I am Dr. Thomas Grove, a certified physician with specialized training in sports medicine. Our primary objective is to prevent individuals from undergoing surgery, to minimize their reliance on pain medications, and to guide them towards a successful recovery.
One of our preferred methods for achieving this is known as regenerative medicine. We harness the capabilities of the body’s natural healing cells, such as platelet-rich plasma and stem cells, which are excellent advanced cellular therapy alternatives that we believe can aid in enhancing the healing process, alleviating pain, and improving functionality.
Today’s discussion centers on back pain. We begin by trying to line-up the findings of your spinal MRI with your reported pain and discomfort. There are instances when the imaging results and the location of pain do not align.
Degenerative disc disease is an extremely common problem that many people experience without even knowing it is a problem because they have no pain. Therefore, we do not wish to pursue surgical recommendations for invasive procedures for people not in pain.
During your first consultation at our clinic, we will conduct a thorough history and perform a comprehensive hands-on physical examination. This process will assist in identifying the source of your symptoms. If we believe it is a condition we can address, we will recommend more conservative treatment options, such as platelet-rich plasma and stem cell therapy.
These procedures are administered with the assistance of ultrasound. This technique enables precise targeting of the injection to the pain source, and it also permits us to manipulate the body to obtain a motion image that reveals issues that a static image may not show. Consequently, we can gain a more comprehensive understanding of the structural integrity of the spine and identify areas where the spine is weak and causing discomfort.
There may be some irritation, possibly of a nerve, for instance, and in such cases, a physician might prescribe a steroid. Steroids are potent anti-inflammatories that can reduce inflammation; however, they do not facilitate healing in conditions involving ligaments, tendons, joints, or muscles. Consequently, if one takes such medication and experiences reduced pain, it may lead to the misconception that the underlying issue has been resolved. It is important to remember that this merely masks the pain by interrupting the pain signal, which can provide effective short-term relief but does not promote healing. In fact, higher doses of steroids can result in increased tissue degeneration, particularly with repeated injections. This scenario is quite prevalent among individuals suffering from back pain who are told to undergo multiple rounds of epidural injections.
I want to get our patients into a position where they can do some exercise every single day. I am a strong advocate for resistance training. We will attempt to lift weights, possibly incorporate resistance bands, and even utilize body weight exercises. As we age, it becomes increasingly challenging to build and maintain muscle mass. It is essential for us to stay physically active. Our focus is on the structures surrounding the spine and the numerous muscles in that region. The lumbar erector muscle group extends over the top of the spine on the posterior side. These muscles serve as powerful stabilizers for the core. Additionally, the abdominal wall connects to the spine, and there are numerous muscles that attach to the lateral aspects of the spine as well.
Cases
I would like to share a recent case I encountered. The individual reached out via email. Initially, the patient experienced some back pain and consulted a spine specialist, but there was a delay in obtaining their MRI. Eventually, they received the MRI, and during the wait for the results, their back pain subsided. The MRI report indicated a lumbar herniation at the L5 level. During their follow-up appointment with the spine specialist, the patient informed the doctor that their back pain had disappeared. Nevertheless, the doctor attempted to schedule a surgery. When the patient inquired about the necessity of surgery given the absence of pain, the response was that they had a disc herniation. This prompted them to seek our opinion. I would not even consider performing surgery on a patient who exhibits no symptoms.
Are MRIs sending people to back surgery who may not need back surgery?
Laminectomy
I received an email from someone who already had a laminectomy. Part of the bone is removed to take pressure off the spinal nerves. This person had no relief from the surgery. The pain remained. After an examination in our office, it was revealed that the pain was coming from the their gluteus Medius. This is somebody who we put them in that category of an unnecessary surgery. What was causing their pain was a completely different structure.
Bone Marrow Mesenchymal Stem Cells in the Treatment of Chronic Low Back Pain
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