Pain management

Regenerative vs. Ablative: The Battle Over Lumbar RFA and Multifidus Atrophy

Medicine advances because advocates for various treatments duke it out in the research literature. That time-honored system produces an intellectual Darwinism effect and one of those evolutionary battles happening in pain medicine is between opposing regenerative and ablative camps. Today we’ll dive into one example of that conceptual crucible by focusing on little muscles in…read more

Playing With Knee Steroid Data, Et Tu Harvard?

A few years back a seminal paper was published showing what many physicians knew was an issue, that mega-dose steroids destroy knee cartilage (1). However, this was a HUGE problem for many physicians who have been injecting this stuff with wild abandon for many years. Hence, it was only a matter of time before papers…read more

Is Blocking Acute Inflammation Causing Chronic Pain?

We’ve known for a long time that injecting high-dose steroids into patients to treat pain is a dumb idea. However, that was based on studies showing harm to the local tissues. What if it’s also creating millions of new chronic pain patients? Let’s dig in. Natural and Mega Dose Steroids The issue with medicine’s steroid…read more

What is the Ligamentum Flavum? Why Should You Care?

One of the more critical ligaments in your spine is generally an unknown for most patients. That’s despite being responsible for causing lots of back pain and general havoc. That structure is called the ligamentum flavum. Let’s dig in. Ligaments and the Spine If we had to hold a competition between different spinal structures like…read more

Making Interventional Orthobiologics Standard of Care Requires Policing

A blog reader who is a physician in Florida recently asked many colleagues what to do about a local chiropractic clinic that is aggressively advertising that their midlevel treats spine with stem cell therapy. My response was that her most effective move would be bringing this issue to the attention of the chiropractic board. Why…read more

Treating Low Back Pain During and After Pregnancy

I’ve seen many patients after pregnancy who have chronic low back pain. In addition, low back pain during pregnancy can also be disabling. So what are the options for treatment? I’ll review that today and go over a recent patient that was treated by our Washington, DC Metro area Regenexx affiliate. Let’s dig in. Low…read more

Dopesick, Purdue, and Oxycotin

This weekend I watched the Hulu original show, Dopesick. It’s a must-watch for anybody trying to understand the Opioid epidemic and how American medicine has become very corrupt. This morning I thought I’d give you a bit of commentary from someone who had a front-row seat to the Oxycontin disaster. Let’s dig in. Dope Sick…read more

What’s the Purpose of a Neck Facet Injection?

These past few weeks I’ve had a number of patients with Neck Instability who are confused as to why we perform Neck Facet injections with Orthobiologics. So today I’ll dive into this topic and try to help everyone get on the same page. Let’s dig in. What Is a Neck Facet Joint? Your spine is…read more