By Dr. Deborah Westergaard | Pain Experts When “Not Covered by Insurance” Is Confused With “Not Legitimate” A question I am frequently asked—often by intelligent, highly analytical professionals—is whether regenerative medicine is covered by insurance  or experimental . What is usually being asked, implicitly, is this: If insurance does not cover it, is it legitimate medicine? That assumption is understandable, but it is incorrect. Insurance coverage has never been a reliable

Deborah Westergaard, MD | Pain Experts | Dallas–Plano Pain Relief Is Not the Same as Avoiding Back Surgery in Dallas For many patients in Dallas, the path toward back surgery begins quietly. It often starts with procedures that calm pain signals—nerve blocks, ablations, injections that temporarily reduce symptoms. And for a long time, that approach represented the best medicine available. I trained in that era. I practiced in that era. And those treatments helped many people

Deborah Westergaard, MD | Pain Experts | Dallas–Plano The Problem: Why Many Patients Struggle to Avoid Surgery As a specialist, I routinely evaluate patients who have already consulted highly skilled and respected surgeons. These physicians do extraordinary work, and I continue to refer to them when surgery is appropriate. However, many patients seeking to avoid surgery arrive after consultations constrained by time which is an unavoidable reality of insurance-driven medicine

By Deborah Westergaard, MD | Pain Experts | Dallas–Plano The Problem: When a Diagnosis Ends the Conversation Instead of Starting It Many patients assume that once a diagnosis is given, the investigation is over. In reality, that is often when the most important questions should begin. I recently evaluated a woman in her early seventies who came to see me for persistent knee pain. She was frustrated—but also oddly reassured. She had been told she had fibromyalgia, and she acce

By Deborah Westergaard, MD | Pain Experts | Dallas–Plano Why Joint Replacement Becomes the Default Too Early Many people assume that once a surgeon recommends joint replacement, the path forward is settled. The diagnosis feels definitive. The plan feels inevitable. But in reality, joint replacement is often a default. Not because it is always the only solution, but because it is the solution most familiar to the system. Outstanding surgeons, ethical, skilled, and well-intenti

By Deborah Westergaard, MD | Pain Experts | Dallas–Plano Nonoperative Knee Treatment Dallas TX There are moments in medicine when clinical judgment is refined not by theory, but by lived experience. This was one of those moments. After a knee injury that dramatically altered my stability, comfort, and function, I found myself standing in front of the mirror one morning realizing something important: My knee finally felt normal again. No guarding. No instability. No persistent

By Deborah Westergaard, MD | Pain Experts | Dallas–Plano “I Was Told Surgery Is the Only Option Left” Patients searching for how to avoid joint surgery often arrive after a familiar sequence: Physical therapy. Steroid injections. A prior PRP injection that “didn’t work.” The conclusion feels inevitable: joint surgery is next. What is rarely examined is whether the regenerative options attempted were biologically sufficient, correctly targeted, or strategically designed to alt

By Deborah Westergaard, MD | Pain Experts | Dallas–Plano The Reflex to “See the Surgeon First” for Your Back Pain For many high-performing individuals, sudden back pain triggers a familiar sequence: “Something is wrong. I need the best. I’ll see an orthopedic surgeon.” On the surface, this feels logical. Surgeons are intelligent, highly trained, and deeply knowledgeable about spinal anatomy. They carry immense responsibility, and patients rightly trust them when surgery is re

By Deborah Westergaard, MD | Pain Experts | Dallas–Plano High-performing individuals rarely identify as “patients.” They are CEOs, entrepreneurs, physicians, athletes, and weekend competitors who expect their bodies to keep pace with demanding professional and personal lives. Yet after 50, even disciplined training and excellent genetics can no longer fully offset age-related changes in joints, tendons, ligaments, and neuromuscular control. In Dallas, orthobiologics has becom

By Deborah Westergaard, MD | Pain Experts | Dallas–Plano Why “It’s Just the Disc” Is an Incomplete Diagnosis and How to Avoid Back Surgery Many patients seeking to avoid back surgery in Dallas are told their pain is caused by a “bad disc.” This conclusion is usually based on MRI findings alone with disc bulges, degeneration, or annular tears. The challenge is not that discs are irrelevant. The problem is that they are rarely the only pain generator. Disc changes are common wi

By Deborah Westergaard, MD | Pain Experts | Dallas–Plano What Most People Get Wrong About MRI Results: Why Facet Pain Often Goes Undetected as Back Pain in Dallas Many individuals with demanding, high-performance lives are told their MRI is “normal,” yet they continue to struggle with persistent low back pain—especially during activities requiring extension, rotation, standing, or prolonged sitting. One of the most overlooked reasons for this disconnect is facet joint dysfunc

By Deborah Westergaard, MD | Pain Experts | Dallas–Plano When Traditional Pain Management Tools No Longer Match the Demands of Modern Life When I transitioned from the intellectually rewarding field of anesthesiology into pain management more than two decades ago, my goal was not simply to join a specialty. I wanted to operate at the highest level of it. That search led me to Texas Tech and the legendary Dr. Gabor Racz, whose fellowship was regarded internationally as the pi

By Deborah Westergaard, MD | Pain Experts | Dallas–Plano Every so often, life offers a moment of stillness. Mine arrived over dinner with a friend of nearly three decades, a reminder of how quickly time escapes us. One moment we are building our careers, certain of our future paths; the next, we look up and wonder how 25 years passed in a blink. The truth is undeniable:The world we are living in now is not the world we lived in even six years ago.Not medically. Not economical

By Deborah Westergaard, MD | Pain Experts | Dallas–Plano Recently, a patient shared that during his MRI, a radiology technologist told him, “PRP really doesn’t work for most people.” The statement wasn’t malicious but it was incomplete. And for patients trying to make informed decisions, incomplete information is often the most damaging kind.  “PRP Doesn’t Work” A Misinterpretation of Technique, Not Science When you hear that PRP is unreliable, the issue is almost never the

By Deborah Westergaard, MD | Pain Experts | Dallas–Plano CMC joint arthritis can quietly erode capability long before pain becomes the main complaint. Among high-performing individuals who depend on precision—surgeons, executives, athletes CMC joint arthritis can quietly erode capability long before pain becomes the main complaint. For one surgeon, the issue wasn’t dramatic swelling or inability to work. It was something far more concerning: subtle grip changes thumb pain dur

By Deborah Westergaard, MD | Pain Experts | Dallas–Plano When Radiculopathy Drives Tendon Pain: The Hidden Link Most Patients Never Hear About Most people are told their tendon pain is a “local problem.” A sore gluteal tendon. A painful hamstring insertion. A stubborn Achilles. But not all tendon pain begins in the tendon. In many high-functioning patients, the true source is upstream—at the spinal nerve root. When a spinal nerve becomes irritated or compressed, the muscle it

By Deborah Westergaard, MD | Pain Experts | Dallas–Plano There’s an old Southern saying: “That Dog Won’t Hunt.” t’s what folks say when something just isn’t going to work—no matter how many times you try. In medicine, we see the same story play out every day. Another round of steroids. Another anti-inflammatory. Another brace, another pill. But here’s the truth: if the same approach hasn’t worked the last three times, it’s time to stop pretending it will magically start worki

By Deborah Westergaard, MD | Pain Experts | Dallas–Plano Myth #11: Going Along to Get Along — Why Playing It Safe with Steroid Shots and Surgery Can Cost You Your Joints There’s an old Southern phrase, "Go along to get along.”I t means you keep doing what everyone else does… not because it’s working, but because that’s what’s familiar. But when it comes to your health and mobility, “going along to get along” can cost you something you can’t get back: your joints. For decades

By Deborah Westergaard, MD | Pain Experts | Dallas–Plano The Hidden Bias Behind “Covered Care” There’s a deeply ingrained belief among both patients and physicians  that if an insurance company doesn’t cover a treatment, it must be unproven or worse, “fringe.” Even excellent, forward-thinking physicians fall into this mindset. We’re trained from day one to consider cost and coverage because we genuinely care about our patients. We want to ease their suffering without creating

By Deborah Westergaard, MD | Pain Experts | Dallas–Plano Orthobiologic Myth #7: “Older Adults Don’t Respond to PRP” There’s a persistent myth that once you cross a certain age, regenerative medicine is off the table. That your platelets are “too old” or your body no longer knows how to repair itself. That simply isn’t true. It’s accurate that platelet viability and stem-cell activity gradually decline with age, and that certain medications (like platelet inhibitors or anti-in