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

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360 Spine Talk, we explore Persistent Spinal Pain Syndrome, or PSPS, the diagnosis that has formally replaced the outdated term “failed back surgery syndrome.”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

Stop the Spinal Fracture Cascade | Vertrae® 360 Spine Talk (Ep. 25)

A spinal compression fracture isn’t just an injury—it’s often a sign of underlying osteoporosis and low bone density. In this episode, we break down what proper bone health management looks like after a fracture—and why it’s critical for preventing future vertebral fractures. Learn how a DEXA scan helps diagnose osteoporosis, why calcium and vitamin D levels matter, and how osteoporosis treatment can significantly reduce the risk of another compression fracture. We also explain the “fracture cascade,” where one spinal fracture increases the likelihood of additional fractures if bone health isn’t addressed. This episode covers the essential steps in post-fracture care, including bone density testing, medication management, and lifestyle changes like weight-bearing exercise and fall prevention. If you’ve experienced a compression fracture or are concerned about osteoporosis, this episode will help you understand how to protect your spine and prevent future fractures.

Is Your Back Pain a Broken Bone? | Vertrae® 360 Spine Talk (Ep. 24)

Could your persistent back pain be more than just a muscle strain? In this episode, we break down how spinal compression fractures are often misdiagnosed—and why that mistake can delay proper treatment and recovery. Learn the key warning signs that distinguish a vertebral fracture from a typical muscle injury, including sudden onset pain, band-like discomfort around the torso, and the critical role of positional pain (worse when standing, relieved when lying down). We also explain why MRI is the gold standard for diagnosing acute spinal fractures, outperforming X-rays by detecting bone marrow edema and determining fracture timing. Finally, we cover when intervention becomes necessary, including the criteria for procedures like kyphoplasty and why conservative treatments such as rest and bracing are the first line of care. If you’re dealing with chronic back pain that isn’t improving, this episode offers essential insights into structural causes, accurate diagnosis, and evidence-based treatment options.