Spine & Nerve

In this week's episode of the Spine & Nerve podcast Drs Nicolas Karvelas and Brian Joves give us an introduction to traumatic brain injuries (TBI) have been on my mind this weekend. TBI is defined as "a disruption of brain function due to an external force or blow to the head." Patients who experience a TBI can present with decreased level of consciousness, memory loss before or after injury, alte...

In this week's episode of the Spine & Nerve podcast Dr. Brian Joves and Dr. Nicolas Karvelas are talking opiates again. They discuss the steps to take to ensure we are doing what we can to optimize the safety of not only the patient but also the healthcare provider when dealing with opioid medications.   In situations where chronic opioid use is indicated, there are certain steps that can be taken...

In this week's episode of the Spine & Nerve podcast, Dr. Nicolas Karvelas and Dr. Brian Joves are introducing electrodiagnostic evaluations. An electrodiagnostic evaluation is a combination of nerve conduction studies and electromyography, or in simple terms a way to look at the health of nerves. The nerve conduction study uses electrodes and an electrical impulse to send a signal through a nerve...

In this week's episode of the Spine & Nerve podcast, Dr. Nicolas Karvelas and Dr. Brian Joves nerd out about chronic pain pathways, specifically the changes that take place in the signaling over time. Chronic, persistent pain changes the physiologic signaling in the body. This means that it is not purely a nociceptive process. Along the pathway, we have the classic components of transmission, tran...

In this week's episode of the Spine & Nerve podcast, Dr. Nicolas Karvelas and Dr. Brian Joves chat about "non specific" lies back pain. Back pain has been well documented as the most common reason people present to a healthcare professional with some studies quoting an incidence as high as 30%. It is also one of the largest causes of disability, morbidity, and lost production in the United States....

In this week's episode of the Spine & Nerve podcast, Dr. Raman Gurai and Dr. Brian Joves introduce the field of regenerative medicine. Regenerative medicine at its core is a theory that we can influence the body's natural healing abilities to help with pain. The field has been developing over the past few decades, but really made it into the mainstream lexicon when professional athletes began util...

Last week, Andrew Luck shocked the NFL world by announcing his retirement. In his retirement speech, he stated "I've been in this cycle of injury, pain, rehab, injury, pain, rehab, and it's been unceasing, unrelenting... The only way I see out of it is to no longer play football." This is probably one of the most high profile retirements in the history of the NFL and adds to the growing list of pl...

In this week's episode of the Spine & Nerve podcast, Dr. Karvelas and Dr. Joves continue the discussion on complex regional pain syndrome. As we discussed last episode, CRPS is essentially nerves not behaving themselves in the peripheral and Central nervous systems, and is one of the models for centralized pain. Because CRPS is so variable in its clinical presentation and the way that our affects...

In this week's episode of the Spine & Nerve podcast, Dr. Karvelas and Dr. Joves discuss complex regional pain syndrome, better known as CRPS. This topic and diagnosis is one that is very poorly understood by the general public, and many within the medical and healthcare communities. CRPS is essentially nerves not behaving themselves in the peripheral and Central nervous systems, and is one of the...

In this week's episode of the Spine & Nerve podcast, Dr. Karvelas and Dr. Joves discuss one of the most common musculoskeletal pain complaints, especially in an older demographic-the hip joint. Listen as the doctors dive deeper into this topic and give some practical tips for people living with or treating chronic pain. Follow our practice on Facebook at Spine & Nerve Diagnostic Center. Please lea...

In this week's episode of the Spine & Nerve podcast, Dr. Karvelas and Dr. Joves discuss the behavioral health aspects of chronic pain. It is very well documented that chronic pain has very significant psychologic connections. The International Association for the Study of Pain define pain as "an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or descr...

In this week's episode of the Spine & Nerve podcast, Dr. Karvelas and Dr. Joves discuss peripheral neuropathy. Neuropathic pain is defined as a process that affects the somatosensory nervous system. When the nerves that are affected lie outside of the central nervous system (brain and spinal cord), it is considered peripheral neuropathy. Painful peripheral neuropathy has been identified in up to 3...

In this week's episode of the Spine & Nerve podcast, Dr. Karvelas and Dr. Joves discuss a procedure called minimally invasive lumbar decompression or MILD. What exactly is MILD? Well, it's a way to create more space in the spine with utilizing small entry ports- which means no large incisions, less recovery time after the procedure and decreased risk for the patient. Listen as the docs discuss the...

In this week's episode of the Spine & Nerve podcast, Dr. Karvelas and Dr. Joves discuss CBD and it's utility in modern pain management. The doctors discuss a very brief introduction of the 2018 Farm Bill and how it has changed and opened an entire industry. They dive into some of the research that has been done, discuss how they are seeing it used in practice, and future considerations for researc...

In this week's episode of the Spine & Nerve podcast, Dr. Karvelas and Dr. Joves discuss shoulder pain. Shoulder pain is the third must common musculoskeletal complaint that brings patients to seek medical care. The shoulder is a complex arrangement of joints, tendons, and muscles... Each of which can be injured and contribute to pain. Follow our practice on Facebook at Spine & Nerve Diagnostic Cen...

In this week's episode, Drs. Gurai and Joves discuss one of the under appreciated pain generators for low back pain- the sacroiliac joint (SI joint). The sacroiliac joint is the place where the spine meets the pelvis. It is, as the name suggests, a joint between the sacrum (lowest portion of the spine) and the ilium (one of the bones of the pelvis). Medical studies attribute between 10 and 40 perc...

In this special episode, Dr. Karvelas and Dr. Joves discuss something near and dear to their hearts, the injury the Kevin Durant sustained in the NBA finals. This is a discussion between two long time Warriors fans, who happen to be physical medicine and rehabilitation physicians. The doctors do not know the details of the injury and are simply talking it through from a medical perspective. This i...

In this week's episode of the Spine & Nerve podcast, Dr. Karvelas and Dr. Joves discuss nutrition, exercise, and pain management. This is a topic that we don't spend enough time on with patients, despite the growing evidence that it can make a significant difference. In the episode, Dr. Andrew Weil's website was mentioned - https://www.drweil.com/diet-nutrition/anti-inflammatory-diet-pyramid/ amon...

We have a special treat this week! This is a recording of a lecture Dr. Karvelas gave discussing chronic pain and non-opioid treatment options. He did a fantastic job of describing chronic pain management in 2019 and ways that we can help patients live there best lives. There are some portions of the recording where the audio quality isn't perfect- thank you for your patience at these portions, it...

Have you heard of text neck or tech neck?? Tech neck is a real thing! Join Dr. Karvelas and Dr. Joves as they explore this topic. Generally speaking, tech neck is the pain in your neck and upper back (periscapular region) muscles. It is caused (or at least exacerbated) by spending a significant amount of time looking down at a tablet or cell phone, improper positioning at a computer workstation (o...

In this week's episode, Dr. Karvelas and Dr. Joves discuss buprenorphine... What it is, what it isn't, and some ways that it is being utilized to help patients with chronic pain. This podcast is for information and educational purposes only, it is not meant to be medical advice. If anything discussed may pertain to you, please seek council with your healthcare provider. The views expressed are tho...

Opioids and the opioid epidemic are everywhere in today's news media. Dr. Karvelas and Dr. Joves discuss a sensitive subject today- how to determine when opioids are failing our patients. This podcast is for information and educational purposes only, it is not meant to be medical advice. If anything discussed may pertain to you, please seek council with your healthcare provider. The views expresse...

Dr. Karvelas and Dr. Joves give an introduction to fibromyalgia. What is it? How has this diagnosis changed within the medical community over the past couple decades? What are the main ways to manage and treat the disease? This podcast is meant for education and entertainment only. This is not medical advice. If you would like further information on any of the topics discussed, please seek council...

Pain in a joint (knee, hip, shoulder, etc) is a common presentation to health care providers. There are many reasons for a patient presenting with pain, and each joint presents a number of different structures that can be pain generators. Drs Gurai and Joves walk us through the basics of evaluating and treating painful joints. In this episode, we discuss the difference between an acute injury and...

Dr. Karvelas and Dr. Joves discuss the various treatment options for patients living with pain. For patients and healthcare providers alike, once an appropriate diagnosis is made, the hard work begins. This is when we have to figure out the next steps towards getting back to function, quality of life, and the activities that make our patients happy. We believe that having a consistent and systemat...