Chronic Back Pain, MRI Limits & Neuromodulation | Vertrae® 360 Spine Talk (Ep. 30)

Chronic Back Pain, MRI Limits & Neuromodulation | Vertrae® 360 Spine Talk (Ep. 30)

What happens when your MRI looks “fine,” your surgery is considered technically successful, but your back pain is still there — or even moving somewhere new? In this episode of Vertrae® 360 Spine Talk, we explore why chronic back pain often requires a deeper diagnostic approach than standard imaging alone. Through the lens of Dr. Kamal Woods’ MotionFirst™ philosophy, this conversation breaks down why an MRI can miss important clues about pain, especially when the spine is only viewed as a static structure rather than a dynamic system in motion. The episode also examines the role of the multifidus muscle, functional instability, the prone instability test, and why some patients continue to experience pain even after a successful spinal procedure. From there, the discussion moves into central sensitization, the connection between chronic pain, depression, anxiety, and the nervous system, and how emerging treatments like neuromodulation may help interrupt amplified pain signals. If you have ever felt dismissed because your pain does not match your imaging, this episode offers a new way to think about chronic back pain — one that looks at movement, muscle function, nerve sensitivity, and the full pain experience. Topics covered include: MRI limitations in chronic back pain Dr. Kamal Woods’ MotionFirst™ philosophy Why pain can persist after spine surgery Multifidus dysfunction and spinal instability Central sensitization and nervous system hypersensitivity Depression, anxiety, and pain amplification Neuromodulation for chronic pain Why chronic pain is not “all in your head” Disclaimer: This podcast is for educational purposes only and is not medical advice. Please consult a qualified healthcare professional for diagnosis and treatment options.

Chronic Pain, Depression & Hope Fatigue | Vertrae® 360 Spine Talk (Ep. 29)

What if chronic back pain is not just about what appears on an MRI? In this episode of Vertrae® 360 Spine Talk, we explore the powerful connection between chronic pain, depression, anxiety, and hope fatigue — and why emotional exhaustion can be deeply tied to the way the nervous system processes pain. Inspired by insights from neurosurgeon Dr. Kamal Woods, this conversation takes a closer look at how chronic pain can physically change the brain. When pain persists for months or years, the brain’s threat detection system can become overactive, while the areas responsible for optimism, planning, and imagining a better future can become quieter. This helps explain why many patients feel like they have reached a permanent ceiling with pain, even when more precise answers may still be possible. We also discuss why depression and chronic back pain often form a two-way cycle, how hope fatigue develops after repeated failed treatments, and why patients should not be pressured into toxic positivity or false hope. This episode also covers advanced pain treatment options such as spinal cord stimulation, neuromodulation, and ReActiv8 therapy, including how these approaches may help target specific pain signals, nerve pathways, or mechanical pain generators like the multifidus muscle. For patients living with persistent spinal pain, failed back surgery syndrome, neuropathic pain, chronic low back pain, or long-term pain after surgery, this episode offers a new way to think about pain: not as a personal failure, but as a complex neurological and mechanical condition that deserves a deeper evaluation. In this episode, we discuss: * Why MRI findings may not fully explain chronic back pain * The link between chronic pain, depression, and anxiety * How chronic pain can rewire the brain and nervous system * What hope fatigue is and why it matters * Why chronic pain can disrupt identity and daily function * How precise pain evaluations can reveal overlooked pain generators * The role of the multifidus muscle in spinal stability * Spinal cord stimulation for neuropathic pain * ReActiv8 therapy for mechanical low back pain * Why restoring function may matter more than chasing zero pain If you or someone you love feels stuck in chronic pain, this episode is a reminder that the right questions may not have been asked yet — and that a new evaluation may reveal a new path forward.

Persistent Spinal Pain Syndrome Is Not Failed Back Surgery | Vertrae® 360 Spine Talk (Ep. 28)

Pain after spine surgery can be confusing, discouraging, and emotionally exhausting — especially when the surgery was technically successful, but the pain remains. In this episode of Vertrae® 360 Spine Talk, we explore Persistent Spinal Pain Syndrome, or PSPS, the diagnosis that has formally replaced the outdated term “failed back surgery syndrome.” This shift matters because persistent pain after spine surgery is not about blame. It is about understanding the biological, structural, neurological, and emotional factors that can continue driving pain after surgery. Drawing from the clinical framework of Dr. Kamal Woods at Vertrae® Surgery Center in Dayton, Ohio, this episode explains why pain can persist after spine surgery, including causes such as epidural fibrosis, adjacent segment disease, recurrent disc herniation, unaddressed facet joint pain, Modic changes, and central sensitization. You’ll also hear why the length of time someone had pain before surgery can influence recovery, how anxiety and depression affect the nervous system’s response to pain, and why a fresh re-evaluation can help identify what is generating symptoms today. Topics covered include: * Why “failed back surgery syndrome” is no longer the preferred term * What Persistent Spinal Pain Syndrome means * Why pain can persist after technically successful spine surgery * Epidural fibrosis, adjacent segment disease, and recurrent disc herniation * Central sensitization and chronic nerve pain * How preoperative pain duration affects PSPS risk * The role of anxiety, depression, sleep disruption, and emotional trauma * Why fresh evaluation matters after persistent pain * Spinal cord stimulation for neuropathic leg pain * ReActiv8® restorative neurostimulation for multifidus dysfunction * Why the next step is not blame, but better diagnosis Seeking a second evaluation after spine surgery is not a betrayal of your original surgeon or an admission that the first decision was wrong. It is an appropriate clinical step when pain persists and a new diagnosis may be needed. This episode is for educational purposes only and is not a substitute for medical advice, diagnosis, or treatment. If you experience sudden loss of bladder or bowel control, new numbness in the groin or saddle area, sudden weakness in the legs, fever with severe back pain, or rapidly worsening neurological symptoms, seek emergency medical care immediately.

Chronic Low Back Pain Is Not a Diagnosis | Vertrae® 360 Spine Talk (Ep. 27)

Chronic low back pain can be exhausting, frustrating, and isolating — especially when imaging looks “normal,” but the pain is still very real. In this episode of Vertrae® 360 Spine Talk, Dr. Kamal Woods explains why chronic low back pain is a label, not a true diagnosis. It describes where pain is and how long it has lasted, but it does not explain the underlying cause. Without identifying the actual pain source, patients may cycle through treatments that only provide partial or temporary relief. This episode explores why a normal MRI does not mean nothing is wrong, how emotional health and chronic pain are connected, and why conditions such as central sensitization, vertebrogenic pain, facet joint pain, sacroiliac joint dysfunction, and multifidus dysfunction may require more targeted evaluation. Dr. Woods also discusses the difference between mechanical and inflammatory back pain, why listening carefully to a patient’s story matters, and which red flag symptoms require immediate emergency care. Topics covered include: * Why chronic low back pain is not a final diagnosis * What a normal MRI can and cannot show * Central sensitization and the nervous system’s role in pain * The connection between chronic pain, anxiety, and depression * Mechanical vs. inflammatory back pain patterns * Vertebrogenic pain and multifidus dysfunction * When back pain symptoms may be a medical emergency * Why precise diagnosis should come before treatment This episode is for educational purposes only and is not a substitute for medical advice, diagnosis, or treatment. If you experience sudden loss of bladder or bowel control, new numbness in the groin or saddle area, sudden weakness in both legs, or severe back pain after a fall or injury, seek emergency medical care immediately.

Kyphoplasty Is Not Bone Failure | Vertrae® 360 Spine Talk (Ep. 26)

When patients hear the word kyphoplasty, the reaction is often immediate fear: Are my bones failing? Is this the beginning of a downward spiral? In this episode of Vertrae® 360 Spine Talk, we break down the reality behind that fear—and separate emotion from clinical fact. Drawing on the framework of Dr. Kamal Woods, a double fellowship-trained neurosurgeon at Vertrae® in Dayton, Ohio, we explore why a vertebral compression fracture is not a sign of total skeletal failure, but rather a localized structural issue that can be precisely repaired. You’ll learn how kyphoplasty works, why it’s a minimally invasive and highly effective procedure, and what the data actually shows about outcomes, recovery, and future fracture risk. We also tackle one of the biggest gaps in care today: untreated osteoporosis—and why addressing bone health after the procedure is just as important as fixing the fracture itself. This episode reframes the entire conversation: Kyphoplasty isn’t giving in—it’s taking control. What You’ll Learn: * Why kyphoplasty does not mean your bones are failing * The real cause behind most spinal compression fractures * How kyphoplasty restores stability and relieves pain * The truth about adjacent fracture risk * Why osteoporosis treatment is often overlooked—and why it matters * How to prevent the “fracture cascade” with proper follow-up care