Module 1.5: The Dorsal Root Ganglion ("The Mini Brain") & Peripheral Sensitization

In this lesson, I break down the most overlooked, game-changing concepts in back pain and sciatica — the dorsal root ganglion, or DRG.

If you’ve ever had a patient who didn’t fit the typical “disc” pattern — no flexion or extension sensitivity, normal slump test, and yet still had weird twitching, burning, or “my leg doesn’t feel like mine” type of symptoms — this lesson will finally make sense of those cases.

I’ll share Athena’s story — a patient who’d seen multiple specialists and was made to feel “crazy” because her symptoms didn’t fit any textbook.

Through her case, you’ll see how the DRG can create powerful chemical & mechanical sensitivities that mimic discogenic referred pain even when the spine looks fine on imaging. Athena’s case demonstrates classic radicular nerve root behavior.

By the end, you’ll:

  • Understand how the DRG acts as a “mini brain” 🧠 for sensory processing

  • Learn how sustained postures can trigger mechanical & chemical irritation

  • See how perception of threat, stress, and prior pain experiences amplify sensitivity

  • Learn how to identify a sensitive DRG pattern when classic disc tests come up clean

  • Walk away knowing exactly how to explain this to patients in language that gives them hope instead of fear

Stay with me through the end — you’ll see how to use these insights clinically and how to set up your next module on peripheral sensitization & the action potential threshold.

⏱️TIME STAMP

0:00 – 0:30 | Welcome to Section 5: The Dorsal Root Ganglion & Peripheral Sensitization
0:31 – 1:05 | Why DRG sensitivity matters for pattern recognition
1:06 – 2:15 | When acute back pain cases don’t fit the disc pattern
2:16 – 3:25 | Story intro: Athena’s confusing pain presentation
3:26 – 5:45 | Subjective clues — morning pain, post-yoga symptoms, leg twitches
5:46 – 7:45 | Objective findings — negative slump, pain only with sustained extension
7:46 – 9:00 | The “aha” moment: reproducing her exact symptoms
9:01 – 10:15 | Why sustained extension can irritate the DRG
10:16 – 12:25 | Anatomy breakdown: how closing the foramen increases pressure
12:26 – 14:40 | The “trash" vs groceries” analogy for venous congestion & hypoxia
14:41 – 17:00 | How ischemia leads to chemical sensitization
17:01 – 19:30 | How DRG irritation amplifies peripheral nerve sensitivity
19:31 – 21:00 | Real-world examples: massage flare-ups & chronic sciatica relapses
21:01 – 22:20 | Why sensitivity is temporary — short receptor lifespan = neuroplasticity
22:21 – 23:40 | How to create hope through felt change, not lectures
23:41 – 24:30 | Pattern recognition recap: the “Athena” patient type
24:31 – 25:05 | Clinical tip: use extension-biased slump testing for subtle DRG cases
25:06 – 25:25 | Preview: next up — Peripheral Sensitization & Action Potential Threshold

Stay tuned for tomorrow's video…

where I discuss clinically relevant physiology of sensory receptors & peripheral sensitization. Why do these receptors become sensitive? How does this show up clinically?

p.s If you don't want to wait for the rest of the module 1 videos and would rather get the rest of this LBP course now​ click here​