Author: drpaulmcdonoughmd

Optimal Treatments for Lumbar Spinal Stenosis

As an orthopedic spine surgeon, Dr. Paul W. McDonough performs procedures on the thoracic, cervical, and lumbar sections of the spine, in addition to advising patients on possible courses of care. In many cases, Paul McDonough, MD, has found that physical therapy can serve as an effective precursor or alternative to surgery for patients. For instance, lumbar spinal stenosis can often be treated with physical therapy.

A condition that causes lower back pain, lumbar spinal stenosis occurs when part of the lower spine narrows. Typically, the degeneration of parts of the spine, such as the facet joints of discs, causes this narrowing. A patient with lumbar spinal stenosis may experience discomfort in the upper thigh or buttocks and pain when walking, standing, or leaning back.

Surgery can alleviate pressure on nerves that cause the pain associated with this condition. However, a research study published in the Annals of Internal Medicine found that patients who underwent surgery and patients who completed a physical therapy program had similar outcomes. Since surgery can pose a higher risk to patient health, physical therapy or other more conservative treatment approaches are a safer first step to address lumbar spinal stenosis. Surgery can be considered after other therapies have failed.

Whispering Pines is the New No. 1 Course in Texas

Paul W. McDonough, MD, a graduate of the UCLA School of Medicine, has spent more than 18 years as a spine surgeon at Orthopedic Associates of Abilene in Abilene, Texas. Beyond his work caring for patients as an MD, Dr. Paul McDonough enjoys playing golf on courses throughout the state of Texas.

Whispering Pines Golf Club has overtaken Dallas National Golf Course as the premiere golf destination in Texas, according to Golf Digest. Located in Trinity, Whispering Pines moved up from No. 2 in Texas for the 2019-2020 season and from No. 55 to No. 54 on the national rankings, the course’s highest ranking to date. Chet Williams constructed Whispering Pines in 2000 around a series of complex bunker and green contouring designs. The course, which debuted on Golf Digest’s national rankings in 2013 at No. 75, is best known for its final six holes, which are routed along Lake Livingston and the gator-infested waters of Caney Creek.

Dallas National, a 2002 Tom Fazio creation, came in as the No. 65 course in the United States. Other highly rated courses in Texas include Bluejack National in Montgomery, No. 114 in the country, and Fort Worth’s Colonial Country Club, the nation’s No. 155 ranked course.

NASS Prepares for First International Conference

Dr. Paul W. McDonough received his MD from the UCLA School of Medicine in 1995. After achieving his MD, he trained as an orthopedic surgeon at UCLA Hospital and as a spine surgeon at the University of Wisconsin. In addition to working as a spine surgeon at Orthopedic Associates of Abilene in Texas since 2001, Dr. Paul McDonough is a member of the North American Spine Society.

The North American Spine Society (NASS) annual meeting will take place in San Diego from October 7-10. NASS will also host NASS International in Bangkok, Thailand, from July 29 through August 1. The organization’s first ever intercontinental meeting, it is titled “Advancing Multidisciplinary Spine Care Worldwide through Education, Research, and Technological Advancement” and will emphasize leading-edge techniques for treating spinal injuries and conditions while showcasing the latest research findings.

Topics at NASS International interactive workshops will range from ways of enhancing interventional spine procedure and injection skills to learning the fine points of cervical, lumbar, complex, and minimally invasive surgical procedures.

Reservations for NASS International can be made at the Renaissance Bangkok Ratchaprasong Hotel. More information about the meeting is available at

Sleeping Positions and Back Pain


Sleeping Positions pic
Sleeping Positions

As a spine surgeon at Orthopedic Associates of Abilene in Texas, Paul W. McDonough, MD, cares for many patients with back pain. Dr. Paul McDonough upholds a commitment to educating patients about their pain and helping them understand potential contributing factors.

Sleep position can have a significant effect on your back pain. The most comfortable sleeping positions tend to maintain the spine in a neutral position, as though you were standing up with good posture. Sleeping on your back tends to be the easiest way to accomplish this, as it keeps your neck in the most natural position and distributes your weight most uniformly.

Experts recommend that you avoid sleeping on your stomach, as it flattens the spinal curve and strains the back muscles, and also rotates the neck. If you are a dedicated stomach sleeper, you may be able to lessen pressure on the back by placing a pillow under your pelvis and lower belly.

Likewise, if you are a side sleeper, a pillow between your knees can help you to keep your pelvis and spine in alignment. Alternating sleeping sides may also help, as consistently sleeping on the same side can lead to muscle imbalance and even scoliosis in extreme cases.

Regardless of your sleep position, experts recommend that you use a pillow to support your neck. A small pillow may be used under the neck itself if you are a back sleeper, but side sleepers need a thick pillow to keep the head in line with the spine.

The Wars of the Roses and the Battle of Bosworth Field


Wars of the Roses  pic
Wars of the Roses

A spine surgeon, Paul McDonough, MD, has served on the clinical team at Orthopedic Associates of Abilene since 2001. Dr. Paul McDonough enjoys reading historical nonfiction and is particularly fond of British historical events, such as the Battle of Bosworth Field and the Wars of the Roses.

The Battle of Bosworth Field took place in August of 1485. It was the last significant battle of the Wars of the Roses, in which the houses of Lancaster and York competed for the crown.

The house of York, symbolized by the white rose, occupied the throne in the person of King Richard III. He took the throne following the death of his young nephew, Edward V, who was murdered alongside his brother Richard in the Tower of London. The blame for the boys’ deaths fell on Richard III, largely because of the deaths of so many others who had claimed the throne.

The house of Lancaster, meanwhile, had been forcibly attempting to regain the throne since the deposition of Henry VI in 1461. These efforts became known as the Wars of the Roses and significantly reduced the number of nobles in England.

The wars ended at Bosworth Field, where Richard III had brought his forces after hearing of the landing of the aspiring king, Henry Tudor, in South Wales. Henry had sailed from France and marched through Wales gathering supporters, while his stepfather Thomas, Lord Stanley, amassed a private army of 6,000.

Stanley stood aside as his army took on Richard III’s army, which numbered 10,000. The advantage shifted from one side to the other until Richard decided to take on Lord Stanley himself.

Stanley ultimately overwhelmed Richard in the one-on-one battle. A bystander removed the crown from the deceased king’s head and brought it to Henry Tudor, who was standing nearby. With this coronation, he became King Henry VII, and the rule of the Tudors began.

Epidural Steroid Injections as Part of the Spine Healing Process


Spine Healing pic
Spine Healing

Paul W. McDonough, MD, is a recipient of the UCLA School of Medicine’s Longmire Medal for achieving the highest average in his graduating class in the area of surgery. Since completing his residency at UCLA Hospital and a spine surgery fellowship at University of Wisconsin, Dr. Paul McDonough has accumulated over 15 years’ experience as a spine surgeon.

Patients who are experiencing back, neck, and leg pain may opt for epidural steroid injections over surgery first, as a form of treatment. While the injections can often work to reduce pain and flush out inflammatory proteins that cause pain around the spine’s structures, they should not be viewed as a cure for spine pain; rather, the injections should solely be used to alleviate pain in order for the patient to progress with his or her rehabilitation program.

After a day of rest and light walking, you should begin post-injection rehabilitation with simple exercises that require little effort from muscles in your back. The American Academy of Orthopaedic Surgeons, for example, recommends 8 to 12 reps of wall squats and ankle pumps in the beginning stages of rehab. As you begin to feel more comfortable, try performing knee and hamstring stretches.

Physical Therapy after Spine Surgery


Dr Paul McDonough MD pic
Dr Paul McDonough MD

As spine surgeon, Dr. Paul W. McDonough MD is the only fellowship trained spine surgeon between Dallas/Ft. Worth Metroplex and Lubbock, Texas. A graduate of UCLA Medicine School, Dr. Paul McDonough recommends physical therapy to patients who’ve had spine surgery.

After spine surgery, physical therapy is necessary to help patients maximize recovery. Many surgeons actually refer patients to physical therapy centers after surgery. This is because physical therapy strengthens the back muscles, reduces back pain, improves motion and flexibility in the hips and spine, and helps heal spine tissues. Physical therapy also helps strengthen the core muscles, removing pressure from the lower back.

A typical post-operation physical therapy rehabilitation process will start with the patient undergoing a physical evaluation to identify problem areas. Next, the therapist identifies motions that cause pain and then formulates manual exercise therapies that alleviate the pain. These exercises include body weight exercises, body ball exercises, aerobics, and resistance training. These are performed in the presence and direction of qualified physical therapists. Therapists may also recommend other treatment methods such as massage therapy, electric simulation, and ice application.

Importance of Maintaining Ideal Weight for Spine and Joint Issues


Maintaining Ideal Weight for Spine

A physician who performs spine surgeries exclusively, Paul W. McDonough, MD, is a respected presence in the Abilene, Texas, medical community. He is the only practitioner in his field with fellowship training in spine surgery between Lubbock and the Dallas-Fort Worth area. Maintaining a personalized approach to medicine, Dr. Paul McDonough educates patients about how weight loss and smoking cessation can improve post-surgical recovery and overall wellness.

The overweight and obese weight classifications have long been associated with elevated risk for a wide range of conditions, including heart disease, high blood pressure, back pain, and osteoarthritis. Characterized by stiffness and joint pain, osteoarthritis can involve tenderness, swelling, and a grating sound when moving problematic joints.

Undergoing surgery that rebuilds or strengthens affected joints will not in and of itself solve the underlying issue. For those whose weight plays a role their joint issues, staying active and moving toward an optimal body weight are important steps in recovery and health maintenance after back surgery. Regular exercise, proper footwear, and weight reduction that reduces stress on the joints are important ways of minimizing reoccurrence of osteoarthritis.

Smoking Behaviors and Spine Surgery Healing

Dr Paul McDonough MD pic
Dr Paul McDonough MD

Paul W. McDonough, MD, serves as a spine surgeon with Orthopedic Associates of Abilene in Texas.
There, Dr. Paul McDonough guides patients through the process of undergoing and recovering from neck and back surgery.

Over the years, research into recovery from spine surgery has shown improved patient healing times and experiences. One of the most recent investigations into this topic has revealed that the impact of smoking on recovery correlates directly with lifelong intensity of the habit.

A recent study, presented at the North American Spine Society’s 31st annual meeting, followed 212 patients who underwent treatment for cervical spondylotic myelopathy. Researchers assessed each patient both preoperatively and postoperatively using the Nurick scale, which evaluates patients’ challenges in walking.

Although the study found no difference in preoperative scores, nonsmokers returned postoperative improvement of 1.53 Nurick scale points, while smokers demonstrated improvement of only 0.6 points. Furthermore, and perhaps more significantly, scores lowered commensurately with a patient’s packs per day and number of pack-per-day smoking years.

Because smoking habits affected postoperative rather than preoperative scores, researchers hypothesize that tobacco use has a negative effect on the body’s healing processes. For surgeons, this finding reinforces the importance of smoking cessation counseling as part of preoperative preparations.

Prevention of Lower Back Pain in Golfers

Dr Paul McDonough MD pic
Dr Paul McDonough MD

Paul W. McDonough, MD, provides surgical intervention for neck and back pain. As a spine surgeon with Texas’s Orthopedic Associates of Abilene. In his free time, Dr. Paul McDonough enjoys playing golf.

Many golfers, both professional and amateur, suffer from low back pain. It often stems from a swing technique that places undue stress on the spine, back muscles, and facet joints. Golfers can help prevent this excess stress by improving mobility in the middle back and hips, as this can relieve some of the load and torque on the lower back.

The middle back has more natural rotation ability, and maximizing rotation there can help a golfer to reduce the need to rotate the less flexible lumbar spine. Stretches such as seated twists can be extremely beneficial, and hip exercises like clamshells, lunges, and stair work can strengthen the hips and support rotation from below.

Golfers can also keep their lower backs stable by establishing a strong standing balance, in which the feet are shoulder-width apart and the knees are bent. This engages the gluteus muscles and the quadriceps, while allowing the pelvis to move forward. The golfer then bends slightly forward from the hips and stands on the balls of the feet.