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Lower Back Pain Treatment in Dubai

Dr Sherief Elsayed, Consultant Spinal Surgeon in Dubai

Who you'll see

Dr Sherief Elsayed

Consultant Spinal Surgeon, FRCS (Tr & Orth), UK-trained

Clinics: OrthoPro Clinic, Dubai Science Park, and UPANDRUNNING, Al Wasl Road
Most major insurance accepted. Please check with reception.

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Physiotherapist assisting patient with treatment.

Medically reviewed by Dr Sherief Elsayed, UK-trained Consultant Spinal Surgeon, FRCS (Tr & Orth). Last reviewed 15 October 2026.

This page explains lower back pain treatment in Dubai when the pain is mainly in the back, not the leg: why most episodes settle, which warning signs matter, when a scan helps, and which treatments work. Dr Sherief Elsayed treats acute and chronic back pain, including the nerve blocks and radiofrequency treatment used for facet joint pain. If pain down one leg is your main problem, see sciatica treatment in Dubai.

At a glance

How common is back pain, and does it get better?

Low back pain is the biggest single cause of disability worldwide (Hartvigsen et al., 2018). The outlook is usually good: in a pooled analysis of 11,166 people, average pain in acute back pain fell from about 52 out of 100 at the start to 23 at 6 weeks and 6 at one year (Menezes Costa et al., 2012).

Episodes often recur, and up to a third of people report at least moderate pain a year after an acute episode that needed care (NICE NG59, Context). Pain lasting 3 months or more is called chronic (NICE NG59, terms used). Severe pain at the start, psychological distress and pain in several parts of the body make persistent pain more likely (Hartvigsen et al., 2018).

Non-specific back pain and specific causes

For nearly all people with low back pain, no single cause can be pinned down (Hartvigsen et al., 2018). This is called non-specific, or mechanical, back pain. The pain is real: discs, facet joints, muscles and ligaments can all contribute, but tests rarely show which one.

NICE advises doctors to keep other diagnoses in mind and to exclude specific causes such as cancer, infection, trauma and inflammatory disease (NICE NG59, recommendation 1.1.1). These include:

Inflammatory back pain behaves differently. In people with long-standing back pain, specialists identified five typical features: it improves with exercise, does not improve with rest, is troublesome at night, comes on gradually and starts before the age of 40. Four or more suggest inflammatory back pain (Sieper et al., 2009), and blood tests, an MRI scan and a rheumatology opinion may then be advised.

Warning signs: when back pain needs urgent assessment

Doctors call these red flags. Several are unreliable on their own: in the study above, 80% of people had at least one, yet fewer than 1 in 100 had a serious cause (Henschke et al., 2009).

Call 998 (UAE ambulance) or go to the nearest emergency department straight away if back pain comes with:

  • numbness between the legs, or around the genitals or back passage;
  • new difficulty passing urine, loss of bladder or bowel control, or new loss of sexual function;
  • leg weakness that is getting worse, or nerve pain in both legs;
  • a major injury, such as a fall from a height or a road accident.

The first three can be signs of cauda equina syndrome, compression of the nerves at the bottom of the spinal canal.

See a doctor within days, not weeks, if back pain comes with:

  • fever, chills or feeling generally unwell;
  • a history of cancer, or unexplained weight loss;
  • a higher chance of fracture: being over 70, long-term steroid tablets and significant injury were the most useful signs in the study above (Henschke et al., 2009), and osteoporosis also raises the risk;
  • constant, severe pain that is no better lying down or at night;
  • the inflammatory pattern above.

Could my back pain be a spinal infection?

Spinal infection (spondylodiscitis, infection of a disc and the vertebrae beside it) is rare but needs prompt treatment. Guidelines advise suspecting it when new or worsening back pain comes with fever, raised inflammatory markers on a blood test (CRP or ESR), or a recent bloodstream infection. The risk is higher in older people, in people who inject drugs or have a weakened immune system (for example from steroids), after a recent spinal procedure or operation, and with a long-term drip line. Tuberculosis and brucellosis are considered where they are common (Berbari et al., IDSA, 2015).

Suspected infection needs prompt assessment, blood tests (including CRP, ESR and blood cultures) and an MRI scan (Berbari et al., IDSA, 2015). A needle sample taken under scan guidance may be needed to identify the germ. Many patients are treated without an operation, but some need surgery. Dr Elsayed and colleagues in Brighton, UK, developed and published the Brighton Spondylodiscitis Score, a scoring system designed to help predict which patients with spinal infection may need surgery (Appalanaidu et al., 2018). If infection is suspected, blood tests and an MRI scan are arranged urgently.

Back pain assessment: what a specialist looks for

Assessment starts with your history and an examination, including the nerves to your legs, to pick up warning signs and specific causes.

When a scan helps, and when it does not

In six trials (1,804 patients) with back pain and no warning signs, routine immediate imaging did not improve pain or function (Chou et al., 2009). Scans also show normal ageing: in people with no back pain, disc degeneration was found in 37% of 20-year-olds and 96% of 80-year-olds (Brinjikji et al., 2015).

NICE advises against routine imaging outside specialist settings, and in specialist clinics advises a scan only if the result is likely to change management (NICE NG59, recommendations 1.1.4 and 1.1.6). An MRI is worthwhile when warning signs are present, when a procedure is being considered, or when symptoms are severe or not settling as expected.

Treatment for acute and chronic lower back pain

Keep active and exercise

Rather than bed rest, NICE advises information, encouragement to continue normal activities and support to return to work (NICE NG59, recommendations 1.2.1 and 1.2.15).

Exercise is the main active treatment. NICE advises considering a group programme: biomechanical, aerobic, mind-body (such as yoga) or a mix, chosen to suit you (NICE NG59, recommendation 1.2.2). A Cochrane review of 249 trials in chronic back pain found that exercise reduced pain by about 15 points on a 100-point scale compared with no treatment, usual care or placebo, a clinically important amount; the gain in function was smaller (Hayden et al., Cochrane review, 2021). See exercises for low back pain. Dr Elsayed can recommend a physiotherapy-led programme.

Manual therapy and psychological approaches

Spinal manipulation, mobilisation or massage may be considered, but only alongside exercise (NICE NG59, recommendation 1.2.7).

If back pain is affecting your mood, sleep or work, mention it at your consultation. It is part of the picture, and it can be addressed alongside the physical treatment.

Medicines

  • Anti-inflammatory tablets (NSAIDs, such as ibuprofen or naproxen). NICE advises considering them, weighing the risks to the stomach, liver, kidneys and heart, at the lowest effective dose for the shortest time (NICE NG59, recommendations 1.2.22 to 1.2.24). In 32 trials, the short-term benefit over placebo was small (van der Gaag et al., Cochrane review, 2020). Check with a doctor first if you have had a stomach ulcer, kidney or heart disease, or take a blood thinner.
  • Paracetamol on its own. NICE advises against it (NICE NG59, recommendation 1.2.26). In a trial of 1,652 people with acute back pain, median recovery took 17 days with regular paracetamol and 16 days with placebo (Williams et al., 2014).
  • Opioids. NICE advises against them for chronic back pain; for acute pain, a weak opioid such as codeine is considered only if an NSAID is unsuitable or has not worked (NICE NG59, recommendations 1.2.25, 1.2.27 and 1.2.28).
  • Antidepressants and nerve pain medicines. NICE advises against SSRIs, SNRIs and tricyclics (such as amitriptyline), and against gabapentin, pregabalin and other antiepileptics, for low back pain (NICE NG59, recommendations 1.2.29 and 1.2.30). If you take one already, do not stop suddenly; ask your prescriber.

Injections for back pain

Injections are not the first step for back pain, and they work best when the source of the pain has been pinned down. When pain persists despite exercise and the examination points to the facet joints or the sacroiliac joints, a test injection can confirm the source. In selected patients, radiofrequency treatment can then give longer-lasting relief and make it easier to keep up with exercise. Epidurals are mainly for leg pain from an irritated nerve; see sciatica treatment in Dubai.

Facet joint pain: test block, then radiofrequency denervation

The facet joints are small paired joints at the back of the spine. Facet pain is usually a low back ache, sometimes spreading to the buttock, often worse leaning backwards or twisting. NICE advises considering radiofrequency denervation when back pain is chronic, non-surgical treatment has not worked, the pain is thought to come mainly from structures supplied by the medial branch nerves (chiefly the facet joints), and localised pain is moderate or severe (5 or more on a visual analogue pain scale, or equivalent) (NICE NG59, recommendation 1.3.2).

It should only follow a positive diagnostic medial branch block (NICE NG59, recommendation 1.3.3). In this test, local anaesthetic is placed under X-ray guidance on the small nerves that carry pain from the joints; if your usual pain eases substantially while it works, the joints are probably the source. Radiofrequency denervation then uses a controlled current through a needle to disrupt the same nerves. They can regrow, so relief is not permanent.

Results vary between patients and between trials. In a Swedish trial of 40 people selected after three positive test blocks, radiofrequency denervation improved pain and function more than a sham procedure (Nath et al., 2008), and international consensus guidelines from a multi-specialty working group conclude that it can benefit well-selected people, with the medial branch block as the test for selecting them (Cohen et al., 2020). In the larger Dutch MINT trial, which selected patients after a positive test block, adding radiofrequency denervation to an exercise programme gave no clinically important extra relief at 3 months (Juch et al., 2017). Careful selection is what matters. Dr Elsayed performs medial branch blocks and radiofrequency denervation at American Hospital Dubai; see facet joint injections and radiofrequency denervation in Dubai.

Sacroiliac joint pain: test injection, then radiofrequency treatment

The sacroiliac joints link the base of the spine to the pelvis. Pain from them is usually felt low in the back, over the dimple at the back of the pelvis and into the buttock, sometimes the thigh. An injection of local anaesthetic, often with steroid, under X-ray guidance can confirm the joint as the source and can ease the pain for a time. When test blocks give clear but short-lived relief, radiofrequency treatment of the small nerves to the joint can give longer relief. In two placebo-controlled trials, more people improved after radiofrequency treatment than after a sham procedure: 47% against 12% at 3 months (Patel et al., 2012), and 64% against none at 3 months, although the relief had faded in most people by a year (Cohen et al., 2008). Dr Elsayed performs sacroiliac joint injections and radiofrequency treatment at American Hospital Dubai.

When is surgery considered for back pain?

For back pain without a specific structural cause, spinal fusion (joining vertebrae together) has not been shown to do better than a good rehabilitation programme. In three trials in Norway and the UK (473 people with chronic back pain), fusion was no better than exercise-based rehabilitation with a cognitive behavioural approach after an average of 11 years, although only 55% were followed up (Mannion et al., 2013).

Surgery becomes relevant for specific structural problems: spondylolisthesis with instability or nerve compression, spinal deformity such as adult scoliosis, an unstable fracture, infection that is damaging the spine or not settling with antibiotics, a spinal tumour, or nerve compression causing leg-dominant symptoms, as in sciatica or spinal stenosis. Dr Elsayed’s surgical work covers complex and revision spinal surgery, deformity, minimally invasive surgery and endoscopy, at American Hospital Dubai (Oud Metha and Dubai Science Park) and Emirates Hospital Jumeirah.

What to expect: the evidence in plain terms

Your consultation with Dr Sherief Elsayed

Dr Sherief Elsayed is a UK-trained Consultant Spinal Surgeon, FRCS (Tr & Orth). For back pain, he takes a full history and examines you, looks for a specific cause, checks for warning signs and reviews any scans, arranging tests only where they would change treatment. He will usually start with exercise-based treatment. Where the facet joints or the sacroiliac joints are the likely source of persistent pain, he offers test blocks and radiofrequency treatment; if a structural problem needs surgery, he can discuss that too. Please bring your scans, reports and a list of your medicines.

He sees patients at OrthoPro Clinic, Dubai Science Park, and at UPANDRUNNING on Al Wasl Road; injections are performed at American Hospital Dubai. To book, call OrthoPro Clinic on 04 835 9000, send a WhatsApp message to 052 105 2798, or use the contact page. Fees depend on the consultation, any tests or procedure, and your insurance. Most major insurance accepted. Please check with reception.

Table of Contents

Frequently asked questions

Which doctor should I see for back pain?

A GP or physiotherapist can manage many new episodes. See a spine specialist if you have warning signs, if pain is not clearly improving after about 6 weeks or keeps returning, or if injections or surgery are being discussed.

Do I need an MRI scan for lower back pain?

Usually not at first. A scan helps when warning signs are present or the result would change treatment.

How long does lower back pain last?

Most new episodes improve considerably within about 6 weeks, but pain can linger or return.

Which painkillers help back pain?

Anti-inflammatory tablets may help a little in the short term if they are safe for you. NICE advises against paracetamol alone, opioids for chronic pain, antidepressants, gabapentin and pregabalin.

Will an injection fix my back pain?

Not on its own, and not as a first step. In selected patients, a test block can confirm whether the facet or sacroiliac joints are the source, and radiofrequency treatment can then give longer-lasting relief while you rebuild strength with exercise. Epidurals are mainly for leg pain.

Do I need surgery for chronic back pain?

Not usually. Surgery is for specific causes such as instability, deformity, fracture, infection or a tumour, not non-specific back pain.

Could my back pain be a spinal infection?

It is rare, but it is considered if back pain comes with fever, a recent spinal procedure, injecting drugs or a weakened immune system, and needs prompt blood tests and an MRI scan.