We’re excited to bring you our latest episode of Pod of Inquiry, featuring distinguished physiatrist Dr. Shane Mangrum, who brings his expertise to one of medicine’s most common yet complex challenges: Spine Health & Low Back Pain Management
In this illuminating discussion, Dr. Mangrum breaks down:
– The intricate relationship between physical activity and back health
– Common misconceptions about back pain treatment
– Evidence-based approaches to managing chronic low back pain
– When to seek medical attention versus self-managing symptoms
– The latest developments in rehabilitation medicine for back pain
As a practicing physiatrist and pain management specialist, Dr. Mangrum offers unique insights into the rehabilitation process and shares practical advice that listeners can apply to their daily lives. Whether you’re dealing with back pain yourself or simply interested in understanding this prevalent condition better, this episode provides valuable information for everyone.
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Guest Biography
Dr. Shane Mangrum
Shane Mangrum, MD, is an experienced, board-certified physiatrist at Axion Spine & Neurosurgery in Alpharetta in the Atlanta, Georgia metropolitan area. He is double-boarded in physical medicine and rehabilitation, as well as sports medicine. He takes a holistic approach to spine treatment and other musculoskeletal disorders, specializing in non-operative interventions.
Dr. Mangrum earned his undergraduate degree in organismic and evolutionary biology from Harvard College in Cambridge, Massachusetts. He completed medical school at the University of Utah in Salt Lake City. Dr. Mangrum finished medical training with residencies in physical medicine and rehabilitation at Mayo Clinic and the University of Utah.
He served as a partner at Eastern Idaho Spine Center in Idaho Falls, Idaho, and medical director of Inpatient Rehabilitation, Occupational Medicine and the Spine Center of Excellence at Eastern Idaho Regional Medical Center in Idaho Falls. Dr. Mangrum is a co-founder of TheraNova, LLC, a biomedical development company.
Dr. Mangrum stays up-to-date with the latest advances in physical medicine and rehabilitation and sports medicine with continuing education. He is board-certified in these fields and is a member of the American Academy of Medical Acupuncture.
Dr. Mangrum also holds a certification from the Titleist Performance Institute (TPI), which focuses on improving golf performance by addressing specific physical limitations.
Drawn to the climate and culture of Atlanta, Dr. Mangrum now resides in Milton with his wife and four beautiful children. He welcomes patients to Axion Spine & Neurosurgery and looks forward to caring for them.
Show Notes from this episode
- Introduction and Guest Introduction 0:00
- Dr. Barrett introduces Dr. Shane Mangrum, highlighting his qualifications and specialization in physiatry and sports medicine.
- Dr. Mangrum shares his journey into medicine, initially considering family practice before discovering physiatry during a summer research project.
- Dr. Mangrum discusses his practice in the Atlanta area, emphasizing the multidisciplinary approach with neurosurgeons.
- Overview of Physiatry and Its Specialization 4:07
- Dr. Mangrum explains the origins of physiatry, starting with the care of veterans post-World War II.
- He describes the specialty’s evolution from treating severe injuries to a focus on improving function and quality of life.
- Dr. Barrett and Dr. Mangrum discuss the differences between physiatry and anesthesia pain management, noting the neurological overlap in physiatry.
- Dr. Mangrum mentions the training in neurology and the use of EMGs and nerve conduction studies, which are unique to physiatry.
- Prevalence and Characteristics of Low Back Pain 8:05
- Dr. Mangrum estimates that spine-related pain, particularly low back pain, constitutes 75-80% of his practice.
- He notes that low back pain is more common than neck pain, with a 60-40 split in favor of low back pain.
- Dr. Barrett and Dr. Mangrum discuss the perception that low back pain is often related to daily activities rather than specific traumas.
- Dr. Mangrum references Gordon Waddell’s work, which criticizes the tendency to confuse back pain with a disease rather than a symptom.
- Diagnosing and Classifying Low Back Pain 11:33
- Dr. Mangrum emphasizes the importance of listening to patients’ stories to identify patterns of pain.
- He explains the different types of low back pain, including facet-mediated pain, disc-related pain, and neuropathic pain.
- Dr. Mangrum describes the common descriptors for facet pain, such as pain worsening with standing and bending back.
- He highlights the importance of subgrouping patients to craft specific treatment solutions.
- Treatment Options for Low Back Pain 18:19
- Dr. Mangrum discusses the use of diagnostic medial branch blocks to confirm facet-mediated pain.
- He explains the traditional treatment of radiofrequency ablation and the newer options of PRP and stem cell injections.
- Dr. Barrett shares his experience with the long-term effectiveness of radiofrequency ablation in peripheral nerves.
- Dr. Mangrum introduces the concept of basal vertebral nerve ablation for anterior column pain, which provides long-term relief.
- Understanding Modic Changes and Vertebral End Plate 24:17
- Dr. Mangrum explains the concept of Modic changes, which are inflammatory changes in the end plate of the vertebrae.
- He describes the role of the basal vertebral nerve in transmitting pain from these changes.
- Dr. Mangrum provides a layman’s explanation of the vertebral end plate and its significance in low back pain.
- He discusses the evolution of treatments for disc-related pain, including the limitations of Chymopapain injections and discograms.
- Preventative Measures and Lifestyle Changes 35:00
- Dr. Mangrum emphasizes the importance of preventative medicine and exercise in managing low back pain.
- He discusses the role of exercise in improving function and reducing pain, including exercises that target the posterior chain.
- Dr. Barrett and Dr. Mangrum agree on the importance of addressing the psychological and emotional aspects of pain.
- Dr. Mangrum highlights the negative impact of untreated depression and anxiety on pain management.
- Advice for Managing Early Signs of Low Back Pain 40:21
- Dr. Mangrum advises against the “maybe it will go away” approach, emphasizing the importance of early intervention.
- He recommends exercise as medicine and being aware of societal patterns that contribute to back pain, such as excessive sitting.
- Dr. Barrett shares his personal experience with traction therapy and the effectiveness of the VAX-D machine.
- Dr. Mangrum mentions the mixed evidence for inversion tables and the better-supported use of cervical traction.
- Conclusion and Contact Information 44:03
- Dr. Barrett thanks Dr. Mangrum for the insightful discussion and expresses a desire to collaborate more often.
- Dr. Mangrum provides information on how to contact his practice, Axion Spine and Neurosurgery, and their website.
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