Archives:

Neck Pain

Do you have Neck Pain? Unfortunately, neck pain affects a large number of people, and the causes do not always seem obvious.   Most of the time,  it will be a self limiting process and will improve with time. Explanations of neck pain include arthritis, which is a degeneration of the bones and joints in […]

HIgh Intensity Zone

  What is a High Intensity Zone? In relationship to the spine,  it is a term that has been used on and off for the past 20 years. Initially described by Drs’ April and Bogduk in 1992,  it is a  MRI finding  identified on a specific sequence called T2.  A High Intensity Zone (HIZ) is […]

Disk Degeneration in 21 Year Olds

During my training,  it was assumed that the average adolescent or teenager should have normal disc anatomy. It was assumed that  disc herniation/degeneration was a rare occurrence in that population.  But,  at that time,  technology such as a MRI scanner was relatively new, rare and expensive.  We did not have the capability to test to see […]

Dermatome Patterns

Dermatomal Patterns help physicians define nerve radiculopathy patterns.  Most neurologists/spine specialists  accept certain associated sensation, muscle strength, and reflex changes patterns to specific nerve roots. L5 radiculopathy is typically associated with weakness of the extensor hallucis longus muscle.  That is the muscle that allows the great toe to point upwards.  L5 radiculopathy also follows a […]

Artificial Disk Replacement

  Have you been told you need an Artificial Disk Replacement?  Usually,  it means you have had neck or back pain, and have not improved with conservative treatments.  Assuming you have had appropriate treatments, but still have significant pain, artificial disk replacement may be an option for you. But,  there are certain questions you need […]

Epidural Steroid Injections

  Should you get Epidural Steroid Injections?      It depends on the rationale for the treatment.  In my practice,  I use Epidural Steroid Injections for both treatment as well as diagnostic purposes.  The research for these injections have been significant, but the conclusions by the various authors have been very different.  If you must […]