CHARLOTTESVILLE, VA (CVILLE RIGHT NOW) – At Advanced Pain Management of Virginia, Dr. Scott Wagner and his team see a countless number of patients, each with their own unique symptoms, conditions and stories.

But with years of experience and a unique approach to medicine, Wagner has the tools and expertise needed to tackle each one. So, how exactly does he respond when presented a case he hasn’t seen before?

Introducing the patient

In this example, the patient is a 53-year-old male and former college athlete. Since last year, he has had multiple bulging discs that pressing onto his nerves, causing spinal stenosis. Wagner described this condition as when the hole in which a nerve comes out of the spine is blocked. It can be caused by a number of reasons, and in this patient, has led to pain so debilitating he can’t even work out anymore.

Wagner said in these patients, they’ve often been irritating a certain area of the body for a number of years, even if they didn’t experience symptoms until recently.

“What I do with cases like this is, I try to show them the age and degenerative pathways of why this one is degenerating more than this one. How old this one is, only by scientific evidence,” Wagner said. “So, it’s a nice discovery for me and our medical team because we know which one to target for symptoms, and we know which one to target from a degenerative standpoint.”

Identifying the problem

Wagner said there are a number of ways stenosis can be treated. Sometimes, if the condition isn’t too severe, patients can receive temporary relief with epidurals and the removal of inflammation from the nerve root. However, if the condition is bad enough, Wagner may have surgeons open up the area.

Based on the description of this patient and his symptoms, Wagner said he was dealing with a biomechanical load of his lumbar spine. He said this pain is caused by torque, not compression. When you add on a compression load onto the torque variable that never fully healed, they slowly get worse.

What Wagner does differently

Wagner’s ability to identify and remove what exactly is causing chronic pain is at the core of his philosophy and work. He said that many people often don’t change how they’re using their joints, even if they are unknowingly damaging them over time. As those people get older and lose their healing response, symptoms can appear, and what many other doctors chalk up to simply age may actually be because of behaviors that have slowly caused damage.

Without this understanding, many doctors and specialist often don’t look at why the pain and damage are happening, simply focusing on eliminating the pain without even examining other parts of the body.

“Unless you understand the physics of this problem, and the nerves’ reaction to this problem, you will never ever solve this problem,” Wagner said.