108 episodes

We are physicians who practice pain management and physical medicine and rehabilitation, and believe that the main goal of our 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.

This podcast is meant for educational and entertainment purposes only, and is not medical advice.

Spine & Nerve podcast Spine & Nerve podcast

    • Health & Fitness
    • 4.7 • 48 Ratings

We are physicians who practice pain management and physical medicine and rehabilitation, and believe that the main goal of our 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.

This podcast is meant for educational and entertainment purposes only, and is not medical advice.

    Movement as Medicine with Evan Hauger, DPT

    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.

    • 32 min
    Trauma Informed Care with Krystyna Holland, DPT

    Trauma Informed Care with Krystyna Holland, DPT

    In this week's episode of the Spine & Nerve podcast, Dr. Julie Hastings connects with Dr. Krystyna Holland, PT, DPT to learn about trauma informed care.

    Trauma informed care has many definitions, including some fantastic work done by the Substance Abuse and Mental Health Services Administration. One definition is a consistent and intentional effort to reduce our propensity for harm. Another describes it as an approach in the human service field that assumes that an individual is more likely than not to have a history of trauma.

    Listen in as Drs. Hastings and Holland discuss this very important topic and share some tips on how to better show up for our patients.


    Krystyna Holland, DPT (she/her)  is a physical therapist in Denver, Colorado specializing in the provision of trauma informed pelvic floor care to individuals across the gender identity spectrum. In addition to helping folks feel confident in their ability to live without leaking and have pleasurable sex, Krystyna aims to change the fundamental patient provider relationship from one that centers the provider as a problem solver to one that focuses on collaboration between the patient and the provider. She is a well-known Instagram educator (@krystyna.holland) and an instructor of trauma-informed care webinars.  She owns a small private practice called Inclusive Care and lives in Denver, CO.

    https://instagram.com/krystyna.holland


    https://www.inclusivecarellc.com/

    • 27 min
    Infectious Spondylodiscitis

    Infectious Spondylodiscitis

    In this week's episode of the Spine & Nerve podcast, Drs. Nicolas Karvelas and Brian Joves discuss infectious spondylodiscitis, a relatively rare inflammatory process involving an intervertebral disc and the adjacent vertebral bodies.

    Spondylodiscitis has a prevalence of about 4-24 per million, and has been increasing as patients have more risk factors (advanced age, immunocompromised states such as HIV infection, intravenous drug users, healthcare-associated infections, expansion of spinal surgery indications) and improved diagnostic modalities.

    Patients generally present with pain and tenderness in the region, about 50% present with high fever, and about 1/4 with neurologic compromise. The symptoms can be fairly non-specific, so patients with risk factors must be evaluated with a high degree of suspicion.

    Infection is the most common cause of spondylodiscitis, which is often spontaneous and hematogenous in origin and most commonly affects the lumbar spine, followed by thoracic, cervical, and sacral. The infectious pathogens can be pyogenic (bacterial), granulomatous (tuberculosis, fungal), or parasitic, though many noninfectious processes affecting the spine such as pseudarthrosis in ankylosing spondylitis, amyloidosis, destructive spondyloarthropathy of hemodialysis, Modic changes type 1, neuropathic arthropathy, calcium pyrophosphate dehydrate (CPPD) spondyloarthropathy and gout can mimic infectious discitis/ osteomyelitis.

    To determine whether a particular patient’s spinal process is due to an infectious versus non-infectious cause and to determine the pathogencan be challenging. Clinical findings and laboratory studies including erythrocyte sedimentation rate (ESR) or C-reactive protein (CRP) can be helpful in the diagnosis due to their high sensitivity; however, their specificity is low. Magnetic resonance imaging and biopsy have become the standard when working up this process, particularly in cases where the origin of the pathogen is unknown.

    Listen as the doctors give a high-level overview of this disease process, and walk us through the challenging diagnostic process of a disease that may have an insidious onset, with subtle and misleading clinical features and briefly discuss management requiring a multidisciplinary approach involving radiologists, infectious diseases specialists, spine surgeons and rehabilitation personnel.

    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.

    1. Salaffi, F., Ceccarelli, L., Carotti, M. et al. Differentiation between infectious spondylodiscitis versus inflammatory or degenerative spinal changes: How can magnetic resonance imaging help the clinician?. Radiol med 126, 843–859 (2021). 

    2. Mavrogenis AF, Megaloikonomos PD, Igoumenou VG, et al. Spondylodiscitis revisited. EFORT Open Rev. 2017;2(11):447-461. Published 2017 Nov 15. doi:10.1302/2058-5241.2.160062

    • 40 min
    Journal Club: Interventional Options to Treat Persistent Pelvic Pain Syndrome

    Journal Club: Interventional Options to Treat Persistent Pelvic Pain Syndrome

    In this week's episode of the Spine & Nerve podcast, Drs. Julie Hastings, Nicolas Karvelas, and Brian Joves present a journal club on interventional management of patients with persistent pelvic pain syndrome.

    Three different interventions are covered in the articles presented, showing a range on invasiveness and diversity of targets to help moderate the pain symptoms.

    Listen as the doctors dive in and discuss these articles and discuss ways these articles might help patients living with persistent pelvic pain syndrome and the physicians caring for them.

    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.


    References:
    1. Hong DG, Hwang SM, Park JM. Efficacy of ganglion impar block on vulvodynia: Case series and results of mid- and long-term follow-up. Medicine (Baltimore). 2021;100(30):e26799.
    2. Agarwal-Kozlowski K, Lorke DE, Habermann CR, Am Esch JS, Beck H. CT-guided blocks and neuroablation of the ganglion impar (Walther) in perineal pain: anatomy, technique,
    safety, and efficacy. Clin J Pain. 2009 Sep;25(7):570-6.
    3. Istek A, Gungor Ugurlucan F, Yasa C, Gokyildiz S, Yalcin O. Randomized trial of long-term effects of percutaneous tibial nerve stimulation on chronic pelvic pain. Arch Gynecol Obstet 2014;290(2):291–8
    4. Hunter CW, Yang A. Dorsal Root Ganglion Stimulation for Chronic Pelvic Pain: A Case Series and Technical Report on a Novel Lead Configuration. Neuromodulation. 2019 Jan;22(1):87-95. doi: 10.1111/ner.12801. Epub 2018 Aug 1. PMID: 30067887.

    • 27 min
    Allow us to Re-Introduce Dr. Raman Gurai - A Journey Through a Distant Land to Achieve Your Goals

    Allow us to Re-Introduce Dr. Raman Gurai - A Journey Through a Distant Land to Achieve Your Goals

    In this week's episode of the Spine & Nerve podcast, Dr. Joves welcomes Dr. Raman Gurai back to the show. Dr. Gurai walks us through his journey in medicine and how he took the road less traveled to achieve his goals and dreams!

    Dr. Gurai's Bio:
    Dr. Raman Gurai is a board certified Physical Medicine and Rehabilitation physician with a special interest in Interventional Spine. He was born and raised in northern California and his interest in medicine started in college where he majored in Molecular and Cell Biology with an emphasis in Neuroscience at the University of California at Berkeley in Berkeley, California. From there he headed to Grenada (West Indies) for his medical degree, and thereafter he completed his residency at the UCLA/VA Physical Medicine and Rehabilitation training program. He stayed on for an extra year to complete his current specialty, Interventional Spine. His medical interests include diagnosing and healing ailments of the spine with a multitude of modalities including EMG/NCS nerve testing and spine procedures including facet injections, epidurals, medial branch blocks, radiofrequency ablations, sacroiliac joint injections, and spinal cord stimulation among other cutting edge techniques. Dr. Gurai’s personal approach to medicine is to treat each individual as if they were a family member.  It is with this approach that he hopes to restore the quality of life and function each person deserves.

    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.

    • 48 min
    Pelvic Physical Therapy with Dr. Julie Hastings and Dr. Shereen Sairafi

    Pelvic Physical Therapy with Dr. Julie Hastings and Dr. Shereen Sairafi

    In this week's episode of the Spine & Nerve podcast, Dr. Julie Hastings sits down with Shereen Sairafi, PT, DPT, WCS to discuss all things pelvic physical therapy related.  Pelvic floor physical therapists play an integral role in helping patients who have urinary, bowel, or sexual dysfunction, as well as pelvic pain. 
    Dr. Shereen Sairafi graduated from Boston University in 2013 with a  doctorate of physical therapy. Since that time she has been working in  the pelvic health field and advocating for broader access for patients  with pelvic floor dysfunction. Most recently she founded the pelvic  health physical therapy program at Denver’s public health, safety-net  hospital. Her clinical interests include rehabbing and preventing  obstetric anal sphincter injuries, assisting patients in returning to  all functional activities (including sex) pain free, and caring for  gender diverse patients.
    In her free time she enjoys running, playing tennis, reading, crafting, and perfecting her tahdig recipe.

    Some of the big questions that they address in this episode:
    Who is an appropriate patient for pelvic PT?
    How to pitch the idea or prepare a patient for pelvic PT?
    How does pelvic floor dysfunction overlap with other musculoskeletal pathologies?


    To find a PT:
    https://aptapelvichealth.org/ptlocator/
    https://pelvicguru.com/directory/
    Return to run guidelines:
    https://www.researchgate.net/publication/335928424_Returning_to_running_postnatal_-_guidelines_for_medical_health_and_fitness_professionals_managing_this_population


    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.

     

    • 32 min

Customer Reviews

4.7 out of 5
48 Ratings

48 Ratings

Lauren NP ,

Great podcast

This is an awesome podcast! I’m an NP starting in a spine and pain clinic, so I listen to an episode every day on my way to work. Thanks for sharing!

MajSaf ,

Pelvic pain

Excellent topic and interview with
Doctor Shereen Sairafi
Very knowledgeable and informative discussion
Really enjoyed the podcast
Thank you

Pezcador ,

Excellent for those interested in pain management

Great discussions, manageable content, nice format. Short podcasts you can listen to on the way to work. It’s kinda funny, I talk to the podcast and 9 of 10 times they answer my question before then end of the show. Great job guys.

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