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 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

By Deborah Westergaard, MD | Pain Experts | Dallas–Plano Pain Transformation: When Pain Becomes the Teacher: Adversity as the Catalyst for Transformation When Pain Interrupts Your Power One day it’s simple. Twisting a cap, shifting gears, or signing your name. Then, seemingly overnight, that freedom disappears. Pain at the base of your thumb, the wrist that once steered your car or typed your vision into reality, now protests every small movement. Blow-drying your hair become

By Deborah Westergaard, MD | Pain Experts | Dallas–Plano  “PRP is just spinning blood and injecting it.” A colleague of mine once called and asked how much blood I draw for a PRP knee procedure.I was honestly flabbergasted—because that question misses the entire point. That’s like asking, “How much anesthesia do you give?” Any experienced physician knows the answer depends on the patient, the pathology, and the plan. When a patient comes in with knee pain, I don’t simply inje

By Deborah Westergaard, MD | Pain Experts | Dallas–Plano It’s human nature to look for one culprit. “One bad disc.” “One torn tendon.” “One joint gone wrong.” But the body doesn’t work that way—because it’s not a collection of parts. It’s a living, moving system. The One-Problem Illusion “My Pain Is Coming from One Problem” We grow up believing that pain must have a single cause. After all, we live in a medical world built on specialists, each one focused on one part of the b

By Deborah Westergaard, MD | Pain Experts | Dallas–Plano The Umbilical Stem Cell Myth: What the FDA Really Says The Myth: You’ve probably heard it. “Umbilical stem cells are the most powerful, youthful cells you can get. Why use your own when you can have younger ones?” It’s a seductive story, especially in an era obsessed with quick rejuvenation. Clinics across the country promote umbilical, placental, and amniotic products as if they were a medical revolution already blesse

And that’s the problem. Because to “feel” your way into a joint, you often have to touch bone — or even hit it — to know you’re deep...

By Deborah Westergaard, MD | Pain Experts | Dallas–Plano “PRP Works Instantly " Is Expecting Instant Gratification From Biology In a...

By Deborah Westergaard, MD | Pain Experts | Dallas–Plano Outdated Thinking About Cartilage Repair After 50 They told you cartilage can’t...