Alabama Sprinter Could Barely Walk With Back Pain. This Nerve-Burning Procedure Got Him Training for the Olympics

Back pain feels like a black box to millions of people, and one spine specialist says that confusion sends patients down the wrong road.

In a recent podcast interview with host Darshan, Dr. Goodman, a minimally invasive spine interventionalist at OrthoAlabama Spine & Sports, laid out his full playbook.

His boldest claim? Pain itself won’t kill you, but your response to it might.

Along the way come a three-column map of the spine, a sprinter’s Olympic comeback, and procedures most patients never hear about.

Stick around to learn which first steps he recommends before any needle gets near you.

Why Inactivity, Not Pain, Is the Real Danger

No one ever dies from back pain. What people die of is lack of activity from their back pain.

Goodman’s point targets a downward spiral. Sore back, less movement, then high blood pressure, obesity, diabetes and bone loss.

Darshan added that muscle loss, called sarcopenia, speeds up after roughly age 45 and again near 70. Result: chasing your tail, with weaker muscle feeding worse pain.

Activity is your longevity molecule.

Walk First, Skip Bed Rest, Rethink Painkillers

Before anyone books a specialist, Goodman offers a short list of self-care moves:

• Walk daily. His summary: “Walking, walking, walking.”
• Avoid bed rest. He says lying down makes the problem worse.
• Limit long-term pain medication. He prescribes zero medications after his procedures.
• Favor anti-inflammatory supplements over Advil-type drugs. He believes those drugs may slow healing, though he concedes they aren’t habit-forming. That view remains debated among clinicians.
• Build overall health. He pointed listeners toward longevity-style habits such as omega-3s and gut health. Evidence strength varies widely from one item to the next.

The Three-Column Map of the Spine

Goodman simplifies spinal anatomy into three columns. His version differs from the trauma-based three-column model in medical literature, and he built it to make conditions easier to understand.

• Front column: discs and vertebral bodies
• Middle column: spinal nerves
• Back column: facet joints and the multifidus muscles

Muscle wraps all three, providing stabilization.

Discs: Silent Damage for Years

Discs handle load, stability and mobility, which makes them prone to tearing during bending plus twisting.

Only the outer third of the disc is innervated by nerve fibers.

Inner tears can stay painless, and discs lack direct blood supply. Small end plate fractures may trigger what Goodman calls “inflammaging,” a slow process unfolding over years.

The problem started years earlier with these asymptomatic issues.

Culprits include lifting with the back, a hockey puck whipping behind you, or countless micro-injuries nobody remembers.

Middle and Back Columns

Middle-column trouble includes pinched nerves and spinal stenosis, typically showing up in people’s 60s and 70s. Back-column trouble involves facet joints, the ones that pop at a chiropractor’s office.

Where Pain Lives vs. Where Needles Go

By Goodman’s own estimates, roughly 40% of chronic spinal pain originates in the front column and about 15% in the back column.

Yet he says around 99% of procedures target the back column, with under 1% aimed at the front.

We’re approaching the spine from the back and only addressing a very small minority of problems instead of approaching the spine where most of the problems are.

His explanation: back-column targets are easier to reach, with a better reimbursement pathway for doctors. Reaching the front requires angling in from the side while dodging nerves and avoiding deep abdominal entry, which risks infection. Hence his self-description as a “special delivery truck driver.”

How Specialists Hunt for the Pain Generator

Clue number one? Patients with front-column problems often refuse to sit. Goodman says they’re frequently standing in the exam room before he walks in.

• Flexion-extension X-rays reveal how the spine moves.
• MRI shows soft tissue plus Modic changes, inflammation-linked bone signals guiding treatment.
• Image quality matters. Closed 1.5 or 3 Tesla magnets beat open MRIs, which he likens to an old cell phone camera.

His MRI threshold is low, partly to rule out infection, tumor or bleeding before inserting a needle.

The Minimally Invasive Toolkit

Epidural Block: The “Carpet Bomb”

Medicine bathes nerves, disc backs and facet joints simultaneously, opening a pain-relief window so normal activity can resume.

Intracept and the Sprinter

A Alabama graduate sprinter, now training for the Los Angeles Olympics, developed incapacitating back pain mid-race. Blocks failed, so Goodman used Intracept, burning nerves inside the vertebral body above and below the disc.

He avoided entering the disc, since a needle can damage disc cartilage. Outcome: “a tremendous result.”

More Options Worth Knowing

• ReActivate: An implanted stimulator, used 30 minutes twice daily, aims to wake up atrophied multifidus muscles. Goodman reports striking results in his own patients, including one person who had it removed after becoming pain-free.
• SPRINT: A temporary peripheral nerve stimulator, left in at most 60 days, works like an implanted TENS unit. Medtronic recently bought the company.
• Minuteman: A “jack in the back” implant, placed in about 30 minutes, indirectly decompresses and stabilizes. Goodman estimates success at 50 to 75% of cases.
• Cyst rupture: Injected fluid can burst facet cysts, though they sometimes return.
• Radiofrequency ablation: He’s moving away from burning facet nerves, since doing so may also hit nerves feeding multifidus muscles.

These figures reflect his clinical experience rather than controlled trial data, so treat them as one expert’s perspective.

Steroids vs. Stem Cells: A Candid Bias

Goodman leans toward steroids: cheap, quick to show whether the target is correct, and manufactured sterile.

So, that’s just my bias. Okay, I’m not saying that that’s correct.

His reasoning on regenerative options:

• No currently available stem cells have been shown to regenerate a disc.
• DiscGenics, in research trials, reported some regeneration in phase one and two.
• Drawing, spinning and handling blood or marrow raises infection risk in poorly perfused tissue.
• No imaging proves biohacker-style spine injections regenerate anything.

Darshan added that infections from these procedures can be far worse than the original problem. Evidence on PRP for spinal problems remains unsettled, which is why Goodman prefers enrolling interested patients in trials with placebo arms.

Even steroids carry trade-offs. He admits that every needle, contrast agent and anesthetic stresses a disc.

The more I see you the worse job I’ve done. The less I see you the better job I’ve done.

When Surgery Still Wins

Goodman doesn’t dismiss operations. Severe instability needs stabilizing, and heavy stenosis needs opening up.

That has to be decompressed. That has to be opened up.

Injections can also pinpoint where a surgeon should cut. Still, surgical paths dominate: he estimates 10 to 20 operating surgeons exist for every interventionalist like him.

Finding the Right Specialist and Reading Up

Because no “backologist” exists, Goodman suggests researching interventionalists connected with these groups:

• North American Spine Society
• International Pain and Spinal Intervention Society (formerly ISIS)
• North American Neuromodulation Society
• American Society of Interventional Pain Physicians

Reading recommendations came with caveats. Stuart McGill emphasizes excellent mechanics and core exercises, though Goodman notes early disc injuries can be silent regardless of technique.

John Sarno’s Mind Over Back Pain offers a psychological angle. Darshan said two patients cut their pain by over half by chapter four, though he acknowledged placebo effects may play a role.

Goodman’s own focus stays on anatomy, with a pro tip: Howard Stern’s book chapter on Sarno, he jokes, “explains Sarno better than Sarno.”

The more knowledgeable the patient can be about their own problem then they can find solutions that are tailored toward them.