By Deborah Westergaard, M.D. Dallas | Regen Experts Dallas & Plano Treating Knee Arthritis in Dallas For decades, the conventional explanation for knee osteoarthritis was simple: the cartilage wears away, the bones rub together, and eventually you need a knee replacement. I believe that explanation is incomplete. In many patients, the cartilage is not the primary problem—it is the victim. Modern research increasingly recognizes osteoarthritis as a disease of the entire osteoc

By Deborah Westergaard, M.D. Dallas | Regen Experts Dallas & Plano If you've been told that nerve burning—also known as radiofrequency ablation (RFA) or rhizotomy is your next step for chronic back pain, you may wonder whether it is your only option. For many years, I performed these procedures myself. Today, I do not. That decision was not based on a single study or a single patient. It came from years of experience, an evolving understanding of spinal biomechanics, and a gr

By Deborah Westergaard, M.D. Dallas | Regen Experts Dallas & Plano Many patients come to my office after months—or years—of pursuing treatments designed primarily to reduce pain. Pain relief matters. But if your goal is to avoid surgery, preserve function, and maintain an active lifestyle, an important question must be asked: Are we treating pain, or are we identifying the structures responsible for the pain? For many patients, those are not the same thing. About Dr. Westerga

By Deborah Westergaard, M.D. Dallas | Regen Experts Dallas & Plano If I Could Go Back to 2008... If I could travel back to 2008, I would ask my younger self one simple question. "Should I have one more conversation before having hip surgery?" At that time, the procedures I perform today simply weren't available. The landmark intraosseous bone marrow concentrate research hadn't yet been published. Physicians weren't discussing subchondral bone as an important contributor to os

Knee Arthritis Dallas: Still active, but your knees are starting to dictate your life? Many high-performing people reach a point where they are told that knee replacement is the next logical step. For some, that may ultimately be true. But many patients wonder an important question first: "Have I explored every reasonable option before replacing my joint?" Recently, I saw a gentleman with a physically demanding job who had been informed that he was a candidate for knee replac

By Deborah Westergaard, MD | Regen Experts powered by Pain Experts Why “Basic Orthobiologics” Often Falls Short in the Pursuit of Nonsurgical Knee Care Precision Versus Performance Decline Most people do not realize they are making a strategic decision about their future mobility until it is almost too late. At first, it is subtle. The golf swing changes. The stairs become irritating. Travel becomes less enjoyable. Recovery after exercise becomes longer. Many high-performing

By Deborah Westergaard, MD | Regen Experts powered by Pain Experts For much of my medical career, my mission was straightforward: Find the pain signal. Calm the pain signal. Help the patient suffer less. And there is absolutely nothing wrong with that. Interventional pain management can be life-changing for people in severe pain. Nerve blocks, epidural procedures, spinal cord stimulation, and radiofrequency treatments have helped many patients regain function, sleep, mobility

By Deborah Westergaard, MD | Regen Experts powered by Pain Experts The Problem: A Diagnosis That Often Leads Straight to Surgery He walked into my Dallas clinic with a familiar story. A high-performing individual. Disc degeneration on imaging. Pain beginning to interfere with movement, travel, and performance. And the message he had already started to hear: “This is degenerative disc disease… and eventually, you may need surgery.” This is where many patients feel their option

By Deborah Westergaard, MD | Regen Experts powered by Pain Experts Hip Pain in Dallas: When It Begins to Change How You Move Hip pain rarely begins as a crisis. It starts subtly: tightness when standing, discomfort when walking, a slight hesitation before taking a step. Over time, that hesitation becomes compensation. And compensation becomes limitation. For many high-functioning individuals, this is the real problem: Not just pain, but the gradual loss of fluid, confident mo

By Deborah Westergaard, MD | Regen Experts powered by Pain Experts Avoid Back Surgery Dallas: Knowing When Surgery Is the Right Decision There are two common extremes in spine care: One pushes quickly toward surgery. The other tries to avoid it at all costs. Neither represents strong decision-making. Because the real question is not “surgery or no surgery.” The question is: “Is this the right decision for this patient, at this time, based on complete information?” To appropri

By Deborah Westergaard, MD | Regen Experts powered by Pain Experts Avoid Back Surgery Dallas: Understanding the Spine as a System, Not Just an MRI A disc bulge appears on an MRI. The conclusion often follows quickly: this must be the cause of the pain and surgery may be required. But this is where many decisions lose precision. Because imaging findings alone do not always explain symptoms. To effectively avoid back surgery in Dallas when appropriate, it is critical to underst

By Deborah Westergaard, MD | Regen Experts powered by Pain Experts Avoid Back Surgery Dallas: When a More Strategic Evaluation Changes the Decision Being told you need back surgery can feel like a final answer. An MRI shows a disc bulge, degeneration, or stenosis—and the path forward appears defined. But high-level decisions—especially irreversible ones—deserve a more complete view. The spine is not a single structure. It is a dynamic system of discs, joints, ligaments, and s

By Deborah Westergaard, MD | Regen Experts powered by Pain Experts The Question Many Patients Ask “My doctor told me I’m a candidate for knee replacement surgery based on my x-ray.” This is one of the most common things I hear from patients who visit my clinic. Often the x-ray shows advanced arthritis or what is sometimes described as “bone-on-bone” cartilage loss. When patients hear this, it can feel like the path forward has already been decided. But in many cases, an x-ra

By Deborah Westergaard, MD | Pain Experts When the Goal to Avoid Rotator Cuff Surgery Becomes the Next Logical Step You have shoulder pain. You complete physical therapy. You modify activity. You may try medication or injections. The pain persists. An MRI confirms a rotator cuff tear. You consult an orthopedic surgeon. Surgical repair is recommended. This recommendation is often appropriate. Surgeons are highly trained in reconstructing torn tissue. When structural failure is

By Deborah Westergaard, MD | Pain Experts If You’re Going on a Vegetarian Diet… Do You Shop at a Butcher? Let me ask you something. If you’ve decided to pursue a vegetarian diet…is the first place you go a butcher shop? Of course not. Not because the butcher is wrong.Not because meat is bad.But because the solution you’re seeking doesn’t match the training of the provider. The same principle applies to your joints and spine. If your goal is to avoid surgery in Dallas, the fir

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 “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 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