisited.

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