Episode 479 Winifred Bragg Practical Pain Solutions for Veterans Transcript
This transcript is from episode 479 with guest Winifred Bragg.
Scott DeLuzio: [00:00:00] You wake up stiff, your back aches, and it feels like just getting out of bed is a battle. You tell yourself it’s just part of getting older or maybe that injury from back in the service is just acting up again. But what if there was another way, a way to take control of your pain without going under the knife?
Today’s guest has helped over 20,000 people manage their pain and reclaim their lives all without surgery. If you’re tired of feeling held back, stick around. This episode could change everything for you. Oh, and before we get started, head on over to Drive On Podcast dot com slash subscribe. Join the mailing list and I’ll send you my top five favorite episodes, the ones every veteran needs to hear.
Let’s get into it.
Welcome to the show, uh, Winfred, really glad to have you here.
Dr. Winifred Bragg: Well, thank you for having me as well.
Scott DeLuzio: Yeah, absolutely.
So, um, tell us a little bit about yourself and your background, kind of your experience dealing with people, uh, suffering with [00:01:00] chronic pain, muscle, musculoskeletal issues, and any unique challenges that they, they have.
Dr. Winifred Bragg: Well, I’ve been treating people who have musculoskeletal pain, back, spinal problems. orthopedic veins, whatever you want to call it, pain from the neck, shoulders, elbows, and back, primarily, over the past 25 years. And my specialty, I focus on non surgical treatment because what people don’t realize is that only 5 percent of people who have back pain really need surgery.
Yet in the United States, back pain, A back surgery is done at twice the rate of other countries, and I’ve treated over 20, 000 people, uh, and that’s what I do.
Scott DeLuzio: That’s, yeah, and that’s awesome too because I know from my own personal experience, I’ve, I’ve had some neck and back pain issues and, uh, a lot of times, you know, they’re, they, they always try with the, the non surgical, uh, first, I, I, I feel [00:02:00] like they, they try to do other things for pain management and, uh, You know, if those don’t work, then eventually they work their way to, okay, well, I guess that’s all that’s left is, is, uh, you know, a surgical approach.
But, um, my guess is there’s, there’s probably more that maybe isn’t even being explored, um, you know, based, based on your experiences, it seems like you, you’ve been able to treat. a good number of people without using surgery. Um, what are some of the, those techniques that, that you’ve been using that, uh, that can help manage some of that pain and, and hopefully alleviate, uh, the, the symptoms altogether,
Dr. Winifred Bragg: Well, one of the first things that what people miss, a lot of people don’t really know when to come to a pain management doctor. A lot of people think you come after you’ve had surgery. Think about it. You’d rather come before you have the surgery. So instead of going to the orthopedic surgeon when your back hurts, uh, your shoulder hurts, consider going to a pain management doctor early on so that they can do those non surgical [00:03:00] things.
So I’ve educated primary care doctors and urgent care centers to send the people to me first. And certainly, If they don’t respond to non surgical things, then I will refer them to the appropriate surgeon. So that’s one of the number one thing you need to know, where you go first. But if the people come to me after they’ve been somewhere else, one of the things, you know, physical therapy, a lot of people have had physical therapy, and they say, oh, I’ve had therapy.
But what I tell people, all physical therapy is not created equal. You need to have a well trained physical therapist, and depending on what you have, they need to do certain exercises. Not all the exercises work for all conditions of back pain. Another specialty that I’m also board certified in is is Physical Medicine and Rehabilitation.
And that trained me how to do non surgical treatments of musculoskeletal problems. And so I know firsthand what therapists should be doing. [00:04:00] And so that helps me work hand in hand with them. I do injections, spinal injections, epidural and injections into various joints that help people as well. So a lot of times, um, you It’s, is there anything so unique?
It’s about getting the best person. Kind of like your haircut. Everybody can’t cut your hair. The man that does it, he knows how your head is. So you need a good physical therapist that can do a customized program for you. And so I work with them and so that’s some of the things. But people focus when they come to pain management, they focus on meds.
M E D S. What’s the medication I could get? And certainly there are medications that help, but I tell them, let’s think about meds, M. E. D. What is your mindset? Is your mindset focused on healing or do you get up in the morning focused only on your pain? So if you’re focusing only on pain, then all day long you’re going to think about pain.[00:05:00]
So mindset. And then the E I tell people is What about exercise? You need to do some stretches daily. When you get up in the morning, if you have chronic pain, get up and do your stretches because you’re going to feel stiff. And as you exercise, you’re going to increase the endorphins in the brain. That’s going to increase the natural pain killing substances in the brain.
And then the D in that MED stands for endorphins. Do something you like. Make sure you do something you like each day because that’s going to help decrease stress. Because we know that when you’re more stressful, what’s going to happen? You have more pain. And the last thing in that is S, sleep. Seven to nine hours a day.
A lot of times people with chronic pain don’t get the sleep they need and that also causes a cycle of more pain. A long answer. But these are things that are really important that I’ve observed over the past 25, 30 years. Right,
Scott DeLuzio: I think all of those things combined, [00:06:00] um, everything from, uh, you know, the mindset that you’re, you’re starting with, right. By all of those other things. Help improve that mindset that kind of builds, builds all of those things too, right? The, the, the exercise, the, you know, doing something that you like, the sleep, all of those help to improve your mindset.
I know there’s been times that I didn’t get a great night’s sleep and I’ve, I’ve woken up and I’ve not been in the clearest of mindsets. I, I, I haven’t been the nicest of people, you know,
Dr. Winifred Bragg: right. You’re grouchy and your other people around you don’t want to be around you because you didn’t get your sleep.
Scott DeLuzio: That’s right. And, and so all of that stuff kind of fits together. I think that that’s, that’s a good thing. Right. Um, and I know, I know there’s, there’s, Veterans out there who are listening to this show, or maybe even their family members who are listening to this show and they’re desperately searching for something to help, right?
And so, you know, from [00:07:00] your, your point of view, yeah, go see a pain management, uh, doctor first. Um, you know, not, not after the surgery, but go beforehand so that hopefully you can manage that pain and maybe mitigate the need for surgery altogether, possibly. But also, from your point of view, it’s the, um, if there’s physical therapy involved, it’s the right physical therapy, right?
If you just go to a physical therapist and say, yeah, I’m doing it, um, but is it the right therapy? exercise that they are even prescribing for you to do. Um, and so I think working with that pain management doctor to, um, you know, have a good understanding of what is it actually that you should be doing and then working with the physical therapist to actually implement that.
That sounds like that’s what you’re, you’re trying to say, right?
Dr. Winifred Bragg: Right. And one of the things you’re going to know if you got the right combination is your doctor is going to be saying, your therapist sent me a note today showing me what you did. [00:08:00] So that then the doctor That’s more of the doctor who’s trained as I am in physical medicine rehabilitation. That’s his specialty as of his own, but that specialty people in that specialty that treat a lot of back pains, like I do, are going to be reading the therapist’s note to see what they need to change.
And that’s how they’re going to work together, uh, by having that, uh, note there. And one of the things that a patient may know, do they have the right therapist? First of all, Are they changing different things as you go and customize it? You are saying, I’m having problems sleeping. Then did they say, well, how are you sleeping?
And let’s address putting you on the mat and see what position you are sleeping in. Can we change that? So they’re going to be changing. And not just sending you to the bike to ride the bike all the time, but putting their hands on you to see what’s changing.
Scott DeLuzio: Right. Yeah, that’s true too, because there may be something, maybe that’s going on under, underneath [00:09:00] the surface and seeing, you know, what is it that’s actually happening here and, and they’ll be able to hopefully be able to tell by, by, like you said, putting their hands on and, and actually getting involved
Dr. Winifred Bragg: Right. But you want to come back to the therapist and tell them about, well, I’m having a problem when I’m sitting at my desk. It may be that your desk and seat is not in the right position. I’m having a problem when I’m sleeping. A lot of people think because they paid 5,000 or 4,000, for a certain mattress that’s, that’s going to help sleep better.
It’s not the cost of the mattress. It’s, did you take your partner, the person that’s going to be sleeping with you and you had on your, Uh, sweatpants, and you tried it out to see if that mattress felt good for you. Because one of the myths that we know is people think that just because it’s a firm mattress, it’s going to help your back pain.
I don’t have a firm mattress in my house because I don’t, that doesn’t work well for me. So try it out and see.
Scott DeLuzio: Right. [00:10:00] That’s true too. And, uh, I, I know there, there’s some places that you can, you can go into like, you know, for a mattress, uh, store and things like that you can go into and you can, you can lay down on, on the mattress and, and feel what, what does this mattress actually feel like? And, you know, is this the right one for me?
And, you know, if you’re laying there for a couple of minutes, your back starts hurting, well, it’s probably not going to be the right one for you. Right.
Dr. Winifred Bragg: Right, that’s right. And don’t look at the price tag and make it the right one for you.
Scott DeLuzio: That’s true, too, right? Because you’re gonna be paying for it night after night after night, one, you know, you’re gonna end up paying for it regardless. So if it, if the price tag is the issue, you know, you’re gonna, you’re gonna pay for it one way or the other if, if that’s not the right mattress for you, right?
Dr. Winifred Bragg: That’s correct.
Scott DeLuzio: You know, so, so yeah, that, I think that’s important too. And that’s, that’s something that you gotta, you gotta pay attention to, because even if you, you have a mattress and you’re like, Oh, geez, I just don’t want to spend all that extra money. Well, [00:11:00] you might have to, uh, otherwise, you know, how much is, is that surgery?
Or how much is that, uh, you know, all the physical therapy sessions and how much does all that costing you? Um, you gotta, you know, weigh all those costs too, is
Dr. Winifred Bragg: And the cause of missing work.
Scott DeLuzio: Yeah, true. Yeah. Yeah. Missing work. Um, you know, especially if it’s, um, you know, if you have a job where, you know, you’re, maybe you’re sitting at a desk all day, right?
And you can’t sit at that chair or you, uh, you don’t have a more physical labor job where you’re, you’re picking things up and moving them and things like that. But maybe you can’t because you’re, you’re, the pain is just so bad. You’re not going to, You’re not going to have that income coming in. Um, you know, so, so yeah, try to take care of yourself as much as possible.
I think that that just makes sense. Um, now something that we, we hadn’t touched on, um, but there’s something as, as I was doing my research for this, this episode, uh, came across something called spinal stenosis. Um, tell us what that, that [00:12:00] treatment or, or sorry, what that, that condition is and, and how it’s identified and kind of what, what exactly is all of that?
Dr. Winifred Bragg: Spinal stenosis is a condition that we usually get after we’re age 50. And it really comes because you may have some arthritis in the spine that’s narrowing the holes in the spine. You see the spinal cord goes through the spine and on the side you have holes where the nerves come out. So spinal stenosis is about that hole.
The spinal canal has become narrow. And so what happens, nerves get pinched. And when those nerves get pinched. You can get numbness and tingling and weakness in your legs. Now there are some people who get spinal stenosis because they have a congenital to defect and they were born with a narrow spine.
So it didn’t take much arthritis or other changes to make it a little more narrow because they were born with that defect. You can have a ruptured disc that could cause spinal stenosis. Anything that compromises this whole [00:13:00] can cause spinal stenosis. And one of the easy ways to know it, if you’re over 50 and you’re going to the store and as soon as you get in there, you want to get on a grocery cart and lean forward.
We call that the grocery cart sign, and I can go to Wal Mart or Target and identify people with spinal stenosis without having an MRI because they are hunched over that grocery cart. Soon as they get ready to pay and stand up and go for their wallet in the back, when you straighten up, your back hurts.
And so that’s one of the Quick ways to know, do you possibly have spinal stenosis? Of course you go to the doctor, they do an MRI and they can tell you the degree of the stenosis. But one of those things, if sitting makes you feel better, but when you stand up, that pain goes from your back down your legs, that may be a hint that you have spinal stenosis.
And even with that, I’ve treated people who’ve had it 15, 20 years who didn’t want surgery and they’ve done well. [00:14:00] But you know that you have to have surgery, really about three or four things. If you have loss of control of your bowel or bladder, that doesn’t mean you’re old and you’re having to run there, that just means you’re getting old.
But if you’re losing control and don’t know that you’re having to urinate or have a bowel movement, that’s something that means the nerves called the colloquial have been compromised. And that is one of the, Surgical emergencies, and it’s rare. You don’t see it that often, but if you have that, you go straight to the ER, um, for that.
But otherwise, with spinal stenosis, therapy, injections, medications, and exercise can be very, uh, effective for you. If you have a leg that’s weak, just because it’s weak doesn’t mean you have to have surgery. We can strengthen it, but if it’s getting weaker, That means from your baseline, that’s a surgical indication.
So, loss of control of bowel and bladder, [00:15:00] progressive weakness, or if it’s just incapacitating pain that nothing has worked for you. Those are really the four indications. where we consider, uh, you know, surgery. Certainly if a person has had major trauma, been in an 18 wheeler, and have a major fracture that’s compromising the spine, then surgery, uh, will be indicated.
But that’s what spinal stenosis is.
Scott DeLuzio: Sure, yeah and I wanted to clear that up, too, because that’s, that’s something that sometimes people are just, oh, I’m just getting older, you know, whatever, and you know, they don’t, they just kind of maybe brush it off, write it off, but there might actually be things that you can do to improve that condition, and as you’re as you’re As yes, we’re all getting older.
Like that’s just a fact of life. And you know,
Dr. Winifred Bragg: There’s a fact of life
Scott DeLuzio: It beats the alternative, right. You know, of not, not continuing to age. Right. But, um, you know, but, but when you have this type of [00:16:00] pain, like you don’t need to live life this way, you, you can find a solution that allows you to go back and do some of those things that you used to be able to do.
You know, standing up straight without. Pain shooting down your legs or, uh, you know, any of that kind of stuff. And so that’s why I wanted to bring that up because, um, you know, it’s something that I’ve, I’ve unfortunately been familiar with myself and, you know, just, um, you know, just through, um, you know, various, uh, you know, pain management techniques and things like that.
I’ve been able to kind of, uh, manage it and, and kind of control it a little bit better, but, um, and still haven’t had, had surgery for it. So, um, but that, that was one of the, uh, one of the things that you mentioned is, you know, the loss of control of your, your bowels or bladder. Um, those were things that I never even considered.
Like, that would be a thing that your back could control. Yeah, it wouldn’t even have crossed my mind that that [00:17:00] would have been an issue until the doctor mentioned it and explained why. And I was like, oh my gosh, didn’t even, didn’t even know that. So, had that happened to me, I wouldn’t, I wouldn’t have even Uh, you know, I would have thought twice about it because obviously that’s a, that’s a thing that, but I would, I would have been like, well, man, I must be getting old or
Dr. Winifred Bragg: getting old, that’s what you would have thought.
Scott DeLuzio: that’s what I would have thought.
Exactly. So, so those things are, are important to pay attention to. So for, for the listeners, if you’re having any of those types of issues, um, yeah, definitely.
Dr. Winifred Bragg: from the neck as well, because the spinal cord runs from the neck all the way down. So it could also be, because you can have spinal stenosis in the neck, and also in the mid back, and in the lumbar, which is the lower. Because the back has really three parts, the spine, you’ve got the neck, The mid back, the thoracic area, and the lower back, the lumbar.
So that could happen in any of those areas that you could have neck that’s compromised with stenosis and have that bowel and bladder problem.
Scott DeLuzio: And you, you also mentioned, [00:18:00] uh, something about ruptured discs, uh, a little bit earlier. Um, are there options for treating those without opting for surgery, uh, as well?
Dr. Winifred Bragg: Now that’s another big myth. There’s so many myths related to back pain. People think, you know, ruptured just sounds so bad. It’s ruptured, you know. When people say ruptured, I got to have surgery. Really about 90 95 percent of people with a ruptured disc can get better without surgery. And the bigger the disc, the better you can do with non surgical treatments like an epidural injection, because it means that the disc is swollen, there’s a lot of inflammation, and we can take a needle right around that nerve, using x rays to guide us, under what we call under fluoroscopy, put medicine right around that nerve that’s affected, and they can alleviate your pain.
Now that doesn’t take the ruptured disc away when you have the epidural. What people don’t really understand is the body. Our body has [00:19:00] natural processes that dissolves your disc over time. I tell people to think about a ruptured disc like a sponge. The sponge you use in the kitchen, when it’s filled with water, that’s like a big ruptured disc and it’s swollen.
But if you leave that sponge on your sink for a week or so, Two or three days, what happens? It shrinks. And so it is, because a disc is made of two parts. Outside, there is a fiber, and on the inside is the gel, much like jello. And what happens if the hole comes in that fibrous part, that ring, some of that gel part comes out.
So, imagine your nerve is a, your toothbrush. And that gel gets on this toothbrush, which I have a pen right here. That’s when you start having numbness, tingling, and pain, because that gel has come on your toothbrush. And what we want to do is keep that gel out of it. And that’s why therapy is important, is when you have a [00:20:00] ruptured disc or have any back problems, we want your core to be strong so that you can protect your disc with that gel.
So that you don’t get ruptures and other pain with the disc. And so that’s why even if you were to have surgery for a ruptured disc, you’re going to still have to have therapy because you want to improve your core strength. But those are the options for a ruptured disc and have therapy. Sometimes we give people what we call a steroid dose pack and people may have prednisone and the doctor may say you take six tablets a day.
5, 4, 3, 2, 1. We call it a steroid taper. Again, we are attacking the inflammation that you’re having from that ruptured disc. And I will tell you, and I don’t want to brag, even though brag is my last name. But if the people listening would simply go to my YouTube station, uh, Dr. Winifred Bragg. It’s free, and every Friday, [00:21:00] I give tips for a pain free Friday, and I have a wonderful video that explains and shows pictures of ruptured discs, and how they dissolve, and all of that, and I take you through.
with videos so you can see that. And it won’t take you but five minutes. Don’t think you’re going to be up there 30 minutes. You’ll be up there about five or six minutes is the video and it gives people a wonderful understanding of how a ruptured disc works.
Scott DeLuzio: Well, and that, that’s a good, uh, explanation of it too, because you’re right, I, I think to someone who isn’t educated in, you know, medicine and, you know, biology and things like that, you’re. Your mind just goes straight to ruptured is like, you know, an explosion or, you know, a crack or something like that.
It’s like you take a balloon and, you know, a water balloon and it explodes and you got ruptured all over the place. And that, that’s where, where your mind goes. And, and it’s like, well, obviously you’re going to need some surgery to reconstruct that, you know, type of [00:22:00] thing,
Dr. Winifred Bragg: I guess it’s like, uh, they have new tires on cars now that never go flat, right? And you used to say, well, I have a flat, I have to get a new tire. Now they have them and they say that these tires, they don’t go flat. And so don’t think, don’t get scared over ruptured with that now. Because we have things to help you, but you do think ruptured.
Oh my God, I’ve got to have surgery. And I think when it comes to orthopedic problems, spinal problems, people run to surgery as the answer quickly than they do other parts. Your eyes, you don’t want to say, give me surgery on my eye. Give me surgery on my heart. You want to know, can I exercise? Can I lose weight?
Can I take a medicine? The same things for your back and other orthopedic problems. You need to think in that same mindset, not just the knife because the knife doesn’t necessarily cure you. If surely they can remove that ruptured disc, but you still going to need the therapy and still the lifestyle changes that you would need, whether you had that [00:23:00] surgery or not.
But what the Treatments would do with that epidural is calm the pain so that while the body is taking care of it, you’re not in excruciating pain.
Scott DeLuzio: Right. And, and I’ve had those, uh, those injections, uh, as well. And so I, I can attest to, you know, folks who are, you know, kind of questioning it and like, ah, gee, I don’t know. They do work. Um, and sometimes like pretty quickly, um, that pain is, is able to be, uh, alleviated rather quickly. And so, um, So then, to your point, you can allow the body to do its job in healing itself without being in excruciating pain.
while it’s doing so. Um, and so yeah, that, that disc is still ruptured. It didn’t change that it, but it allows the body to heal itself. Um, I mean, just the same way, like if you cut yourself, you know, your body’s going [00:24:00] to heal itself,
Dr. Winifred Bragg: Correct.
Scott DeLuzio: Yeah, sure. You’re going to put a bandage on it or something like that.
And, and, but you allow it to heal, you, you keep it clean. So it doesn’t get infected and all that kind of stuff, but you allow it to heal. Um, And, and then eventually it’s done and it, it’s finished it and you know, like I’ve, I’ve had cuts on my hands, but I don’t have any cuts on my hands anymore, like they’re, they’re, they’re good.
So, cause I allow my body to heal it. So, you know, allow your, your, your body to heal, you know, your, your back, your neck, you know, whatever. Um, and, and those, those types of things will, eventually they, they’ll start to get better if you allow them to,
Dr. Winifred Bragg: Yeah, because there are organisms, macrophages and monocytes and we won’t get too deep here, but they work at the site of inflammation to help to dissolve that disc and that’s what’s happening that we don’t even see. But I show on that video where you can see the big blob that a person had a herniated disc and then you are seeing six or eight months later it’s gone.
Now for most people we don’t get to have the pleasure of doing that because once they come to [00:25:00] me and say I’m better, I’m back at work, the insurance company is not going to let me get that after. The show is gone. I was able to get that from a guy who volunteered and let me do some people who were gone so that I could use it for educational purposes, purposes to show people that the disc dissolved because once it’s gone, there’s nothing to show them.
And the insurance company is going to say, well, they’re better now. They have no pain. Why would you want an MRI? So that’s why I have those pictures there to show you that the healing. of the picture lags behind how you feel maybe six to seven months. So you may be feeling better six to seven months before that picture catches up with it.
Scott DeLuzio: Interesting. Okay. Well, yeah, so it’s good that you have that information, that data too. Now, I know, uh, heat and ice, uh, are, are treatments that, that can be used for, for pain relief, for, for different things. Um, when is it appropriate for heat versus ice when, when you’re talking [00:26:00] about this type of pain?
Dr. Winifred Bragg: Very good question because so many people get that mixed up and I think so, because if you had a choice to have a warm bubble bath or a cold bubble bath, most people in good mind would say a warm bubble bath. But ice really helps you if your injury is less than 72 hours because you want to decrease the pain, the inflammation, and the swelling.
So use ice. But you can also use ice for a chronic problem when you have muscle spasms. A lot of times people go straight to heat for muscle spasms. But ice works much better, and I tell people don’t use the ice but about 10 to 15 minutes, and never use it directly on the skin. Wrap the ice pack. I recommend a gel ice pack.
You can put it in the freezer, whatever. Wrap it in a pillowcase. Wrap it in a towel or old shirt or whatever you have, but don’t put it directly on the skin. And [00:27:00] put it there about 10 to 15 minutes. But you never use ice if there’s a malignancy, if you have diabetes with vascular problems, or you have impaired sensation because then you can’t tell that you’ve let it stay on too long.
But that’s when you use ice. And ice really works well for pain. And if you would just jump on that ice when you’re pulling your weeds in your garden when the spring comes and you’re doing your shrubbery. I tell my neighbors every year who want to run over my house, Oh, my back is hurting. I said, I told you last year, you’re not 25 years old anymore. Don’t cut the whole grass and and try to pill up all the weeds in one session number one But if you do put some ice on it the first 72 hours put that ice on there and that works well so then after about 72 hours You can use heat and heat is going to stretch, tighten muscles and that’s when we use it.[00:28:00]
But again, you don’t want to use it with malignancy. You don’t want to use it with pregnancy. You don’t want to use it if you have infection or inflammation with ice. I mean with heat, you don’t want to use it. And then, but always know you just because it’s a chronic problem that you’ve had more than three months, you can go back to ice.
Scott DeLuzio: and that’s good to, uh, to, to know too, uh, how, um, the different heat and ice work with the body and, you know, for, um, You know, for the different, uh, types of pain that you might be having or, or, uh, you know, depending on when you’re having it, um, you know, that, that type of thing too is, I think it’s important to point that out because you’re right, some people just go straight to the heat, um, you know, maybe, maybe it’s more comforting than, than having cold ice on you.
And it’s like that, that might be just a little uncomfortable, right? But maybe it’s the cold ice that is what you actually need. So, um, [00:29:00] you know, kind of, you know, Pay attention to those, those factors as well, um, before, um, before jumping straight to the
Dr. Winifred Bragg: When you think about it, if you go to a luxury spa, they’re going to be using that, uh, heat on you. Because it kind of feels good and they cut the light off and let you go to sleep. But if your back is hurting, you got to think about, you want to get rid of the pain and inflammation. And when you use heat, don’t keep it on there longer than 15 minutes.
I can’t tell you how many people I’ve seen that I can look at their back and it looks like a checkerboard. And I’m like, Hey, you’ve been using too much heat because you’re getting superficial burns. So you can’t keep it on too long. Some people, well I slept in it all last night. Well you’re burning your superficial layers of your skin.
So you don’t want to keep it on, but 15 minutes at a time, let it rest and then go back and you may use some more.
Scott DeLuzio: And how much time in between, uh, you said let it rest, but how much time for
Dr. Winifred Bragg: if I had it for maybe about 15 minutes, I may wait a couple of hours and then go back and do some more. But the [00:30:00] main thing, you don’t want it just to be, Oh, longer than that 15 minutes.
Scott DeLuzio: Yeah, right. Um, so I, I think all of this information is really important. Um, as far as, um, the, uh, individuals who are listening to this, you know, don’t take any of this as necessarily like medical advice, specifically geared to you, because everybody’s going to be different.
Um, we, we all have different issues and there might be some underlying issues, there might be some other things that are going on with you, uh, so definitely go talk to your doctor and, uh, and, you know, get a, a diagnosis that’s appropriate for you, but I find that when You have a little bit of education, a little background, uh, knowledge on whatever it is that’s going on with you.
You’re able to talk a little bit more effectively with the doctor and have a conversation about whatever it is that’s going on with you. And this isn’t just for, you know, doctors. Back pain or neck pain or it’s really [00:31:00] anything that’s going on with you. So if you have a little bit of knowledge of what’s going on and and how the different treatments can help you can go in and have a little bit of a more knowledgeable conversation with that doctor and not have to basically spend half the appointment with the doctor educating you on what it is that’s going on with you.
Um, you can kind of say, yeah, no, I, I, I’m familiar with that. Um, you know, like let’s talk about treatment and, and we can get into that type of thing. Um, you know, but again, everybody’s going to be different. So, um, you know, definitely go talk to your doctors and, and get the right diagnosis for you based on the conditions and the symptoms and everything that you are feeling.
Right. Uh, I think that’s, that’s important for. I think it’s important for the listeners to understand too is that none of this is specifically geared to any one individual. This is kind of more generic, general knowledge, kind of information. Um, but I know, um, just having experienced [00:32:00] pain like this myself, uh, sometimes you start to feel kind of hopeless.
Like Nothing’s going to work. I’ve tried all these different things. Nothing’s going to work. Um, based on your experience though, is that true or false? We talking like most people have some sort of outcome that that’s a positive outcome, right? With, with this, uh, before resorting to surgery.
Dr. Winifred Bragg: Well, I think it depends upon when you entered into the health care system. And I’m glad you brought up because back pain can be a symptom of some serious things. That’s why we want to make sure that you’re doing your basic things. You’re a male, you’re getting your prostate evaluations because sadly, prostate cancer spreads to bone and can’t go to the back.
I’ve seen some people who came to me for the first time who had been dealing with the pain for years but just sought treatment and I had to diagnose them with cancer. Breast cancer and thyroid cancer and so kidney cancer can go to the bone. So you want to make [00:33:00] sure that you are taking your women getting mammograms, men getting prostate exams and that you’re over 50 that you’re getting your colon evaluated and maybe earlier depending on your family history.
So we all have different things in our families, as you say, and this is just for educational benefit and not just specific. Okay. But to your point you brought out a wonderful point. You don’t want to spend the whole time with the doctor saying, Hmm, looking confused. What’s going on? You know, pain, unlike other things you can put a monitor on it, your blood pressure.
You can tell my head may be hurting and the doctor takes your blood pressure, say your blood pressure is high. We don’t really have a monitor or a meter that we can put on you and tell about your pain. You have to really understand that pain scale, zero to 10. Okay. And a lot of people don’t understand that, you know, in life, we shoot to be a 10 in everything.
But when it comes to pain, you don’t want to be a 10.
Scott DeLuzio: You want to be a zero?
Dr. Winifred Bragg: what it is so [00:34:00] that we can understand what’s going on. And you need to be able to describe the pain, which is what’s most important. Do you have numbness and tingling? Is it achy? Is it pulling like a muscle? Because there’s so many parts of the back of the neck, That can cause pain, that your words are what’s going to key the doctor in to thinking what could it possibly be.
And if you’re over 50 and you’re getting pain worse at night, you want to be able to say that because are you losing weight with the pain? I’ve been losing weight over the last six months and not trying to and I’m having back pain. Then that’s going to signal that maybe you have a malignancy or something else going on.
So you want to be able to describe those things to people to your point so you’re not wasting the whole Uh, and all over the place. And when you describe your pain, practice it on your significant other, so that you understand what I was saying. You know, I had people come in and tell me, I’ve been hurting since [00:35:00] 1969, and it’s 2025 now, and I’ve done this, this, this, this, that, and the other.
You know, it’s just too much. Bring me on up. You know, I know you had it since 69, but you got to tell me something that brings it to the now. And they want to take me through all from 1969 on. You got to put it in chunks so that the doctor can understand so that we can help you. And as you said to your point, a very good point, bring some information so that it is meaningful when you come.
And I tell people just like when you’re interviewing for a job or something where That 30 seconds, you know, you talk about elevator pitch, your 30 seconds, practice your 30 seconds, how you’re going to enter with the doctor when you come. Because when you come and say, I’m 50 years old, I’ve had back pain the last six months, I injured it at work, and it radiates from my back down my leg.
Now, that didn’t take you but about 10 seconds. See? Then, that makes it so nice. So, practice it to make it better. Sure, [00:36:00] that what you’re saying that your wife or somebody, a friend that cares about you say, Oh, I can understand that. But if you are rambling and going on and on and you ask your significant other, Now, do you understand what I said?
And she says, I don’t have a clue. Can I give you a hint? The doctor won’t either because you’re all over the place and there’s only a certain amount of time. So you want to be clear in what your complaint is and give those associated factors of what makes it worse, what makes it better. But you could do all of that in about 30 seconds if you just think about it and write it down.
I tell people, Write it down. Read it back to yourself and say, now, do I understand when it hurts? Am I telling that right? And hopefully that’ll make your time with the doctor more meaningful. And I think that together you work together to get rid of your pain. And that’s, what’s going to give you hope because when you go, you’re going to feel like the doctor understands you and they can give you some concrete things.
It may be [00:37:00] just little things that they are tweaking. Uh, so usually most people, you know, you may not be able to get rid of their pain if they’ve had five or six surgeries. That is a tall order, and I have seen people come to me with five or six surges with metal rods and screws everywhere. And that is very difficult, uh, if you’re in that situation.
But in that situation, still you need to be able to come and tell the history of what’s going on. And every time someone says, don’t say, I tried that, I tried that. And you may say it, but you’ve got to come with an open mindedness. that you want to try something other than just getting medications.
Medications can be beneficial, but our goal, especially as we get older, is to treat you with as little medication as possible because the medications can affect the kidney, the liver, and so we want to give medications, but as little as possible. So most people get some benefit if we can do [00:38:00] things to just help you with your sleep, as you talked about earlier.
How much better that makes your life, right? If we can help your quality of life with your sleep. Sometimes it’s as simple as today, you know, they’re going to be having football games and we all like television. But after you’ve been sitting an hour and a half or two hours, get up, go to the kitchen, go to bathroom, walk around the table because prolonged sitting is one of the worst things we can do for our back.
So sometimes people just have just little things that they have taken for granted and didn’t know that can improve their life. So. Yes, with chronic pain does come some depression, insomnia and sometimes people have financial losses because they lost a job as well. So all of those can be sequelae of chronic pain, but most of the time it’s about the mindset if you’re focusing on, I am looking for something positive where I can get better and it [00:39:00] comes with the mindset of how you enter into this process.
Scott DeLuzio: Yeah, for sure. And I just want to go back to what you were saying before about that, kind of that elevator pitch, um, that 30 seconds being able to communicate with a doctor. Um, I think that the important thing is that you go in and you have thought about what it is that you want to say. to the doctor.
You, you have, uh, maybe practice it, rehearse it, even write it down if you need to, and then time yourself, take a timer out and time it. And can I do this in 30 seconds? If I’m, if I’m looking at the timer and it’s, you know, five minutes have gone by and I’m still rambling on, well, you probably got too much information in there.
Um, you know, to your point of that person who, you know, hurt their back in 1969. Okay, fine. Maybe, maybe say, What happened back then, because that may be relevant, you know, you fell off a ladder or you, you know, something happened that okay, good, that might be that might be relevant. But then fast forward, let’s get to the point of like, what’s going on now?[00:40:00]
Like, how is it affecting you now? Because I’ve done some stuff, you know, 2030 years ago, but it doesn’t necessarily mean it’s relevant right now, you know, and so all that stuff that comes in between then and now, maybe we don’t necessarily need all that, that information,
Dr. Winifred Bragg: and what you don’t realize, just like that 30 seconds is so empowering when you’re meeting people on the elevator or wherever you meet them for a job or whatever, think about how the doctor views you as this guy is well informed, he knows that, he’s done these things, and how impressive that is, and how they’re looking forward to knowing that you’re going to bring a Something information to that visit as well when you can say that because you know, depending upon if you are the ER urgent center, every time somebody encounters you, a nurse or anybody else, you may tell that little speech 30 times before you get to a hospital bed somewhere.
So you want to have it down in 30 seconds. So people say, [00:41:00] okay, this is the man who fell off the ladder who bruised this and his pain goes from his back to his leg. They got it. So that’s why you want to do that to make sure that you’re getting the best care you can and having a dialogue and not wasting time with people trying to, okay, 969, it may be relevant, as you said, I initially hurt myself when I was in armed services in 1969, and that’s very relevant.
But since that time, this is what’s been happening.
Scott DeLuzio: right? That’s right.
Dr. Winifred Bragg: And do time it. I recommend you time it and write it down and rehearse that, and you will see how much more engaged and how enhanced your visit with the doctor can be.
Scott DeLuzio: That’s right. And uh, I, I know when people, sometimes they try to give too much information, they’re, they’re talking to you. They, they’re giving you all sorts of information and they, and like we’re saying, they kind of drone on and on and on. And sometimes you just start to glaze over and you start to just not really be paying attention that closely to [00:42:00] what the person’s saying anymore.
And. I mean, that’s not what you want from your doctor, you
Dr. Winifred Bragg: don’t, and the other thing is, know where you had your diagnostic studies. Don’t assume that the doctor can just get them, because although we are using electronic medical records, all of them don’t talk to each other. And if you were injured, especially the VA, and you were at Fort so and so, and this Fort, and that Fort, the doctor may not have access to those things, but you need to tell them where they had it.
And if you could get copies of that before you came, the most recent diagnostic studies, x rays and MRIs, and here are my recent MRIs and x ray, that would save time and facilitate to you getting down the road. Because what happens with a lot of Chronic pain people, they get frustrated in the process.
They’ve seen so many doctors that they lost hope. And so, but their records are everywhere. It’s up to you to kind of compile them and have them so [00:43:00] that you’re a source of information. And I think that I found that to benefit a lot of people over the years.
Scott DeLuzio: absolutely. And I, I think that’s something that we commonly say to people who, uh, have served in the military, keep copies of all your medical records from your time in the military, but it applies even afterwards for, you know, any care that you get through the VA or outside the VA and, you know, other, other medical facilities, keep records of everything that, and it’s, it’s so easy these days with electronic records, just to save them in a file on your computer and,
Dr. Winifred Bragg: That’s right
Scott DeLuzio: them there, right? Um, and, and, and don’t, don’t get rid of that stuff because that stuff may be relevant at some point down the line. And Especially, now this is kind of getting a little bit off topic, but especially for folks who served in the military, who may have some disability, uh, you know, issues, well, you have to be able to tie that to your military service in order to get that disability, so if you don’t have those medical records from your time in the [00:44:00] military, saying that something happened to you that might cause the back pain or the, you know, Any other issue that you may be dealing with, well, they’re not going to be as likely to give you that disability, uh, rating because you don’t have that That link that connects it back to your military service.
So, um, you know, keep those records. It’s, it’s important, um, you know, because you are that, that source of information, like you were saying, you’re, you’re your own source of information. You can’t rely on other people, including the doctors to always have access to that information. So, so keeping that on hand is, is, uh, definitely good,
Dr. Winifred Bragg: and how well said I have seen many veterans to come to me And they wanted a rating as you said since you brought that up And they were said they were injured in the military in the 70s, and they’re showing up to me 2023 and we can’t make the link and I said it’s up to you You have to fill that gap and make the link.
Well, they know that I was injured Well, you want me to tell you that this is [00:45:00] what happened, but you don’t have records. And so, uh, unfortunately I have seen too many of them to come and not have that information and you can’t make the link.
Scott DeLuzio: That’s right. Um, you’ve also written a book on this subject. I think I mentioned it in the, the intro, but I don’t know if I gave the title of the book, but Knock Out Pain, Secrets to Maintaining a Healthy Back. Read this before you go to the doctor. Um, tell us what listeners can expect from your book.
Dr. Winifred Bragg: Well, what people say it’s an easy read. I wrote that book after my mother injured her back and I was taking care of her and she said, well, what are people going to do who don’t have you? I’m like, mom, I’m trying to run a practice and I’m trying to take care of you. Now you want me to write a book? She said, yes, you got to do something for the other people.
So people say it’s an easy read. Uh, it has charts in it, it has logs in it to help you keep up with your medications, the injections that you’ve had. Because you don’t want to have too many injections over a certain amount of time. So it has a chart where you can keep when you had [00:46:00] those injections. It points out other good health facts that you need to do.
prostate evaluations, colonoscopies, breast evaluations, but more importantly, from a back standpoint, it, it, uh, addresses a number of back conditions. It’s going to tell you the symptoms. It’s going to tell you the treatments. It’s going to tell you the diagnostic workup. Some of them are going to have stories about what other people had and what they experienced and how the treatments were.
And so, people say that, um, it’s a good book and You know, I talked about when you watch television, it gives you exercises you can do when you watch television. I tried to make it practical. It has uh, myths, a lot of different good information, uh, in it that can help a person who has back pain. That’s an easy read.
Scott DeLuzio: Excellent. Excellent. And so I will have a link to your book in the show notes, uh, for the listeners. So you can, they can check that out. So especially those who are dealing with, uh, types of pain like this, [00:47:00] or if you know someone who is, uh, get a copy of the book and Use the tracking that’s in there, you know, check out some of the myths, some of the other stories and things like that from other folks, um, to see maybe what might work for you, um, based on some of the information that’s in that book.
Um, but again, all in the spirit of trying to educate yourself, um, in, being able to be the, the, the, as well informed as you can be to help your doctor, uh, you know, in the diagnosis of whatever it is that’s, that’s going on with you. And so if you, you keep those records, you have the information from, you know, sources like your, your book.
Uh, I think that’s, that’s a great for first step, um, you know, when going into that doctor.
Dr. Winifred Bragg: And one of the things to do to give you a sample of the book, you can get a free chapter by going to my website, nakaopain. com, and you can download a free chapter, and it’ll give you the style of what the book is written on, so you can see if [00:48:00] you like that style, but I want to encourage everyone to get that free chapter at least, and see what you think, and If you want the book, you can get it at Amazon.
If you don’t, but it gives you a free sample.
Scott DeLuzio: Excellent. Excellent. And again, I’ll have all those links in the show notes for the listeners. Um, Dr. Bragg, it’s been. Awesome. Uh, having this conversation with you, I think a lot of folks are going to benefit from the information that you were able to provide here, uh, today. So thank you very much for taking the time to join me and sharing your, your advice on managing pain without surgery.
So thanks. Thanks so much.
Dr. Winifred Bragg: And thanks for inviting me. I’ve enjoyed it. And I hope that the listeners have gotten some benefit from it. And if they have any comments or anything, they can certainly contact me, uh, at my website and on my YouTube channel. And, uh, I look forward to hearing from them.
Scott DeLuzio: Excellent.