Spine & Nerve

Spine & Nerve

By Brian Joves, M.D.Health & Fitness
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Spine & Nerve episodes

  • A Year in Review: Global Insights, Spinal Health, and Looking Ahead to 2024

    In this episode of The Spine & Nerve Podcast, Dr. Dr. Jason Kung and Dr. Brian Joves have a reflective and forward-looking discussion as we transition from 2023 into 2024, sharing our podcast's journey, personal insights, biggest happenings in pain medicine, and anticipations for the new year.
    1. Podcast Journey and Global Reach:
    Transitioning through 2023: The evolution of our podcast through the year.
    Spotify Wrapped Insights: A deep dive into our audience demographics, celebrating a significant international listenership with a special shoutout to our friends in New Zealand, India, Spain, Brazil, and Hungary.
    2. Engaging Medical Discussions:
    Spotlight Episode - Spinal Stenosis: Discussion on why our spinal stenosis episode resonated with so many listeners and the importance of addressing prevalent health issues.
    Medical Innovations and Literature: A look back at the year's significant advancements in radiofrequency ablation and the evolving landscape of pain management.
    3. Personal Reflections and Resolutions:
    Embracing Challenges: The team's participation in a Spartan Race, symbolizing our dedication to personal growth and community engagement.
    4. Community Impact and Listener Engagement:
    Top 10 Recognition: Celebrating being in the top 10 of listeners' favorite podcasts and what it means to us.
    Listener Interaction: Encouraging feedback, stories, and engagement from our global audience.
    5. Looking Forward to 2024:
    Medical Community and Conferences: Anticipation for upcoming medical conferences, new technologies, and the continuing battle against the opioid crisis.
    Optimism for the Future: Our commitment to staying informed, optimistic, and ready to tackle the challenges and opportunities the new year brings.
    Closing Thoughts:
    A heartfelt thank you to all our listeners for their continued support and engagement. We look forward to another year of learning, growth, and community.
    Contact Information:
    We Encourage listeners to stay connected through our social media channels (LinkedIn, YouTube, Twitter (X), and Facebook are the easiest), website, and Spotify Podcast page for feedback, questions, and community stories.
    Disclaimer:
    Reminder that the information provided is for educational purposes and is not intended as medical advice. Always consult with a healthcare professional.

    33 min
  • Managing Chronic Pain through Education with Dr. Andrea Furlan
    In this episode of the Spine & Nerve Podcast, Dr. Brian Joves has the distinct pleasure to welcome Dr. Andrea Furlan to the show. Dr.
    Furlan is a pain specialist in Toronto Canada. She is a physiatrist (specialist in Physical Medicine & Rehabilitation). She holds a
    medical degree from the University of Sao Paulo and a Ph.D. degree from the University of Toronto. She has 30 years of experience helping people
    with chronic pain to get better quality of life.
    In this insightful conversation, Dr. Furlan shares her vast experience in managing chronic pain, addressing key aspects of pain management that
    are crucial for medical providers to understand.
    Key Takeaways:
    1. The Complexity of Chronic Pain:
    Chronic pain is a multifaceted condition with complex neurobiological and psychosocial components. Understanding the diverse factors
    contributing to chronic pain is essential for medical providers to provide effective care.
    2. The Role of Empathy and Communication:
    Dr. Furlan emphasizes the importance of empathy and active listening when interacting with patients in pain. Effective communication skills
    are crucial for building trust and facilitating patient-doctor relationships.
    3. Educating Patients:
    Educating patients about their condition and treatment options is a fundamental aspect of pain management. Medical providers should learn
    how to explain complex medical concepts in simple terms to ensure patient comprehension.
    4. The Value of Multidisciplinary Approaches:
    Chronic pain often requires a multidisciplinary approach, involving various healthcare professionals such as physiatrists, psychologists,
    and physical therapists.
    5. The Impact of Lifestyle Modifications:
    Lifestyle modifications, including diet, exercise, sleep, and stress management, play a significant role in pain management.
    6. Emotions and Pain Perception:
    Emotions can influence pain perception, making it essential for medical students to consider the emotional well-being of patients.
    7. Patient Support and Online Communities:
    Dr. Furlan discusses the value of patient support groups and online communities, where individuals with chronic pain can share their
    experiences and learn from one another. Medical providers can explore these resources to better understand patient perspectives.
    8. Dr. Furlan's Book - A Resource for providers:
    Dr. Furlan's book, which outlines eight steps for managing chronic pain, is recommended for medical providers looking to deepen their knowledge
    of pain management. The book provides practical insights and strategies for patient care.
    Medical providers should embrace the holistic approach to chronic pain management, considering both the physical and emotional aspects of the
    condition. Dr. Furlan's expertise and insights shared in this episode offer valuable lessons for aspiring healthcare professionals in the
    field of pain medicine.
    This podcast is for information and educational purposes only, it is not meant to be medical or career advice. If anything discussed may pertain
    to you, please seek council with your healthcare provider. The views expressed are those of the individuals expressing them, they may not
    represent the views of Spine & Nerve.
    You can find Dr. Furlan at:
    https://www.youtube.com/ @DrAndreaFurlan 
    https://www.doctorandreafurlan.com/
    X  @adfurlan 
    IG @dr.andrea.furlan
    41 min
  • Growing a strong and healthy thrower with Dr. Robert Bowers
    In this episode of the Spine & Nerve Show, Dr. Robert Bowers joins Dr. Brian Joves to discuss the progression of young athletes in throwing sports, such as baseball. He emphasizes the importance of allowing children to play multiple sports and avoid specializing too early. Dr. Bowers also highlights the risks associated with overuse injuries and the need for rest periods. He discusses the role of mechanics and training programs in preventing injuries and increasing velocity. Dr. Bowers also touches on the use of biologics, such as PRP, in the treatment of injuries in young athletes.​
    About The Guest: Dr. Robert Bowers is a sports medicine physician at Emory in Atlanta, Georgia. He specializes in the treatment of throwing athletes and has a particular interest in baseball injuries. Dr. Bowers has extensive experience working with athletes at all levels, including professional baseball players and college athletes. He is passionate about helping athletes optimize their performance and prevent injuries.​
    Key Takeaways:
    - Young athletes should play multiple sports to develop athleticism and motor skills.
    - Rest periods are crucial for preventing overuse injuries in young athletes.- Proper mechanics and training programs can help prevent injuries and increase velocity.
    - Weighted ball programs can increase velocity but also carry an increased risk of injury.
    - Biologics, such as PRP, can be used to treat certain injuries in young athletes.​
    Quotes:
    "If these kids can take three months of throwing off, four months, even better, that should be good to allow their arm to rest."-
    "The harder you throw, the more at risk your arm is."
    "Velocity gets kids noticed, but it also increases injury risk."
    "Weighted ball programs increase velocity but also increase injury risk."
    "The way to deal with increased intensity is to decrease volume."
    1 hr 1 min
  • To Anticoagulate or not to Anticoagulate with Interventional Spine Procedures

    In this episode of the Spine & Nerve podcast, Dr. Jason Kung and Dr. Brian Joves delve into a comprehensive discussion surrounding anticoagulation guidelines and their implications in interventional pain procedures.

    With over a hundred thousand downloads and over 1,000 YouTube subscribers, we would like to express our sincere gratitude to all the listeners for your engagement and support. Please continue to share and subscribe to help more people discover the podcast.


    Today's episode focuses on the safety of epidural steroid injections and the critical role of anticoagulation management.Understanding the rationale behind a patient's anticoagulation therapy is vital for interventional pain physicians. This approach empowers clinicians to make informed decisions about whether to continue or withhold anticoagulation medications prior to procedures. There is a delicate balance between patient-specific risks and the benefits of these interventions.


    One of the things that must be known and emphasized is the remarkable safety profile of epidural steroid injections. Approximately nine million epidural steroid injections are administered annually, resulting in an adverse event rate of about one in 780,000. This reassuring statistic is attributed to the collaborative efforts of medical societies and the implementation of strict anticoagulation guidelines. The hosts emphasize the role of fluoroscopic guidance, non-particulate steroids, and avoidance of deep sedation in enhancing the safety of these procedures.


    The episode further delves into the nuances of assessing bleeding risks in patients undergoing interventional pain procedures. As always, we must underscore the importance of a comprehensive physical examination, with a specific focus on identifying signs of easy bruising and mucosal bleeding. The hosts discuss the relevance of specific medications, including aspirin and NSAIDs, and their implications for procedural safety.


    The hosts engage in an insightful exploration of the guidelines for managing anticoagulation medications pre- and post-procedure. They stress the need for pain physicians to consider the anatomical location of the intervention and evaluate the potential risks versus benefits.


    The doctors conclude the episode by highlighting the crucial role of shared decision-making and patient education. By fostering collaboration between patients and physicians, the hosts emphasize the creation of a safe and informed healthcare environment.In this thought-provoking episode, the doctors try to help you navigate the complexities of anticoagulation management in interventional pain procedures, and offer some insights for practitioners seeking to provide the highest level of care to their patients.


    References:


    Anesthesia Quality Institute Closed Claims Database Review 2011 through 2021 for Epidural Steroid Complications. Naeem Haider. Pain Physician 26 (3), E251, 2023

    Stephen Endres, MD and others, The Risks of Continuing or Discontinuing Anticoagulants for Patients Undergoing Common Interventional Pain Procedures, Pain Medicine, Volume 18, Issue 3, March 2017, Pages 403–409, https://doi.org/10.1093/pm/pnw108

    Narouze S, Benzon HT, Provenzano D, et alInterventional Spine and Pain Procedures in Patients on Antiplatelet and Anticoagulant Medications (Second Edition): Guidelines From the American Society of Regional Anesthesia and Pain Medicine, the European Society of Regional Anaesthesia and Pain Therapy, the American Academy of Pain Medicine, the International Neuromodulation Society, the North American Neuromodulation Society, and the World Institute of PainRegional Anesthesia & Pain Medicine 2018; 43:225-262.

    The ASRA App: https://www.asra.com/the-asra-family/asra-app

    28 min
  • Going it alone with Dr. Nikhil Verma

    In this episode, we have a special guest, Dr. Nikhil Verma, who shares his inspiring journey from undergrad to establishing his own medical practice. Dr. Verma opens up about the challenges he faced, the pivotal moments that shaped his career, and the lessons he learned along the way. Join us as we delve into his story of perseverance, passion, and the pursuit of personalized medicine.
    Episode Highlights:
    Dr. Verma recounts his early struggles and the uncertainties he faced during his pursuit of medical school.
    Despite not getting accepted initially, he used the time to reflect and explore different options, eventually finding his way to St. George's University.
    The importance of resilience and perseverance shines through as he shares how he overcame setbacks and stayed motivated.
    Dr. Verma's interest in rehabilitation medicine and sports medicine grew during his residency.
    He shares how his personal experience with a sports-related injury shaped his perspective and ignited his passion for helping others through physical therapy and non-surgical interventions.
    Dr. Verma discusses the decision to open his own medical practice, highlighting the challenges and rewards of being an independent practitioner.
    From finding the ideal location to setting up the practice and acquiring necessary equipment, he shares the steps involved in laying the groundwork for his venture.
    Dr. Verma emphasizes the importance of tailoring treatments to individual patients, providing temporary relief while considering long-term solutions.
    He highlights advanced procedures and technologies that enable more targeted and effective interventions, showcasing the potential impact of personalized medicine.

    Dr. Verma encourages med students and early residents to stay open-minded and embrace change.
    He shares the significance of finding passion and purpose in one's work, reminding listeners that it's okay to evolve and pursue new interests within the medical field.

    Dr. Nikhil Verma's story is a testament to the power of determination, adaptability, and following one's true calling. His journey from facing initial rejections to establishing a successful practice showcases the importance of resilience and finding personal fulfillment in the medical profession. Join us in thanking Dr. Verma for sharing his insights and experiences. Tune in to the full episode to hear his story in his own words.


    You can find Dr. Verma on all your favorite social platforms, as well as our hosts.



    This podcast is for information and educational purposes only, it is not meant to be medical or career advice. If anything discussed may pertain to you, please seek council with your healthcare provider. The views expressed are those of the individuals expressing them, they may not represent the views of Spine & Nerve.

    39 min
  • Find yourself a health coach with Dr. Hunter Vincent

    In this week's episode of the Spine & Nerve podcast, we have a return guest! Dr. Hunter Vincent returns to the show to chat with Dr. Brian Joves about health coaches and how they can help your patients to be more successful in their journey with and through chronic pain.


    In this episode we'll discuss:


    What is a health coach?


    Where does this fit into the treatment and provider paradigm?


    How can ancillary team members like health coaches help your patients and your team to be more successful?



    Dr. Vincent is the CEO of Pogo Health. He is a double board certified physician who received his residency training from UC Davis in Physical Medicine & Rehabilitation (PM&R) with a subspecialty certification in Pain Medicine from UCLA. Prior to starting his medical training, he received a Bachelor's of Science in Exercise Biology. He has spent the last decade actively involved in healthcare initiatives focused on maximizing patient engagement in their own health journey. He has worked with various healthcare teams in the fields of clinical obesity, chronic pain, and neurological disorders. 


    Pogo Health is a virtual platform Virtual that utilizes a team approach to treating chronic pain. Their interdisciplinary opioid-free approach integrates the pain physician, pain therapist and specialized health coach to create a completely virtual and customized treatment program. The Pogo Health multi-modal approach utilizes evidence based techniques to provide long term physical and mental health benefits to combat chronic pain.


    Learn more at https://pogo-health.com/



    This podcast is for information and educational purposes only, it is not meant to be medical or career advice. If anything discussed may pertain to you, please seek council with your healthcare provider. The views expressed are those of the individuals expressing them, they may not represent the views of Spine & Nerve.

    26 min
  • IPGs, Artificial Intelligence and Cochrane! An SCS Update with Dr. Jason Kung and Dr. Brian Joves
    In this week's episode of the Spine & Nerve podcast, Dr. Jason Kung and Dr. Brian Joves try to digest all the recent happenings in the world of neuromodulation.
    They address:
    Internal Pulse Generators
    Artificial Intelligence
    The Cochran Study
    Listen as the doctors get excited, frustrated, and try to bring a silver lining to the whirlwind of headlines that have been discussing neuromodulation so far this year!
    There were many references in this episode, but most importantly here is the Cochran review on SCS for low back pain:
    Traeger AC, Gilbert SE, Harris IA, Maher CG. Spinal cord stimulation for low back pain. Cochrane Database Syst Rev. 2023 Mar 7;3(3):CD014789. doi: 10.1002/14651858.CD014789.pub2. PMID: 36878313; PMCID: PMC9990744.
    Here is the Hara study:
    Hara S, Andresen H, Solheim O, Carlsen SM, Sundstrøm T, Lønne G, Lønne VV, Taraldsen K, Tronvik EA, Øie LR, Gulati AM, Sagberg LM, Jakola AS, Solberg TK, Nygaard ØP, Salvesen ØO, Gulati S. Effect of Spinal Cord Burst Stimulation vs Placebo Stimulation on Disability in Patients With Chronic Radicular Pain After Lumbar Spine Surgery: A Randomized Clinical Trial. JAMA. 2022 Oct 18;328(15):1506-1514. doi: 10.1001/jama.2022.18231. PMID: 36255427; PMCID: PMC9579901.
    This podcast is for information and educational purposes only, it is not meant to be medical or career advice. If anything discussed may pertain to you, please seek council with your healthcare provider. The views expressed are those of the individuals expressing them, they may not represent the views of Spine & Nerve.
    33 min
  • Allow us to Introduce Dr. Jason Kung

    In this week's episode of the Spine & Nerve Podcast we would like to introduce you all to the newest member of the Spine & Nerve family... Dr. Jason Kung.  Jason Kung, MD, is a board-eligible anesthesiologist and interventional pain physician who joined Spine & Nerve last year. Listen in as Brian Joves, MD gets to know Dr. Kung better and explore his journey into medicine and to discovering his passion for pain medicine.


    He  graduated from the University of San Francisco in California with a  bachelor's degree in biology. He then went to Boston University School  of Medicine in Massachusetts for his medical degree.

    Dr. Kung  completed his residency in Anesthesiology and fellowship in  Interventional Pain at Harvard Medical School, Massachusetts General  Hospital in 2020.

    Dr. Kung specializes in several interventional  procedures, including spinal cord stimulation, epidural injections,  radiofrequency ablations, implantable devices, and ultrasound-guided  nerve/joint injections. He strives to provide  compassionate evidence-based care to all his patients.

    He is certified as an instructor in  medical simulation. Dr. Kung has completed research and published in the  areas of bone healing and the effects of natural sources of vitamin D.

    During  his free time, he enjoys playing guitar, surfing/snowboarding, and  exploring California with his wife and dog. 


    This podcast is for information and educational purposes only, it is not  meant to be medical or career advice. If anything discussed may pertain  to you, please seek council with your healthcare provider. The views  expressed are those of the individuals expressing them, they may not  represent the views of Spine & Nerve.

    33 min
  • Spinal stenosis
    In this week's episode we take a deep dive into lumbar spinal stenosis, discussing the underlying disease process as well as treatment options in the medical literature. The studies referenced in this podcast are given at the end of the podcast. This is meant for education and entertainment only, this is not to be interpreted as medical advice. If you feel that something discussed may be relevant to you, please discuss with your medical provider. The views and opinions discussed in this podcast are those of the individuals who express them, and are not the views and opinions of Spine & Nerve Diagnostic Center.
    23 min
  • Movement as Medicine with Evan Hauger, DPT
    In this week's episode of The Spine & Nerve Podcast, Evan Hauger, DPT joins Brian Joves, MD to discuss movement as medicine.
    Dr. Evan Hauger
    Evan specializes in  sports physical therapy, strength, and conditioning. He knows the ins  & outs of injury from years of personal experience. Growing up, he  was a multi-sport athlete and went on to play baseball at Shasta College. Through multiple personal injuries related to his athletic career, Evan realized that he had a passion for improving the way people  move and enhancing their performance in sport and life. Also a  StrongFirst Certified Level 1 instructor, Evan earned his Doctorate in  Physical Therapy from Sacramento State University and has worked with  athletes of all calibers, including MLB, NFL, NBA, UFC, and Olympians.  He has also spent time with some of the best minds in sports physical  therapy in Boston, MA, been a medical team leader for the USA Track and  Field National Championships, assisted with NFL combine training at Exos  in Phoenix, AZ, and been the performance coach for a group of Olympic athletes. This podcast is for information and educational purposes only, it is not meant to be medical or career advice. If anything discussed may pertain to you, please seek council with your healthcare provider. The views expressed are those of the individuals expressing them, they may not represent the views of Spine & Nerve.
    33 min

About Spine & Nerve

From the publisher's feed

We are physicians who practice pain management and physical medicine and rehabilitation, and believe that the main goal of practice is to improve the quality of life of our patients and communities. We will dive deep into the world of modern pain management to help healthcare providers and consumers understand various diagnoses, treatment options, and the changing landscape of pain management.