Why asymptomatic discs look pathological. How labwork may help with dx. Where in the encounter to leverage change in behavior to improve pain.


    Most US States and ALL Canadian Provinces


    Immediately usable on Monday! Hone your history exam to dial in detail on what current research suggests is at the root of painful, discogenic back pain.



A lively debate currently exists regarding the value of imaging to determine whether a disc is a source of pain and/or nociception. While painful discs typically demonstrate pathological findings on imaging, all discs with pathological findings are not painful. In this course, we sift through the current literature for clues as to what features in the patient history and physical exam correlate with painful discs. 


Upon completion, the registrant would be able to:

1. Describe the paradox of the appearance of equally pathological discs on imaging in both symptomatic and asymptomatic patients.

2. Describe the role of chronic sterile inflammation in the wind up of chronic pain.

3. Offer several potential causes for higher levels of sterile inflammation in patients.

4. List multiple inflection points in the clinical history to create a thoughtful, organized treatment plan to reduce sterile inflammation

5. Discuss metrics and laboratory findings that may be tracked over time to demonstrate the effectiveness of the epigenetic-targeted treatment plan

Course curriculum

  • 1

    The Riddle of the Symptomatic vs. Asymptomatic Disc: Epigenetic Clues to Painful Discs-Phillip Snell, DC

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Learn how to help those "challenging cases" that
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  • CE CREDITS: How do I obtain chiropractic CE credits?

    ProChiroOnlineCE offers PACE accreditation for chiropractors in most US states and Canadian provinces. YOU ARE RESPONSIBLE FOR FINDING OUT IF YOUR STATE ACCEPTS PACE ACCREDITATION! A list of states and provinces that accept PACE accreditation is available at this link: https://pacex.fclb.org/pages/RegulatoryBoards.php.

    Please note that many states and provinces DO NOT require accreditation through a 3rd party, such as PACE. If you don't require 3rd party accreditation, please do not request it.

    Upon completion of your course, you must notify us directly at [email protected] to request a PACE accreditation certificate. If we do not receive an email within 14 DAYS OF COMPLETION OF YOUR COURSE, no PACE accreditation will be available.

    Other healthcare professionals are welcome to take coursework on our site, but no accredited CE is provided.

  • SUPPORT: How do I get help if I need it?

    You can get assistance by contacting us via email at [email protected]. We attempt to respond to all queries within 24 hours.

  • ACCESSIBILITY: What devices and operating systems can I use to access my course?

    In short, any device or platform that allows you to interact with us as you are now. Because all content in your course is online except the downloadable course notes, the only restriction is your availability to data stream or wi-fi access. For best results we recommend high speed wi-fi connection to reduce buffering times for the video stream. All devices, browsers and operating systems are supported.

  • ADMINISTRATION: How can I change my account information, password and payment information?

    Sign in to your account at the top right of the home page. If you forgot your login, use the prompts for password retrieval on the login page. Once logged in, you can change your account details in the top right of the page on the link to your profile. If you have any difficulty, contact support at [email protected].

  • EXPIRATION DATE: Is there a limit on the amount of time I have access to the course?

    No, your course is yours to view as long as our website exists. If you wish to receive PACE accreditation for CE hours, you must request that within 14 days of completion of your course. Contact us at [email protected].

  • STATE/PROVINCE REPORTING: What are the reporting requirements for CE for my state?

    Please contact your state/national board for your reporting requirements. On request, we will provide you with a digital certificate of completion for your course after you have completed all proficiency tests with an 80% passing grade. If your state or province requires third party accreditation, we will provide PACE accreditation if you contact us within 14 days of completion of your course. Contact us at [email protected]. A list of states and provinces that accept PACE accreditation is viewable at https://pacex.fclb.org/pages/RegulatoryBoards.php.

  • REFUND POLICY: What if I want a refund for my course?

    All sales are final and non-refundable. However, if for some unforeseen technical problems, you are having trouble viewing your course, contact support at [email protected]. We will consider the situation on an individual basis and make it right. That decision may result in credit for other courses on ProChiroOnlineCE or repayment. All decisions by ProChiroOnlineCE regarding refunds are final.

  • ELIGIBILITY: Who is this course for?

    This course is for licensed chiropractic physicians (DCs) and offers CEUs to doctors in most states and provinces. While other licensed healthcare professionals (PT, LAc, MD, DO, ND, ATC, LMT, personal trainers) will find this material helpful in care of their patients and clients, those professionals should contact their state organizations to determine eligibility of this material for CEUs.


Senior Instructor

Phillip Snell, DC

Dr. Phillip Snell is a chiropractic physician with clinical practice in Portland, OR, USA. As adjunct faculty at University of Western States, he has taken part in the largest federally funded (NIH) research grants in the history of the chiropractic profession. Additionally, Dr. Snell is the creator and content manager of 5 online websites which leverage technology to help clinicians and members of the general public improve understanding of application of exercise in neuromusculoskeletal injury and pain.

Dr. Snell is the creator and curator of ProChiropracticOnlineCE.com, a resource for chiropractic physicians to obtain accredited continuing education via video delivery of online lectures.

FixYourOwnBack.com is a self-guided online tool for those suffering from lumbar disc herniation. Subscribers receive education and exercise recommendation to help them reduce risk of injury and improve long term healing of lumbar disc herniation.

DermalTractionMethod is a neurocentric manual therapy technique developed by Dr. Snell and Dr. Justin Dean. The method focuses on easy to learn and easy to teach manual techniques to assess and correct mechanical interface dysfunction of the superficial cutaneous neurology.

NeuroCentricApproach.com is the first comprehensive physical medicine and rehabilitation method combining unique assessment, manual therapy and exercise interventions. With Dr. Justin Dean, Dr. Snell offers coursework in this innovative approach to an old problem...chronic pain.

Dr. Snell also lectures internationally at professional conventions and in-person continuing education presentations on exercise interventions, manual therapy and integrated pain science in the treatment of chronic pain and neuromusculoskeletal injury.