Expert Blog


3 Tips for Choosing a Physical Therapy Plan

May 18, 2018

Many entering the world of pain management feel overwhelmed by their options. After all, no two methods are alike. Here are the factors you need to keep in mind when choosing your physical therapy plan.

Referrals and Experience

Even if you aren’t required to receive a referral from your primary care doctor, ask your doctor to recommend a physical therapist or facility for your specific issue. Don’t be afraid to ask family and friends for recommendations as well. The internet is also a great place to find reviews.

As you begin to visit different offices, be sure to ask many questions about the physical therapist’s experience with your condition. It’s important to verify that your physical therapist is licensed and has advanced certifications or credentialing.

What Does it Include?

One very important question to ask is what your insurance will be able to cover. Check your health plan to determine details of your coverage, and find out how much out-of-pocket expenses you’ll have to pay. See if your physical therapist’s office accepts your plan.

Investigating what your insurance covers will help you decide exactly what you need and/or have access to. There are several types of rehabilitation methods, from cardiovascular training to taping. Ask what the facility offers and if certain locations offer different programs that may meet your needs better.

Convenience and Comfort

Don’t let a long drive keep you from working on your health. Choose a facility that’s close by or has several locations, especially if you experience discomfort driving. If you choose an office that’s far away, you’ll soon be missing appointments.

Lastly, make sure you’re comfortable with your therapist. You should look forward to your appointments, not dread them.

Are you suffering from chronic back pain? Find your solution at Sonoran Spine, offering services from physical therapy to surgery. Contact us to request an appointment today.

Posted in Expert Blog


Conservative Treatment for Musculoskeletal Pain

May 10, 2018

One in two Americans have a musculoskeletal condition. These conditions vary from arthritis, back and neck pain, and osteoporosis. If you’re suffering from musculoskeletal pain, you can find pain relief beyond pain killers and operations. Here’s what you need to know.

What is Musculoskeletal Pain?

Musculoskeletal pain affects the muscles, ligaments, tendons, and bones.


Musculoskeletal pain can be caused from:
  • Wear and tear of daily activities
  • Jerking movements
  • Auto accidents
  • Falls
  • Fractures
  • Dislocations
  • Direct blows
  • Postural strain
  • Repetitive movements
  • Overuse
  • Prolonged immobilization
  • Poor body mechanics


The symptoms of musculoskeletal pain vary from person to person. They include:
  • Entire body aches
  • The feeling of pulled or overworked muscles
  • Twitching
  • Burning
  • Fatigue
  • Sleep disturbances

Conservative Treatments

Medication is often used to treat inflammation or pain. More and more people are rightfully seeking drug-free treatments. Nearly 500,000 people are admitted to emergency rooms every year due to overdose, and lowering dosage can often cause withdrawal symptoms, even when addiction isn’t present. Non-medicated pain solutions include:
  • Bracing
  • Dorsal Root Ganglion Therapy
  • Electromyography and/or Nerve Conduction Studies
  • Epidural Injections
  • Facet Joint Injections
  • Joint/Tendon Injections
  • Medical Branch Blocks
  • Physical Therapy/Home Exercises
  • Radiofrequency Ablation
  • Sacral Iliac Injections
  • Spinal Cord Stimulator

Facts About Surgery

Experts say that tens of thousands of times each year, patients undergo surgery that is not necessary. In fact, studies find 10-20% of all operations are unnecessary. These operations include cesarean sections, hysterectomies, knee replacements, and yes, spinal surgeries. It’s important for spine professionals to seek options for their patients outside of surgery. Its equally as important for those suffering from musculoskeletal pain to find doctors that practice both surgical and conservative methods.

What to Do

The experts at Sonoran Spine are dedicated to creating individual plans for our patients, seeking out every option possible, and approaching surgery conservatively. To find a solution for your pain, request an appointment today.

Posted in Expert Blog


Child Scoliosis

April 17, 2018

Discovering your child’s been diagnosed with scoliosis can be terrifying. A million thoughts run through a parents’ head. It’s important to take a breath and find some answers.

Does My Child Need Surgery?

Your child may likely not need surgery if their spinal curve is less than 26 degrees or if they are almost fully grown.

Instead, it’s recommended that the curve is simply monitored to ensure it does not worsen. This may involve checks ups every four months and x-rays.

What is Bracing?

A brace will not straighten your child’s spine, but it will prevent it from getting worse. Bracing is recommended when the spinal curve is between 26-40 degrees and the child is still growing. Braces often decrease the need for future operations.

How Safe is Spinal Fusion Surgery?

If your child’s spinal curve is greater than 45 degrees, surgery may be recommended. This surgery is called spinal fusion. Spinal fusions straighten the spinal curve and then fuse the vertebrae together into one bone.

How it Works

  1. The surgeon makes an incision in your child’s neck, back, side, abdomen, or throat to access the spine.
  2. Bone graft (small pieces of bone) are either taken from a bone bank or the child’s body, usually the pelvis.
  3. Bone graft is inserted in spaces between the vertebrae and fused. Metal rods, attached by hooks, screws, and/or wires, hold the bones in place during fusion

The description of the surgery is often worry-inducing, but spinal fusion is a safe procedure. Keep in mind that if your child’s scoliosis is left untreated, it can affect lung function

Life After Spinal Fusion

As we’ve covered, there are a lot of myths and facts about scoliosis. There are common misconceptions about spinal fusion, as well.

Metal placed in the spine won’t always set metal detectors off, and when it does, security is usually understanding. Contact sport is advised against, but remaining active and healthy is recommended. Spinal fusion doesn’t affect fertility or childbearing either.

What it will do is straighten your child’s spine and impact their health positively.

If your child has been diagnosed with scoliosis, speak with one of the experts at Sonoran Spine. We’re dedicated to finding both surgical and non-surgical solutions for our patients. Contact us today.

Posted in Expert Blog


How Digestive Disorders Affect Bone Health

April 03, 2018

Research shows bone loss is much more common in women than men. This can be a frustrating fact to read for women because one of the causes is low calcium intake. Why are women taking in less calcium? It could be because women are twice as likely to suffer from IBS.

IBS stands for irritable bowel syndrome. It’s an intestinal disorder that causes stomach pain, gas, diarrhea, and constipation. One of the treatments is something called a low FODMAP diet, which means cutting back on dairy products that cause IBS symptoms. IBS experts warn that dairy is an important source of calcium and, therefore, should not be eliminated completely. It’s the same warning lactose intolerance experts give, especially to women. Lactose intolerance in women immediately raises a women’s risk for bone health problems.

Both women and men with digestive disorders are stuck between a rock and hard place. Either their digestive system suffers or their calcium intake, and thus, bone health.

What You Can Do

If you’ve been diagnosed with IBS, lactose intolerance, or a similar condition, there are still ways of keeping your bones healthy.

  • Exercise—working out encourages bone health and growth
  • Vitamin D— sunlight exposure, for instance, is necessary for bone strength
  • Calcium—if dairy causes stomach issues, try green vegetables and lactose-free milk and cheese

Other Digestive Disorders

Inflammatory bowel diseases, such as ulcerative colitis and Crohn’s disease, also affect the digestive track. Currently, there is no evidence showing FODMAP diets help IBD. Even though dairy intake doesn’t seem to affect IBD, IBD can lead to spinal arthritis.

Symptoms include lower-back pain and morning stiffness, especially in Crohn’s disease.

Get Checked

It’s important for anyone who suffers from a gastrointestinal disorder and/or cannot consume dairy to speak to their doctor about how it may affect their bone health. This is especially true for women and those older than sixty

Your spine issues and intestinal disorders may be more related than you thought. At Sonoran Spine, we consider every factor when it comes to your spine and back. Request an appointment today.

Posted in Expert Blog


Should You Get Surgery for a Herniated Disk?

March 27, 2018

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

March 08, 2018

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

February 21, 2018

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

February 02, 2018

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

January 24, 2018

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

January 04, 2018

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?

December 20, 2017

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

December 08, 2017

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

November 27, 2017

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

November 27, 2017

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

November 10, 2017

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

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