text: Julie McKenzie thought scoliosis was the cause of her bad back . Julie McKenzie was assured by her GP that her nagging back pain was down to a mild curvature of the spine. She'd gone to see him three months after suddenly developing back problems and had been referred for X-rays. These revealed that her spine was slightly curved, a condition known as scoliosis. 'My GP said that as far as he was concerned, my pain was the result of the scoliosis and that I should try Pilates to build up my muscle strength'. But Julie, 53, felt there was more to it - she'd always been strong and active until the pain began in the spring of 2013. As she explains: 'I'd been doing a lot of gardening, and noticed my lower back ached afterwards,' she says. 'At first a hot bath would sort it out, but as the months passed I found the aching was bad after strenuous activity, such as DIY, and didn't go away after a bath any more.' Painkillers were of little help. 'If I made a sudden movement, I'd experience a sharp, pinching pain in my lower spine that would take my breath away and force me to stop whatever I was doing.' A month after seeing her GP, and feeling increasingly desperate, Julie, an administrator, who is divorced with two grown-up children, and lives in Bushey, Herts, used her private medical cover to see a spinal surgeon, Robert Lee. The consultant ordered an MRI scan, which showed that she did have some scoliosis and her discs had signs of wear and tear, suggesting arthritis. But crucially the radiographer spotted that Julie's coccyx - the bone at the tail of the spine - was slightly enlarged. It contained a tumour. Cases like Julie's are why some experts feel that too often back pain is written off as something that is to be endured, rather than investigated. 'Eighty per cent of people will experience an episode of severe back pain in their lifetime - but only 8 per cent of these go on to suffer chronic pain,' says Peter Hamlyn, a neurosurgeon at University College Hospital London and the Spine Surgery London. 'Many of these chronic sufferers are simply dismissed as having 'non-specific low back pain'. 'That term needs to be abandoned and early referral for investigation and diagnosis-based treatment should instead become the norm.' Back pain is 'very often under-investigated', adds surgeon Robert Lee, of the Spire Hospital in Bushey. 'This means that treatable conditions such as disc prolapses, osteoporotic fractures, deformity, infection and tumours can be missed.' She sought a second opinion from a private surgeon, who sent her for an MRI scan . He adds: 'Most back pain is the result of muscular strains, and is short-lived.'As long as there are no 'red flag' symptoms - such as numbness around the groin and difficulties passing urine or with your bowels - then painkillers and physiotherapy are good approaches. 'However, an MRI should be offered when back pain goes on for eight weeks or more so that you know what you are dealing with and can treat this accordingly.' For instance, arthritis may be relieved with a simple painkilling spinal injection. If the pain is being caused by a nerve being compressed, treatment may involve surgery. Around 1,000 people a year are diagnosed with tumours - benign or malignant - that start in the spine. In many cases, a growth on the spine will be a benign notochordal tumour. These are made of tissue left over from embyronic cells which help form a baby's spinal cord. By the time a baby is born, these cells should have disappeared - if they remain, and nobody knows why this happens, they can develop into tumours. It's estimated that 14 per cent of people have this kind of benign tumour on their spine and, in most, these are harmless. Much more rarely, spinal tumours are malignant. Sometimes these are secondary to cancer elsewhere in the body, particularly breast, brain or pancreatic cancer. Cancer cells often go to the bones with the greatest blood supply, which includes the spine. These, too, can cause back pain. Less commonly, the problem is a malignant tumour called a chordoma that originates in the spine. Typically, they occur in adults between ages 40 and 70, and often they are detected late - patients live on average just six years after diagnosis. A very observant radiologist spotted a tumour, which was removed . Chordomas can occur anywhere along the spine, and the later symptoms such as back pain, numbness, aching and tingling can be mistaken for more minor strains or disc problems. As they get bigger, they may also cause changes in bowel and bladder function, and weakness of the arms and legs. In up to 40 per cent of patients they spread to the lungs, liver, bones, and skin. Although it was apparent from her MRI that Julie had a tumour, it was impossible to tell if it was cancerous or benign. The only options were to remove the entire coccyx, or leave the tumour and scan every few months to see if it grew. Mr Lee recommended removing it. 'The coccyx isn't a necessary part of our anatomy. In fact, it's simply the remains of a tail from an earlier stage in our evolution,' he says. Julie had her operation in October 2013. Her coccyx was removed, complete with the 2cm tumour inside it. The tumour was sent for testing and was found to be malignant. However, it was surrounded by healthy tissue within the bone, which meant it had not spread. 'I asked Mr Lee to tell me the results over the phone,' Julie recalls. 'I didn't know what to feel as I was in the very strange position of not actually knowing I had cancer until I was cured.' Following the surgery, sitting hurt so much that Julie was off work for six weeks. She now has a three-inch scar, and will need scans every year for five years - 'But after that we would consider her cured,' says Mr Lee. 'If the tumour was found later, the outcome could have been much bleaker.' Ironically, after the operation, Julie still has back pain as a result of her arthritis. But she feels that dealing with the pain is nothing compared with what might have been. 'I'm so pleased I made a fuss instead of leaving things,' she says. brainandspine.org.uk .
target: Julie McKenzie, 53, from Bushy, Herts, had a nagging back pain .
  Her GP assured her it as down to a mild curvature of the spine .
  But she'd always been strong and active until the pain began in 2013 .
  She used her private medical cover to see a spinal surgeon, Robert Lee .
  MRI scan revealed her coccyx contained a tumour .