Pain impulses are perceived as increasingly intense over time, even when nothing anatomically has changed. This is called “sensitization.” Skill Requires Repetition Consider how you learn almost any new skill. It is with initial education of the proper movements and then, “practice, practice, practice.” Every performing art and athletic skill … Read More
I am a surgeon I have a problem being a surgeon and interacting with patients with chronic pain. I am trained to do surgery, so offering surgery is my first instinct. Referring physicians and my patients also often view surgery as the “definitive solution” to a given problem. When I … Read More
Identification of a potential “pain generator” is always the first step in dealing with low back pain. It is the role of your surgeon to order the appropriate tests to define your anatomic problem. If there is a definable structural source of pain, then there is the option of having … Read More
Start stress management immediately. If you need sleep meds, talk to your doctor about it right away. Two to four weeks into the DOCC Project, I expect you to be participating in a daily writing program. I did not have easy access to psychologists who specialized in chronic pain when … Read More
I learned about the importance of sleep somewhat by chance. It was covered in my medical training. I read a book, The Promise of Sleep. It was an autobiography of William Dement, who started the first sleep lab at Stanford. I became interested in the effects of sleep on chronic … Read More
I moved to Sun Valley in late 1999. I joined another spine surgeon in a small spine practice. I had been practicing spine surgery in downtown Seattle for 13 years. It was a challenging transition. A significant aspect of major spine surgery is having a large hospital with an ICU. … Read More
Chronic pain is a complex problem consisting of many variables that affect your perception of it. Additionally, we now know that unpleasant mental input is processed in a similar manner as physical pain. Applying simple solutions to such a multi-layered problem can’t be and isn’t effective. The DOC (Direct your … Read More
I am a Surgeon I am a surgeon. I think like a surgeon, which means I am intent on finding a structural problem I can surgically correct and relieve my patient’s suffering. When this happens, I feel a deep sense of satisfaction and I am my patient’s hero. It is … Read More
From Seattle to Sun Valley In 1999 I moved to Sun Valley, Idaho for personal reasons. I became the sole proprietor of a one-physician spine surgery practice in 2001. I did not have rehab physicians to rely on. I made a commitment to myself that I would take care of … Read More
I started my practice in Seattle in 1986. I was feeling pretty beat up from my spine training. I felt well-trained and still had a rather high opinion of myself, but I was tired. It also quickly became clear that low back pain was much more complicated than I had … Read More