Lack of blood flow (ischemia) is the most common cause of back pain. The disc is poorly perfused even under optimal conditions. Everybody knows the brain and the heart need blood supply, but so does the spine. Too often, the search is only for the "pain generator" and the "underlying cause" has been forgotten. We are looking at the tree with a microscope, but we've forgotten to look at the forest. If all the trees have Dutch elm disease, will it help to remove the most affected tree?

This audiobook is like an "antibiotic" to improve all the trees in the forest; to improve blood supply to the entire spine. Better blood supply helps prevent progression of degenerative disc disease and the cascade of adverse events that follow it like foraminal stenosis, central stenosis, bridging osteophytes, DISH, OPLL, OLF, Schmorl's nodes, radiculopathy, myelopathy, disc space calcification, and spine autofusion. Atherosclerosis, lumbar artery stenosis, gallstones, fibroids in the uterus, diverticulosis, and fatty liver all go together. Vegan diet is the easy way to lower blood viscosity and to prevent and reverse atherosclerosis.

The author is an interventional radiologist and neuroradiologist who used to run a spinal-injection clinic and who has seen tens of thousands of spinal CT scans and MRIs and who has observed patterns of disease and outcomes for decades. Best outcomes come from deep understanding of disease and of treatment options. Motivated, educated patients and doctors are able to get the best results.

When you walk, you improve blood supply to the disc because the vertebral body endplates move and cause a gentle, alternating mild compression and decompression of the disc that moves nutrients into the disc and waste products out of the disc.

Did you ever sit for several hours and then have back pain when you first stood? That's because the disc is ischemic from prolonged sitting. Walking also increases nitric oxide vasodilator in the artery to the endplate.