Expert Blog


Should You Get Surgery for a Herniated Disk?

Young discs are made almost entirely of water. As we age, they become less pliable and more prone to damage. The vast majority of herniated disc patients are given conservative treatments because most improve within six months without the help of surgery. That said, it’s important to move onto aggressive care if other therapies don’t work. X-rays, EMGs, and CT scans will determine the source of your symptoms and thus their best cure.

Passive Nonsurgical Options

Deep tissue massage and heat therapy can help to relieve muscle spasms, and in so doing, allow you to achieve a posture that reduces further damage. Muscle spasms can also be relieved with TENS machines and hydrotherapy.

Active Nonsurgical Options

Therapies as simple as spending less time on bed rest can have a drastic impact on pain levels, so physiotherapy and occupational therapy are the nucleus around which all other therapies must revolve. Developing enough core stability to reduce pressure on the offending disc is a necessity in almost all cases. Anti-inflammatories and muscle relaxers may help you cope with your symptoms, and anticonvulsants can raise your pain threshold. In severe cases, medications can be injected directly into the pain site.


  • Discectomies remove some or all of the offending disc.
  • Microdiscectomies magnify the surgery site to guide disc removal.
  • Anterior discectomies and fusions reach the site through the neck before fusing the vertebrae and replacing it.
  • Cervical corpectomies remove both the offending vertebra and those next to it for decompression.
  • Laminoplasties reconstruct the spinal canal.
  • Spinal laminectomies treat stenosis by reliving spinal cord pressure.

Pain leads to depression and erodes quality of life, so it should always be taken seriously. Sonoran Spine has a team of specialists who support your progress and will not only improve your odds of recovery, but reduce your sense of hopelessness.

Posted in Expert Blog


Surgery for Degenerative Disk Disease

Those with degenerative disc disease enjoy a 33% reduction in pain score and a 25% decrease in disability when compared to non-surgical patients. Operative care even reduces treatment costs. Spinal fusion has been the traditional go-to approach for many years, but treating such a broad range of conditions in the same way is like trying to shoot a fly with a cannon. Thorough diagnostics will determine the best surgical option for you.


Fusion stabilizes parts of the spine that are causing pain. There are three broad options here: posterolateral, interbody, and minimally invasive fusions. The latter evades muscle damage and speeds up recovery times. This makes it an excellent choice for patients who have a high risk of infection and inflammation.

Artificial Disc Replacement

Artificial discs are best for pain that’s caused by the disc itself rather than by instability. This surgery can’t recreate full motion, but it does leave you with more movement than fusions can achieve, which could reduce the likelihood of further degeneration. The incision is made directly over the spine these days rather than above the abdomen, which reduces risk of injury. Total disc replacement removes all disc tissue, while disc nucleus replacement implants a device between the vertebra.This technique has been in use since the Sixties, but its results and safety profile are comparable with fusion.

The more precise your diagnosis, the better your odds of choosing an effective surgical cure. Your doctor will need to assess your risk of delayed healing, infection, and neurological impairment to make sure your surgery doesn’t lead to further damage. Tissue engineering techniques will eventually be added to your options. They’re currently bring put through human trials, so one day, it might become possible to grow new tissue at the damage site.

If you've been diagnosed with degenerative disk disease, it's not too late to visit Sonoran Spine. We treat every patient uniquely and explore all of their surgical options.

Posted in Expert Blog


Conservative and Surgical Treatments for Your Spine

Treatments for medical concerns related to the spine vary from conservative to surgical interventions. Depending on the area of the spine, the level of injury or disability, and the degree of problems in those injuries, treatment options will vary. Whether your spinal issues are related to arthritis, hernias, sciatica, or sprains and strains, you can find effective solutions to treat all issues of the cervical, thoracic, and lumbar spine.

Conservative Treatments

Effective conservative treatment can include pain management services. Seeing a specialist in pain management can go a long way to getting you back to work or simply moving again without the restrictions of chronic pain. Interventions for pain management vary with:

  • Use of injections
  • Medical branch blocks
  • Physical therapy
  • Radiofrequency ablation
  • Spinal cord stimulator

Individual Plans

Having an individualized plan created for your specific needs without the heavy reliance on pain medications or extensive surgical options is an effective solution that you can advocate for with your spine treatment provider.

Spinal Surgery

Sometimes spinal surgery is required in order to effectively address the medical issues. When this occurs, there can be different types of surgical interventions available to you-- minimally invasive, significantly invasive, or reconstructive. Seeking a spine specialist with extensive experience in this area of treatment is a must. Surgical treatment can address:

  • Bone infections of the spine
  • Instability of the spine
  • Neurological dysfunctions

Seeking Help

Making the decision to seek out expert medical diagnoses and treatment recommendations is the first step in addressing spine pain and problems. There are effective, conservative, and more extensive surgical options available to address your spinal needs. Treatment options can be explored and explained to you by medical professionals. Don't hesitate to seek out the support today to get on the road to being healthy and pain free. Request an appointment at Sonoran Spine.

Posted in Expert Blog


Back Pain-- Reduce, Relieve, Manage

Back pain can be caused by a multitude of factors from sprains and strains to degenerative diseases. When struggling with chronic pain in you back, seek a spine specialist for diagnoses and treatment. Seeking treatment allows you to return to regular activity and the kind of life you've wanted to lead. Relieving, reducing, and managing back pain is a real possibility for you, too.


Addressing pain begins with an accurate diagnosis of the symptoms and difficulties. Diagnostic tools vary depending on where the problem is located. These tools could include:

  • X-ray
  • MRI
  • PET Scan
  • CT Scan
  • Nerve Conduct Study

Once an appropriate diagnosis of what the pain is caused by, the intervention to address your back pain can begin. Pain management options will defer depending on what the cause of your pain is, but there are several different options to chose from. Your medical provider will be able to provide you with an individualized plan for treatment, Some options to relieve, reduce or manage your back pain include the following:

Radiofrequency Ablation

Radio waves are used to generate heat around the nerves, thereby causing the nerve to lose its ability to send pain signals to the brain. This is a minimally invasive procedure that should be effective for more than 12 months.

Medical Branch Block

This intervention is an injection that will block sensory signals to the brain. Additionally, a medical branch block can also diagnose a pain related issue. You can return to regular activity rather quickly after the treatment.

Facet Joint Injection

Similar to the previously described block, this in a injection that is used to diagnose and treat a pain related issue. This steroid injection provides pain relief quickly.

Epidural Injection

This injection reduces inflammation which can cause back pain. This block reduces the pain cycle, improves your recovery, and helps you get back to your desired activities. Sometimes, more than 1 injection is recommended to get the most relief from this treatment. Regardless of what kind of pain you have, there is assistance available. Sonoran Spine has a team specialists dedicated to accurate diagnosis and treatment recommendations.

Learn about your options to relieve, reduce, and manage your pain. Request and appointment today.

Posted in Expert Blog


Recent Advancements in MRI Technology

The last few years have seen significant advances in the field of MRI imaging. Let's take a look at some of the most important upgrades:

MRI-Conditional Implant Scans

Medical implant technology has grown increasingly sophisticated, but implants traditionally complicated the MRI scanning procedure. Nowadays, however, spinal implants, pacemakers and other devices are becoming MRI-conditional, which means they do not interfere with the scanning process within certain parameters. In the past, the scanner needed to be manually adjusted to budget for the presence of the implant. But Philips recently unveiled an MRI automated user interface model which patients to be scanned faster and easier.

Silent Scanning

Noises during spinal imaging can be a real headache. With the new SilentScan package included in GE Healthcare's Signa Pioneer 3T system, the noise created during spinal imaging and other types of MRI processes can be greatly reduced.

The Ingenia 1.5T System

This system includes an Ambient Experience technology package that offers a soothing experience for the patient complete with imagery, sound and light specially designed to help patients relax. Ingenia also offers ScanWise implant technology, which greatly simplifies the process of scanning patients with spine implants and other types of implants.

Signa MRI

The Signa Pioneer carries a piece of technology known as Total Digital Imaging (TDI), designed to greatly improve the quality of the image yielded by the MRI. Spinal images offer superior homogeneity as well as uniformity, while Zero TE imaging allows for the imaging of tissues that can be difficult to see with regular MRI. The machine is designed to be cheaper than its competitors and uses up to 34% less energy as well.

At Sonoran Spine, we're dedicated to making your spinal treatments as comfortable and effective as possible. Request an appointment today.

Posted in Expert Blog


Finding the Right Team for Your Spine

Finding a top rated team of interventional pain management specialists requires one to understand what you need in a provider. When seeking a pain management medical provider to address my spinal issues, choose carefully. These tips will help you find the right medical specialist.

Experience and Training

It goes without saying that using a highly trained medical professional is absolutely mandatory. Your doctor must be renowned in their field and have extensive experience with providing the treatment you need, in this case pain management. Where was their training? Have they been involved in research? Do they have subspecialty expertise that can address your needs? Do they have professional affiliations? Are they licensed and credentialed or board-certified? These questions can be asked and answered by your provider.

The Team

Using a provider that has an "in-house" team of professionals to meet all of your needs is a priority. This team includes more than just your doctor but assistants, nurses, and effectively trained support staff. Is there a designated person to ask billing and insurance questions? Is there emergency help available should you need it? A comprehensive treatment team that can create an individualized approach to your pain management means that all of your needs are addressed. This can provide diagnosis and treatment all under one roof so to speak.


Overall, when seeking a top rated team, do your research. Check their website, ask friends and family about their experiences with the provider, and make sure you feel comfortable. Your questions should be answered, and there should be a clear and understandable treatment plan in place to diagnose and treat your pain. A great pain management team will make you feel listened to and respected. Pain impacts your quality of life but change and relief occur with the right interventional pain management specialist.

Sonoran Spine has an extensive medical team of surgeons and pain management physicians. We believe in transparency, allowing our patients to see everything from their nurse practitioner to their doctor's medial assistant. Meet our staff and request and appointment today.

Posted in Expert Blog


What is Osteoporosis?

The International Osteoporosis Foundation estimates that 44 million women and men 50 and older have osteoporosis or low bone mass. That represents 55% of Americans in that age bracket. That’s a startling statistic, especially if you’re nearing that magic number and are concerned about your own bone health. Knowing about Osteoporosis is one of the best ways to prevent or treat it.

The Silent Disease

Osteoporosis is known as the “silent disease” because it has few symptoms and even those can only be explained in numerous ways. Backaches, loss of height and fractures of the wrist, hip, or spine are some possible symptoms.

Gradual Diagnosis

Osteoporosis doesn’t happen overnight. In fact, many people are diagnosed with Osteopenia first, which simply means the bones are beginning to weaken.

How to Tell if You Have Osteoporosis

The only conclusive way to know if you have Osteoporosis is to measure the density of your bones. This can be called a Bone Mineral Density Test, a densitometry test, or a DEXA scan. The testing is painless and will tell you if you fall within the parameters of Osteoporosis. Many physicians suggest a baseline test around the age of 50 in order to compare it to scans performed later on.


There is good news. Osteoporosis can be prevented or moderated with proper nutrition, weight bearing exercise, and calcium supplements. If you’re diagnosed with Osteoporosis, there are medications that have been developed to prevent further bone loss, and in some cases, reverse it.

In the world of health, knowledge is power. If you are concerned about bone health or considering taking supplements, whatever your age, request an appointment at Sonoran Spine. Our experts are dedicated to providing you treatment made just for you.

Posted in Expert Blog


Spinal Trauma Diagnosis and Treatment

Spinal trauma can impair movement, cause chronic pain, and impact your quality of life. Seeking out a spine specialist for an accurate diagnosis and effective treatment can return you to the life you want to live and make all the difference in the world. Whether your spinal trauma is caused by an injury, accident at work or a chronic condition, you can get support to get moving again.


Accurate diagnosis of your medical concern is the first step to treating your trauma. Diagnosis should be completed by trained spinal specialists using the tools of the trade. The devices involved in the diagnosis of spinal trauma can include the following:

  • Magnetic Resonance Imaging or MRI
  • X-Ray
  • Computer Tomography Scan or CT Scan
  • Electromyography

Once accurately diagnosed, your spine specialist can create an individualized treatment plan for your needs. These may include surgical or non-surgical approaches to your care. Treatment will vary depending on your specific needs.

Non-Surgical Treatment

  • Pain Management
  • Physical Therapy
  • Exercise Programs
  • Wearing Braces

Surgical Treatment

These medical interventions will have different goals and approaches depending on the type of injury. It may involve traction for several months, repairing different areas of the spine, addressing fractures, bone grafting or fusion. Surgery is only recommended when absolutely necessary and your treatment provider will likely provide you with many different options prior to that step. Regardless of the type of spinal trauma you may have endured, you can heal and return to your past functioning. It takes an accurate diagnosis, effective treatment interventions and seeing a spine specialist to make these changes. Request an appointment today.

Posted in Expert Blog


Prevent Back Pain During Holiday Shopping

Holiday shopping is said to burn 1500 calories per trip, so it can be as harsh on your body as it is on your bank account. There are 12000 ER visits caused by activities of the season every year. 10% of them are caused by back strain, and 34% are related to falls. Keep your shopping trips safe and injury-free with these tips:

Keep a Light Purse and Slim Wallet

You probably know you need to empty out your purse before a long shopping trip, but your wallet can cause as many back problems as the weight you carry. Keeping an overloaded wallet in your back pocket can put pressure on the sciatic nerve, causing pain. Keep your cards and license in a front pocket and wear a purse diagonally over your chest.

Stay Alert

Most acute back pain is caused by overstretching and accidents, so save your Christmas shopping for times when you’re alert. Making your shopping trips when you're alert will also help you stay attentive to traffic and avoid injuries caused by road crashes and near misses.

Balance Your Load

Carry your shopping bags in such a way that weight is evenly distributed on both sides of your body. Better yet, use a shopping cart. Bring your own sturdy, comfortable bags instead of using the ones from stores.

Learn Healthy Lifting Habits  

Don’t bend at the waist, as this places weight on your spine. Instead, use your legs and arms where possible, keeping any weight focused on the top of the spine. Make use of railings and handholds where possible, and if you experience pain, respect your need for rest.


If you’ve just woken up or are going shopping after spending hours at a desk, do some simple stretches before you go shopping. Don’t neglect your neck, hamstrings, and lower back.

Finally, don't forget to stay hydrated. The holidays are supposed to be a festive time, so make sure your shopping trip leaves you energized and ready to celebrate the season pain-free. 

Posted in Expert Blog


Throw Yourself A Bone: Prevent Osteoporosis

Osteoporosis has found itself in the midst of more than a few debates, particularly for its responsiveness to supplementation. Vitamins D, K, and calcium are often pinpointed as the roads to perfect bone health, but the truth is not quite that simple.

The Truth About Supplementation

Osteoporosis’ catastrophic falls and fractures make even the most marginal improvements important. Vitamin D has been the subject of a few tiny studies but hasn’t performed consistently in meta studies. Calcium and vitamin D deficiencies certainly lead to bone softening, but that doesn’t make supplements after diagnosis a cure. D supplements do reduce falls slightly, so they’re an important part of care. Calcium levels need to be increased in most adults because daily intake is generally lower than the recommended levels. The Cochrane Review concluded that supplementation over recommended daily allowances has little effect as a preventative measure. In other words, it's best to get your nutrition from food whenever possible.

Building through Prevention

Osteoporosis develops over decades, so bone strength and density must be protected continuously through daily habits. Alcohol and nicotine consumption will cause more problems than those D supplements will ever prevent. Quit smoking, forego that second glass of wine, and watch your estrogen levels.

If you have a high risk of developing osteoporosis, do regular bone density scans and add regular weight bearing exercise to your routine. This way, you can encourage the resorption and formation of new bone, which should compensate for normal bone loss.

Bisphosphonate drugs are effective at reducing spine fractures and raising bone density, but such vertebral fractures are often asymptomatic and subclinical. Medications are thus only recommended when there is significant risk of fractures. Every patient needs the judgement call of their own doctors.

Osteoporosis arises from lifestyle choices made from adolescence onward, so it’s never too early to begin a preventative program. 

Posted in Expert Blog


Dr. Chang featured in azcentral article

Michael S. Chang, MD was recently interviewed for an azcentral article. Read about Dr. Chang and his expertise on spinal conditions in children and adults.

Read "Spinal conditions in children and adults"

Posted in Expert Blog, Michael Chang MD


Tingling In Your Spine? It Might Not Be Halloween

You might think that numbness and tingling don't deserve serious care because these symptoms seem more benign than pain, but any unusual sensation is your body’s request for change. Numbness can be surprisingly debilitating. It even takes a toll on your emotional resources. It should be looked into as soon as possible, because it may indicate stroke, seizures, or circulation loss.


Complete or partial numbness is usually a sign of damage or nerve compression, which can be caused by carpal tunnel syndrome, a slipped disc, or secondary problems related to diabetes. The hands and feet are more prone to this form of damage. Most numbness is not associated with strokes or tumors, but these causes must be ruled out by a doctor anyway. You can assist with diagnosis by keeping a diary of your symptoms, along with their time of day, your activity levels, and exercise. An EMG and MRI might be needed, but the more careful you are with recording your symptoms, the faster and more accurate your doctors will be.


Tingling and numbness often coexist and even have the same causes sometimes. However, tingling can also be a sign of an insect bite, nutritional deficiencies, infection, and Raynaud’s Phenomenon. You’ll need a thyroid test and your physician might look for spinal cord swelling. Seizures and migraines can also cause strange sensations, including skin crawling. A toxicology screen, angiogram, and ultrasound might also be ordered, depending on your response to basic in-practice diagnostics.

The Creepy-Crawlies In Medical Terms

In addition to these two symptoms, you might experience formication—the sensation of bugs crawling on or under the skin. This latter symptom could be the result of medication side effects, so take a list of the pharmaceuticals you use to your appointment. The absence of pain doesn’t mean the absence of suffering, and you deserve care. 

Posted in Expert Blog


Halloween Skeleton Facts

Your spine might well be the oddest part of your body. It evolved too poorly to do its job well, undergoes changes from morning to night, and has the same number of vertebrae as a giraffe. It’s made from billions of neurons and keeps your brain in contact with the rest of your body. As spine specialists, we thought we'd share some fun facts about the spine in time for Halloween:

If You Want To become Taller, Visit the Moon

Gravity affects your height more than you might imagine. You’re taller when you wake up than when you go to sleep. Astronauts who spend time in space grow by as much as two inches. Once they return to planet earth, gravity goes to work to steal all that precious height.

Your Spine is Your Body’s Data Center

The spinal cord consists of a tangle of billions of nerves that send and receive information to and from the rest of the body. It’s the hub of all the body’s nerve signals. It doesn’t even need messages from the brain in all scenarios. Sometimes, it sends signals autonomously.

Doctors are Starting to do Robotic Back Surgeries

Robot-assisted spine surgery might sound as though it belongs in a sci-fi film, but surgeons are already using it to do surgeries in some locations. In the future, the technology will improve precision and outcomes.

Babies have "Extra" Vertebrae

Humans usually have 33 vertebrae, which are separate at birth. As you grow, the bones of the lower spine fuse, forming the sacrum and coccyx. So, if you've ever envied a baby's flexibility, don't feel bad.

The Spinal Cord Has Gray Matter

Just like the brain, the spine is made from white and gray matter. The latter is a collection of motor neurons, and the former is responsible for communicating with the rest of the body.

The spine is your brain’s personal assistant, and it does its job beautifully. If you are experiencing issues with your spine, contact us for a consultation.

Posted in Expert Blog


Stem Cell Study Shows Promise for Paralyzed Patients

Stem cell therapy is among the most exciting developments in modern medicine. The science is still in its early stages, so it’s not quite time to make an appointment, but legitimate trials are beginning to show promising results.

Can Stem Cells Cure Paralysis?

Asterias Biotherapeutics conducted one of the largest human trials in 2016, using a sample group of six patients with varying degrees of paralysis. The trial’s results began to roll in in October 2017, a year after 10 million stem cells had been transplanted. Four of the six patients experienced improved mobility significant enough to impact their quality of life. While a study of this size and scope cannot be viewed as conclusive, researchers have high hopes based on these results.

Human Trials in Stem Cell Spine Research

As yet, most trials have had small sample groups or animal subjects. Stem cell research has ambled along at a sluggish pace, and Asterias’ trial patients may have improved for reasons unrelated to the use of embryonic cells. Spontaneous recovery is surprisingly common in patients with some forms of paralysis. 27% of traumatic six-nerve palsy patients recover on their own, and most of those with Bell’s palsy recuperate within six weeks.

Stem cells could restore communication between your body and brain, but with no clear direction in sight, researchers are still arriving at the most effective way to handle transplants. 99% of spinal cord injury patients who are paralyzed a month after a back injury never walk again, so researchers have been focusing on transplanting new cells into the cavity formed by the damaged area in the spinal cord. They also hope that stem cell therapy will reduce inflammation that causes further paralysis.

Nobel laureate Shinya Yamanaka says there are 10 diseases that may respond to embryonic stem cell therapy. Medical breakthroughs takes time, but the science is already beginning to prove its mettle. 

Posted in Expert Blog


How Do NFL Players Recover From Spine Injuries?

NCAA football season has arrived with all its fans, thrills, and injuries. Each year, scholastic football endures almost 15 catastrophic cervical spine injuries. That’s a rate of four injuries for every 100,000 players. That said, the situation does come with a little hope. A study by Wolters Kluwer Health found that most NFL players who undergo upper cervical spine surgery for herniated discs recover and move on to enjoy another season -- three seasons, in fact, with performance comparable to athletes who have not sustained these types of injuries.

CDH Surgery and the NFL

The study surveyed 53 players who’d had the life-changing surgery between 1979 and 2017. 15 had upper spine herniation and 25 had lower level injuries. Nine months after the procedure, between 67 and 72% of the players had returned to the game. Of those who’d had spinal fusion, four required further surgery. Of the six who had less invasive ACDF surgery, half needed more treatments. Researchers believe that professional athletes should receive treatments tailored to their desire to return to high-performance athletics.

Cervical Spine Surgeries

Minimally invasive percutaneous cervical disc nucleoplasties are effective in 81% of patients. 95 to 98% of non-players who undergo the procedure enjoy excellent results, which underlines the importance of post-operative care. Football players in the Kluwer study returned to the field only nine months after their procedures, which may not be long enough for the bone to mature and solidify.

It’s recommended that patients get back to exercise once the fusion has set, and a reconditioning program is needed to gradually introduce stretching, strengthening, and aerobic exercise. While some patients can begin training six months after the procedure, every case should be treated as unique. Full recovery usually occurs at between 12 and 18 months.

Posted in Expert Blog

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