Cardiopulmonary Exercise Testing (CPEX) is a non-invasive assessment that provides detailed information about how the heart, lungs, and muscles work together during physical exertion. Performed on a treadmill or stationary bike while wearing a breathing mask and heart monitors, the test measures oxygen consumption, carbon dioxide production, and heart function under stress. CPEX is widely used to diagnose unexplained shortness of breath, assess exercise intolerance, and evaluate overall cardiopulmonary fitness. It also helps doctors plan safe exercise programmes, monitor treatment outcomes, and determine fitness for surgery.

Investigating unexplained breathlessness or fatigue

Assessing exercise intolerance

Pre-surgical evaluation of heart and lung function

Monitoring treatment in heart or lung disease patients

Tailoring training programmes for athletes or rehabilitation

Shortness of breath during activity

Dizziness or fatigue with exertion

Reduced exercise tolerance

Chest discomfort when active

Unexplained decline in stamina

CPEX Testing (Cardiopulmonary Exercise Testing)

Diagnostics

A follow-up consultation in a longevity clinic is designed to assess how well current treatments and lifestyle changes are working. During this session, the GP will review test results, track improvements or setbacks, and make any necessary adjustments to your care plan. This appointment is particularly important for managing chronic conditions, monitoring preventive health strategies, and ensuring that treatments for issues such as diabetes, asthma, menopause, or weight management remain effective over time. It provides ongoing support and guidance for maintaining long-term health and wellbeing.

Continuing care for chronic conditions such as COPD or diabetes

Reviewing progress with weight management or bone health

Monitoring menopausal symptom management

Checking effectiveness of preventive health strategies

Updating or adjusting lifestyle and treatment plans

Ongoing or unresolved health issues after initial treatment

New or worsening symptoms related to chronic conditions

Persistent fatigue or low energy

Fluctuating blood sugar levels or breathing difficulties

Menopausal symptoms not improving with treatment

Follow-Up Consultation (Longevity)

Consultations

The initial consultation in a longevity clinic is a comprehensive, GP-led appointment focused on understanding your overall health and long-term goals. During this session, the doctor reviews your medical history, current symptoms, and lifestyle factors before recommending tailored investigations or treatments. This consultation may cover a wide range of conditions including COPD, bronchial asthma, pre-diabetes, diabetes, menopause, bone health, and weight management. It is also an opportunity to discuss preventative strategies designed to improve wellbeing, reduce future health risks, and support healthy ageing.

First-time visit to address chronic health concerns

Preventive health check for long-term wellbeing

Management planning for menopause or hormonal changes

Assessment of risk factors for diabetes, asthma, or COPD

Establishing a tailored health and lifestyle plan

Persistent cough or breathing difficulties

Fatigue or low energy

Irregular menstrual cycles or menopausal symptoms

Unexplained weight gain or difficulty losing weight

Joint or bone pain affecting mobility

Initial Consultation (Longevity)

The initial consultation in pain management is a detailed session where a specialist reviews your medical history, current symptoms, and the impact pain has on your daily life. This appointment may include a physical examination, discussion of previous treatments, and recommendations for further diagnostic tests if needed. The goal is to understand the underlying cause of pain and design a tailored management plan that may involve medication, injections, physiotherapy, or advanced interventional techniques. This consultation is the first step toward reducing pain, improving mobility, and restoring quality of life.

First-time visit for chronic or unexplained pain

Assessment before starting advanced pain treatments

Ongoing discomfort after injury or surgery

Pain interfering with sleep, work, or physical activity

Evaluation of failed previous treatments

Persistent back, neck, or joint pain

Nerve pain or sciatica

Headaches or migraines

Muscle stiffness or spasms

Pain that worsens with activity or movement

Initial Consultation (Pain Management)

A limb or joint diagnostic ultrasound is a non-invasive scan used to evaluate musculoskeletal conditions affecting the knees, shoulders, elbows, ankles, and other joints. Unlike X-rays, it does not use radiation but instead relies on high-frequency sound waves to create real-time images of soft tissues, tendons, ligaments, and cartilage. This test is especially useful for identifying injuries, inflammation, arthritis, bursitis, and tendon tears. Because it can be performed while moving the joint, it gives valuable insight into how tissues behave during activity. Ultrasound is also often used to guide further treatments, such as injections, for more precise targeting.

Knee pain after injury or overuse

Shoulder or elbow pain during movement

Sports-related injuries (ligament or tendon tears)

Swelling or inflammation around a joint

Limited flexibility or stiffness in a limb

Pre-treatment imaging before an injection

Localised joint pain

Swelling or tenderness around the joint

Stiffness and reduced movement

Clicking, grinding, or locking sensations

Weakness or instability in the affected limb

Limb or Joint Diagnostic Ultrasound

Treatments

Lipogems is an advanced regenerative therapy that harnesses the healing potential of your body's own fat tissue. A small amount of fat is collected, processed to concentrate reparative cells, and then injected into the affected joint or soft tissue. These cells help reduce inflammation, improve cushioning, and stimulate the body's natural repair processes. This minimally invasive procedure is designed for patients with arthritis, chronic joint pain, or sports-related injuries who are seeking an alternative to repeated steroid injections or surgery. Lipogems can be particularly effective for knees, hips, shoulders, and tendons where damage or degeneration has caused persistent discomfort.

Osteoarthritis in major joints (knee, hip, shoulder)

Sports injuries not responding to standard treatment

Chronic tendon or ligament damage

Patients wishing to delay or avoid joint replacement surgery

Persistent soft tissue pain despite physiotherapy

Pain with walking, climbing stairs, or exercise

Tenderness around injured tendons or ligaments

Ongoing joint pain and stiffness

Swelling and inflammation in the joint

Reduced mobility and range of motion

Lipogems

A Multidisciplinary Team (MDT) consultation is a patient-centred approach that brings together healthcare professionals from different specialties to provide integrated and holistic care. During regular meetings, the team reviews medical history, test results, and patient concerns to make shared decisions and design tailored treatment plans. This model is especially valuable for patients with complex or multiple conditions, unclear diagnoses, or those focused on preventive health and wellbeing. The MDT may include GPs, gynaecologists, urologists, endocrinologists, cardiologists, nutritionists, psychotherapists, and internal medicine specialists, ensuring that physical, psychological, and lifestyle factors are all addressed.

Patients with more than one chronic condition

Complex symptoms without a clear diagnosis

Preventive health planning and wellbeing management

Coordinating care across different medical specialties

Long-term management of cardiovascular, hormonal, or psychological conditions

Multiple overlapping health issues

Persistent unexplained symptoms

Stress, anxiety, or mood disorders

Fatigue or reduced quality of life

Ongoing medical concerns not improving with single-specialty care

Multidisciplinary Team (MDT) Consultation

A nerve block is a specialised injection used in pain management to interrupt pain signals travelling along specific nerves. Using ultrasound or X-ray imaging, the doctor accurately guides the needle to the affected nerve and delivers a local anaesthetic, sometimes combined with steroids, to reduce pain and inflammation. Nerve blocks can be used for diagnostic purposes to identify the source of pain, or as a therapeutic treatment to provide temporary or long-term relief. They are often recommended for patients with chronic pain syndromes, nerve-related pain, or pain not responding to medication and physiotherapy.

Chronic pain syndromes affecting the back, neck, or joints

Nerve pain after injury or surgery

Sciatica or radiating leg pain

Pain preventing rehabilitation or physiotherapy progress

Diagnostic use to confirm the source of nerve pain

Sharp, shooting, or burning nerve pain

Persistent localised pain despite medication

Pain radiating to arms or legs

Numbness or tingling associated with nerve irritation

Chronic discomfort interfering with daily activities

Nerve Block Injection

Ostenil Plus is a visco supplementation treatment that involves injecting hyaluronic acid directly into the affected joint. Hyaluronic acid is a natural substance found in joint fluid that helps with lubrication, shock absorption, and smooth movement. In osteoarthritis, the amount and quality of this fluid decreases, leading to pain, stiffness, and reduced mobility. By replenishing hyaluronic acid, Ostenil Plus injections can reduce pain, improve mobility, and delay the need for more invasive treatments such as surgery. The procedure is minimally invasive, performed in an outpatient setting, and commonly used for the knees, hips, hands, and spine.

Osteoarthritis in the knee, hip, hand, or spine

Joint pain limiting walking, bending, or daily activity

Patients not responding to painkillers or physiotherapy

Individuals seeking to delay or avoid surgery

Sports-related wear and tear causing cartilage loss

Joint pain and stiffness

Swelling around the joint

Reduced range of motion

Pain during weight-bearing activities

Grinding or cracking sensation in the joint

Ostenil Plus – Visco Supplementation Joint Injection

Platelet-Rich Plasma (PRP) therapy is a minimally invasive treatment that uses a small sample of your own blood to support healing and regeneration. The blood is processed to concentrate the platelets, which are rich in growth factors that stimulate tissue repair and reduce inflammation. The PRP is then injected into the affected joint, tendon, or soft tissue under sterile conditions. PRP therapy is widely used for sports injuries, chronic tendon problems, arthritis-related joint pain, and even in aesthetic medicine for skin and hair treatments. It is particularly effective when conventional treatments like medication or physiotherapy have not provided sufficient relief. Because it uses your body's own healing components, the risk of adverse reactions is minimal.

Soft tissue injuries not responding to standard treatments

Sports injuries such as ligament or tendon strains

Chronic tendonitis (tennis elbow, Achilles tendonitis)

Early to moderate osteoarthritis

Joint pain in knees, hips, or shoulders

Persistent joint pain

Swelling and inflammation around a joint or tendon

Stiffness or reduced range of motion

Pain during physical activity or sports

Slow recovery from injury

PRP (Autologous Blood Injection)

Radiofrequency lumbar spine treatment, also known as radiofrequency ablation or denervation, is performed under C-arm imaging guidance to ensure precision and safety. The procedure delivers controlled radiofrequency energy to specific spinal nerves responsible for transmitting pain signals. By interrupting these signals, it can significantly reduce or eliminate chronic lower back pain. This treatment is especially helpful for patients who have not responded to medication, physiotherapy, or injections. It is a day-case procedure with minimal recovery time, offering an effective alternative to surgery for many people with persistent lumbar pain.

Chronic lower back pain unresponsive to other treatments

Sciatica or radiating leg pain caused by nerve irritation

Pain returning after steroid injections or physiotherapy

Difficulty with daily activities due to ongoing lumbar discomfort

Patients seeking non-surgical alternatives for back pain management

Persistent lower back pain

Pain radiating into hips, buttocks, or legs

Stiffness or reduced mobility in the spine

Nerve-related discomfort or burning sensations

Pain aggravated by movement or prolonged sitting

Radiofrequency Lumbar Spine

Spirometry is a non-invasive diagnostic test used to assess lung function. By breathing forcefully into a specialised device, doctors can measure how much air you inhale, how much you exhale, and how quickly you exhale it. These measurements help detect lung conditions such as asthma, chronic obstructive pulmonary disease (COPD), and other breathing disorders. The test is quick, painless, and provides immediate results. Spirometry is often recommended for patients experiencing ongoing breathing difficulties, chronic cough, or shortness of breath, and it plays a key role in monitoring lung health over time.

Routine lung health check

Diagnosing asthma or COPD

Monitoring existing lung conditions

Assessing lung function before surgery

Investigating unexplained breathing problems

Shortness of breath

Wheezing

Chronic cough

Difficulty exhaling fully

Fatigue during physical activity

Spirometry

Tenex is an advanced, minimally invasive treatment designed to address chronic tendon pain caused by scar tissue and calcifications. Using a high-frequency ultrasonic needle, the procedure precisely breaks down and removes damaged tendon tissue while preserving the surrounding healthy structures. This targeted approach eliminates the underlying source of pain and supports the body's natural healing response. The procedure is efficient, typically lasting less than 20 minutes, and performed through a tiny incision that does not require stitches. Because it avoids conventional surgery, recovery is generally quicker and less disruptive. Tenex has proven particularly effective for persistent tendon conditions affecting the elbow, shoulder, knee, Achilles tendon, and foot, including plantar fasciitis and patellar tendinitis.

Chronic tendon pain not improving with physiotherapy

Sports-related overuse injuries (tennis elbow, golfer's elbow)

Plantar fasciitis causing heel pain

Achilles tendon pain affecting walking or running

Patella tendinitis causing knee pain

Shoulder tendon injuries

Localised tendon pain lasting more than six weeks

Stiffness or weakness in the affected joint

Swelling or thickening around the tendon

Pain during activity such as running, jumping, or lifting

Sharp pain when pressing on the tendon area

Tenex

A transforaminal epidural injection (lumbar) is a minimally invasive procedure used to treat lower back and leg pain caused by nerve compression or inflammation. Performed under C-arm imaging guidance, the injection delivers a mixture of steroid and local anaesthetic to the area around the affected spinal nerve. This reduces swelling, decreases irritation, and provides pain relief that can last for weeks or months. It is commonly used for conditions such as herniated discs, spinal stenosis, and sciatica when conservative treatments like medication or physiotherapy have not provided sufficient relief. The procedure is typically carried out as a day case and allows patients to return quickly to normal activities.

Lumbar back pain with nerve irritation

Sciatica (pain radiating down the leg)

Herniated or slipped disc

Spinal stenosis

Persistent lumbar pain despite medication or physiotherapy

Pain interfering with daily function or sleep

Sharp or shooting pain in the lower back

Pain radiating into the buttock or leg

Numbness or tingling in the legs or feet

Weakness in the lower limbs

Pain worsening with movement, sitting, or standing for long periods

Transforaminal Epidural Injection (Lumbar)

An ultrasound-guided injection is a safe and accurate treatment that uses ultrasound imaging to guide the needle directly to the painful joint, tendon, or soft tissue. Unlike traditional 'blind' injections, this technique allows the doctor to see inside the body in real time, ensuring that the medication (such as corticosteroids, hyaluronic acid, or regenerative treatments) is delivered exactly where it's needed. This approach is widely used in sports and regenerative medicine to treat arthritis, tendon injuries, bursitis, and persistent joint pain. It improves accuracy, reduces the risk of complications, and often leads to faster and more effective pain relief. The procedure is typically quick, minimally invasive, and performed as an outpatient treatment.

Persistent knee, shoulder, or hip pain

Sports injuries (tendon or ligament inflammation)

Arthritis-related joint pain

Pain that hasn't improved with medication or physiotherapy

Need for precise treatment before or instead of surgery

Swelling and inflammation around the joint

Pain when walking, lifting, or exercising

Warmth or tenderness in the joint area

Ultrasound-Guided Injection

Ultrasound-guided injections are a minimally invasive treatment used in pain management to target specific joints, tendons, or soft tissues. By using real-time ultrasound imaging, the doctor can guide the needle with accuracy, ensuring that medication such as corticosteroids, anaesthetics, or regenerative agents is delivered exactly where it is needed. This approach increases safety, reduces the risk of complications, and improves the effectiveness of pain relief compared to blind injections. It is commonly used for pain syndromes related to arthritis, tendon injuries, bursitis, and nerve irritation, helping patients regain mobility and improve quality of life.

Chronic joint pain from arthritis

Tendon or ligament inflammation

Pain after sports injuries

Persistent pain not responding to oral medication

Pain syndromes affecting mobility or daily activities

Localised pain in a joint or tendon

Swelling or inflammation around the affected area

Stiffness and reduced range of motion

Tenderness during movement or pressure

Persistent discomfort despite rest or physiotherapy

Ultrasound-Guided Injection (Pain Syndrome)

The VO₂max test is a gold-standard method for evaluating aerobic capacity and overall cardiovascular fitness. It measures the maximum volume of oxygen your body can consume per minute while exercising at increasing intensity, typically performed on a treadmill or stationary bike with a breathing mask. This test is widely used by athletes to optimise training, but it is also valuable in clinical settings to assess heart and lung function, detect exercise intolerance, and monitor recovery from illness or injury. Results provide detailed insight into endurance levels, helping to tailor exercise programmes and track progress over time.

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Ultrasound

Breast Ultrasound (including bilateral) (note)