Back Talk Doc

From Host to Guest: Dr. Sanjiv Lakhia Discusses Back Care on "Interview the Expert" at The SpineXchange

Sanjiv Lakhia - Carolina Neurosurgery & Spine Associates — Thu, 04 Jan 2024 03:00:00 -0400

After undergoing multiple spine surgeries himself, Joel Proskewitz founded the SpineXchange to offer educational materials for others who are dealing with back surgery or general back pain.

On this episode of Back Talk Doc, Dr. Lakhia sits in the hot seat as he is interviewed by expert guest Joel for the SpineXchange. Joel and Dr. Lakhia cover advice on many different aspects of back care.

Both Joel and Dr. Lakhia found a passion for spinal care and education through personal experiences. For Dr. Lakhia, it was his exposure to osteopathic medicine that included over 300 hours of hands-on training in osteopathic manipulation that sparked his interest in lightening the burden patients feel when suffering from spine issues. Joel shares Dr. Lakhia’s interest in spine care and knows first-hand how important spine health is after having to undergo multiple surgeries to repair a fracture in his spine.

Combining standard medical interventions with additional elements like addressing stress levels, prescribing breathing exercises, discussing research-based supplementation, and incorporating acupuncture is core to Dr. Lakhia’s approach. He emphasizes the need for evidence-based alternative treatments as part of a comprehensive approach for patients.

“What I've observed in my career is patients are moving away from a pill for every ill, and they want to be able to take more control of their health and use natural interventions,” Dr. Lakhia says when describing the increased interest in integrative medicine for spine health.

If you’re interested in learning more about the SpineXchange and becoming a subscriber you can check out their website here: https://thespinexchange.com/.

💡 Featured Expert 💡

Name: Joel Proskewitz

What he does: For over two decades Joel Proskewitz has specialized in spinal rehabilitation for people that have undergone or are facing spinal surgery. He has built up a wealth of experience, both as a long-term spine patient himself and working with doctors and physicians from across the medical world. His specific focus is on spinal pathologies, their associated intervention surgeries, and subsequent patient rehabilitation.

Company: The SpineXchange

Words of wisdom: “The owner of the spine has emotions. They have certain stressors that can systematically create a whole bunch of problems, and you really need to understand the individual who's sitting in front of you.”

Connect: Website | LinkedIn

⚓ Anchor Points ⚓

Top takeaways from this Back Talk Doc episode

Having a healthy functioning spine is critical to having a healthy functioning life. Dr. Lakhia’s passion for anatomy led him to osteopathic medicine. He wanted to dive deeper into spine care and understand the science behind a healthy spine so he could contribute to treating dysfunction. In addition, his osteopath older brother inspired him to pursue physical medicine.
The modern lifestyle is impacting our health. Dr. Lakhia stresses the importance of reviewing your diaphragm’s ability to expand correctly. The connection between good diaphragmatic movement, posture, and overall health is paramount. Those who disregard the influence of posture on pain are overlooking a crucial component of their health.
You have to meet people where they are. When meeting patients, Dr. Lakhia establishes a rapport through open-ended questions and understanding their personal story. Understanding the patient’s goals and motivations for treatment helps align the treatment plan with the individual. Armed with that knowledge, he can suggest appropriate treatment options, such as physical therapy, spinal injections, and collaboration with neurosurgical colleagues when necessary.

⚕️ Episode Insights ⚕️

[02:55] A history of physiatry: Dr. Lakhia provides an overview of his speciality and how it came to be. Physiatrists focus on restoring function and reducing pain and operate as a hybrid between neurology and orthopedics.

[07:10] Across the ages: As people are living longer, Dr. Lakhia explains why he is seeing more patients in the 70-plus age range. At the same time, he’s also seeing more patients from younger generations, potentially driven by the work from home movement.

[10:04] The spine impacts your overall health: Joel shares his personal experience in how restoring the natural curvature of his spine through surgery improved his quality of life, supporting Dr. Lakhia’s comments on the importance of spinal health.

[12:12] No longer a pill for every ill: Dr. Lakhia reviews how he uses integrative medicine in his practice and how he sees the approach benefit his patients.

[15:20] Sprinkle in a little extra: Standard medical interventions absolutely have their place in treatment, however adding interventions, like breathing exercises, can go a long way in improving patient quality of life.

[18:27] The patient journey: Dr. Lakhia walks listeners through the journey of a patient in his office, starting with building a rapport and learning the patient’s backstory.

[22:12] Everything offered in-house: Dr. Lakhia reviews the different types of treatments available at the Carolina Neurosurgery and Spine Associates.

Subscribe & Contact

👉 If you enjoyed this episode of Back Talk Doc, check out our recent episode We Feel Your Back Pain with Dr. Joe Cheatle.

👉Apply for an Integrative Medicine consult with Dr. Lakhia (NC/SC residents only).

🔎 For more information on Dr. Sanjiv Lakhia and the podcast visit BackTalkDoc.com

👀Check us out on the 15 Best Back Pain Podcasts list!

🎧 Subscribe in your favorite podcast app.

Back Talk Doc is brought to you by Carolina Neurosurgery & Spine Associates, with offices in North and South Carolina. To learn more about Dr. Lakhia and treatment options for back and spine issues, go to backtalkdoc.com. To schedule an appointment with Carolina Neurosurgery & Spine Associates, you can call us at 1-800-344-6716 or visit our website at CNSA.com.

We Feel Your Back Pain with Dr. Joe Cheatle

Sanjiv Lakhia - Carolina Neurosurgery & Spine Associates — Mon, 13 Nov 2023 03:00:00 -0400

Even with their in-depth medical training, doctors can brush off accidents and deny the possibility of a lumbar issue. It’s not until the pain persists or worsens that they come to terms with the possibility of having a longer-term injury.

Doctors can even experience a sense of shame about having a spine problem while being a spine expert.

On this episode of Back Talk Doc, Dr. Sanjiv Lakhia invites his colleague and friend Dr. Joseph Cheatle, a neurosurgeon at Carolina Neurosurgery and Spine Associates, to discuss the personal challenges that he has faced with low back pain.

Dr. Cheatle’s injury occurred following a skiing accident where they were hit by another skier. Initially, he brushed off the incident, but over time, he began experiencing increasing discomfort in his back and buttocks. As the pain worsened, he realized the challenge of diagnosing his own condition.

Even after finally seeking professional help with his injury, which included physical therapy and an MRI, Dr. Cheatle was still not entirely upfront with his own family. But they noticed changes in his behavior, including staying in his car longer after arriving home from work because it hurt to get up, and having to excuse himself to go lay down.

Ultimately it was conservative therapies, including spinal injections, that helped Dr. Cheatle reduce his pain and begin to recover. It was at this point that he was able to reintegrate exercise into his life with the help of physical therapy.

The experience has made him a better doctor, allowing him to provide more meaningful support and encouragement to patients during the healing process. He emphasizes that the emotional aspect of recovery is often as challenging as the physical.

💡 Featured Expert 💡

Name: Joseph Cheatle, MD

What he does: As a board-certified neurosurgeon at Carolina NeuroSurgery & Spine Associates, Dr. Cheatle, provides adult neurosurgical care. His clinical special interests include treating brain tumors, degenerative spinal disorders, transsphenoidal surgery, and spinal cord stimulation.

Company: Carolina NeuroSurgery & Spine Associates

Words of wisdom: “I'm a better doctor, for sure. And what I mean by that is that I can sympathize and not empathize.”

Connect: Website

⚓ Anchor Points ⚓

Top takeaways from this Back Talk Doc episode

You should be a patient, not a doctor for yourself. After realizing the severity of his situation, Dr. Cheatle sought professional help from the physical therapy department. He completed a thorough examination and underwent an MRI.
Don’t immediately jump to surgery as a solution. A discectomy would likely have provided quick relief. But even as a surgeon, Dr. Cheatle recognized the importance of trying other therapies first. He opted to explore more conservative treatment options before considering more invasive measures.
Distinguishing between sympathy and empathy. Dr. Cheatle says that he is a better doctor after his injury. It allowed him to connect with patients on a deeper emotional level. By sharing his patients own struggles and triumphs, he can better relate to patients undergoing difficult situations.

⚕️ Episode Insights ⚕️

[04:28] Brushing off an injury: Dr. Cheatle shares how he was involved in a skiing accident that he originally brushed off — before realizing it could be something more serious.

[08:45] Discovering new humility: Dealing with an injury of his own made Dr. Cheatle more compassionate towards his patients, as he could more directly relate to the pain they were feeling.

[10:14] Asking for help: After attempting to deal with the injury on his own, Dr. Cheatle sought our professional assistance for his recovery including physical therapy and an MRI.

[11:16] Phenomenal physical therapists: For those looking to learn more about physical therapy and neck pain, Dr. Lakhia mentions additional podcast episodes on Thoracic Outlet Syndrome and neck pain.

[12:51] Did you get a piercing?: Dr. Cheatle and Dr. Lakhia discuss battlefield acupuncture, which uses small needles that can resemble ear studs. You can learn more in Episode 65 of Back Talk Doc on Battlefield Acupuncture for Pain with John Howard.

[15:03] Practice what you preach: The doctors discuss why non-operative care can be the right choice for people and why in his case, Dr. Cheatle decided to opt for conservative therapies first.

[18:07] Finding relief: A series of spinal injections administered by Dr. Lakhia did end up providing some relief. Dr. Cheatle shares his experience being on the patient side of the procedure for the first time.

[23:58] Building strength through pain: Reintegrating exercise into your routine is an important part of recovery from an injury. A healthy way to do so is discussed in more detail in another episode on Back Pain and the Sacroiliac Joint with Tanner Holden, PT.

[28:27] Addressing the questions: Dr. Cheatle and Dr. Lakhia address questions from the audience, including what can be done to address severe pain, how to treat recurrent pain after surgery, and why pain can flare up in the morning.

Subscribe & Contact

👉 If you enjoyed this episode of Back Talk Doc, check out our recent episode Empathy and Compassion: The Journey from Spine Patient to Provider with Physician Assistant Lindsay Howard

👉Enroll in Dr. Lakhia’s 6 week course to lower inflammation.

👉Apply for an Integrative Medicine consult with Dr. Lakhia (NC/SC residents only).

🔎 For more information on Dr. Sanjiv Lakhia and the podcast visit BackTalkDoc.com.

👀Check us out on the 15 Best Back Pain Podcasts list!

🎧 Subscribe in your favorite podcast app.

Empathy and Compassion: The Journey from Spine Patient to Provider with Physician Assistant Lindsay Howard

Sanjiv Lakhia - Carolina Neurosurgery & Spine Associates — Mon, 30 Oct 2023 03:00:00 -0400

What happens when the doctor becomes the patient? In the first episode in this new series, Dr. Sanjiv Lakhia discusses personal back care journeys with some of his esteemed colleagues.

On this episode, he talks with Lindsey Howard, PA-C, a physician assistant in the physiatry department at Carolina Neurosurgery and Spine Care. Her spine care journey began with scoliosis.

When she was 12, she was diagnosed with scoliosis during a routine school screening for the condition. Her spinal curve was 40 degrees and quickly progressed to 72 degrees. Her doctor recommended surgery or, he told her parents, she likely wouldn’t live past age 30.

She hadn’t experienced much pain, only discomfort, from her scoliosis, but she remembers some of her post-op pain clearly. It’s helped her become more empathetic with patients.

“The resident was trying to peel off the bandage on my back — that was very painful,” she said. “So now when I remove bandages, I'm very, very sensitive to that for patients.”

Thankfully, surgery allowed her to get back to a sporty lifestyle and allowed her to be a cheerleader in high school. And the experience as a whole inspired her to work in medicine.

Originally, her plan was to go to medical school, with the goal of helping other girls who suffered from similar issues. But she ended up becoming a physician assistant because she liked to spend more time with patients in their care transitions.

Tune in to this episode of Back Talk Doc to hear more of Lindsey’s story with scoliosis and how she uses that difficult experience to be a better care provider today.

💡 Featured Expert 💡

Name: Lindsey Howard, MPAS, PA-C

What she does: Lindsey has been a physician assistant with Carolina Neurosurgery and Spine Associates since she graduated in 2013. She works in the physiatry department with Drs. Wiercisiewski and Sumich.

Company: Carolina Neurosurgery and Spine Associates

Words of wisdom: “The main reason I got into this is because I don't want anybody to ever feel [alone]. I think whenever you go through a major illness or any major medical issue, you can sometimes feel really alone.”

Connect: Website | LinkedIn

Subscribe & Contact

👉 If you enjoyed this episode of Back Talk Doc, check out our recent episode Talking Artificial Disc and Facet Replacement Surgery with Dr. Vince Rossi.

👉 Enroll in Dr. Lakhia’s 6 week course to lower inflammation.

👉 Apply for an Integrative Medicine consult with Dr. Lakhia (NC/SC residents only).

🔎 For more information on Dr. Sanjiv Lakhia and the podcast visit BackTalkDoc.com.

👀 Check us out on the 15 Best Back Pain Podcasts list!

🎧 Subscribe in your favorite podcast app.

Talking Artificial Disc and Facet Replacement Surgery with Dr. Vince Rossi

Sanjiv Lakhia - Carolina Neurosurgery & Spine Associates — Tue, 10 Oct 2023 03:00:00 -0400

As non-urgent medical procedures slowed during the height of COVID in 2020, some docs faced a lot of stress. Vince Rossi, MD, took advantage of his more-open schedule to get an MBA.

So, why did Dr. Rossi want to pursue another degree after becoming a successful neurosurgeon? He wanted to better understand the health care system in which he works, believing that knowing the business world would benefit both his patients and his practice. That desire to benefit his patients led him to do a year of his residency in Australia. He was able to see a higher volume of arthroplasty procedures in a shorter period of time.

On this episode of Back Talk Doc, Dr. Sanjiv Lakhia and his guest, Dr. Vince Rossi, talk about artificial disc and facet replacement surgery. Dr. Rossi is a minimally invasive spine surgeon at Carolina NeuroSurgery & Spine Associates (CNSA).

Dr. Rossi’s entire philosophy surrounds improving the lives of his patients — from understanding the business and back end of things to ensuring each one of his patients has explored all conservative treatments before even considering spine surgery.

“If there's a reasonable option for any sort of interventional procedure or injections, then those are all the first first line treatment for that patient,” explains Dr. Rossi. “For me, the younger the patient is, the longer I make them wait before we talk about arthroplasty. Even if they've done six months of conservative treatments and they're a young, mid-20s-year-old, I want them to give their body as much chance as possible to heal that on its own.”

Tune into this episode of Back Talk Doc to hear Dr. Rossi discuss arthroplasty, his typical route for diagnosis, and what he would tell any potential patient about the pros and cons of this newer intervention.

💡 Featured Expert 💡

Name: Vince Rossi, MD, MBA

What he does: Dr. Rossi is a neurosurgeon practicing minimally invasive spine surgery at Carolina NeuroSurgery & Spine Associates (CNSA). He believes in using the least invasive methods to help patients reclaim their pain-free lives. Dr. Rossi focuses on motion preservation, specializing in non-fusion techniques such as endoscopic spine surgery and disc replacement.

Company: Carolina Neurosurgery & Spine Associates (CNSA)

Words of wisdom: “When patients come to CNSA and get motion preservation options there, they're not just getting someone that knows how to implant these devices, they're getting an organization that really has [made] this technology available locally, nationally, and internationally.”

Connect: LinkedIn

⚓ Anchor Points ⚓

Top takeaways from this Back Talk Doc episode

Conservative treatments are still the first option. While artificial disc and facet replacement surgery is changing lives for recipient patients, following conservative routes of treatment — spine injections, physical therapy, etc. — are still the first path for patients experiencing lumbar pain.
Prevention is the best treatment. Dr. Rossi emphasizes the importance of maintaining a healthy spine. Practicing good behaviors in everyday life, such as when picking something up or doing core-strengthening exercises, will do more to protect the spine than anything else. Prevent and maintain before treatment is even necessary.
Get curious. Curious about how to better help and improve the lives of his patients, Dr. Rossi determined that understanding the business and back end of the healthcare system would be beneficial. He pursued an MBA when surgeries slowed during lockdown to bolster that knowledge.

⚕️ Episode Insights ⚕️

[03:22] Bit of background: From his MBA to his rich family history in the medical field, to his residency in Australia, Dr. Rossi introduces himself and his history to listeners.

[06:42] Diving in: Dr. Rossi gets into the episode’s main topic: arthroplasty. He provides an overview of what it is and explains why it is so relevant in the world of spinal care.

[09:23] Presentations and responses: Based on different types of pain presentations, Dr. Rossi shares how he might triage a patient based on their symptoms.

[17:05] Before innovations: Prior to the emergence of arthroplasty options and still today, the standard of care for degenerative discs is physical therapy, over-the-counter pain medications, and lifestyle modification.

[20:54] Pros and cons: Dr. Rossi discusses some advantages and disadvantages of arthroplasty versus fusion, something he does with each of his patients.

[27:12] The brick and mortar: Just like hip and knee implants, lumbar arthroplasty devices have titanium and plates with a high polyethylene polymer core in the middle. Dr. Rossi breaks down what the device is made of, as well as what it looks like.

[34:29] Maintenance: Dr. Rossi maintains a healthy back through proper lifting techniques and core strengthening exercises. As he reminds patients, maintenance is cheaper and easier than repair.

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👉 If you enjoyed this episode of Back Talk Doc, check out our recent episode An integrative approach to low back pain with Dr. Elizabeth Yurth

👉Enroll in Dr. Lakhia’s 6 week course to lower inflammation.

👉Apply for an Integrative Medicine consult with Dr. Lakhia (NC/SC residents only).

🔎 For more information on Dr. Sanjiv Lakhia and the podcast visit BackTalkDoc.com.

👀Check us out on the 15 Best Back Pain Podcasts list!

🎧 Subscribe in your favorite podcast app.

An integrative approach to low back pain with Dr. Elizabeth Yurth

Sanjiv Lakhia - Carolina Neurosurgery & Spine Associates — Mon, 28 Aug 2023 03:00:00 -0400

You get hurt, and your instinct is to blame the injury itself, right? For Dr. Elizabeth Yurth, it’s a much broader picture than just the injury.

While Dr. Yurth got her start in orthopedics and sports medicine, she took a pivot about 15 years into her career. She started looking at ways to keep patients out of her office, rather than coming back in.

“I was patching people back together, throwing them back in the fire, and they're back a month later,” she says of her patients. “So I started to ask, could we do better? Could we make people healthier? That way, they could actually heal more completely and they wouldn't keep coming back into my office.”

Rather than looking at just the injury, Dr. Yurth looks at the whole inflammation framework. And fortunately, she’s found that you don’t need expensive lab tests to figure out if your hormones are the source of your inflammation. Basic lab work, like CBC, metabolic panels, and glucose tests, can indicate whether hormones are off balance — and at a low cost.

Her best advice to maintain health before you even hit the doctor’s office? Keep moving. It’s tempting to stop exercising when you’re injured, but something is better than nothing. Find the movement that works for you and stick to it. Why? Because your muscle acts like an organ, and building and stimulating muscle can help reduce pain.

“Stop moving and you will die,” she says. “You’ve got to do something … you've got to move your muscles.”

On this episode of Back Talk Doc, hear some of Dr. Yurth’s top tips for staying out of the doctor’s office, such as identifying and minimizing sources of inflammation and treating your muscle as an organ.

💡 Featured Expert 💡

Name: Elizabeth (Betsy) Yurth, MD

What she does: An expert in orthopedics and spine care, Dr. Yurth is the co-founder and Chief Medical Officer of the Boulder Longevity Institute. She’s fellowship trained in anti-aging medicine, regenerative medicine, and cellular medicine, with over 500 hours of continued education in longevity, nutrition, epigenetics, bioidentical hormone replacement therapy, and regenerative orthopedic procedures.

Company: Boulder Longevity Institute

Words of wisdom: “We have absolute certainty and absolute proof now that the cause of the degenerative disease is not the trauma. It’s the immune response to the trauma. If you can change that immune response, then you shouldn't see the trauma go on.”

Connect: LinkedIn | Instagram

Subscribe & Contact

👉 If you enjoyed this episode of Back Talk Doc, check out our recent episode Food Elimination and Pain with Heather Wolcott.

👉Enroll in Dr. Lakhia’s 6 week course to lower inflammation.

👉Apply for an Integrative Medicine consult with Dr. Lakhia (NC/SC residents only).

🔎 For more information on Dr. Sanjiv Lakhia and the podcast visit BackTalkDoc.com.

🎧 Subscribe in your favorite podcast app.

Food Elimination and Pain with Heather Wolcott

Sanjiv Lakhia - Carolina Neurosurgery & Spine Associates — Wed, 09 Aug 2023 03:00:00 -0400

As a holistic nutritionist, as well as a health and wellness coach, Heather Wolcott understands concerns about all-or-nothing lifestyles and dietary changes. Instead, Heather believes in promoting a well-rounded lifestyle — and understanding that nothing is forever.

On this episode of Back Talk Doc, Dr. Sanjiv Lakhia and his guest, functional health coach Heather Wolcott, talk about nutrition and its effect on health, wellness, and even pain. Much of their discussion focuses around food elimination diets.

Heather understands that the term “elimination diet” can be daunting for some people. But, she says, this form of lifestyle change is really just a tool to identify food sensitivities and intolerances that can cause brain fog, joint pain, rashes, anxiety, bloating, and fatigue.

As with all things in wellness and nutrition, the key is balance. Even elimination dieting doesn’t have to last forever, says Heather. For some people, it may only last a couple of weeks.

Everyone is different, and no two paths to health are the same. But Dr. Lakhia and Heather have both observed that certain foods seem to cause more problems than others.

Tune in to learn how you might be able to improve your lifestyle by simply cutting certain foods.

💡 Featured Expert 💡

Name: Heather Wolcott

What she does: As a holistic nutritionist for more than 20 years, Heather has been helping clients improve their health and achieve their nutrition goals. She is a National Board Certified health and wellness coach and an ADAPT-Certified Functional Health Coach.

Company: Heather Wolcott

Words of wisdom: “I love to really dial into nutrition because it's super complicated and complex when you get granular with it, but it doesn't have to be. I think people just need to be more educated.”

Connect: Website | Instagram

Subscribe & Contact

👉 If you enjoyed this episode of Back Talk Doc, check out our recent episode Evaluating Supplement Quality with Dr. Tod Cooperman

👉Enroll in Dr. Lakhia’s 6 week course to lower inflammation.

👉Apply for an Integrative Medicine consult with Dr. Lakhia (NC/SC residents only).

🔎 For more information on Dr. Sanjiv Lakhia and the podcast visit BackTalkDoc.com.

🎧 Subscribe in your favorite podcast app.

Evaluating Supplement Quality with Dr. Tod Cooperman

Sanjiv Lakhia - Carolina Neurosurgery & Spine Associates — Thu, 27 Jul 2023 03:00:00 -0400

Nutritional supplements are a recurring topic in discussions between doctors and patients. Many people incorporate supplements into the daily routine when they are looking to enhance their well-being or cure an ailment. But how do you know if you’re using the right nutritional supplements?

On this episode of Back Talk Doc, Dr. Sanjiv Lakhia and Dr. Tod Cooperman, MD discuss how to choose effective supplements, and what factors you should consider when looking to add supplements to your diet.

Dr. Cooperman is the president, founder, and editor-in-chief of ConsumerLab.com, which is dedicated to independent reviews of supplements. He pursued the testing and review of supplements after seeing the impact of the DSHEA act in the 1990s, which allowed companies to make claims about products that they previously weren’t able to, leading to an explosion of interest in the health supplement market.

Understanding what goes into supplements can be a complex science in an industry that lacks FDA regulation. The team at ConsumerLab.com has set up detailed testing procedures at specialized labs to identify which products on the market are delivering on their claims.

Despite a boom in popularity, Dr. Cooperman explains he’s not a fan of gummies because their dosage can be inaccurate due to the semi-liquid environment of the product.

“There are not a lot of requirements from the FDA, but a product does have to have 100% of what it claims,” says Dr. Cooperman. “So companies don't want to produce a product that's going to fall below that; otherwise, they're in violation of the regulations. So they put in more.”

Dr. Cooperman also shares insight into how to make an informed purchase, what to be wary of when shopping online for supplements, and what supplements he takes personally.

💡 Featured Expert 💡

Name: Dr. Tod Cooperman, MD

What he does: Dr. Tod Cooperman is a nationally recognized and respected researcher, writer, and speaker on consumer healthcare issues. Dr. Cooperman is a graduate of the Boston University School of Medicine, receiving his M.D. in 1987. He also received his Bachelor's degree from Boston University with a major in Medical Sciences and a minor in Economics. Recognizing a lack of quality standards and oversight in the U.S. dietary supplement industry, Dr. Cooperman founded ConsumerLab.com in 1999, guiding it to become the leading independent evaluator of dietary supplements and nutritional products.

Company: Consumer Lab

Words of wisdom: “Very rarely is there a situation where there are limits on contaminants. That’s left up to the manufacturer, so you’re at the mercy of the supplement company to do the right thing by you when you're buying a supplement. Some companies will cut corners or use simple methods, and others hold their products to a much higher standard.”

Connect: Website | LinkedIn

Subscribe & Contact

👉 If you enjoyed this episode of Back Talk Doc, check out our recent episode Back Pain and the Sacroiliac Joint with Tanner Holden, PT.

👉 Enroll in Dr. Lakhia’s 6 week course to lower inflammation.

👉 Apply for an Integrative Medicine consult with Dr. Lakhia (NC/SC residents only).

🔎 For more information on Dr. Sanjiv Lakhia and the podcast visit BackTalkDoc.com.

🎧 Subscribe in your favorite podcast app.

Back Pain and the Sacroiliac Joint with Tanner Holden, PT

Sanjiv Lakhia - Carolina Neurosurgery & Spine Associates — Fri, 14 Jul 2023 03:00:00 -0400

Despite its limited range of movement, the sacroiliac joint is prone to instability and is often a source of back pain in patients.

On this episode of Back Talk Doc, Dr. Sanjiv Lakhia and Tanner Holden, PT from Carolina Neurosurgery and Spine Associates discuss the SI joint itself, some common causes of SI joint pain, and what the latest science has to offer for management.

Patients can experience SI joint pain during or after pregnancy, pain from the joint itself, or autoimmune pain. However, diagnosing SI joint pain is rarely straightforward because medical imaging is not typically helpful in diagnosing SI joint pain. The pain can present in unexpected places and is often best diagnosed with the help of pain provocation tests.

Once diagnosed, patients can opt for regular pain-reducing injections for a quick solution. A more holistic treatment plan looks at patient goals and finds ways to improve movement over time. This may also include lifestyle modifications to remove the irritants or activities that cause the pain to flare up. Since SI joint pain sources vary from patient to patient, plans are customized to individual needs.

Tanner believes that healthy movement, activity, and strength are key to living an active and pain-free life. He and Dr. Lakhia discuss how this approach puts the patient first and removes the need for unnecessary supports like braces and belts. Instead, a strength-based approach allows patients to take their care into their own hands, resulting in fewer medical visits.

💡 Featured Expert 💡

Name: Tanner Holden, PT, DPT, OCS, CSC

What he does: Tanner is a residency-trained Doctor of Physical Therapy and Certified Strength and Conditioning Specialist serving Charlotte and the surrounding area. He holds a board certification as an Orthopedic Clinical Specialist.

Company: Carolina Neurosurgery and Spine Associates

Words of wisdom: “We like to get people in and out and living their life.”

Connect: Website | LinkedIn

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👉 If you enjoyed this episode of Back Talk Doc, check out our recent episode Rethinking Osteoarthritis and Degenerative Disc Disease.

👉 Take Dr. Lakhia’s 14 Day Challenge to get your health back on track.

👉 Apply for an Integrative Medicine consult with Dr. Lakhia (NC/SC residents only).

🔎 For more information on Dr. Sanjiv Lakhia and the podcast visit BackTalkDoc.com.

🎧 Subscribe in your favorite podcast app.

Rethinking Osteoarthritis and Degenerative Disc Disease

Sanjiv Lakhia - Carolina Neurosurgery & Spine Associates — Wed, 21 Jun 2023 03:00:00 -0400

If your back has been hurting and you haven’t been able to find relief, or you have chronic recurrent arthritic pain, it may be time to explore new options.

On this episode of Back Talk Doc, Dr. Sanjiv Lakhia hosts a solo episode to reframe how patients should be thinking about osteoarthritis and degenerative disc disease. He proposes that patients move away from thinking of these conditions as the inevitable result of wear and tear, and instead look at them through the lens of metabolic dysfunction.

Using a framework focusing on food and supplementation options, Dr. Lakhia discusses the connection between what we put in our bodies and the pain that we feel.

Two of the biggest culprits for inflammation in the North American diet are gluten and dairy. Studies have shown that removing these from your diet can reduce back pain. Dr. Lakhia discusses the benefits of adding collagen, EGCG, melatonin, and a botanical nutrient combination that uses cannabidiol and a fatty acid known as palmitoylethanolamide (PEA). Each supplement is backed by research and has shown promise for treating back pain.

“I think those are some really exciting options to consider beyond the typical thought process of just vitamin D, turmeric, and fish oil,” says Dr. Lakhia. For those interested in learning more, check out the 14 Day Challenge that is available on Dr. Lakhia’s website.

💡 Your Host 💡

Name: Dr. Sanjiv Lakhia, DO

What he does: As a board-certified physiatrist and integrative medicine physician at Carolina NeuroSurgery & Spine Associates, Dr. Lakia specializes in nonsurgical approaches to spine and orthopedic conditions and offers a diverse range of innovative treatments for back pain, including acupuncture, spinal injections, and prescriptive exercise. Dr. Lakhia favors a conservative, holistic approach to spine care and understands the importance of getting to know each patient. He believes that listening to a patient without judgment is essential to finding the best course of treatment for back pain relief and a return to a normal life.

Company: Carolina Neurosurgery & Spine Associates

Words of wisdom: “We know that patients and consumers nowadays are spending lots of time on the internet downloading, digesting information at a very, very rapid pace. So as clinicians, it's our duty to keep up as best we can with the evolving literature in the space.”

Connect: Website | LinkedIn

Subscribe & Contact

👉 If you enjoyed this episode of Back Talk Doc, check out our recent episode Bone and Spine Health With Dr. Stephanie Plummer.

👉Take Dr. Lakhia’s 14 Day Challenge to get your health back on track.

👉Apply for an Integrative Medicine consult with Dr. Lakhia (NC/SC residents only).

🔎 For more information on Dr. Sanjiv Lakhia and the podcast visit BackTalkDoc.com.

Bone and Spine Health With Dr. Stephanie Plummer

Sanjiv Lakhia - Carolina Neurosurgery & Spine Associates — Wed, 31 May 2023 03:00:00 -0400

We all feel invincible sometimes, even as we age. Our minds do a great job of remembering how active and agile we were in our 20s and 30s. Even if we maintain an active lifestyle into our 50s and 60s, there are silent diseases that could be lurking in the background. Whether we feel it or not, osteoporosis can sneak up on us, so it’s important to be proactive.

Dr. Stephanie Plummer, a physiatrist at Carolina NeuroSurgery & Spine Associates, joins Back Talk Doc host Dr. Sanjiv Lakhia to share how women — and men — can best support their bone health to avoid disease and injuries as they get older.

As an avid marathon runner, Dr. Plummer is quite active. But she emphasizes the importance of adding strength, flexibility, and balance work into our routines to help build bone density, as she’s done in her own workout regimen.

“The flexibility and balance component is huge, and I think is really overlooked,” she says. “It’s great if we build good bone density and bone structure. That’s important for helping to prevent fractures. But if your balance is poor — or you don’t have the mobility to be able to prevent falling in the first place — then you may still be at higher risk.”

Dr. Plummer and Dr. Lakhia also discuss the differences between osteoarthritis, osteopenia, and osteoporosis. They touch on hormonal influences as a reason why women are more likely to develop bone disease, as well as the role diet and sleep play in bone health.

💡 Featured Expert 💡

Name: Dr. Stephanie Plummer, DO

What she does: Dr. Plummer joined Carolina NeuroSurgery & Spine Associates as the first female physiatrist in 2021 & has been practicing physiatry in the Charlotte, NC area since 2013.

Company: Carolina NeuroSurgery & Spine Associates

Connect: LinkedIn

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Battlefield Acupuncture for Pain with John Howard

Sanjiv Lakhia - Carolina Neurosurgery & Spine Associates — Mon, 01 May 2023 03:00:00 -0400

Battlefield acupuncture, a form of ear acupuncture, is well-known in military medicine. It’s now making its way to the civilian population due to ease of use, minimal risk involved, and effectiveness in relieving pain.

John Howard, a clinician and academic, is a leading authority on this revolutionary technique. Upon earning his degree in acupuncture, he completed a five-year fellowship with the father of battlefield acupuncture himself, Dr. Richard Niemtzow. John joins Back Talk Doc host, Dr. Sanjiv Lakhia, to discuss battlefield acupuncture’s history, how it works, as well as some of the programs he runs to help fellow clinicians learn and implement the technique.

Battlefield focuses on inserting needles into specific points in the ear to relieve pain. And with the low risk involved combined with high pain reduction rates, it’s a safe alternative to opioid use. “There's no contraindication with the medicine. You can’t say well, since you’re on this medication, I can’t give you this needle.” John says. “You don’t have to contact the pharmacy to see if there are any problems with this. It’s that simple.”

John and Dr. Lakhia also share examples of how the technique has relieved pain with their own patients, as well as discussing John’s upcoming book to help other clinicians implement battlefield and bring their patients a better quality of life.

💡 Featured Expert 💡

Name: John Howard, LAc., Dipl. Ac

What he does: John is a clinician and academician, providing international lectures in acupuncture and auriculotherapy. He has authored five books and 21 articles on the subject.

Company: Battlefield Acupuncture Seminars

Words of wisdom: “It's really embryology at its finest. Have one of your members look at someone’s ear, or even look at their own ear in the mirror. It kind of looks like an inverted fetus in the womb. And you can go back to physics where the part contains the whole, where the specific parts on the ear contain specific parts of the body. And with the interaction of the cranial nerves, that's how the body balances out the pain and its processes. And that's the question everybody always asks. They always say, Well, how does battlefield work? And I say, Very well, thank you, and just go along with that.”

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👉 If you enjoyed this episode of Back Talk Doc, check out our recent episode Pain, Function & Parkinson's with Sam Schroeder, PT

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Pain, Function & Parkinson's with Sam Schroeder, PT

Sanjiv Lakhia - Carolina Neurosurgery & Spine Associates — Wed, 19 Apr 2023 03:00:00 -0400

For those living with Parkinson's, back pain and stiffness can be some of the most frustrating symptoms of the neurological disorder. Luckily, with cutting edge physical therapy programs like LSVT BIG®, those living with Parkinson’s can combat the slowing and smallness of movements associated with the disease.

Samantha Schroder, DPT, a physical therapist based in Carolina Neurosurgery and Spine’s Charlotte office is certified in the approach. She joins Back Talk Doc host, Dr. Sanjiv Lakhia, to discuss how the program reorganizes nerve networks in the brain to improve functioning.

The program focuses on big movements, which yield significant improvements in patients committed to the regimen. Samantha explains, “[We] get them to move really big. While it might seem super exaggerated when we act it out, when [the patient] acts it out, it's essentially going to be normal movement because they're starting from a place that's smaller. Having them do things that feel really exaggerated to them is going to look normal to us, and that's one of the main parts of the program.”

In addition to explaining the science behind the program, Samantha shares exercises that patients can do to improve their posture and decrease back pain, also noting the benefits of integrating diaphragmatic breathing into the routine.

💡 Featured Expert 💡

Name: Samantha Schroeder, DPT

What she does: Samantha Shroeder, DPT, is a licensed physical therapist living in Charlotte, NC. She has extensive experience in treating neuromuscular and musculoskeletal conditions, with specific interest in Parkinson’s Disease. Samantha is certified in treating Parkinson’s using the LSVT BIG® method.

Company: Carolina Neurosurgery & Spine

Words of wisdom: "I fell into Parkinson’s because, during my clinical rotations, I noticed that it was more common than I had realized. It's the second most common neurological disease in the U.S., and people with Parkinson's can experience moderate to severe functional deficits. I believe that there is a significant role for physical therapy in treating Parkinson's, and that's where my interests stem from."

Connect: LinkedIn | LSVT BIG® Promotion

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A Guided Meditation for Pain: Breathe and Body Scan

Sanjiv Lakhia - Carolina Neurosurgery & Spine Associates — Mon, 03 Apr 2023 03:00:00 -0400

In this special episode, Dr. Sanjiv Lakhia offers listeners a guided meditation session to help manage daily pain levels.

Dr. Lakhia emphasizes the importance of deep breathing as a powerful tool to connect with the present moment and promote relaxation. This episode is especially helpful for those struggling with pain who are looking for natural ways to manage their symptoms.

This meditation is meant to be listened to in a quiet, comfortable environment, perhaps seated in a comfortable chair or laying down comfortably. Do not listen to this meditation if you are operating machinery, a vehicle, or in any situation that could be harmful.

💡 Featured Expert 💡

Name: Dr. Sanjiv Lakhia

What he does: In addition to hosting Back Talk Doc, Dr. Sanjiv Lakhia is a board-certified physiatrist who cares for patients at the Ballantyne and Rock Hill offices of Carolina Neurosurgery & Spine Associates. As a physiatrist, he specializes in non-surgical approaches to spine and orthopedic conditions and offers a diverse range of innovative treatments for back pain, including acupuncture, spinal injections, and prescriptive exercise.

Company: Carolina NeuroSurgery & Spine Associates

Connect: Website | LinkedIn

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👉 If you enjoyed this episode of Back Talk Doc, check out our recent episode Back Surgery Revisions with Patrick Jowdy, MD

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Back Surgery Revisions with Patrick Jowdy, MD

Sanjiv Lakhia - Carolina Neurosurgery & Spine Associates — Thu, 16 Mar 2023 03:00:00 -0400

During medical school, Dr. Patrick Jowdy was drawn to neurology and neurosurgery because of the challenges of the pathology and the importance of the work in improving patients’ lives. It was seeing the patients doing well post-op that finalized his interest in neurosurgery.

In this episode of Back Talk Doc, host Dr. Sanjiv Lakhia talks with colleague Dr. Jowdy, now a neurosurgeon at Carolina Neurosurgery & Spine Associates, about how he treats patients who may need second low back surgeries.

“Whenever anybody presents with [recurring] issues, the main thing that you need to really tease out is what the history is and what's really bothering them,” says Dr. Jowdy. “Sometimes there could be problems from an error in judgment and not really technique. That's why it's really important to identify what the problem is to begin with.”

In addition to discussing treatment options for second, or revision, spinal surgeries, Dr. Jowdy also offers guidance on how back pain sufferers can try to avoid needing a second surgery. Tune in to hear how surgeons approach patients who present recurrent back pain after surgery and tips for maintaining a healthy spine.

💡 Featured Expert 💡

Name: Patrick Jowdy, MD

What he does: As a neurosurgeon at Carolina Neurosurgery & Spine Associates, Dr. Jowdy offers personalized care to his patients by using minimally invasive techniques and complex procedures to treat spine and brain pathologies.

Company: Carolina Neurosurgery & Spine Associates

Words of wisdom: “What I tell patients after the operation is, there is a defect that the disc herniated through in the first place. The best chance you can give it to heal is to take it easy for a couple of weeks after the surgery. So I tell them, no heavy lifting, no bending, no twisting, just to give your back a rest in the weeks that come after the surgery just to reduce the chance that more discs can re-herniate.”

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👉 If you enjoyed this episode of Back Talk Doc, check out our recent episode Conquer Pain With Virtual Reality.

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Heal Your Disc, End your pain with Dr. Greg Lutz

Sanjiv Lakhia - Carolina Neurosurgery & Spine Associates — Tue, 28 Feb 2023 03:00:00 -0400

It was more than 13 years ago that a veterinarian introduced Dr. Gregory Lutz to platelet-rich plasma (PRP). Dr. Lutz had a lame horse suffering from a tendon injury. With the help of a portable ultrasound, the veterinary physician drew the horse's blood, spun it in a centrifuge, and injected it into the tendon, right there in the stall. Within a few weeks, the horse was running around like a pony. That inspired Dr. Lutz to research this treatment for his own patients.

With more than 30 years of clinical experience under his belt, Dr. Lutz has proven himself to be a driving force in today’s regenerative medicine movement. He has co-authored more than 60 scientific publications on the topic of PRP and continues to research the power of this treatment to improve outcomes.

“We have to share research, speak openly about our findings, report the good and the bad and the ugly, so that people are aware of the risks, and see if we can keep moving this forward,” says Dr. Lutz. “It's been a very exciting journey to finally find something that I think has staying power.”

In this episode of Back Talk Doc, host Dr. Sanjiv Lakhia and Dr. Lutz discuss PRP treatments for low back pain and Dr. Lutz’s new book.

💡 Featured Expert 💡

Name: Gregory Lutz, MD

What he does: Dr. Lutz is the founder of the Regenerative SportsCare Institute, Physiatrist-in-Chief Emeritus at New York City's Hospital for Special Surgery (HSS) and a Professor of Clinical Rehabilitation Medicine at Weill Medical College of Cornell University. Nationally known for his work and writing on platelet-rich plasma treatments for disc injuries, Dr. Lutz just authored a new book, Heal Your Disc, End Your Pain: How Regenerative Medicine Can Save Your Spine.

Company: Regenerative SportsCare Institute

Words of wisdom: “There's some merit to that thought that if we intervene early with a structured healing treatment, you might prevent some of the degenerative changes that occur with the spine that most likely would result in more aggressive treatment like surgery.”

Connect: Website | LinkedIn

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👉 If you enjoyed this episode of Back Talk Doc, check out our recent episode Conquer Pain With Virtual Reality.

👉Enroll in Dr. Lakhia’s 6 week course to lower inflammation.

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Back Talk Doc is brought to you by Carolina Neurosurgery & Spine Associates, with offices in North and South Carolina. To learn more about Dr. Lakhia and treatment options for back and spine issues, go to backtalkdoc.com. To schedule an appointment with Carolina Neurosurgery & Spine Associates, you can call us at 1-800-344-6716 or visit our website at CNSA.com.

Conquer Pain with Virtual Reality

Sanjiv Lakhia - Carolina Neurosurgery & Spine Associates — Fri, 17 Feb 2023 03:00:00 -0400

When we think of virtual reality, we usually think about its most obvious uses: gaming, socializing, or even shopping.

But researchers and doctors are also experimenting with VR in the healthcare field. Harvard MedTech has found that VR has unique properties that help the brain address pain and return to homeostasis in a holistic way.

In the Vx Therapy program, clinicians work alongside VR to help guide anyone from surgical patients to hospice patients and veterans toward relief from their pain.

Using a biopsychosocial approach, practitioners there have found that creating acute distractions during a VR therapy session leads to pain relief that lasts hours, the equivalent of a pharmacological option like painkillers. That activity also encourages neuroplasticity and has helped patients achieve long-term relief and even sleep improvement.

“We're tapping into the human brain in a way that we've never really been able to do before,” says Gerry Stanley, MD, Senior Vice President and Chief Medical Officer at Harvard MedTech. “We always treated it with drugs, we would treat it with injections, we would do different things, but now we're leaning into the brain's natural ability to find homeostasis and heal itself.”

In this episode of Back Talk Doc, host Dr. Sanjiv Lakhia sat down with Dr. Stanley to discuss Harvard MedTech’s Vx Therapy program, why VR therapy works, and how it can revolutionize medicine as we know it.

💡 Featured Expert 💡

Name: Dr. Gerry Stanley

What he does: As Senior Vice President and Chief Medical Officer at Harvard MedTech, Dr. Stanely leads the company’s tech and VR solutions to help combat the opioid epidemic and mental health crisis in the United States. He is also a consultant and business leader providing guidance to healthy systems on healthcare solutions.

Company: Harvard MedTech

Words of wisdom: “If we treat people holistically, we give them a tool to engage them biopsychosocially — look at the savings on the backend for the carriers. Look at the happiness of the patients […] That’s the holy grail.”

Connect: Website | LinkedIn

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👉 If you enjoyed this episode of Back Talk Doc, check out our recent episode Hip vs. Back pain with Dr. Puneet Aggarwal

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Back Talk Doc is brought to you by Carolina Neurosurgery & Spine Associates, with offices in North and South Carolina. To learn more about Dr. Lakhia and treatment options for back and spine issues, go to backtalkdoc.com. To schedule an appointment with Carolina Neurosurgery & Spine Associates, you can call us at 1-800-344-6716 or visit our website at CNSA.com.

Hip vs. Back pain with Dr. Puneet Aggarwal

Sanjiv Lakhia - Carolina Neurosurgery & Spine Associates — Tue, 07 Feb 2023 03:00:00 -0400

One of the more challenging conditions for doctors to diagnose whether pain is originating in the hip or back. In this episode of Back Talk Doc, host Dr. Sanjiv Lakhia and his guest, Dr. Puneet Aggarwal, MD, troubleshoot different patient symptoms and explore how they would treat them.

Dr. Aggarwal is the director of Atrium Health Musculoskeletal Institute of Sports Medicine, where he specializes in non-surgical treatments for the spine and interventional pain medicine.

Dr. Lakhia and Dr. Aggarwal discuss multiple scenarios and treatment methods for a patient presenting hip and back pain. They run through different ways of identifying the root cause of the pain, how they would go about treating it, and the multiple options for patients who need more help.

And for patients dealing with ongoing pain, Dr. Aggarwal stresses the importance of stretching and strengthening to maintain flexibility in your joints and muscles.

From tight IT bands to testing pain on the stairs to SI joint pain and steroid injections, the two doctors cover the full gambit of hip and back pain. They provide tips for physicians to diagnose pain issues, and also help patients assess their own pain.

💡 Featured Expert 💡

Name: Puneet Aggarwal, MD

What he does: As the director of Atrium Health Musculoskeletal Institute of Sports Medicine and division chief of Physical Medicine and Rehabilitation, Dr. Aggarwal specializes in non-surgical spinal treatments and interventional pain medicine.

Company: Spine First - Atrium Health

Words of wisdom: “I think maintaining strength, but also maintaining flexibility at the same time is the key.”

Connect: Website

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👉 If you enjoyed this episode of Back Talk Doc, check out our recent episode Grief Connects Us with Jodi Stern, MD

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https://www.drlakhia.com/apply

🔎 For more information on Dr. Sanjiv Lakhia and the podcast visit BackTalkDoc.com.

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Back Talk Doc is brought to you by Carolina Neurosurgery & Spine Associates, with offices in North and South Carolina. To learn more about Dr. Lakhia and treatment options for back and spine issues, go to backtalkdoc.com. To schedule an appointment with Carolina Neurosurgery & Spine Associates, you can call us at 1-800-344-6716 or visit our website at CNSA.com.

Grief Connects Us with Jodi Stern MD

Sanjiv Lakhia - Carolina Neurosurgery & Spine Associates — Fri, 27 Jan 2023 03:00:00 -0400

When his younger sister, Victoria, died from leukemia, Dr. Joseph Stern stepped out of his white coat, becoming more than a physician. He was a patient’s loved one — his sister’s caretaker and advocate.

In this episode of Back Talk Doc, host Dr. Sanjiv Lakhia talks with Dr. Stern about how his experience with his sister led him to reexamine what it means to be a physician, which he chronicles for readers in his book Grief Connects Us: A Neurosurgeon’s Lessons on Love, Loss, and Compassion.

“I saw, as if for the first time: what it was like to be a patient and what it's like to be a patient's family member. It really had a tremendous impact on me personally in terms of my relationship with her and family, but also how I take care of patients and the whole notion of passion in medicine,” says Dr. Stern. “I realized that, in many ways, I had never really been as empathetic as I needed to be or as compassionate, and hadn't really understood what it was like to be a patient [going] through this kind of illness.”

Dr. Stern explains how physicians can become better doctors by practicing more patience, understanding, empathy, and compassion. He references multiple resources, in addition to his own book, so listeners can learn more about the power of connection between patient and physician.

💡 Featured Expert 💡

Name: Joseph Stern, MD

What he does: Dr. Stern is a neurosurgeon, author, and inventor. He is a partner at Carolina Neurosurgery & Spine Associates and practices neurosurgery at the Moses H. Cone Hospital.

Company: Carolina Neurosurgery & Spine Associates

Words of wisdom: “Have patience and the ability to listen — not being hurried — being present and listening and appreciating the [patient’s] experience is of vital importance. It makes you a better doctor, but it also takes your care to a whole different level in terms of the relationship you establish with a patient and family members.”

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👉 If you enjoyed this episode of Back Talk Doc, check out our recent episode 2022 Gift List For Back Pain2022 Gift List For Back Pain.

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2022 Gift List for Back Pain

Sanjiv Lakhia - Carolina Neurosurgery & Spine Associates — Mon, 19 Dec 2022 03:00:00 -0400

Holiday shopping season is upon us, and there’s something out there for everyone. Dr. Sanjiv Lakhia reflects on the guests that decked the halls of Back Talk Doc in 2022 and compiled a list of the top ten gifts for people with back pain.

The list is inspired by discussions with guests, including Dr. David Schecter and Esther Gokhale, and addresses a range of prices and applications. Finding the perfect gift is tough, so Back Talk’s top ten list helps strike the balance of something that lights up your loved ones’ faces while not depleting your budget or inflicting more back tension.

Dr. Sanjiv Lakhia’s Top Ten List

10. Think Away Your Pain by Dr. David Schechter

9. Desert Tortoise Botanicals Trauma Pain Salve

8. Dr. Eric Goodman’s Foundation Training App

7. Fresh N Lean Meal Delivery Service

6. 8 Steps to a Pain-Free Back by Esther Gokhale

5. Back Mechanic by Dr. Stuart McGill

4. Crossover Symmetry Padded Bands

3. Ear Seeds

2. Thermophore Heating Pad

1. The Back Talk Book by Dr. Sanjiv Lakhia

Bring enlightenment into friends’ and families’ spines and homes this holiday season and start 2023 with habits that are guaranteed to ease any back pain or stress. Listen to this episode of Back Talk for the top ten gifts people with back pain can’t wait to receive this year.

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👉 If you enjoyed this episode of Back Talk Doc, check out our recent episode Back Pain Relief with Spinal Cord Stimulation

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Back Pain Relief with Spinal Cord Stimulation

Sanjiv Lakhia - Carolina Neurosurgery & Spine Associates — Mon, 28 Nov 2022 03:00:00 -0400

Physicians strive to find ways for their patients to live healthy, active lifestyles, and that is what attracted Dr. Dave Eichman to the specialty of spinal cord stimulation.

In this episode of Back Talk, host Dr. Sanjiv Lakhia and his guest, Dr. Eichman, cover what makes a patient a good candidate for the treatment, what to expect from it, and some potential pitfalls.

“The unique ability to test the device before committing can help patients feel more confident in their choice. “[Once] you've had the surgery done, there's no going back. But with the stimulator, there's a five-to-seven day trial period where you come in, like you're gonna have an injection performed,” Dr. Eichman says while explaining a unique aspect of this treatment. “You just get to try it out, see if you can walk further, stand longer, sleep better, use less pain medicine. Are you comfortable with it?”

The technology behind spinal cord stimulation has made significant progress since it first became available almost 50 years ago. In the past ten years alone there have been major improvements in the therapeutic modality of the device, so patients have more choices in what the treatment feels like to them. The devices are also now MRI-friendly, giving patients more imaging choices than they traditionally had if they had chosen to pursue this treatment.

Tune in to this episode of Back Talk to hear how spinal cord stimulation can improve the lives of patients living with recurring nerve pain.

💡 Featured Expert 💡

Name: Dave Eichman, MD

What he does: As a clinician, Dr. Eichman enjoys caring for patients by using critical thinking, patience, and perseverance. He specializes in pain management with a special interest in spinal cord stimulation, peripheral nerve stimulation, MILD procedure, and Botox for migraines.

Company: Carolina Neurosurgery & Spine Associates

Words of wisdom: “My interest has been in trying to make people's lives as bearable as possible. There are a lot of people that, unfortunately, are dealing with conditions that make it difficult for them to function throughout their day. So I've developed an interest in trying to make their lives better.”

Connect: Website | LinkedIn

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👉 If you enjoyed this episode of Back Talk Doc, check out our recent episode A Guided Meditation For Pain: Creating A Safe Space.

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A Guided Meditation for Pain: Creating a Safe Place

Sanjiv Lakhia - Carolina Neurosurgery & Spine Associates — Thu, 20 Oct 2022 03:00:00 -0400

If you’re listening to Back Talk Doc, you or someone you know is probably dealing with some type of pain.

Chronic pain can be very hard to handle, but many times when we create a mental image of our suffering, we tend to aggravate this pain, thus increasing it. This mental image leads to negativity on a conscious and subconscious level associated with your pain.

Today, give your body a safe place to deal with pain. Join us on a guided meditation that will teach techniques to change the mental image that has been created from this pain, and transform it to a peaceful association with pleasant visualizations that create a warmer bonding between you and your body’s sensations.

💡 Featured Expert 💡

Name: Dr. Sanjiv Lakhia

Company: Carolina Neurosurgery & Spine Associates

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👉 If you enjoyed this episode of Back Talk Doc, check out our recent episode Reduce Your Back Pain Frequency with Dr. Carol McMakin.

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Reduce Your Back Pain Frequency with Dr.Carol McMakin

Sanjiv Lakhia - Carolina Neurosurgery & Spine Associates — Mon, 19 Sep 2022 03:00:00 -0400

It is never too late to chase after a dream or make a difference in other people’s lives. Dr. Carolyn McMakin, DC is a testament to that. After deciding to pursue her lifelong goal at the age of 40, Dr. McMakin enrolled in pre-med courses and the University of Western States Chiropractic College. Upon graduation, Dr. McMakin opened her own practice and by 1996 began treating patients with a list of frequencies first documented in the 1920s.

This work led her to present her results at the American Back Society National Meeting and subsequently publish the first 50 cases of neck pain treatment in 1998. To say her work has been monumental and influential in the medical world is an understatement.

Dr. McMakin is the leading expert on frequency specific microcurrent (FSM). In fact, she discovered a specific treatment that could eradicate a patient’s pain caused by fibromyalgia as a result of spinal trauma. Not only did she discover a reproducible treatment, but one that could help a patient feel relief within just an hour.

On this episode of Back Talk Doc, host Dr. Sanjiv Lakhia talks with Dr. McMakin about FSM and her work introducing it to physicians, chiropractors, physical therapists, and practitioners all over the world.

💡 Featured Expert 💡

Name: Carolyn McMakin, DC

What she does: Dr. Carolyn McMakin is the leading expert in FSM. She is a published author, teacher, and practicing chiropractor.

Company: The FSM Clinic and Training Center

Words of wisdom: “Do what you love and love what you do and everything else you need will follow. That’s it: Follow your passion.”

Connect: Website | LinkedIn

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👉 If you enjoyed this episode of Back Talk Doc, check out our recent episode Neuropathy and Its Many Facets with Dr. Ki Jung.

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Neuropathy and Its Many Facets with Dr. Ki Jung

Sanjiv Lakhia - Carolina Neurosurgery & Spine Associates — Thu, 08 Sep 2022 03:00:00 -0400

Have you ever sat in one position too long and had your foot fall asleep? And when you stood up, you felt a prickling or tingling that was almost painful? Or have you ever rolled over in the middle of the night and found your hand was numb? Each of these occurrences are considered positive symptoms of neuropathy — they are the presence of an abnormal sensation.

What exactly is neuropathy and what causes it? On this episode of Back Talk Doc, host Dr. Sanjiv Lakhia is joined by one of the newer partners at Carolina NeuroSurgery & Spine Associates, neurologist Ki S. Jung, MD to discuss neuropathy. Dr. Jung is newer to the practice, but not new to neurology as he offers over 18 years of expertise and is well-established in the community as a subject matter expert in his field.

Dr. Jung walks listeners through a few examples of the various symptoms that bring patients to his office, as well as how to rule out the most common causes of neuropathy and test for sensory modalities to potential medications. He also discusses alternative technologies for pain management and relief.

💡 Featured Expert 💡

Name: Ki S. Jung, MD

What he does: As a board-certified and fellowship-trained neurologist, Dr. Jung performs on-site neuro-diagnostic testing and has over 18 years experience diagnosing and treating disorders of the brain, spinal cord, peripheral nerves, muscles, and other issues of the nervous system.

Company: Carolina NeuroSurgery & Spine Associates

Words of wisdom: “Our bodies, we have to treat them right. And you need fuel. That's what food does, but make sure that fuel is super unleaded. Make sure you get rid of all the bad stuff and just supply your body with the good stuff. So good nutrition, adequate hydration, get some exercise in, and rest.”

Connect: Website

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👉 If you enjoyed this episode of Back Talk Doc, check out our recent episode Botanicals and Back Pain with John Slattery

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Botanicals and Back Pain with John Slattery

Sanjiv Lakhia - Carolina Neurosurgery & Spine Associates — Mon, 15 Aug 2022 03:00:00 -0400

Could a couple of drops of an herb tincture enable someone who underwent open heart surgery to feel her chest for the first time in four years? Could it help you mitigate and prevent back pain?

In our society, it’s easy to think that the most complex, advanced medicine is the best cure for any and all pain. And yet, a powerful tool for pain treatment could be an overlooked plant growing in your backyard. In this episode, Dr. Sanjiv Lakhia and his guest John Slattery of Desert Tortoise Botanicals dive into herbalism and its potential.

Botanical medicine has held a key role in medicine since ancient times. Herbalists and indigenous people have preserved wisdom on medicinal plants and how to use them, and they are reviving awareness about botanical medicine.

“In the way that the nature of a plant resonates with the nature of an individual, it can allow for opening and release in their physical tissue as the consequence of where that resonance meets, such that a healing experience can be facilitated within their physical body,” says John. “That may sound a little bit metaphysical, and it is, but it's also observable.”

Listen to this episode of Back Talk Doc to learn all about botanical medicine and how it can help you treat back pain and other ailments.

💡 Featured Expert 💡

Name: John Slattery

What he does: John is a bioregional herbalist, forager, and author. Inspired by his desire to improve the accessibility of botanical medicine, he founded Desert Tortoise Botanicals, a company that sells products made from sustainably foraged herbs.

Company: Desert Tortoise Botanicals

Discount Code: Back Talk Doc listeners are eligible to receive 10% off their first purchase from Desert Tortoise Botanicals.

Words of wisdom: “Because the body and the mind are inextricably linked, the so-called placebo effect is actually extremely powerful, meaning that how we hold our mind in wave form within our body consolidates into particle form into the tissue.”

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👉 If you enjoyed this episode of Back Talk Doc, check out our recent episode The Vagus-Trigeminal-Pain Connection with Sharik Peck, PT.

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The Vagus-Trigeminal-Pain Connection with Sharik Peck, PT

Sanjiv Lakhia - Carolina Neurosurgery & Spine Associates — Mon, 25 Jul 2022 03:00:00 -0400

Imagine relearning how to walk — and learn — in your senior year of high school. For this episode’s guest, Sharik Peck, that was reality.

Mr. Peck’s battle with chronic pain began when he was only two years old. As a young child, he fractured his second cervical vertebrae. Years later, he crushed multiple spinal vertebrae in his thoracic region. Finally, he experienced a vertebral artery dissection that forced him to relearn how to walk and learn. Instead of allowing his injuries and pain to defeat him, Mr. Peck used them as inspiration. His goal was simple: Help others who experience life-altering events and chronic pain.

With this aim in mind, Mr. Peck became a physical therapist and earned his master’s degree in rehabilitation counseling. Later, he realized that he wanted to increase accessibility to chronic pain treatment by creating a device that anyone could use. This resulted in Rezzimax.

Rezzimax is a handheld device that helps decrease chronic pain by recalibrating your body’s nervous system using vibration frequencies.

To understand why this is effective, first, you must understand the relationship between the vagus nerve and trigeminal nerve. The vagus nerve is in charge of keeping your nervous system healthy and happy whereas the trigeminal nerve is integral to your fight or flight response. Mr. Peck likens these two nerves to the two ends of a seesaw. For your body to work well, they need to be balanced.

By moving Rezzimax to areas of the body where you can reach your trigeminal nerve and changing frequencies, you calm down the trigeminal nerve so that your vagus nerve can better function, thus decreasing pain.

Access a 20% coupon to purchase Rezzimax today.

💡 Featured Expert 💡

Name: Sharik Peck

What he does: After being a physical therapist for 28 years and receiving his master’s degree in rehabilitation counseling, Mr. Peck invented the Rezzimax to treat chronic pain by targeting the vagus nerve.

Company: Rezzimax

Words of wisdom: “The vagus nerve’s entire job is to get the nervous system healthy, happy, sleeping well, in great relationships with others, and creating families. … One of the main nerves that is responsible for the fight or flight response in the nervous system is the trigeminal nerve. ….The relationship between the trigeminal nerve and the vagus nerve is a delicate seesaw. In order to get that vagus tone improved, we've got to get that trigeminal tone to calm itself down.”

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👉 If you enjoyed this episode of Back Talk Doc, check out our recent episode Back to the Basics: Reducing Back Pain Through Healthy Eating

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Back to the Basics: Reducing Back Pain Through Healthy Eating

Sanjiv Lakhia - Carolina Neurosurgery & Spine Associates — Mon, 11 Jul 2022 03:00:00 -0400

Back pain can feel impossible to control. However, there are things that you can do to reduce pain. In this episode, Back Talk Doc host Dr. Sanjiv Lakhia empowers listeners to reduce back pain through mindful eating and nutrition.

As Dr. Lakhia explains, “It's important that we zoom out and ask ourselves, what's really going on with our food and our diet?”

By mastering the basics of healthy eating, you can reduce inflammation levels and consequently decrease pain levels. But with the many diets out there, all claiming to be the best, it’s challenging to sort fact from fad.

That’s why in this episode, Dr. Lakhia teaches you the building blocks of healthy eating rather than talking about a specific diet. Once you understand the necessary components of healthy eating, you can modify your diet to account for any special dietary needs.

Dr. Lakhia provides the listener with five key steps to healthy eating to decrease back pain. These steps may seem simple, but if you can “adopt these basic recommendations, a lot of your health situations will improve. Pain should go down, and you'll feel better,” says Lakhia. Listen to this episode to learn more about each step and the scientific evidence behind them.

💡 Featured Expert 💡

Name: Dr. Sanjiv Lakhia

Company: Carolina Neurosurgery & Spine Associates

Words of wisdom: “If you're aware of who you are when you come to the table to eat and how you feel, it literally can translate into better health or, conversely, create increased levels of inflammation in your body.”

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👉 If you enjoyed this episode of Back Talk Doc, check out our recent episode Releasing Pain and Trauma with David Berceli, PhD

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Releasing Pain and Trauma with David Berceli, PhD

Sanjiv Lakhia - Carolina Neurosurgery & Spine Associates — Mon, 27 Jun 2022 03:00:00 -0400

In a bomb shelter under attack in the Middle East, Dr. David Berceli, PhD observed what would become the foundation for much of his work. As mortar shells assaulted the shelter’s exterior, David observed as young children shook in terror and adults sat, stoic and unmoving.

“We train ourselves out of these endogenous rhythmic movements of the human body that actually are designed to help us reduce stress or release trauma,” David observed. “By trembling, those two year olds were actually healthier than the adults who simply froze that mechanism and didn't allow their body to discharge the excited [energy] that was being created by the mortar shells.”

This was the match that lit the flame for David, who then decided to dedicate his life to helping people deal with trauma, specifically in mass quantities. This led to the creation of the Tension & Trauma Releasing Exercises (TRE®), a series of exercises that stimulate the body to release deep muscular patterns of stress, tension, and trauma. This system of exercises initiates the body’s natural reflex mechanism of shaking or vibrating to release tension and calm the nervous system.

In this episode, Dr. Lakhia and Dr. David Berceli discuss all things trauma and how to release that through the body’s natural response to trauma and stress.

💡 Featured Expert 💡

Name: David Berceli, PhD

What he does: As an international author, presenter, and trainer in the area of trauma intervention, stress reduction, and resiliency and recovery training, David specializes in recovery with large populations. He is the creator of a revolutionary set of tension and trauma release exercises and the author of three books about releasing tension through therapeutic body tremors.

Company: TRE® for All, Inc.

Words of wisdom: “The tremor mechanism does not just heal what's going on in you now; it actually goes back in time inside your body to find those patterns that you completely learn to live with, or forgot you even had, or didn't even know you had. And it can undo all those patterns to bring your body to this present moment in its healthiest pulsating state that it can achieve.”

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👉 If you enjoyed this episode of Back Talk Doc, check out our recent episode, Back Pain Relief with Foundation Training.

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Back Pain Relief with Foundation Training

Sanjiv Lakhia - Carolina Neurosurgery & Spine Associates — Mon, 16 May 2022 03:00:00 -0400

Sometimes, the greatest struggles can bring forth the greatest innovations.

That is certainly true for Dr. Eric Goodman, DC, the founder of Foundation Training. As a young man in chiropractic school, his severe back pain from multiple disc herniations became unbearable.

“I had about a year left of chiropractic school when my back got bad to the point that I was like, ‘I don't want to be a chiropractor,’” Dr. Goodman tells Dr. Lakhia. “Driving hurt, standing hurt, sitting hurt, and laying hurt. You're just out of options.”

It was in experimenting with his own pain in motion that he was able to develop Foundation Training, a combination of exercises and breathing techniques that helps with anything from basic daily movements to athletics.

Josh Brigham became a devotee of Foundation Training from his own spinal issues. Now a trainer and owner of Adapt CLT, he uses Foundation Training to bring others the same relief he’s experienced.

He says a video about decompression breathing that he saw at his first Foundation Training event changed how he thought about breath. “It was just real easy to make that concept live inside of you,” Josh said. “And that's how it was introduced to me. And it never went away.”

In this episode, Dr. Lakhia, Dr. Goodman, and Josh discuss all things Foundation Training — how to get started, and why changing how you bend and breathe can change your pain.

💡 Featured Experts 💡

Name: Dr. Eric Goodman, DC

What he does: As a trained (but not practicing) chiropractor, Dr. Goodman used his education as a springboard to understanding how to strengthen the spine. He developed his series of Foundation Training exercises as a way for people to take their spine health into their own hands.

Company: Foundation Training

Words of wisdom: “The ability to understand what your body is doing, as it's doing it, is probably the most important skill of chronic pain relief through lifetimes.”

Connect: LinkedIn | Foundation Training Streaming | Instagram | YouTube

Name: Josh Brigham

What he does: Josh found Foundation Training following a cervical spine injury that was treated with an artificial disc replacement. He now trains others in restoring their own spinal health at his Charlotte-based Adapt CLT.

Company: Adapt CLT

Words of wisdom: “We want people to move and to do the things that they enjoy, whatever that movement looks like. But if you're not doing it connected, you're not going to be doing it well.”

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👉 If you enjoyed this episode of Back Talk Doc, check out our recent episode, Back Pain Relief Through Posture and Movement, With Esther Gokhale.

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Back (Pain)…to the Future. Spine Biologics with Dr. Peter Bailey

Sanjiv Lakhia - Carolina Neurosurgery & Spine Associates — Mon, 02 May 2022 03:00:00 -0400

Regenerative medicine has great potential. It empowers the body’s own healing mechanisms to cure injuries that would normally require surgery or other invasive measures.

In this episode of Back Talk Doc, Dr. Peter Bailey discusses his work in regenerative spinal care.

Research on regenerative spinal care is steadily progressing, despite a lack of funding. Most companies fund research into drugs rather than regenerative medicine, so progress has taken time and dedication. In spinal care, regenerative treatments can improve patient pain. For this to be effective, the cause of the pain must be accurately diagnosed to ensure that the proper treatment plan and target area are selected.

Regenerative spinal care is best at targeting disc pain in ways that physical therapy and surgery cannot. “The disc is the largest structure in the body that does not have its own blood supply,” said Dr. Bailey. “When we injure a disc, it doesn't heal up very well. It creates an environment that, over time, predisposes the disc to further degenerate.”

Dr. Bailey primarily treats disc pain with platelet-rich plasma. In this method, platelets from the patient’s body are injected into the spine. Platelets are the body’s first responders to injury. By giving the injured area more platelets, the body’s healing responses are increased enough that the spinal injury can be healed well.

Regenerative medicine on its own is not enough. Dr. Bailey recommends accompanying the treatment with physical therapy and exercise to prevent re-injury of the spine.

Excited to learn more? Tune in to this episode of Back Talk Doc to discover more about regenerative spinal care.

Read the Full Show Notes on our website BackTalkDoc.com.

💡 Featured Expert 💡

Name: Dr. Peter Bailey

What he does: As a physiatrist at Carolina Neurosurgery and Spine Associates, Dr. Bailey is pioneering the field of regenerative spine care.

Company: Carolina Neurosurgery and Spine Associates

Words of wisdom: “If you have a patient who is younger to middle age, who has kind of a bad-looking disc, a surgeon doesn't really want to operate on that. Surgical outcomes for axial back pain are not that great. So it’s a great tool to have for that segment of the population that offers hope for the management of back pain, when it seems like other options aren't available. As far as the future goes, it's definitely going to be critical.”

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👉 If you enjoyed this episode of Back Talk Doc, check out our recent episode Back Pain Relief Through Posture and Movement, With Esther Gokhale.

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Fact vs Fiction: Back Rehab with Dr. Stuart McGill

Sanjiv Lakhia - Carolina Neurosurgery & Spine Associates — Mon, 18 Apr 2022 03:00:00 -0400

For Dr. Stuart McGill, surgery should be the last resort.

In fact, for many patients who don’t properly address their pain, surgery is, at best, a temporary option. Consider this: following a disc hernia procedure, many patients, including those Dr. McGill sees, usually fall back into old habits and run the risk of re-injuring their damaged spine. “So you are going to have to change the way that you move [and] become more efficient in purposefully stimulating the adaption that you need in your body to become robust again,” he says.

The problem, Dr. McGill says, is that most orthopaedists don’t do a full exam of the whole patient to find the source of the pain. That can take two to three hours.

“The assessment, if it's thorough enough, will always give you the answer,” says Dr. McGill. And that answer is rarely putting a patient under the knife. Other solutions, which can often include long-term therapies, will get to the source of the pain and lead to long-term healing “95% of the time,” he says.

Dr. McGill knows what he’s talking about: he has literally written the book on the mechanics of back pain, how to assess it, and published award-winning research on spine biomechanics. Also, as a distinguished Professor Emeritus at University of Waterloo, he is considered one of the world’s leading biomechanists.

On this episode of Back Talk Doc, Dr. McGill joined Dr. Lakhia with special guest Dr. John Lesher, MD, MPH, of Carolina Neurosurgery & Spine Associates to talk all about spine biomechanics: from the benefits of a technique experts refer to as “virtual surgery,” to the mechanics of strengthening exercises for back pain.

Read the Full Show Notes on our website BackTalkDoc.com.

💡 Featured Expert 💡

Name: Dr. Stuart McGill, PhD

What he does: Dr. Stuart McGill is one of the world’s most renowned spine biomechanists. He is a distinguished Professor Emeritus of spine biomechanics at the University of Waterloo, where he published over 200 peer-reviewed papers and award-winning research in the field of low back biomechanics. He is also the author of several books, the most recent being Back Mechanic (2015).

Company: BackFitPro

Words of wisdom: “The way to stay pain-free is, one day a week, rest. Don't do anything. That's the day that your body adapts. So all the stimulation that you've done all week long, let it adapt.”

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👉 If you enjoyed this episode of Back Talk Doc, check out our recent episode Back Pain Relief Through Posture and Movement, with Esther Gokhale.

🔎 For more information on Dr. Sanjiv Lakhia and the podcast visit BackTalkDoc.com.

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Back Pain Relief Through Posture and Movement, With Esther Gokhale

Sanjiv Lakhia - Carolina Neurosurgery & Spine Associates — Mon, 04 Apr 2022 03:00:00 -0400

What if back-pain relief was just a few steps away? Esther Gokhale’s work with posture and movement finds that just changing the way you sit, stand, lie down, and walk can eliminate your back pain.

Esther grew up in India helping her mom treat orphaned babies and she studied biochemistry at college. Later, she became a licensed acupuncturist. So when her own pain and herniated disc issues emerged, it motivated Esther to study how people move.

“There were some seeds already sown in my brain that ‘there's something going on with people who live close to the ground that makes sense and that works.’ And so when this horrible thing happened to me, it resonated for me to study techniques that changed the way you use your body,” Esther says.

Esther developed and trademarked the Gokhale Method, an eight-step plan to adjust your back’s curvature and movement from an S or C-shaped curve to a J-shaped curve. Esther found this technique by studying the common thread between ancient cultures and today’s primal cultures:

“If you go to your museums and you look at the Greek statues, they're doing exactly what these Ubong guys are doing, they look the same. And so why would that be? Well, the simplest explanation is that it is natural. That's why they converge on the same form. And we in modern times have just lost our way.”

In this episode, Dr. Lakhia and Esther talk through modern and ancestral movements, and what you can do right now to start moving more primally and, ultimately, relieve your back pain.

Read the Full Show Notes on our website BackTalkDoc.com.

💡 Featured Expert 💡

Name: Esther Gokhale

What she does: Esther used her crippling back pain during her first pregnancy to propel her interest in vanquishing back pain for all. Her Gokhale Method focuses on using posture and movement to bring the body back to a state of pain-free living.

Company: Gokhale Method Institute, Inc.

Words of wisdom: “You often develop your passions in response to some humongous challenge that you're faced with. And if you manage to be successful in getting past that, you have acquired a lot of knowledge, skill, and insights.”

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👉 If you enjoyed this episode of Back Talk Doc, check out our recent episode, Power of Compounding.

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The Brain-Pain Connection with Dr.David Schechter

Sanjiv Lakhia - Carolina Neurosurgery & Spine Associates — Mon, 21 Mar 2022 03:00:00 -0400

Dr. David Schechter didn’t always buy into the idea of the mind-body pain connection. As a medical student, he relied on conventional and traditional approaches to pain management.

But that was before he developed knee pain that felt almost impossible to resolve. He tried mechanical therapy and strengthening exercises as is typically recommended, but nothing seemed to work. So he approached an NYU physiatrist for help: Dr. John Sarno, who became one of America’s most famous back pain doctors.

Dr. Sarno told Dr. Schechter that his pain was psychosomatic. “That really threw me for a loop,” Dr. Schechter said. “It was not what I was expecting to hear.”

But it worked. And Dr. Sarno’s theory of Tension Myositis Syndrome, or TMS — that the mind creates pain in order to suppress traumatic events or subconscious thoughts and feelings — has been supported by independent research showing how the brain reacts differently to chronic and acute pain.

It’s an idea that has unfortunately come with social stigma: patients who suffer from TMS worry that the pain is “all in their head.”

But psychosomatic pain is real, Dr. Schechter says, and understanding how our brain impacts our physical bodies is the first step to accurate treatment and recovery.

Dr. Schechter joins us on episode 44 of Back Talk Doc to discuss the research behind mind-body medicine and the mind-body methods that best help address pain.

“It's a more effective way to treat a particular type of symptom, typically chronic pain,” he says. “And it's a better way to define it. If you make the correct diagnosis, you're more likely to move forward with the correct treatment program.”

Read the Full Show Notes on our website BackTalkDoc.com.

💡 Featured Expert 💡

Name: David Schechter, MD

What he does: Dr. David Schechter is a physician in Culver City, California with a medical degree from New York University. He specializes in sports medicine with a particular focus on non-surgical approaches and mind-body medicine. Dr. Schechter is the author of several books including The MindBody Workbook.

Company: David Schechter, MD (private practice)

Words of wisdom: “If you're afraid of failure, if you're afraid to not get there those opportunities may not ever become available. So don't be afraid to fail. Try it, and if it doesn't work out, learn from it and move on. And do even better next time.”

Connect: LinkedIn

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👉 If you enjoyed this episode of Back Talk Doc, check out our recent episode All About Radiofrequency Ablation for Spinal Arthritis with Dr. Stephanie Plummer.

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Power of Compounding

Sanjiv Lakhia - Carolina Neurosurgery & Spine Associates — Mon, 07 Mar 2022 03:00:00 -0400

Bryana Gregory works at a compounding pharmacy, an option that many physicians in traditional medical circles have never considered.

But compounding could be the key to recovery and better long-term health for some patients. Rather than seeking only to relieve pain, compounding pharmacists take a holistic approach to a patient’s health to create personalized treatments.

“It’s like back in the day, when we used to have apothecaries, and see doctors and pharmacists behind the counter mixing up medications that were customized for the patient,” Bryana says. “Compounding pharmacy is more of an individualized approach.”

Often, treatments for pain involve as little medication as possible, with compounding pharmacists opting instead for supplements that can replenish or rebalance the entire body.

On this episode of Back Talk Doc, Dr. Lakhia talks with Bryana about what makes a good compounding pharmacist and how functional medicine can address pain.

We also talk about some popular treatments, including topicals like low-dose naltrexone, CBD, and even oxytocin, better known as “the love hormone.”

Read the Full Show Notes on our website BackTalkDoc.com.

💡 Featured Expert 💡

Name: Bryana Gregory, PharmD, RPh

What she does: Bryana is a pharmacist and physician liaison who is passionate about compounding pharmacy and personalizing options for her clients to help them maximize their health. She majored in kinesiology at the University of California, Davis and later earned a PharmD at Harding University. In between, she competed as a professional golfer.

Company: Physicians Preference Pharmacy

Words of wisdom: “I think that the best thing that a patient or just anybody can do for themselves is to self-educate, to be your own advocate.”

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👉 If you enjoyed this episode of Back Talk Doc, check out our recent episode CBD: Beyond the Hype with Matt Parks.

🔎 For more information on Dr. Sanjiv Lakhia and the podcast visit BackTalkDoc.com.

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All About Radiofrequency Ablation for Spinal Arthritis With Dr. Stephanie Plummer

Sanjiv Lakhia - Carolina Neurosurgery & Spine Associates — Mon, 21 Feb 2022 03:00:00 -0400

Have you ever been told you have “Uncle Arthur,” more commonly known as arthritis? This ailment affects so many that either you or someone you know likely has pain from arthritis. With so many ways for a back to hurt, how do you tell if your back hurts from arthritis?

Back pain from arthritis is a somewhat different affair than disc pain or structural pain. Instead of the pain radiating, it stays fairly localized to the facet joints, which Dr. Lakhia refers to as “the knuckles of the spine.”

Back Talk Doc guest Dr. Stephanie Plummer walks through a specialized treatment that she performs called a radiofrequency ablation that is used to treat arthritic back pain. In short, the procedure “burns” the nerve that is causing pain, disrupting the signal from the nerve to the brain with few side effects.

To determine whether an ablation will be beneficial, patients go through not one, but two injection procedures called medial branch blocks. These are short-term anesthetic treatments to see if the targeted area gets relief from numbing various nerves. If both treatments are effective, the patient and doctor can decide whether radiofrequency ablation is right for them.

“Despite all the positives, patients should know that the results are not permanent. Over time, the nerves do repair and come back together,” says Dr. Plummer. If successful, patients can expect six months to two years of relief from radiofrequency ablation.

Ready the Full Show Notes on our website BackTalkDoc.com

💡 Featured Expert 💡

Name: Stephanie Plummer, DO

What she does: While she’s a new partner at Carolina Neurosurgery and Spine, Dr. Plummer has been a practicing interventional spine physiatrist since 2013. Dr. Plummer completed her osteopathic medical school training at the Osteopathic School in New Jersey, served as a resident at East Carolina University and worked as a fellow in interventional spine through the Orthopaedic Specialists of the Carolinas in Winston-Salem, North Carolina.

Company: Carolina Neurosurgery and Spine

Words of wisdom: “My patients know that I talk a lot about core strength and core stability. I really think that that can't be underestimated and I don't know that any of us can ever be too strong in our core. I really try to make sure that I'm doing my job of keeping my core healthy by doing exercise for core strength and core stability a couple of times a week.”

Connect: Website

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👉 If you enjoyed this episode of Back Talk Doc, check out our recent episode A Breakthrough Treatment for Low Back Pain

🔎 For more information on Dr. Sanjiv Lakhia and the podcast visit BackTalkDoc.com.

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A Breakthrough Treatment for Low Back Pain

Sanjiv Lakhia - Carolina Neurosurgery & Spine Associates — Tue, 08 Feb 2022 03:00:00 -0400

Carolina Neurosurgery & Spine Associates’ Dr. Andrew Sumich is one of a handful of physiatrists across the country participating in trials of Relievant Medsystems' revolutionary technology that can reduce long-term pain for patients with chronic low back pain: the Intracept Spine Procedure.

The secret to the procedure lies in new research, which deepens the medical understanding of spinal anatomy. While most patients experiencing low back pain are treated for discogenic pain, recent findings have revealed that pain can actually originate from vertebral endplates, the bones found on either side of the disc.

Intracept targets the basivertebral nerve in a minimally invasive outpatient procedure, which improves function and decreases pain, even in the long term — a differentiating factor from many other low back pain treatment options.

Dr. Sumich has worked with approximately 40 patients in FDA-approved trials and has seen remarkable results firsthand, claiming that many procedures have resulted in “a home run” for pain relief.

He shares when the procedure is a viable option for those experiencing chronic lower back pain, when other treatment options may be a better fit, and discusses the profile of an ideal candidate for the revolutionary procedure.

Tune in to episode #41 of Back Talk Doc with Dr. Sumich to learn about the nitty-gritty of this medical procedure and how it’s transforming patients’ lives by reducing low back pain.

💡 Featured Expert 💡

Name: Andrew Sumich, MD

What he does: Dr. Andrew Sumich is a member of the Carolina Neurosurgery & Spine team. He is a board certified physiatrist, specializing in interventional spine care.

Company: Carolina Neurosurgery & Spine Associates

Words of wisdom: “Where we put medicine matters in terms of what's hurting or not.”

Connect: LinkedIn

⚓ Anchor Points ⚓

Top takeaways from this Back Talk Doc episode

★ There’s no one-size-fits-all for treating pain. There are many different causes for pain. Pain generation is an essential part of a medical diagnosis because it signals which treatment plans are most likely to benefit the patient. Not all pain indicates the same root cause, so while The Intracept Procedure may be a good fit for some candidates, it’s not a cure-all.

★ The Intracept Procedure targets vertebrogenic pain. Medical understanding of the spine continues to evolve. The role of endplates in the spine have just recently gained increased attention.

While most cases of chronic low back pain are treated as discogenic disorders, advanced and new understanding of the role of vertebral endplates has changed how to decrease pain for some patients. Vertebrogenic pain, unlike disc-oriented pain, is transmitted through the basivertebral nerve. The Intracept Procedure targets the nerve with a one-time ablation.

★ The results are “staggering.” Intracept’s parent company, Relievant Medsystems, has tracked results of the surgical procedure over a five-year period — a shockingly long time period for medical technology studies. The long-term efficacy of the procedure is unlike anything else that Dr. Sumich has seen in spine care. He’s also seen anecdotal evidence in the improved quality of life from the trial participants he’s treated.

⚕️ Episode Insights ⚕️

[00:00] Check out our sponsor: QxMD builds mobile solutions that drive evidence-based medicine and clinical practice.

[01:42] Introducing Dr. Sumich: Dr. Andrew Sumich returns to the podcast to talk about a novel technique to treat low back pain: the Intracept Spinal Procedures. Dr. Sumich previously discussed spinal injections on one of our most downloaded episodes of Back Talk Doc.

[03:59] A breakthrough for back pain: The Intracept Procedure is a recent advancement in helping with neuropathic pain. Dr. Sumich shares the development of the procedure and how the field’s understanding of spinal anatomy has evolved.

[05:54] Pain generators, explained: There are many different things that can cause back pain. Identifying which spinal structure is the biggest source of pain is essential to determining a treatment plan.

[9:15] Parts of the spine: The vertebral endplate is the anatomical focus for intracept spinal procedures. The understanding of endplate anatomy and how endplate health influences pain is a recent evolution in neuropathic medicine.

[10:13] Procedural options for back pain: Dr. Sumich provides an overview of treatment options for patients experiencing lower back pain (without pain that travels down the legs). Many patients have similar symptoms, but need different treatment plans.

[18:54] New knowledge creates new solutions: Medical breakthroughs in better understanding discogenic pain have allowed doctors to develop new treatments that better target root causes to pain.

[22:39] Durable pain relief: Unlike lumbar facet joint ablation, which needs to be repeated, intracept spinal procedures do not need to be repeated and results in long-term relief.

[24:17] Profile of an ideal patient: Dr. Sumich discusses FDA-approved indications that qualify potential patients for the new procedure.

[28:37] Insurance coverage for new technology: As is often the case, health insurance agencies are hesitant to cover new procedures. Parent company, Relievant Medsystems, can be a resource for individuals looking to pursue the procedure, but needing help coordinating insurance coverage.

[30:03] When a procedure hits a homerun: Dr. Sumich has helped approximately 40 patients at Carolina Neurosurgery & Spine Associates since 2020. He is pleased with the success rates and patient feedback.

[31:36] When a lumbar fusion is the better bet: Sometimes a lumbar fusion is a better solution to back pain. This depends on the patient’s level of instability. In some circumstances, a lumbar fusion is a better option, especially for those with narrowing foramen. Intracept spinal procedures are better suited for those in the early stages of disc degeneration.

[35:35] The upsides and downsides: Dr. Sumich shares the benefits of the new technology and outlines potential risk factors.

[39:43] Yoga as a health tool: Morning yoga has become a regular part of Dr. Sumich’s well-being regimen during the pandemic. A personal favorite is “5 Sun Salutation As +Bs” on YouTube.

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👉 If you enjoyed this episode of Back Talk Doc, check out our recent episode These Simple Exercises Will Keep Your Back Healthy With Jackson Bellis, DPT.

🔎 For more information on Dr. Sanjiv Lakhia and the podcast visit BackTalkDoc.com.

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These Simple Exercises Will Keep Your Back Healthy With Jackson Bellis, DPT

Sanjiv Lakhia - Carolina Neurosurgery & Spine Associates — Mon, 24 Jan 2022 03:00:00 -0400

As a CrossFit level 1 trainer with a 13-year physical therapy career and an interest in golf, running, skiing, and hiking, it’s fair to say that Dr. Jackson Bellis practices what he preaches when it comes to maintaining a healthy back.

Dr. Bellis is always challenging his own body and encouraging his patients to safely challenge their bodies to see what they can do.

“I really think we can make a big change in back health. And I think looking at the way we move, and the things that work and don't work, is a big piece of it,” he says.

Back health has everything to do with the way we move. Some of the most frequent patients who come into our offices are runners, golfers, and truck drivers.

And while their pain might have different causes, it all really comes down to movement, and a few go-to exercises can help almost any type of pain, Dr. Bellis tells us. It’s all about the hips, the abs, and the glutes.

Dr. Bellis shares actionable advice for how stretching and strength-training can serve as strategies to maintain and improve mobility.

Tune in to episode #40 of Back Talk Doc with Dr. Bellis to learn more about the tactics we should all be doing to help treat — and prevent — pain.

💡 Featured Expert 💡

Name: Jackson Bellis, DPT COMT

What he does: Dr. Bellis has been a physical therapist for 13 years, spending 10 of those years of service at Carolina Neurosurgery. He is also a certified orthopedic manual therapist (COMT) with experience in dry needling, selective functional movement assessment (SFMA), and titleist assessment. He enjoys CrossFit, running, golf, skiing, and hiking.

Company: Carolina Neurosurgery & Spine Associates

Words of wisdom: “One thing my patients always say is, I did not realize how tight I was. I did not realize how weak I was. If we never really get to the point where we're trying to see what our body can and can't do, we may not be enjoying it to the fullest.”

Connect: LinkedIn ⼁Website

⚓ Anchor Points ⚓

Top takeaways from this Back Talk Doc episode

★ Think backwards. When trying to figure out the source of pain and how to treat it, it can help to think backwards and treat with opposite movements. For example, if someone has pain from bending forward, laying down in an extended position can help take pressure off the nerve. Treatment can be active, “like on the ground in a cobra position” or passive. “It’s a way to test out and find out Hey, this was a disc."

★ It’s all in the hips. “Everything in life is through the hips,” Dr. Bellis tells us. Understanding how the hips work can also help us understand what causes pain, and figure out the right treatments. Learning how to properly bend at the hips and use the hips during exercise can keep your back healthy and prevent injury. How to use your hips to bend (VIDEO)

★ The bridge and plank are key to a healthy back. Whether it’s lower back pain, seated pain, walking pain, or pain from bending over, Dr. Bellis swears by these two exercises that activate the glutes and the abdominals. Doing it correctly can help control the neutral position of the spine. “I have never had a person come in here with back pain who could activate their abdominals and activate their glutes,” he says.

⚕️ Episode Insights ⚕️

[00:00] Check out our sponsor: QxMD builds mobile solutions that drive evidence-based medicine and clinical practice.

[01:38] Introducing Jackson: Today’s guest is our very own Jackson Bellis, a physical therapist and manager at Carolina Neurosurgery’s Matthews office who has been with us for 10 years.

[03:12] Flexion-sensitive disc pain: We open our Q&A with Dr. Bellis with a common condition that can lead to a herniated disc: radiculopathy, or the type of back pain that comes from bending over.

[06:10] Restoring confidence: Figuring out what went wrong in the first place is step one in physical therapy for patients with herniated discs, and the first step toward building the confidence to bend again. All that power, Dr. Bellis says, comes from the hips.

[7:34] How to hinge: Dr. Bellis discusses common hip faults and how to properly use our hips to bend.

[8:44] Think opposites: One tactic that can help identify a disc herniation and reduce pain is working in opposites: extending the body in the opposite direction in which the pain occurred, making sure to work slowly and gently. Dr. Bellis gives us some at-home tips.

[12:01] Staying on the course: With constant twisting and rotating, golfing may be one of the hardest activities on your back. Dr. Bellis tells us how using the hips and upper back can keep golfers healthy. Back Talk Doc discusses golf rehabilitation in-depth in a prior episode with Dr. Graham Claytor.

[13:46] Standing pain: The causes of lower back pain when standing or walking usually comes from spending too much time in a hyperextended position. Treatment differs from patient to patient. We discussed spinal stenosis with Joe Cheadle on episode 16 of Back Talk Doc.

[18:37] Sitting pain: Carolina Neurosurgery often sees truck drivers coming in with increased back pain. Sources and treatment of that pain can differ, from pelvis imbalance to a disc issue.

[23:10] SI joint pain (or Sacroiliac Joint Dysfunction): Treatments as simple as daily leg extensions can help relieve sacroiliac joint pain, the pain from the joints where the hip bones and the sacrum meet.

[27:24] Keep the glutes active: Dr. Bellis shares his go-to glute exercises and explains how they can help the back, from relieving SI joint pain to strain from golfing.

[29:54] Essential exercises: Dr. Bellis recommends two exercises for anyone and everyone, with or without pain: the bridge and the plank. These exercises can lead to greater control of the spine. “Like we talked about, where does the power come from? Power comes from the hips.”

[32:51] The great hamstring debate: Is stretching our hamstrings really necessary? It depends on who you are and the type of activity you do every day. “When I'm meeting my average person to learn how to bend over [to load] the dishwasher, I can get that person to learn how to hip hinge pain-free without necessarily having to stretch their hamstrings.”

[35:58] Words of wisdom: Dr. Bellis shares his advice on challenging your body and paying attention to previous injuries.

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Fact or Fiction: The Truth About Lumbar Spinal Injections

Sanjiv Lakhia - Carolina Neurosurgery & Spine Associates — Mon, 03 Jan 2022 03:00:00 -0400

Lumbar spinal injections can help reduce back and leg pain and are a highly requested treatment at our offices.

But there are also plenty of misconceptions about them.

Can epidurals be a first-line treatment for low back pain? How well can they help us determine a source of pain? Can injections heal discs?

We brought on Dr. Joseph Zuhosky, who recently joined our team at Carolina Neurosurgery & Spine Associates, to get answers to these questions and more. Along the way, we hope to alleviate some myths and points of confusion about spinal injections.

Joe gives us his recommendations for when – and how – to treat pain with epidurals, explaining how they can not only help treat pain, but also help narrow down a pain’s source and identify further treatment.

“I think there definitely is a role for epidural steroid injections in identifying pain generators. And if it doesn't give our patient long-term, effective relief that they can live with, it helps our surgical partners to determine that it is, indeed, a level that we can reliably operate on.”

Toward the end of this episode, we also hear more about Joe’s personal experiences with disc herniations and how he’s been able to recommend exercises based on his own experience with the workout group he co-founded.

💡 Featured Expert 💡

Name: Joseph P. Zuhosky, MD

What he does: Before joining us recently as a physician at Carolina Neurosurgery & Spine Associates, Dr. Zuhosky went to medical school at The Ohio State University. He did his residency at the Rehabilitation Institute of Chicago at Northwestern University McGaw Medical Center and completed a fellowship, training in sports and spine rehab, at the Illinois SPINE & Sportscare Centers, Ltd. in Bloomingdale, Illinois.

Company: Carolina Neurosurgery & Spine Associates

Words of wisdom: “I don't think we should take all the credit for healing the disc … it's a thought of managing it going forward because even when the pain isn't there, you still have a weak area of your body that you're going to have to compensate for going forward.”

Connect: Website

⚓ Anchor Points ⚓

Top takeaways from this Back Talk Doc episode

★ Injections are more than just a band-aid. Some patients worry that getting a spinal injection will only be a temporary fix for their pain. But it actually does a lot more than that, as long as the injections are used appropriately. While pain relief may only be temporary, an injection can tell us more about where the pain comes from and gives us clues on further ways to treat the patient.

★ A ‘series of three’ injections can limit treatment options. The ‘series of three’ injections myth stems from a research study on sciatica originally published in 1960, but further research found this treatment is only effective two times out of three. Since doctors can only give a limited number of injections within a period of time, this method can also rule out other treatment options that offer quicker relief.

★ An epidural is only one part of treatment. While a shot can relieve pain, it can’t actually heal a damaged disc. Instead, the epidural steroid reduces the swelling and inflammation that causes pain, getting the patient through the acute stage while Mother Nature does the rest of the work.

⚕️ Episode Insights ⚕️

[00:00] Check out our sponsor: QxMD builds mobile solutions that drive evidence-based medicine and clinical practice.

[01:59] Meet Dr. Joe: Joseph Zuhosky is the newest member of Carolina Neurosurgery & Spine Associates. Before joining us, he did his residency at the Rehab Institute of Chicago at Northwestern University and a fellowship in sports and spine rehab in Bloomingdale, Illinois.

[04:05] From pediatrics to orthopedics: Dr. Zuhosky talks about his varied interests as a medical student, beginning in pediatrics and eventually landing in spine health.

[06:32] Fact or fiction: Lumbar spinal injections are a type of corticosteroid that can reduce inflammation and alleviate back pain in the back and leg. We clarify some misconceptions about the injections.

[07:33] Low back pain: Though a lot of patients seek lumbar spinal injections for low back pain, epidurals generally have a low success rate among this population.

[10:59] Specificity: An injection can be helpful in determining a source of pain and ways to treat it, as long as the injection is done appropriately.

[15:02] Series of three: Originally introduced in a 1960 paper, the ‘series of three’ injection treatment strategy is a myth: Since the number of injections that can be given to a patient is limited, this practice could limit further treatment options.

[18:49] Discs: The steroid injection does not necessarily “heal” a disc, but it does reduce the inflammation and pain caused by a herniated disc and can help patients through the acute healing phase.

[22:18] Spinal stenosis: There are advantages to using lumbar epidural injections to treat spinal stenosis, but to suggest that they can heal this condition is misleading. Spinal stenosis was discussed on a previous episode with Dr. Joe Cheatle.

[26:38] Center or side: A transforaminal epidural – or when the epidural is injected directly to the nerve root rather than off-center – tends to have a slightly higher response rate.

[34:22] Personal experience: Dr. Zuhosky has personally experienced both lumbar and cervical hernias. He recommends a workout group with branches across the country called F3 that has helped with his lower back pain.

[40:15] Hamstring exercises: Dr. Zuhosky tells us more about hamstring stretches that won’t aggravate the back.

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CBD: Beyond the Hype

Sanjiv Lakhia - Carolina Neurosurgery & Spine Associates — Mon, 20 Dec 2021 03:00:00 -0400

Health care has been a constant presence in Matt Parks’s life for much longer than most people.

His mother is an ER nurse. His older brother was born with a rare condition and was often hospitalized as a child. And as a college baseball player, Matt started taking nonsteroidal anti-inflammatory drugs (NSAIDs) to cope with a shoulder injury.

He became dependent on the medications and started to experience migraines. He also developed depression when his parents divorced, which he still struggles with.

By 2019, having been Vice President and Sales Manager at Williams Medical Supply Inc. for over a decade, Matt was a veteran of the medical supply industry. Conversations with people in his field who had looked into cannabidiol — better known as CBD — and customers who had used it, convinced him that the majority of CBD products were ineffective.

This inspired him to see if he could come up with something better. He had three main areas of improvement. He wanted to create a hemp-derived topical CBD cream that he could verify did not contain tetrahydrocannabinol (THC), the main psychoactive compound in cannabis. He also wanted to build a company that was directly accessible to customers who had questions, and a brand that didn’t traffic in the usual hype.

That year, he founded One Less CBD — as in “one less pill to take.”

Listen to this episode of Back Talk Doc to find out what CBD is and isn’t, how to choose a CBD product, and to hear about Matt’s journey from patient to employee to entrepreneur.

💡 Featured Experts 💡

Name: Matt Parks

What he does: Before founding One Less CBD in 2019 and leading the business as CEO, Matt was Vice President and Sales Manager at Williams Medical Supply Inc for over a decade.

Company: One Less CBD

Words of wisdom: “[CBD is] not going to regrow cartilage. What we see is a daily topical application to help people become more mobile, become more active and create a better overall lifestyle, and stop reaching for two or three Aleve every single day, and apply something that is more plant-derived and natural.”

Connect: LinkedIn

⚓ Anchor Points ⚓

Top takeaways from this Back Talk Doc episode

★ CBD is thought to help reduce inflammation by assisting your body’s endocannabinoid system (ECS). Endocannabinoids are anti-inflammatory molecules produced by your body. However, certain enzymes interrupt the ECS process, and absorb endocannabinoids, reducing the system’s effectiveness. “The whole idea behind CBD is, let's introduce more cannabinoids, block out some of those enzymes, and actually let the body do some natural healing,” Matt says.

★ Hemp-derived and marijuana-derived CBD are different. Both hemp and marijuana are types of cannabis plants. The key legal difference is that marijuana contains more than 0.3% THC, the psychoactive component that causes users to experience a high, and less CBD than hemp. Hemp contains 0.3% THC or less. It’s important that CBD consumers know that the topical they’re using does not contain more than 0.3% THC, because if it does, they could fail a drug test.

★ Consider who’s selling you CBD. If you have a question about the CBD you just bought, it’s not a given that you’ll be able to connect with a real person or even find legitimate information on the product’s website. And while CBD is legal, there’s no regulatory body for the industry yet. Get it from a naturopath or chiropractor rather than, say, a gas station or convenience store.

⚕️ Episode Insights ⚕️

Top takeaways from this Back Talk Doc episode

[00:00] Mobile-based solutions for clinical practice: Check out our sponsor, QxMD, which builds mobile solutions that drive evidence-based medicine in clinical practice.

[01:44] Meet Matt: Matt Parks is the founder and CEO of One Less CBD. As a college baseball player, Matt injured his shoulder, and began taking NSAIDs to cope. He became dependent on the medications, which led to migraines.

[6:04] Unimpressed: Working in the medical supply industry after college, Matt interacted regularly with consumers dealing with painful conditions like rheumatoid arthritis. They were underwhelmed by CBD products. Matt was inspired him to come up with a superior product.

[10:34] Opening the floodgates: The 2018 Farm Bill took CBD off the Schedule I narcotics list, which sparked the CBD craze. But there wasn’t any regulatory framework to ensure quality control.

[16:29] Blocking the blockers: The endocannabinoid system (ECS) reduces inflammation in our bodies by releasing cannabinoids, but these cannabinoids are sometimes intercepted by enzymes that absorb enough of them to prevent the ECS’s therapeutic effects. CBD products are designed to block some of these enzymes so healing can occur.

[18:30] A supplement, not a cureall: Matt describes his CBD as a topical application to help people become more active and mobile, while avoiding the stomach damage that can result from taking NSAIDs like ibuprofen or aspirin. The name One Less CBD refers to taking one less pill.

[22:08] The goal: Everything One Less sources is made in the U.S. Matt and his team found a supplier who could provide them with 99.99% pure CBD. It was important that there was no THC in their product, so that customers would not experience side effects or fail drug screenings.

[28:06] Full disclosure: A transparent CBD company should provide contact information, indicate whether its products have been tested by an independent third-party, and list where its CBD is available for purchase.

[33:54] The future of CBD: CBD is still trending upward despite a decline during COVID-19 — and Matt predicts that it hasn’t peaked yet.

[36:01] Worth a look: Matt recommends the Original Strength fitness program and the book “Atomic Habits” by James Clear.

[39:34] Special offer: Get a free travel jar of One Less CBD Topical Inflammation Cream. Just pay $4.95 for shipping.

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👉 If you enjoyed this episode of Back Talk Doc, check out our recent episode A Neurological Approach to Treating Pain.

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A Neurological Approach to Treating Pain with Garrett Salpeter of NeuFit

Sanjiv Lakhia - Carolina Neurosurgery & Spine Associates — Fri, 10 Dec 2021 03:00:00 -0400

Being told your pain is only in your head is maddening when it’s your back that hurts. But is there more truth to this statement than we have long believed?

NeuFit founder Garrett Salpeter says that pain is sometimes not an accurate depiction of the extent of an injury, but rather an overreaction by your nervous system.

At NeuFit, Garrett draws on his background in engineering and neuroscience to help athletes and other patients recover from injury, develop sustainable fitness regimens, and improve their overall health.

Garrett joins this episode of Back Talk Doc to explain why his unusual approach to treatment acknowledges the structural focus of traditional pain management, but operates within a neurological framework.

“There is this very important common thread… from early-stage rehabilitation all the way through general fitness and elite athletic performance, and that is the nervous system,” Garrett says. “It controls so many things about us: How we heal and recover from injuries, how our muscles work and move, whether we experience pain or not.”

Garrett also created a new muscle stimulation device, the Neubie, that combines the alternating current traditionally used in these devices with direct current, to maximize relief. In addition to using it with patients, he relies on it to optimize his own workouts.

Listen to this episode of Back Talk Doc to explore the intersection of neuroscience, engineering and physiology, and how it can offer a holistic approach to treating pain.

💡 Featured Experts 💡

Name: Garrett Salpeter

What he does: Garrett has studied engineering and neuroscience. From this unique vantage point, he leads neuromuscular therapy provider NeuFit, which is dedicated to treating athletes and patients, helping them reach their fitness goals and heal from injuries. He also hosts The NeuFit Undercurrent Podcast and is the author of “The NeuFit Method: Unleash the Power of the Nervous System for Faster Healing and Optimal Performance.”

Company: NeuFit

Words of wisdom: “If someone comes in because they ‘threw out their back’ … in that really acute spasm-like state, a lot of times there’s some minor insult or something like that, but the reason that they’re in such pain and they’re so debilitated is because of the neurological overreaction.”

Connect: LinkedIn

⚓ Anchor Points ⚓

Top takeaways from this Back Talk Doc episode

★ Examining your pain within a neurological framework offers advantages over a traditional approach. The traditional approach to treating pain tends to lean heavily on structural explanations: If your back hurts, there must be something physically wrong with it. Instead, focusing on your body’s response to an insult as a neurological overreaction that creates pain (without discounting the possibility of a structural issue) may be more effective.

★ The body’s protective responses to stimuli are necessary, but often an overcorrection. When Garrett and his team identify a defensive neurological reaction to an insult, they are careful not to eliminate it completely, because it serves a purpose. Yet the response is often too far-reaching. Many times, this has to do with bad habits that a patient has developed in the way they move their bodies, so treatment is usually more a matter of recalibrating the response than getting rid of it.

★ When it comes to muscle stimulation, direct current is worth a second look. Direct current fell out of favor among pain specialists decades ago. Despite its therapeutic effectiveness, it burned and stung the skin. To address this and harness direct current’s power, Garrett developed the Neubie, a device whose proprietary waveform feature uses alternating and direct current.

⚕️ Episode Insights ⚕️

Top takeaways from this Back Talk Doc episode

[00:00] Mobile-based solutions for clinical practice: Check out our sponsor, QxMD, which builds mobile solutions that drive evidence-based medicine in clinical practice.

[02:01] Meet Garrett: Garrett Salpeter is the author of “The NeuFit Method: Unleash the Power of the Nervous System for Faster Healing and Optimal Performance.” He founded neuromuscular therapy provider NeuFit, and also hosts The NeuFit Undercurrent Podcast.

[04:59] The common thread: From general rehab patients to elite athletes, the nervous system is the key differentiator when it comes to controlling how we recover, move, think and feel. It controls our muscles, hormones and pain responses.

[6:10] Tip of the iceberg: Often when a patient comes in complaining of an acute injury, the real reason for their pain, even if they have suffered some minor injury, is the nervous system’s overreaction to it, e.g. a back spasm.

[6:59] A different paradigm: Instead of focusing on the affected structures, Garrett and his team focus on the neurological responses to injuries. They do this by identifying where the brain and nervous system are activating those responses, and stimulating those areas to reset, recalibrate and reeducate the response patterns.

[9:02] First things first: This is a different framework but not a substitute for considering real physiological issues. Before investigating a patient’s neurological responses, NeuFit checks to make sure there’s nothing structurally wrong with them.

[11:32] Root causes: When patients experience pain from certain types of movements or extensions, it’s often because certain muscles are shut down or inhibited.

[13:01] The strength within: By measuring and mapping pain and then focusing on root causes, NeuFit helps people tap into muscle they already have but are preventing themselves from activating.

[13:57] Hyperfocus: In addition to manual muscle testing, NeuFit uses electrodes that send direct currents to identify the protective responses the patient is exhibiting.

[18:49] Next-level muscle stimulation: NeuFit’s proprietary device, the Neubie, uses direct current stimulation to communicate with the nervous system precisely and efficiently, and alternating current to provide comfort during muscle stimulation.

[25:37] Balancing it out: NeuFit’s treatment process determines how much of the body’s neurological response is necessary, and how much is an overreaction to a perceived danger.

[27:54] More function than form: Garrett has seen people make more progress by emphasizing function over structure.

[31:05] Sweeter dreams: Using the Neubie in conjunction with his workout regimen, Garrett has significantly improved his quality of sleep.

[37:08] What he’s reading: Garrett recommends “Head Strong” and “Super Human” by Dave Asprey.

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👉 If you enjoyed this episode of Back Talk Doc, check out our recent episode The Art and Science of Trigger Point Treatments.

For more information on Dr. Sanjiv Lakhia and the podcast visit BackTalkDoc.com.

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The Art and Science of Trigger Point Treatments

Sanjiv Lakhia - Carolina Neurosurgery & Spine Associates — Tue, 29 Jun 2021 03:00:00 -0400

Sometimes imaging doesn’t explain a patient’s pain, and when that is the case, many will feel discouraged if not flat-out alarmed.

Trigger points can offer answers, and it’s the topic of this episode of Back Talk Doc.

Marty Kestin joins the podcast to explain more about trigger points and how they are involved in causing pain. At Ensoma Bodyworks, Marty teaches both patients and students how to restore and improve body functioning by the way of advanced orthopedics like neuromuscular massage therapy and neuroplasticity.

Trigger points typically come into play when MRI imaging and other avenues of identifying pain come up short. Just because the cause of pain can’t be detected through imaging, doesn’t mean the patient is faking it. Quite the opposite. As Dr. Lakhia remarks in this episode: “Your pain is real. We're going to go on the hunt to find where it's coming from.”

Listen to this episode of Back Talk Doc to understand the science behind how trigger points work, their role in causing pain, and how understanding them can lead to better pain management.

💡 Featured Experts 💡

Name: Marty Kestin

What he does: As a Pain Detective, Marty draws on 25-years of pain management experience to not only find what is causing a patient’s pain, but to rid them of it.

Company: Ensoma Bodyworks

Words of wisdom: “My practice has been attracting recalcitrant or just stubborn enigmatic cases for about 10, 15 years now. Fortunately, they've already been to the doctor, or the chiropractor, or the PT, or the acupuncturist. Or the massage therapist. They come to me and go, ‘Nobody could figure it out.’ So they've gone through a lot of diagnostics and assessments, and I ask them, ‘How many people have examined your skeletal muscle in a microscopic way where they're combing over what they think the problematic area could be?’ Almost always, nobody's ever done that for them.”

Connect: LinkedIn

⚓ Anchor Points ⚓

Top takeaways from this Back Talk Doc episode

★ Don’t overlook trigger point evaluation if you haven’t come up with answers for your pain. Many doctors don’t consider trigger points when it comes to determining the cause of pain; you’ll need to see a specialist. It’s important to know that it is an option, especially if a physician cannot determine what is causing your body pain in a traditional manner.

★ There are multiple ways to treat trigger points. There is never a one size fits all approach to pain, even when the pain results from trigger points. With a host of different treatment options, it’s important to understand each treatment method and what may be best for you. Dry needling is particularly popular, but “spray and stretch” may be more comfortable for some people.

★ Other symptoms could be related to trigger points. With trigger points, it’s not uncommon for there to be other symptoms aside from pain. Abdominal trigger points can cause diarrhea or IBS, for example.

⚕️ Episode Insights ⚕️

[00:00] Mobile-based solutions for clinical practice: Check out our sponsor, QxMD, which builds mobile solutions that drive evidence-based medicine in clinical practice with over 500 easy-to-use decision support tools.

[01:50] The bodywork savant: Dr. Lakhia introduces Marty, a friend and colleague, and his work with trigger points and massage therapy.

[03:43] What is a trigger point?: Marty defines exactly what a trigger point is by explaining its history and physical representation in a person’s body.

[08:21] When to suspect a trigger point: Dr. Lakhia asks Marty what can indicate a trigger point is the cause of pain and what to look out for, and which doctors to seek out.

[11:09] A short history on imaging studies: Marty talks about imaging studies — especially in relation to trigger points and pain patterns.

[13:18] Treatment options: Dr. Lahkia brings up different options for treatment of trigger points from Travell’s method to injecting trigger points with substance. Marty offers additional suggestions, including self-treatment options.

[17:10] Classic pain patterns: With trigger points, there are classic pain patterns to know and understand, like sciatica. Dr. Lakhia and Marty explain what the most common pain patterns are and how to identify them.

[21:26] When a headache isn’t just a headache: Trigger points can, well, trigger autonomic symptoms such as headaches, vertigo, and dizziness. Marty discusses the autonomic presentations that he has seen.

[24:42] It’s not just about the back: The front of the body and its trigger points often get neglected in favor of back and spinal issues.

[26:52] Self-care in the modern age: Marty offers suggestions for how people can stay out of trouble when it comes to trigger points.

[28:42] How Marty thrives personally and professionally: Marty breaks down what keeps him going, not only as a clinician but as a human being.

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👉 If you enjoyed this episode of Back Talk Doc, check out our recent episode Should You Be Concerned About Seeing a Physician Assistant for Spine Care?

🔎 For more information on Dr. Sanjiv Lakhia and the podcast visit BackTalkDoc.com.

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Should You Be Concerned About Seeing a Physician Assistant for Spine Care?

Sanjiv Lakhia - Carolina Neurosurgery & Spine Associates — Mon, 10 May 2021 13:20:00 -0400

Just like the spine — the clinicians, doctors, and practitioners who practice spinal care comprise a complex system.

In this episode of Back Doc Talk, we are talking about the team it takes to manage your spinal health, and especially the role of Physician Assistants (PAs).

PAs like Mike Nido of Carolina Neurosurgery and Spine Associates are responsible for a range of treatments and assistance when it comes to fixing back and spine problems.

But is patient care compromised when you see a PA instead of a physician?

PAs are a backbone of the spine issue treatment. Pun fully intended!

Whether it is always seeking that second opinion, having multiple safety nets in place when it comes to films and imaging, or just having a friendly face,

“We make it very clear to [patients] that even though I'm here providing your care, the doctor that's standing behind me is very aware of what's going on and very involved in all of the decisions that are made,” Mike explains.

Listen to this episode of Back Talk Doc to understand the role of a PA and the type of care you can expect from one, how they work with physicians to address spine issues, and much more.

💡 Featured Expert 💡

Name: Michael Nido

What he does: Mike pulls double duty not only as a Physician Assistant, but also as the Director of Clinical Services at Carolina Neurosurgery and Spine Associates. He’s been with the clinic for 24 years.

Company: Carolina Neurosurgery and Spine Associates

Words of wisdom: “The important thing for our patient to understand is that you're not getting second class care. You're not going to the B team. This is your way of getting your foot in the door, getting your care initiated in such a way that by the time you see the physician, all the important stuff has been completed and ready for his review.”

Connect: LinkedIn

⚓ Anchor Points ⚓

Top takeaways from this Back Talk Doc episode

★ The team needed to keep a clinic running is larger than you think. Between doctors and receptionists, nurses, and PAs, there are more types of medical professionals at your local spinal clinic than you may realize. It truly takes a team to provide care and aid your back and spinal recovery.

★ PAs and physicians are in constant communication. One of the main concerns from patients when they go into a clinic and are assigned a Physician's Assistant rather than a doctor is that they may not believe the PA is up to the task. But the fact is that PAs work very closely with physicians and are making sure you are getting the highest quality care. PAs and physicians communicate a ton behind the scenes.

★ Seeing a PA is practical. When patients see a Physician’s Assistant rather than a physician, they’re not getting sub-quality care. In fact, it makes practical sense because a PA can help a doctor get all the tools needed to make a diagnosis. PAs help get tests done and identify the problem so that by the time the patient does see the doctor, everything will be in place for diagnosis and treatment.

⚕️ Episode Insights ⚕️

[00:00] Mobile-based solutions for clinical practice: Check out our sponsor, QxMD, which builds mobile solutions that drive evidence-based medicine in clinical practice.

[02:47] Introducing Physician Assistants: The lead Physician Assistant at Carolina Neurosurgery & Spine Associates, Mike Nido, describes his role.

[05:13] The role of Physician Assistants in clinics: Mike gets into the details of his day-to-day experience as a PA, including the education needed and what types of patients he cares for.

[07:33] PA vs. Certified Nurse Practitioner: Knowing all the different types of practitioners can be overwhelming. Dr. Lakhia asks Mike to explain the difference between these roles, especially in a clinic and hospital setting.

[9:55] But I don’t want to see the PA: Communication is important. Mike and Dr. Lakhia discuss why patients are often skeptical of Physician Assistants. They also talk about why this skepticism usually isn’t founded.

[12:09] Teamwork: Not all clinics have a collaborative model, but it is something Dr. Lakhia believes is beneficial for overall care.

[13:20] Getting an appointment is the hardest part: Everyone understands the pain of waiting to be seen. By choosing a PA instead of a physician, Dr. Lakhia explains that patients can get into the clinic a lot faster.

[14:13] Show and tell: Wrapping up. Mike Lido shares a bit more about himself and his family.

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👉 If you enjoyed this episode of Back Talk Doc, check out our recent episode How Back Pain Can Affect Your Relationship (and What to Do About It).

🔎 For more information on Dr. Sanjiv Lakhia and the podcast visit BackTalkDoc.com.

🎧 Subscribe in your favorite podcast app.

How Back Pain Can Affect Your Relationship (and What to Do About It)

Sanjiv Lakhia - Carolina Neurosurgery & Spine Associates — Mon, 26 Apr 2021 03:00:00 -0400

We’re talking about healthy relationships on this episode of Back Doc Talk.

What does that have to do with back and spine health? A lot.

With power couple and relationship coaches Jocelyn and Aaron Freeman at the helm, this episode examines how back and spine issues can affect your relationship and vice versa.

Physical pain influences how we feel and how we interact with others, and developing a conscious awareness about how that affects our loved ones is critical.

Aaron dissects the difference between pain and suffering, while Jocelyn explains the importance of setting expectations.

A sudden injury can change your life considerably, and dealing with the pain can feel like a burden to a partner. One way to address this is by more clearly defining roles and responsibilities when a family member is dealing with pain. This helps ensure there’s a discussion around expectations and to avoid leaving family members disappointed.

Helping a partner who is managing pain is a balancing act — one that can be strengthened by better understanding how your partner communicates. No one is a mind reader!

Tune in to this episode to discover how you can improve communication about back pain and prevent spine issues and injuries from wreaking havoc on your relationship.

💡 Featured Experts 💡

Name: Aaron and Jocelyn Freeman

What they do: Aaron and Jocelyn are a power couple in the relationship world, helping couples navigate the highs and lows of married life. Through their sold-out events all over Arizona, their book, and coaching classes, Aaron and Jocelyn are in the business of healthy relationships. They are the founders of the Empowered Couples University, which helps couples harness important communication skills and invest in their relationship.

Company: Meet the Freemans

Words of wisdom: “[T]he place to really start to make a differentiation here, between the impact on the person that has the ailment, and is actually in physical pain versus the spouse. It is the difference...between pain being of the body and suffering being of the mind.”

Connect: LinkedIn | Facebook | Podcast

⚓ Anchor Points ⚓

Top takeaways from this Back Talk Doc episode

★ Open communication is your greatest tool. To prevent pain from creating havoc on your relationship, open and honest communication is essential for couples. This applies directly to how spouses and partners deal with their loved ones being in pain. How to navigate that is critically important, not only for suffering but for support.

★ Understanding you and your partner’s personality type is crucial. Whether you are a reserved or assertive communicator will affect how you handle a challenge — like pain in your relationship. Knowing whether you need to ask more questions (or fewer!) can be critical in navigating pain management and care of a loved one. Jocelyn and Aaron developed a quiz to determine your personality type. Take it at mycouplesquiz.com.

★ ‘Depositing’ thanks and ‘withdrawing’ energy. Using a bank account as a metaphor to describe the transfer of energy and emotions between couples is a useful way to think about pain and stress. When you’re the one in pain, “depositing” gratitude into your partner’s bank account can greatly help your recovery process. On the other hand. “withdrawing” too much of their energy can cause resentment. Balancing this and understanding you’re not a burden is a hard lesson to learn, but an important one.

⚕️ Episode Insights ⚕️

[00:00] Mobile-based solutions for clinical practice: Check out our sponsor, QxMD, mobile solutions for driving evidence-based medicine in clinical practice.

[01:34] Introducing the Freemans: Dr. Lakhia introduces relationship coaches Aaron and Jocelyn Freeman, authors of “The New Power Couple” and “The Argument Hangover: Empowering Couples to Fight Smarter and Overcome Communication Pitfalls.”

[04:51] Breaking L1 to L4 and her relationship: Jocelyn speaks to how hurting her back had an emotional impact on her previous relationship because she pushed herself too far.

[07:29] Navigating back pain and interpersonal issues: Aaron and Jocelyn detail how to mitigate and develop a conscious awareness of how pain can affect relationships.

[9:58] Pain in the face of powerlessness: Being in pain can give people a sense of powerlessness that can leak over into relationships. Jocelyn talks about her personal experience.

[13:21] Checking on expectations in a relationship: Introducing the theme of their newest book, “The Argument Hangover,” the Freemans talk about managing expectations in a relationship, especially when there is a sudden and dramatic change like a back injury.

[17:23] Do the work: Dr. Lakhia challenges listeners to write down everything they need to do to help with their pain, from exercises to knowing who in your family is doing what. Make it concise and clear.

[18:00] Pain journaling can help expectations: While pain journaling is nothing new, Dr. Lakhia and his guests discuss how it can be used to help set and meet expectations when it comes to pain.

[22:08] Knowing your communication type: Jocelyn breaks down the communication personality types outlined in their book and the importance of not only knowing your own communication type but understanding your partner’s.

[27:17] A love bank account: The Freemans break down the concept of a “love bank account” and how the metaphorical idea of depositing and withdrawing energy from one another is applicable to relationships in crisis.

[30:32] On feeling like a burden: Dr. Lakhia reveals his own struggles with feeling like a burden to his family when he suffered a disc injury.

[35:15] Authentic conversations on Clubhouse: Aaron mentions he got on Clubhouse recently and was surprised at the vulnerable conversations people were having about their relationships.

[37:45] Healthy habits: Dr. Lakhia asks Aaron and Jocelyn about their personal workout and health routines.

[40:15] Words have meaning: Dr. Lakhia explains why the most important book in his life is “Autobiography of a Yogi,” by Paramahansa Yogananda.

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👉 If you enjoyed this episode of Back Talk Doc, check out our recent episode Ins and Outs of Spinal Fusions with Dr. Hunter Dyer.

🔎 For more information on Dr. Sanjiv Lakhia and the podcast visit BackTalkDoc.com.

🎧 Subscribe in your favorite podcast app.

In’s and Out’s of Spinal Fusions with Dr. Hunter Dyer

Sanjiv Lakhia - Carolina Neurosurgery & Spine Associates — Tue, 13 Apr 2021 15:00:00 -0400

The general public’s understanding of spinal fusion often starts with a misconception.

When Dr. Hunter Dyer talks to people about lumbar fusion, many think that it’s the screws doctors place that are the fusion. But that’s not true — the hardware just holds the spine in alignment until the vertebrae or spinal elements grow back together.

As an expert in spinal fusions, Dr. Dyer is familiar with what people get wrong or just don’t understand about caring for their spine and fixing spinal issues. It’s a complicated field of medicine and, as such, patients considering surgery like a fusion should consult with an expert first.

For example, Dr. Dyer says that most patients with back pain don’t actually need surgery. Rather, alternative care like physical therapy is often a better starting point before committing to the sometimes-extensive recovery from a fusion procedure.

In addition, there are myriad risk factors to consider: Does the patient smoke? What’s their surgical history? How old are they? What’s their body type? All these things and more, Dr. Dyer says, can influence whether a patient is a good candidate for a spinal fusion.

On this episode of Back Talk Doc, Dr. Dyer explains all things spinal fusion with host Dr. Sanjiv Lakhia.

💡 Featured Doc 💡

Name: Dr. Hunter Dyer

What he does: Dr. Dyer is an expert in degenerative spine disease, endoscopic spine surgery, minimally invasive spine surgery, skull base surgery, spinal fusion, transsphenoidal surgery and vascular neurosurgery. He is the President at Carolina Neurosurgery & Spine Associates.

Company: Carolina Neurosurgery & Spine Associates

Words of wisdom: “The key to any great job, or being good at what you do, is I absolutely love what I do. I wake up every single day excited to see what I've got for the day and see if I can help people surgically, to see if I can help people in the clinic. And that's why we love being physicians and we love being in health care, because it's just so rewarding.”

Connect: LinkedIn

⚓ Anchor Points ⚓

Top takeaways from this Back Talk Doc episode

★ Most spinal issues probably don’t need surgery. Even as a surgeon, most patients Dr. Dyer sees can address their issues with conservative care — physical therapy, spinal traction, or injections. “The only people that we need to consider for spinal fusion are typically those that have problems where they require so much bone removal that they require stabilization of the spine,” he says.

★ Smoking is a major risk factor for spinal issues. It can affect people with problems in either the neck or back. “We typically do not like to even consider spinal fusion if somebody is using tobacco,” Dr. Dyer says. “If they've used it in the past, it's likely that they get degeneration of the disk and that can lead to accelerated adjacent-level problems.”

★ The direction of spinal surgery can influence the healing process. Dr. Dyer explains that when a surgeon uses a lateral approach, patients don’t often experience a lot of pain. When the best course of action involves the posterior or anterior approach, patients can experience more pain after surgery. “In general, there's more pain with the posterior approach, but it's still the most common way because it does provide that direct view of the nerves,” he notes.

★ Spinal fusion techniques are advancing rapidly — which is good for patients. In the past five years, technology has advanced so that surgeons can be more precise with placing screws, thanks to MRI and CT images. In addition, robotic tools have made surgery much safer and much easier to heal from. “For many people, it’s just a better thing all around,” Dr. Dyer says.

⚕️ Episode Insights⚕️

[00:00] Mobile-based solutions for clinical practice: Check out our sponsor, QxMD, mobile solutions for driving evidence-based medicine in clinical practice.

[01:45] Introducing the physician: Dr. E. Hunter Dyer is a specialist in degenerative spine disease and endoscopic spine surgery, among other things.

[03:50] Neurosurgery isn’t just for the brain: The reality, Dr. Dyer says, is that spinal issues make up the majority of neurosurgeons’ caseloads.

[05:50] Conservative care can help most spinal issues: Care options like physical therapy or injections are often the first steps in recovery before exploring spinal fusion.

[8:20] What is lumbar fusion?: It’s not actually referring to the hardware. “Fusion is actually the growth between or around the spinal elements, whether it's the vertebrae growing together, or whether it's the spinal elements in the back part of the spine that grow together,” Dr. Dyer explains.

[10:40] Two types of spinal instability: One is in patients who haven’t had any procedures and have their vertebrae moving due to degeneration of spinal joints; the other is found in someone who has had excess bone removed, creating an unstable spine where doctors must secure spinal segments.

[13:00] Changes for lower back care: Dr. Dyer says spinal fusions for lower back pain are much less common than they were a decade ago.

[15:30] Differences in lumbar fusion acronyms: Dr. Dyer explains what ALIF, XLIF and other types of fusions actually mean.

[18:40] Recovery times vary: Dr. Dyer explains how and why the healing will differ depending on whether a surgeon uses an anterior, lateral, or posterior approach.

[20:40] Complexities of evaluating spinal surgery: A myriad factors within a patient can influence what types of treatment are best.

[23:44] Breaking down recovery restrictions: Post-surgery recovery varies from person to person but often can last several weeks at minimum.

[27:15] Benefits of physical therapy: Most spinal fusion patients find that physical therapy helps at a certain point in their recovery.

[28:26] On adjacent-level disk disease: Dr. Dyer explains the importance of identifying the exact problem in the patient, common post-spinal fusion issues and risk factors.

[32:27] Outlook for future surgery: There is a possibility that patients who have lumbar fusion could require an extension or further surgery down the road. Dr. Dyer says while it’s not common and it is a “complete game changer” for some, doctors should educate patients about possibilities down the road.

[34:45] Are spinal fusion surgeries overdone?: Dr. Dyer discusses why some in the medical community have the perception that not all spinal fusions are necessary and shares current insights on when it makes sense to skip the procedure.

[37:06] Looking ahead: Robotic tools, minimally invasive procedures, and new imaging technology are making for quicker-healing and less-painful procedures. “There also are incredible advances in what we call navigation,” he says, noting that navigation enables doctors to attach instruments to the imaging study.

[40:43] Final thoughts: “I'm not the best example of somebody who is an extremely regular exercise person, but I stay on the go and I think my metabolism stays at a high rate, which helps,” he says reflecting on what has helped his success. “I lean on having great family support. I've got a great wife and kids. And also the key to any great job [is] I absolutely love what I do.”

Subscribe & Contact

👉 If you enjoyed this episode of Back Talk Doc, check out our recent episode Reduce Back Pain and Improve Posture with Active Sitting.

🔎 For more information on Dr. Sanjiv Lakhia and the podcast visit BackTalkDoc.com.

🎧 Subscribe in your favorite podcast app.

Reduce Back Pain and Improve Posture with Active Sitting

Sanjiv Lakhia - Carolina Neurosurgery & Spine Associates — Mon, 29 Mar 2021 13:00:00 -0400

With fifteen years of experience as a spine physician, Dr. Sanjiv Lakhia is always on the lookout for ways to help his patients improve their back health, particularly with natural, less invasive methods that can be easily integrated into their day-to-day lives. Today, we’re going to be discussing a common cause of back and neck pain, prolonged periods of sitting.

Joining us on this episode of Back Talk Doc is Dr. Turner Osler, a retired trauma surgeon, epidemiologist, entrepreneur, and founder of QOR360, a company designing chairs to improve posture and prevent back pain caused by conventional sitting.

Dr. Osler explains “Sitting Disease” and explores the negative affects sitting prolonged periods of sitting have on the body. “We think all the chairs that we have are normal, and they are not. Humans are not designed to sit all day… We're simply not set up to sit slumped in front of a PC all day.” (6:37) Many issues like headaches, neck and back pain, weight gain, and even mood disorders can be traced back to incorrect posture while sitting. Dr. Osler discusses the natural human posture (10:05) and how we have been letting our chairs shape our bodies, instead of shaping our chairs to fit our bodies. (11:34)

Dr. Osler then discusses the benefits of “active sitting” (a sitting experience that allows and/or encourages movement while seated), including reducing back pain and improving posture. (21:23)

Other topics discussed include negative effects of sitting in a slumped posture (14:03), contraindications for using an active sitting chair, (35:11) and a word of caution for those with lumbar disk herniations or acute back pain. (38:51)

Links and Resources

To learn more about Dr. Osler’s mission of educating the community about the benefits of active sitting, visit QOR360.com and ButtOnChairs.org, which promotes active sitting for children.

View Dr. Osler’s TED Talk.

The Gokhale Method: a system of healthy posture and movement to help restore your structural integrity, so you can live an active and pain-free life.

For more information on Dr. Sanjiv Lakhia and Back Talk Doc visit BackTalkDoc.com.

Uncovering Pediatric Spinal Deformities with Dr. Michael Bohl

Sanjiv Lakhia - Carolina Neurosurgery & Spine Associates — Tue, 09 Mar 2021 14:30:00 -0400

On Episode 13 of Back Talk Doc we spoke with Dr. Matt McGirt about Adult Spinal Deformity (Ep. 13 - Adult Spinal Deformity with Dr. Matt McGirt.) It proved to be a popular and valuable episode for our community, so today we’re following up that episode with a discussion of scoliosis and spinal deformity in pediatric patients.

Joining us is Carolina Neurosurgery and Spine Associates’ new partner, Dr. Michael Bohl. Dr. Bohl attended medical school at the University of Michigan and completed his residency at Barrow Neurological Institute. A U.S. Marine Corps Veteran, Dr. Bohl was involved in humanitarian aid missions in East Africa. While he was not considering medical school at the time, the impact of that experience led him to return to East Africa after leaving the Marine Corp to work as a nurses aid.

Dr. Bohl and Dr. Lakhia first differentiate between the terms ‘scoliosis’ and ‘spinal deformity’, which are frequently used interchangeably. (10:17) The latter is the umbrella term which describes a condition wherein the shape of the spine is leading to a problem. Scoliosis, on the other hand, is a type of deformity where the spine shows an S or C-shaped curve.

They examine the causes of pediatric spinal deformities and urge parents to be mindful of their child’s posture as they grow. (13:20) Indicators of pediatric scoliosis include a visible curve in the spine, a curve that worsens over time, and whether or not the spinal deformity is causing symptoms like pain or neurological symptoms. The goal of treatment is to keep the curve from getting worse, usually through minimally invasive methods like bracing and physical therapy. (16:32) And, as with many medical conditions, early intervention is the key to more successful outcomes. (21:21)

Scoliotic curves get worse during periods of active growth, so a brace can help stabilize and control the growth of the curve. (21:55) Early intervention is important here because once the curve reaches a certain severity the problem is likely to continue getting worse into adulthood. If bracing is ineffective and the curvature is becoming more sever, spinal surgery may be an option. However, in a pediatric patient, smaller, less invasive surgeries are performed to manage the curve and not impede the child’s growth. (25:10)

Candidates for surgery include curves greater than fifty degrees and curves that are rapidly progressing and not adequately responding to a brace. Dr. Bohl stresses that while surgical outcomes are overwhelmingly positive, non-surgical treatment options remain a priority for treating pediatric spinal deformities.

For more information on Dr. Sanjiv Lakhia and Back Talk Doc visit BackTalkDoc.com.

Diagnosing and Treating Upper Back/Thoracic Pain with Dr. Scott Otis

Sanjiv Lakhia - Carolina Neurosurgery & Spine Associates — Mon, 22 Feb 2021 03:00:00 -0400

We have addressed numerous aspects of low back pain from surgical angles to medications, nutrition, and injections on the podcast, but an increasing number of patients are also suffering from mid-back pain or “thoracic pain.”

On this episode of Back Talk Doc, Dr. Sanjiv Lakhia is joined by Dr. Scott Otis, a physiatrist at the Carolina Neurosurgery and Spine Associates, to discuss thoracic back pain. Dr. Otis attended medical school at The Ohio State University College of Medicine and completed his internship at Riverside Hospital in Columbus. Dr. Otis is currently affiliated with the American Academy of Physical Medicine and Rehab. An expert in electro-diagnostic medicine and interventional spine care, Dr. Otis works out of the main office in Charlotte.

Dr. Otis reveals why thoracic back pain is so challenging to diagnose, any pain experienced in that area of the body are often compensatory issues from neck or low back issues or referral pain from neck and low back issues that present as thoracic spine pain. (4:45) He also discusses non-spinal issues that cause pain and abnormalities, including GI issues, pulmonary and heart ailments, and liver disease. (07:34) The Doctors also cover other ailments including “White Collar Disease” (09:35), poor body posture, and how poor ergonomics in furniture lead to upper back pain. (09:18)

Dr. Otis also examines the methods physiatrists employ to evaluate back pain and stress the importance of ruling out non-spinal causes before arriving at a proper diagnosis. (10:30) Thoracic back pain treatment includes self-care, physical therapy, and in a few extreme cases, surgical intervention. (13:05)

More topics discussed on this episode include:

The effects of Scoliosis and osteoporosis (15:03)
How to prevent osteoporotic fractures (16:33)
The role of physical therapy in treating upper back pain (18:33)

If you enjoyed this episode of Back Talk Doc, check out our recent episode A Pain in the Neck (and Back!): How Technology, Stress, and Genetics are Leading to Aches and Pains With Dr. Sameer Vemuri

For more information on Dr. Sanjiv Lakhia and the podcast visit BackTalkDoc.com.

Subscribe in your favorite podcast app.

A Pain in the Neck (and Back!): How Technology, Stress, and Genetics are Leading to Aches and Pains With Dr. Sameer Vemuri

Sanjiv Lakhia - Carolina Neurosurgery & Spine Associates — Thu, 28 Jan 2021 10:30:00 -0400

By the numbers, a solid percentage of you are listening to this 29^th episode of Back Talk Doc on your mobile device or in front of your computer. You may be hunched over peeping at the show notes on the screen, a noticeable strain rippling down your back. Whether you’re experiencing back or neck pain as you’re reading these words, this episode is here to help.

On today's episode of Back Talk Doc, our host Dr. Sanjiv Lakhia is accompanied by Dr. Sameer Vemuri, a partner at Carolina Neurosurgery and Spine Associates. Dr. Vemuri works at the Ballantyne and Mathews offices. Board-certified in physical medicine and rehabilitation, Dr. Vermuri received his medical training at the American University of the Caribbean School of Medicine, then went on to intern at Providence Hospital and Medical Center in Michigan. (2:27)

Dr. Lakhia and Dr. Vemuri discuss the burden of spine care in the United States. Both men care for a tremendous number of patients suffering from neck and back pain, with many patients suffering from both. Dr. Vemuri reveals four common factors leading to back pain: (1) genetics, (2) day-to-day stresses, (3) acute injuries, and (4) a big factor both doctors see: the use and overuse of technology devices. (8:59)

"Technology and our phones and our devices has really taken over our life and forced all of us to be looking down constantly and promoting somewhat of a rounded posture." (9:31) Dr. Vemuri explains that these postures place strain on the structural cervical spine in the neck region. "Eventually, you're going to have some changes in the structural anatomy of that spine, and afterwards, you're going to have more chances of irritation of some of these nerves that come through that spinal area." (10:27)

More topics discussed on this episode include:

Providing patients with realistic expectations during the healing process (23:43)
The importance of mind-body connections when discussing back and neck pains. (26:36)
When a headache is more than just a headache: how to know when back and neck problems are leading to headaches. (31:36)

For more information on Dr. Sanjiv Lakhia and the podcast visit BackTalkDoc.com.

Electrical Stimulation Devices for Back Pain

Sanjiv Lakhia - Carolina Neurosurgery & Spine Associates — Thu, 07 Jan 2021 11:15:00 -0400

While COVID-19 has the headlines, for many, 2020 has also become synonymous with back pain. Working from home has cast many people from their ergonomic office chairs to couches, spare bedrooms, and dining room chairs.

On this episode, our Back Talk Doc, Dr. Sanjiv Lakhia, explores the benefits of utilizing electrical stimulation to combat those work-from-home back pains. Electrical stimulation, a form of neuromodulation, is essentially applying different types of electrical or electricity-based products and magnetic-based products to influence the physiology of your nervous system, that is, the brain, spinal cord, or peripheral nervous system. (3:46)

Dr. Lakhia identifies and briefly reviews three of the most common electrical stimulation devices.

TENS unit (4:50): TENS stands for transcutaneous electrical nerve stimulation and is available at any local pharmacy. The cost ranges from $50 to a couple of hundred dollars. The TENS unit stimulates the sensory nerves to block pain signals and generate endorphins. It is often used for the treatment of acute post-operative pain and chronic intractable pain. The downside to TENS is that it provides very short-term relief, sometimes providing relief only while being used, with a maximum relief window of 3-4 hours.
Alpha-Stim (8:45): Alpha-Stim waveform electrotherapy is FDA approved for the treatment of chronic pain, anxiety, and depression and is one of the more well-researched neuromodulation devices for pain. The Alpha-Stim works with small electrodes that clip to your earlobe and send a low microcurrent 0.5-hertz frequency wave through cranial nerve connections from the ear into the deep pain centers of the brain. This can stimulate the brainstem as well as the cortex and affect serotonin, norepinephrine, other neurotransmitter levels. The Alpha-Stim can also be used with wand-like electrode probes that can be applied to each side of an affected area. The probes send quick electrical pulses to the area. The Alpha-Stim may also provide relief to patients suffering from insomnia and other back pain-related sleep problems.
H-Wave (15:42): H-Wave is a multi-functional electrical stimulation device intended to speed recovery, restore function, and manage chronic, acute, or post-operative pain. The H-Wave delivers a low voltage current that promotes injury recovery and rehabilitation by stimulating muscles and can help prevent disuse atrophy. The H-Wave can provide significant relief, and, like the Alpha-Stim, it appears that the benefits of H-Wave are cumulative and lasting. So, over time, you get better and better results the more you use it. And it's an alternative to the use of prescription pain medication. The typical session lasts around 30 to 60 minutes. H-Wave is available both by prescription and offered as an OTC model.

For more information on Dr. Sanjiv Lakhia's practice, visit BackTalkDoc.com

Top 10 Gifts for a Healthy Spine

Sanjiv Lakhia - Carolina Neurosurgery & Spine Associates — Wed, 16 Dec 2020 16:15:00 -0400

While the holiday season is known for evoking feelings of joy and merriment, we know that back pain can dampen even the most festive of spirits. That’s why we’re devoting this episode to our Top 10 Gift Ideas to promote a healthy spine. If you have a friend or family member struggling with back issues this holiday season, consider a gift that will help them stay active and pain-free in 2021.

1. Traditional Medicinal Tea. Medicinal teas are available at most grocery stores, and many contain ingredients like ginger, turmeric, and meadowsweet that can reduce inflammation in the body and control or modulate your immune system. Dr. Lakhia’s favorite Tumeric with Meadowsweet & Ginger $5.79/box.

2. Lumbar Support. Whether you suffer from back pain or not, we can all benefit from lumbar support. A lumbar support is a cushion intended to help create proper lordosis, or proper curvature, in your low back. You can use a lumbar in any of your chairs. Dr. Lakhia recommends the Core Products Small Inflatable Lumbar Cushion $30.

3. Foam Roller. A foam roller is a cylindrical tool that you can use almost as a portable massage therapist. Placing it on the ground, you use the roller to target problem areas. A quick search on YouTube will return numerous exercise options. Dr. Lakhia recommends getting two sizes, a smaller one and a longer one, to target specific areas. Foam rollers are a cheap and critical tool to have in the toolbox as you battle any sort of back issue. Try the Gimmer 10 Foam Roller $23.

4. Thera Cane. A Thera Cane is a handheld tool for self-treating myofascial trigger points and tender points in your back, hip, and pelvis. The Thera Cane’s design allows you to get leverage to address your pain points if no one is around to assist you. Dr. Lakhia recommends the Body Back Buddy Elite $30.

5. Trigger Point Manual. If you’re purchasing a Thera Cane, you will also want to pick up the Trigger Point Manual. It’s a patient education manual and it shows you where you can find all the trigger points. (Learn more about trigger points in our episode on Acupuncture vs. Dry Needling) Trigger Point Therapy Workbook $20.

6. HeartMath. HeartMath is a biofeedback tool that provides you with guided breathing exercises to help you develop what’s called heart and brain coherence, where the energy of your heart center can become in tune with the energy of your brain. The HeartMath tool takes you through daily breathing exercises. Over time, it can improve your heart rate variability, which means you’re lowering your stress and boosting your immune system and overall health. HeartMath $120

7. Venom Back Brace. The Venom brace is like a portable physical therapy gym, allowing you to treat yourself on the go with built-in deep heat and vibration. Venom Brace from Hyperice $199.

8. Oura Ring. The Oura Ring is a premium sleep tracker that tracks your sleep time, sleep cycles, and helps you understand how your daily habits help or hinder your sleep. OuraRing.com $299.

9. HigherDOSE Infrared Sauna Blanket. With amethyst, tourmaline, and charcoal in the cover, the sauna blanket is going to heat you up, promote detoxification, and relax your muscles. It’s also incredibly portable and comes at a fraction of the price tag of a traditional sauna. (Listen to this episode where Dr. Lakhia discusses the far-infrared sauna) Dr. Lakhia cautions you to stay hydrated and replenish your electrolytes with coconut water or another natural, low-sugar beverage. HigherDOSE Infrared Sauna Blanket $499.

10. Original Mattress Company Orthopedic Ultra Plush Mattress. One of the top questions doctors receive about back pain is, “what mattress should I use?” This can be a hard question to answer because, like finding a good pair of shoes, mattresses are a highly personalized experience. What works wonders for one person may be awful for another. With that said, Dr. Lakhia recommends the Original Mattress Factory Orthopedic Ultra Plush Mattress. The mattresses are composed of high-quality materials, the prices are reasonable, and the company stands by its products. Original Mattress Factory Orthopedic Ultra Plush Mattress Set $600-$1300.

With something on here for everyone’s price point, we hope these products can provide some value and relief to you or a loved one this holiday season. If you have a limited budget and really can only go for one of these things, Dr. Lakhia recommends the foam roller. It’s an incredibly useful tool that any physical therapist would likely recommend.

For more information about our sponsor, QxMD, visit qxmd.com, or email contact@qxmd.com. To try QxMD’s apps, download them on your device’s app store or follow these links: Calculate by QxMD, Read by QxMD, Learn by QxMD.

For more information on Dr. Sanjiv Lakhia’s practice, visit BackTalkDoc.com

QxMD, Mobile Solutions That Drive Evidence-Based Medicine with Dr. Daniel Schwartz

Sanjiv Lakhia - Carolina Neurosurgery & Spine Associates — Fri, 27 Nov 2020 14:37:00 -0400

Because medicine is in a perpetual state of evolution, it is incumbent upon medical practitioners to be lifelong learners, always sharpening their intellect and skillset. In recent years, much of this continuing education has become reliant on technology. While clinicians have access to scientific journals, magazines, blogs, podcasts, and other digital sources at their fingertips, quickly accessing full research articles continues to be a hindrance. Enter QxMD, a company designing apps to help clinicians keep up with the latest research and integrate decision support tools into their practices.

On today’s episode of Back Talk Doc, Dr. Lakhia welcomes the co-founder of Back Talk doc’s new sponsor, QxMD, Dr. Daniel Schwartz. Dr. Schwartz is a practicing kidney doctor, nephrologist, clinical educator, and vice president of WebMD. Additionally, he’s the medical director of a regional home dialysis program and a clinical assistant professor of medicine at the University of British Columbia.

Dr. Schwartz shares his experience building QxMD. From starting with a product with no commercial strategy to an eventual partnership with WebMD, Dr. Schwartz reveals how solving his own problem led him to designing a service focused on making it easier for doctors and other healthcare providers to access relevant medical literature. Dr. Schwartz also walks us through three of QxMD’s innovative products: Calculate, Read, and Learn.

Highlights from the episode:

Dr. Schwartz’s path from clinician to entrepreneur (03:37)
On building a useful product and then finding a pathway to profit (06:52)
What is QxMD? (09:39)
Overcoming access to information obstacles (13:45)
The birth of QxMD (17:13)
The relationship between QxMD and WebMD. (22:43)
What’s on the horizon for QxMD (28:01)
Health hacks from Dr. Daniel Schwartz (30:13)

For more information about QxMD visit qxmd.com, or email contact@qxmd.com. To try QxMD’s apps, download them on your device’s app store or follow these links:

Calculate by QxMD, Read by QxMD, Learn by QxMD.

For more information on Dr. Sanjiv Lakhia’s practice, visit BackTalkDoc.com

Regenerative Spine & Orthopedic Medicine with Dr. John Lesher

Sanjiv Lakhia - Carolina Neurosurgery & Spine Associates — Fri, 13 Nov 2020 14:45:00 -0400

From Kim Kardashian getting a vampire facial to Hines Ward's extraordinary knee recovery in the weeks leading up to the 2009 Super Bowl, regenerative medicine has gained a tremendous amount of interest in both the lay population and the scientific community. This medical-assisted self-healing process has helped athletes including Tiger Woods, Kobe Bryant and other high-profile celebrities not only overcome injuries but increase their recovery times.

On this special one-year anniversary episode of Back Talk Doc, Dr. Lakhia welcomes Dr. John Lesher to discuss regenerative spine and orthopedic medicine, including the use of platelet-rich plasma (PRP) injections and stem-cell therapy. Dr. Lesher is board certified in physical medicine and rehabilitation with subspecialty certifications in sports medicine, electrodiagnostic medicine, and certification in musculoskeletal ultrasound.

Dr. Lesher shares his experience and knowledge in regenerative spine and orthopedic medicine from a personal and professional perspective. Given his background in athletics, he also discusses regenerative medicine and its applications in the sports arena.

Highlights from the episode:

What we mean when we say “regenerative medicine” (8:32)
Examples of medical-assisted self-healing (9:47)
Stem Cells 101 (14:01)
Joint arthritis: the difference between corticosteroid injections vs stem cells or PRP (20:22)
Effectiveness of regenerative medicine options: joints and tendons (23:34)
The role for regenerative medicine in spine care (32:45)
The future of regenerative medicine (43:26)
Dr. John Lesher’s personal health tips (46:19)
Dr. John Lesher’s podcast recommendations (48:03)

Resources mentioned on this episode:

Prospective study of disc repair with allogeneic chondrocytes presented at the 2012 Joint Spine Section Meeting by Coric D, Pettine K, Sumich A,
Mesoblast Study by Mesoblast the regenerative medicine company
Cell-based therapy for spinal disc regeneration by Coric D.
Clinical Study to Evaluate the Safety and Preliminary Efficacy of IDCT, a Cell Therapy to Treat Moderate, Symptomatic Lumbar Degenerative Disc Disease by Silverman L, Coric D, Foley K,
British Journal of Sports Medicine
Outside podcast
The Peter Attia Drive Podcast
The People's Pharmacy

For more information on Dr. Sanjiv Lakhia’s practice, visit BackTalkDoc.com

If you enjoyed this episode of Back Talk Doc, check out our episode Introduction to Spinal Artificial Disc Replacement Surgery with Dr. Dom Coric.

Using an Inversion Table for Back Pain: Is It Safe?

Sanjiv Lakhia - Carolina Neurosurgery & Spine Associates — Mon, 26 Oct 2020 03:00:00 -0400

In the world of back pain, there are a variety of vendors in the marketplace offering purported solutions. And, with patients searching for alternatives to injections, physical therapy, surgery, and traditionally prescribed medications, the market for these alternatives treatments is booming. With these solutions ranging in efficacy from widely accepted remedies to ineffective and potentially harmful, how do you know what is and isn’t safe? Welcome to Back Talk Doc.

In this episode, Dr. Sanjiv Lakhia is taking on gravity-assisted devices, more commonly known as inversion tables. Dr. Lakhia reveals his personal experience and research with inversion tables and addresses the most common questions he receives from patients: “When I tilt on [the inversion table], it helps. But, is that safe? Is this something that's effective? Something that I should use?"

Dr. Lakhia presents two studies on inversion therapy, explaining the methodology of the studies, and the conclusions presented. Dr. Lakhia then provides examples of how to perform common gravity-assisted interventions for low back pain.

Highlights from the episode:

· Inversion Therapy in Patients with Pure Single-Level Lumbar Discogenic Disease: A Pilot Randomized Trial (02:16)

· What is an inversion table? (04:14)

· Lumbar decompression (5:08)

· Warnings about using gravity-assisted devices (9:47)

· The Effects of Aquatic Exercise Programs on Low Back Pain Disability in Obese women. (11:17)

· Summary of the two research articles (16:56)

Resources mentioned on this episode:

· Inversion Therapy in Patients with Pure Single-Level Lumbar Discogenic Disease: A Pilot Randomized Trial by Prasad KS, Gregson BA, Hargreaves G, Byrnes T, Winburn P, Mendelow AD.

· The Effect of Aquatic Exercise Program on Low Back Pain Disability in Obese women. by Abadi, F. H., Sankaravel, M., Zainuddin, F. F., Elumalai, G., & Razli, A. I.

For more information on Dr. Sanjiv Lakhia’s practice, visit backtalk.com

If you enjoyed this episode of Back Talk Doc, check out our episode Worth a Shot? Spinal Injections with Dr. Andrew Sumich.

Golf Rehabilitation and Fitness with Dr. Graham Claytor

Sanjiv Lakhia - Carolina Neurosurgery & Spine Associates — Sun, 11 Oct 2020 03:00:00 -0400

If you live or work in the Carolinas, you probably either play golf or have a friend or loved one that plays. Golf is an excellent sport for children and retirees alike and a popular activity for competitive exercisers that don’t want to strain their bones and muscles in high-impact sports. However, golf can also lead to its fair share of aches and pains, so today’s episode focuses on preventing and treating golf-related injuries.

On this episode of Back Talk Doc, our host Dr. Sanjiv Lakhia welcomes Dr. Graham Claytor, Director of the Physical Therapy at Carolina Neurosurgery & Spine Associates, to explore his golf rehabilitation and fitness programs. While Dr. Claytor admits physical therapy wasn’t a childhood dream, a combination of family and educational experiences ignited his passion for patient work.

After several years in private practice, Dr. Claytor met professional golf agent Thomas Parker, catapulting him into his niche in golf rehabilitation and therapy, “look, I have a lot of guys that need this kind of specific golf treatment and there’s not really anybody around here that’s doing this. There are places in Florida, whether it’s a golf mecca, there are places in California, but there’s not really this niche in Charlotte.” (7:28)

Dr. Claytor explores his TPI certified program, The Golf Rehabilitation and Fitness Program, his typical patients, and a number of recommended exercises. He also reveals the preventative benefits of the golf rehab program and available recovery resources for patients, “any of Greg Cook’s stuff is very good. And any of the Sea Island golf pro guys that are trainers down there, Randy Myers, some of the golf fit pro apps are very good to go see. (31:28)

To learn more about Dr. Graham Claytor’s Golf Rehabilitation and Fitness Program, visit GolfRehabAndFitness.com. For more information on Dr. Sanjiv Lakhia and treatment options for back issues, visit backtalkdoc.com

If you enjoyed this episode with Dr. Graham Claytor, check out our episode on Health Care and Spirituality, with Dr. John Welshofer.

Back Talk Doc is brought to you by Carolina Neurosurgery & Spine Associates, with offices in North and South Carolina. To learn more about Dr. Lakhia and treatment options for back and spine issues, go to backtalkdoc.com. To schedule an appointment with Carolina Neurosurgery & Spine Associates, you can call us at 1-800-344-6716 or visit our website at carolinaneurosurgery.com

Health Care and Spirituality, with Dr. John Welshofer

Sanjiv Lakhia - Carolina Neurosurgery & Spine Associates — Fri, 18 Sep 2020 03:00:00 -0400

Imagine you suffer from a painful disc injury that prevents you from engaging in many of your daily activities. For most people, the obvious course of action is to go see your doctor, where it’s likely you’ll have a physical examination and be prescribed medications and/or surgery. At the end of this course of treatment, you hope to be pain-free and back to your daily routine. Many patients never stop to ask themselves, “is there anything else I could be doing to improve my circumstances?” Dr. John Welshofer would answer you with an emphatic “yes!,” and he’s here today to tell you why.

While the idea of spirituality can be off-putting for some, a growing number of physicians believe spirituality can play a significant role in our physical and emotional health. On this episode of Back Talk Doc, our host, Sanjiv Lakhia, speaks with Dr. John Welshofer, a physician that believes in integrating faith and spirituality into the healing process. Always a science-minded person, Dr. Welshofer became interested in medicine after a severe car accident left a close friend paralyzed from the waist down. (2:17) After his residency in physical medicine and rehabilitation, he regularly dedicated his time to medical mission trips, where he served in communities that lacked health care.

Wanting to give back and serve others, Dr. John Welshofer traveled with the Bless Back Worldwide organization to Haiti and Nicaragua to provide care for underserved communities. For Dr. Welshofer, this experience gave him perspective on how fortunate he was to live in the United States. “[I]t makes you very appreciative of what you have, but also sort of stokes the fires of trying to help others beyond just your own comfort zone.” (6:05) While Dr. Welshofer encountered some truly devastating cases, the positive metamorphosis he observed over the course of return trips showed him the power of the human spirit to make the most amazing things out of the most horrendous circumstances. (7:21)

Dr. Lakhia and Dr. Welshofer go on to explore the weighty question of whether doctors should discuss religious or spiritual beliefs with patients. Dr. Welshofer avoids spiritual questions, instead opting to approach the topic with subtlety. “I don’t really overtly do spiritual histories…I more just try to provide hope for people that don’t seem to have hope when day-to-day they’re going through significant difficulties. (11:52)

While a Doctor should avoid imposing their beliefs on patients, Dr. Welshofer encourages physicians to speak to their patients about their spiritual connections using open-ended questions, as it can help them maintain hope in desperate times, “don’t be afraid to ask a question, if it’s a benign question, you’re not forcing anything, just…how are you doing emotionally and spiritually with your problems?” (21:25)

Having treated thousands of patients in his career, Dr. Welshofer has identified two types of doctors, “You have doctors who treat the problems people have, and then you have doctors who treat people that have problems. If you're a problem treater, you get burned out. Because if all day long, you see 30, 40 patients…all day long it’s people bringing problems. As opposed to, if you're a people treater, then you get to know the patient and then the patient becomes personal to you. So, it's no longer ‘I'm treating the disc problem that Nancy has, I'm treating Nancy that has a disc problem,’ and there's a huge difference. (19:20)

Resources Mentioned In This Episode:

To contact Dr. Welshofer and Dr. Lakhia’s or to learn more about their practice, visit cnsa.com.

If you enjoyed this episode of Back Talk Doc, check out our episode The Recommended Diet to Reduce Inflammation.

Physical Therapy and Health Tips for Patients with Back Pains, With Dr. Eleanor McMillan

Sanjiv Lakhia - Carolina Neurosurgery & Spine Associates — Wed, 02 Sep 2020 15:00:00 -0400

Do you frequently suffer from back pain and don’t know the right way to treat them? Or do you think your home exercises are making the pain worse? Patients often mistake the difference between being physically active versus going to physical therapy to treat a specific injury, causing them to worsen the pain and fail to properly recover from herniated discs or muscular back strains.

In this episode of Back Talk Doc, our host Dr. Sanjiv Lakhia, welcomes Dr. Eleanor McMillan, a physical therapist who loves to exercise and enjoy a healthy lifestyle; she’s also helped numerous patients recover from painful back injuries. Dr. McMillan shares the virtues of physical therapy and how it can help you regain control of your life when suffering from back pain.

Dr. McMillan stresses that physical therapy has a specific purpose, a particular strength, and a frequency to help people; all patients are different, and you may wonder, what makes my pain better? What makes it worse? “Are your hamstrings tight? Are your hips weak? What’s your core look like? Or are your hip flexors very tight because we’re sitting at an office desk all day? Those are the kinds of things that we…look at.” (12:17)

Primarily, she wants to give her patients their lives back when they feel there is nothing they can do, like activities around the house or even gardening. “It’s just…teaching them activity modification, getting them the right dosage of standing tolerance, activity tolerance, how we can kind of slowly manipulate those variables to help out the patient and kind of give them their life back because they feel like they can’t do anything!” (16:44)

Dr. McMillan also tells us the steps to follow after recovering from disc or sciatic pain; how important it is to maintain your cardiovascular activity and the different exercises that can be done from home so as not to fall into the same physical pains again: ellipticals, swimming, static bicycles, etc.

For more information on patient education, visit our webpage backtalkdoc.com.

If you enjoyed this episode with Dr. Eleanor McMillan, check out our episode on Spinal Stenosis with Joe Cheatle MD.

Back Talk Doc is brought to you by Carolina Neurosurgery & Spine Associates, with offices in North and South Carolina. To learn more about Dr. Lakhia and treatment options for back and spine issues, go to backtalkdoc.com. To schedule an appointment with Carolina Neurosurgery & Spine Associates, you can call us at 1-800-344-6716 or visit our website at carolinaneurosurgery.com.

Innovations in Spine Surgery with Dr. Chris Holland

Sanjiv Lakhia - Carolina Neurosurgery & Spine Associates — Mon, 17 Aug 2020 03:00:00 -0400

Although advancements in technology have made many things possible in medicine, particularly in the surgical aspect, robotics is still somewhat a relatively new concept. This sector is gaining traction in the market, but you won’t find robots in most hospitals in the U.S.

In this episode of Back Talk Doc, Dr. Sanjiv Lakhia is joined by neurosurgeon Dr. Chris Holland to explore surgical robots utilized in spine surgery. Chris goes in-depth into what surgical robots are, how these work, and how they’re adopted in the OR for neurosurgery or spine surgery. He emphasizes that these devices are not like what you would see in sci-fi movies. Rather, they comprise of a multi-articulating arm and an instrument at the end that performs a function.

He also speaks briefly on the history of surgical robots and their differences between the da Vinci robot. For the latter, the spine surgery robot is used as a guide for the correct placement of hardware, like screws or interbody cages. The benefits of using a robot and other challenges to adopting it in the OR were also discussed.

Chris has a positive outlook on future innovations in the industry, which will provide increased safety and accuracy, along with lower morbidity rates among patients.

Key Moments in the Episode

What is a surgical robot 09:22

How surgical robots work 11:26

Robots in spine surgery 13:06

Benefits of using a surgical robot 15:13

Challenges to adopting robotics in spinal surgery 23:03

Certifications and training 25:14

The da Vinci robot 27:14

The difference of spine surgery robots 29:23

Future innovations in spine surgery 30:27

Dr. Chris Holland's tips for health and wellness 33:00

Every episode of Back Talk Doc includes a Health Matters segment intended to provide actionable health information you can immediately put into practice in your life. This week, Dr. Lakhia talks about magnesium, an important mineral to maintain good health and well-being. He shares the benefits of magnesium, which include muscle relaxation, energy production, improved bone formation, and growth, There’s also a correlation between magnesium levels and back pain.

He also gives recommendations on what formulation of the mineral to take, including magnesium oxide and magnesium citrate.

Links Mentioned in the Episode

Neurosurgical Robotics: A Review of Brain and Spine Applications - Journal of Robotic Surgery

Back Talk Doc is brought to you by Carolina Neurosurgery & Spine Associates, with offices in North and South Carolina. To learn more about Dr. Lakhia and treatment options for back and spine issues, go to backtalkdoc.com. To schedule an appointment with Carolina Neurosurgery & Spine Associates, you can call us at 1-800-344-6716 or visit our website at carolinaneurosurgery.com.

Introduction to Spinal Artificial Disc Replacement Surgery with Dr. Dom Coric

Sanjiv Lakhia - Carolina Neurosurgery & Spine Associates — Mon, 03 Aug 2020 03:00:00 -0400

Replace defective joints in the knee and hips is not unheard of and there’s a big chance that you or someone you know has had this surgery done. But can this type of procedure be done to address issues in the spinal region?

In this episode of Back Talk Doc, Dr. Sanjiv Lakhia is joined by Dr. Dom Coric, who is an expert in spine trauma, spine surgery, and in particular, spinal arthroplasty. They dive deep into all aspects of artificial disc replacement surgery in the neck and lower back. Dom describes what happens during this type of procedure, which involves replacing the structural problem with an artificial disc, instead of the normally used spacers, rod screws, plates, etc. He also talks about the types of artificial discs that are typically used, how they have evolved through the years, and the differences between those that are utilized for the neck versus the lower back.

Dom discusses some exclusion criteria for artificial disc surgery. This procedure is recommended only for discs that are younger and don’t have spondylosis or wear and tear changes. Having healthy lumbar facet joints is an important factor as well.

Although this is a fairly new area in spine surgery and results are more visible long-term, there is a lot of cutting-edge research being conducted. And so far, the medical community is expecting positive outcomes with artificial disc replacement surgery.

Key Moments in the Episode

What is artificial disc replacement surgery 06:27

Incidence of sacroiliac joint pain after lumbar fusion surgery 12:06

What is an artificial disc 13:19

Artificial disc for the lumbar spine 17:18

Types of devices for low back versus neck 18:49

Exclusion criteria for artificial disc surgery 19:55

Positive outcomes for disc replacements in the neck and low back 21:30

Decrease in incidence of adjacent level disease with disc replacement surgery 22:35

Shelf-life of disc replacement devices 24:17

Lumbar facet joints 26:32

Dr. Dom's go-to health habits 30:13

Back Talk Doc is brought to you by Carolina Neurosurgery & Spine Associates, with offices in North and South Carolina. To learn more about Dr. Lakhia and treatment options for back and spine issues, go to backtalkdoc.com. To schedule an appointment with Carolina Neurosurgery & Spine Associates, you can call us at 1-800-344-6716 or visit our website at carolinaneurosurgery.com.

What’s the Point? Acupuncture vs Dry Needling

Sanjiv Lakhia - Carolina Neurosurgery & Spine Associates — Mon, 20 Jul 2020 03:00:00 -0400

Aside from clinical treatments for back pain and pain in general, acupuncture and dry needling are increasingly becoming part of treatment plans prescribed by physicians. However, there are misconceptions about these two interventions, with people often interchanging one for the other.

In this episode of Back Talk Doc, Dr. Sanjiv Lakhia goes into a discussion on dry needling and acupuncture and the significant differences between these two treatment options. It’s not so much as which is more effective than the other, but rather which intervention is the best course of action for your specific issue.

Generally speaking, acupuncture involves the insertion of needles in certain areas of the body to trigger positive physiologic responses. In dry needling though, your physician or physical therapist has to look at nerve and muscle patterns to identify and stimulate trigger points. While acupuncture is more of a system of care that can normalize other issues in the body as well.

He dives deep into the various scientific research studies that show the efficiency and benefits of these two interventions. These include increased blood flow to the pain area, releasing endorphins, a natural pain-relieving hormone, decreasing muscle banding, and triggering other sympathetic responses.

Dr. Sanjiv emphasizes that both dry needling and acupuncture are great additions to a comprehensive treatment plan. It’s important to consult with your physician to see whether these interventions can help alleviate and manage your back pain.

Key Moments in the Episode

History of acupuncture 02:51

Origins of dry needling 04:24

Scientific research on dry needling and acupuncture 07:23

Physiologic research studies on acupuncture 11:10

Physiologic research studies on dry needling 12:42

Trigger points 15:02

Benefits of dry needling 16:27

Differences in acupuncture and dry needling 18:15

Contraindications 20:36

Resources on dry needling and acupuncture 22:45

Links Mentioned in the Episode

Glute power with Ryan Klomparens, PT

All About the Thoracic Outlet Syndrome

Myofascial Pain and Dysfunction, The Trigger Point Manual

The Gunn Approach to the Treatment of Chronic Pain: Intramuscular Stimulation for Myofascial Pain of Radiculopathic Origin

Acupuncture Energetics: A Clinical Approach for Physicians by Dr. Joseph Helms

Getting to Know You: A Physician Explains How Acupuncture Helps You Be the Best YOU by Dr. Joseph Helms

Back Talk Doc is brought to you by Carolina Neurosurgery & Spine Associates, with offices in North and South Carolina. To learn more about Dr. Lakhia and treatment options for back and spine issues, go to backtalkdoc.com. To schedule an appointment with Carolina Neurosurgery & Spine Associates, you can call us at 1-800-344-6716 or visit our website at carolinaneurosurgery.com.

All About the Thoracic Outlet Syndrome

Sanjiv Lakhia - Carolina Neurosurgery & Spine Associates — Mon, 06 Jul 2020 03:00:00 -0400

Besides cases of lower back pain, another common problem that most people face is neck pain. In severe instances, the pain shoots from the neck to the arm, which can lead to numbness and immobility. One condition that is often difficult to diagnose is the Thoracic Outlet Syndrome (TOS).

In this episode of Back Talk Doc, Dr. Sanjiv Lakhia is joined by Carolina Neurosurgery & Spine Associates’ nurse practitioner Emily Tucker and physical therapist Jay Murugavel in this roundtable discussion on TOS. Drawing from his expertise, Jay dives into what the thoracic outlet is and what causes pain in this particular spinal region. He talks about the various occupational risk factors connected to this condition, including certain sports like baseball and swimming, and working for long periods in awkward positions. You should also look out for things such as predisposing injury and congenital anomalies that can exacerbate

Treatment options such as surgery and physical therapy were also described, which are going to vary depending on the assessment of the patient’s clinical state. The goal is to minimize stiffness in the muscles and promote joint mobility. Breathing patterns also play a huge role in recovery and Jay encourages regular diaphragmatic breathing.

Emily provides valuable insight as well by sharing her personal experience with TOS, from diagnosis to treatment, and how she continues to manage her pain. She highlights the importance of listening to your body and your physicians and being compliant with the treatment plan devised by your medical team.

Key Moments in the Episode

Emily's experience with thoracic outlet syndrome 03:47

Consulting with a specialist 08:40

Course of treatment 11:16

What is the thoracic outlet 13:56

Occupational risk factors 15:11

Anatomical structures that lead to TOS 17:21

Difference between cervical radiculopathy and TOS 20:10

How to approach patients seeking treatment for TOS 24:02

Influence of breathing patterns on TOS 28:41

Activities to promote better posture 32:41

Looking beyond the spine to better diagnose and treat TOS 35:01

Jay and Emily’s health tips 37:40

Links Mentioned in the Episode

Top 5 Non-Disc Causes of Low Back Pain and Sciatica

Back Talk Doc is brought to you by Carolina Neurosurgery & Spine Associates, with offices in North and South Carolina. To learn more about Dr. Lakhia and treatment options for back and spine issues, go to backtalkdoc.com. To schedule an appointment with Carolina Neurosurgery & Spine Associates, you can call us at 1-800-344-6716 or visit our website at carolinaneurosurgery.com.

Picture this: Understanding spinal imaging

Sanjiv Lakhia - Carolina Neurosurgery & Spine Associates — Mon, 22 Jun 2020 03:00:00 -0400

One of the most common responses to feeling back pain is asking your physician for an x-ray to determine what’s causing it. However, the process of coming to diagnosis to properly treat any pain goes more than just reading off of an x-ray or MRI test result.

In this episode of Back Talk Doc, Dr. Sanjiv Lakhia gives a rundown on how physicians determine the proper dedicated imaging option needed for a patient. Numerous factors affect decision-making as each scenario is different. First, the doctor takes a look at the medical history and identifies any red flags such as a history of cancer, unexplained weight loss, and other neurological symptoms.

For many cases, if there are no alarming red flags, then conservative care is suggested first before undergoing any type of imaging test. When the pain isn’t managed after, then the physician may require either an x-ray, MRI, or CAT or bone scans. Dr. Sanjiv also discusses the best and most effective imaging option for certain spine conditions, including herniated discs, spinal infections, osteoporosis, cancer, and other rare conditions.

At the end of the day, if your physician does not suggest any type of imaging, then you may have a low risk for any serious condition. Conservative care is always recommended to spare you any unnecessary testing and radiation. The majority of low back pain, in particular, is going to be self-limiting and with the proper management will resolve after some time.

Key Moments in the Episode

Red flags that affect the physician's decision-making process 03:19

Low back strain 08:10

Radiculopathy 09:30

Herniated disc 10:43

Considerations bout gadolinium 12:45

Lumbar spinal stenosis 13:13

Cauda Equina Syndrome 15:27

Spinal infection 16:24

Malignancy or cancer 17:44

Osteoporosis 20:43

Disc herniations 22:14

Links Mentioned in the Episode

The Use of Imaging in the Management of Patients With Low Back Pain by Dinesh Rao

Worth a Shot? Spinal Injections with Dr. Andrew Sumich

Cutting Edge Surgery with Dr. Mark Smith

The Narrowed Path, Understanding Spinal Stenosis with Joe Cheatle MD

Back Talk Doc is brought to you by Carolina Neurosurgery & Spine Associates, with offices in North and South Carolina. To learn more about Dr. Lakhia and treatment options for back and spine issues, go to backtalkdoc.com. To schedule an appointment with Carolina Neurosurgery & Spine Associates, you can call us at 1-800-344-6716 or visit our website at carolinaneurosurgery.com.

Food is Medicine: The Benefits of Olive Oil

Sanjiv Lakhia - Carolina Neurosurgery & Spine Associates — Mon, 01 Jun 2020 03:00:00 -0400

Managing inflammation and back pain goes beyond taking medication and undergoing surgeries or therapy. It requires overhauling your lifestyle to one that will support your healing, which involve taking care of your mental well-being, regular exercise, and a nutrition-dense diet. One of the food plans that is known for its anti-inflammatory benefits is the Mediterranean Diet, of which olive oil is a key component.

In this episode of Back Talk Doc, Dr. Sanjiv Lakhia speaks to Mary Mori, director for technical services at California Olive Ranch on olive oil. She talks about the olive fruit itself, the different methods of making olive oil and its different variants and how to store it properly in your pantry.

Mary recommends using extra virgin olive oil, for its naturally occurring phenols, as well as the presence of antioxidants, unsaturated fats and fatty acids. These contribute to the anti-inflammatory, cardiovascular and skin benefits that olive oil brings. Additionally, she gives tips on how you can use olive oil in your day-to-day life. Besides cooking with it and adding it to smoothies and ice cream, you can include it in your skincare routine as an exfoliant or moisturizer.

There are many advantages to incorporating olive oil in your everyday diet to minimize inflammation, without adding toxic medications to your body.

Key Moments in the Episode

Process of making olive oil 07:49

Life cycle of an olive 11:28

Difference between black and green olives 12:35

Difference between the fruit and olive oil in terms of taste 14:02

Regions famous for olive gardens and high-quality olive oil 15:22

How to determine the quality of the olive oil 16:57

How to store olive oil 19:36

Explaining the dates on olive oil bottles 21:05

Extra virgin olive oil 22:52

Phenol content in olive oil for health 26:01

Olive oil's anti-inflammatory benefits 28:19

Benefits of eating whole olives 29:53

How to adopt olive oil in your diet 31:21

Avocado oil as a great alternative 33:10

Benefits of replacing you roil with olive oil 33:34

Personal tips to stay healthy 35:33

Links Mentioned in the Episode

California Olive Ranch

California Olive Ranch Instagram

California Olive Ranch Facebook page

Back Talk Doc: The Recommended Diet to Reduce Inflammation

Back Talk Doc is brought to you by Carolina Neurosurgery & Spine Associates, with offices in North and South Carolina. To learn more about Dr. Lakhia and treatment options for back and spine issues, go to backtalkdoc.com. To schedule an appointment with Carolina Neurosurgery & Spine Associates, you can call us at 1-800-344-6716 or visit our website at carolinaneurosurgery.com.

Top 5 Non-Disc Causes of Low Back Pain and Sciatica

Sanjiv Lakhia - Carolina Neurosurgery & Spine Associates — Mon, 18 May 2020 03:00:00 -0400

If you are experiencing lower back pain or sciatica, it’s important to determine its cause for proper treatment and better pain management. However, there are some cases where patients, who reported to have issues in this region, find out through medical diagnosis that the cause is not rooted in bulging or degenerative lumbar discs.

In this episode of Back Talk Doc, Dr. Sanjiv Lakhia dives deep into the top 5 reasons behind your lower back pain. These are the piriformis syndrome, sacroiliitis, lumbar and gluteal trigger point syndrome, hamstring strains and lumbar facet referral pain patterns. Most of these are related to certain muscle groups in the lower region of the body and spinal joints. He discusses the causes behind each condition, common symptoms, ways to diagnose these and treatment options.

He also points out to thoracic myelopathy, a serious upper back condition that not only causes lumbar pain, but dysfunction of the spinal cord as well.

For Dr. Lakhia, it’s important that you always refer to a specialist or skilled practitioner to properly diagnose your pain. They are able to give you the best treatment and pain management options, which normally include physical therapy and medication.

Key Moments in the Episode

The importance of personal experience 01:02
Piriformis syndrome 02:56
Causes of piriformis syndrome 04:01
Treatment options for piriformis syndrome 05:35
Sacroiliitis 08:14
Factors that aggravate the sacroiliac joint 09:07
Diagnosing sacroiliitis 10:08
Lumbar and gluteal trigger point syndrome 11:36
Common trigger points that cause back pain 12:57
Treatment options for lumbar and gluteal point syndrome 14:14
Hamstring strains 23:48
Lumbar facet referral pain patterns 25:51
Treatment options for lumbar facet referral pain 27:51
Thoracic myelopathy 28:52

Every episode of Back Talk Doc includes a Health Matters segment intended to provide actionable health information you can immediately put into practice in your life. This week, Dr. Lakhia talks about active rest techniques and how you can incorporate these in your daily lifestyle. He refers to strategies outlined in the book The Power of Rest by sleep expert Dr. Matthew Edlund.

It’s essential that you engage in activities that rejuvenate your mind and that provide you with mental rest, social rest, spiritual rest and physical rest. He also encourages taking a nap about 3 hours before your normal bedtime for improved productivity during the day. Making social connections, deep breath work and mediation are other techniques you can incorporate to optimize your health through rest.

Links Mentioned in the Episode

Back Talk Booklet by Dr. Sanjiv Lakhia

Travell & Simons' Myofascial Pain and Dysfunction: The Trigger Point Manual

The Power of Rest by Dr. Matthew Edlund

The Rest Doctor

Back Talk Doc is brought to you by Carolina Neurosurgery & Spine Associates, with offices in North and South Carolina. To learn more about Dr. Lakhia and treatment options for back and spine issues, go to backtalkdoc.com. To schedule an appointment with Carolina Neurosurgery & Spine Associates, you can call us at 1-800-344-6716 or visit our website at carolinaneurosurgery.com.

Adult Spinal Deformity with Dr. Matt McGirt

Sanjiv Lakhia - Carolina Neurosurgery & Spine Associates — Mon, 04 May 2020 03:00:00 -0400

It’s pretty common to have your posture be significantly affected by a spine condition. Whether you’ve had congenital scoliosis as a child or went through an accident that caused the deformity, it’s important to have an understanding of these so you know your options are towards recovery.

In this episode of Back Talk Doc, Dr. Sanjiv Lakhia speaks with Dr. Matt McGirt, a partner doctor at the Carolina Neurosurgery and Spine Associates. Dr. McGirt dives deep into spinal deformities that occur in adults, including complex spines and scoliosis. He discusses the types of scoliosis that develops in children, and once it stabilizes, as they grow older. The main thing to check for as an adult is the pelvic-spine-shoulder alignment, making sure that any malalignment does not progress over time.

He also lists down the various symptoms that signal a worsening spinal deformity, including more muscle strain and stress around the spine area. Conservative care is always the first option, where your quality of life is improved first, including doing minor outpatient procedures. It’s only when there’s a severe loss of quality of life such as reduced lung capacity that spinal surgery becomes an option, which Dr. McGirt gives a brief overview on.

Before things take a turn for the worse, you can help yourself by doing activities such as building core strength and flexibility, stretching, and losing weight.

Dr. McGirt suggests adopting healthy habits like cultivating relationships, developing hobbies and doing breathwork, to improve your overall health and well-being.

Key moments in the episode

What is a complex spine 06:14
Definition of spinal deformities 08:53
Types of scoliosis developed in kids and adults 11:04
Routine imaging for an individual with mild scoliosis 14:05
Symptoms that signal worse spinal deformity 15:16
Schroth method 17:20
Symptoms to determine if surgery should be considered 18:17
Non-musculoskeletal symptoms 19:40
Surgeries to address adult spinal deformity 21:47
Big scoliosis surgery 24:13
Going to work after spinal surgery 27:38
Surgical approaches 29:16
Dr. McGirt’s personal health habits 31:50

Links mentioned in the episode

Back Talk Doc is brought to you by Carolina Neurosurgery & Spine Associates, with offices in North and South Carolina. To learn more about Dr. Lakhia and treatment options for back and spine issues, go to backtalkdoc.com. To schedule an appointment with Carolina Neurosurgery & Spine Associates, you can call us at 1-800-344-6716 or visit our website at carolinaneurosurgery.com.

The Recommended Diet to Reduce Inflammation

Sanjiv Lakhia - Carolina Neurosurgery & Spine Associates — Mon, 20 Apr 2020 03:00:00 -0400

Did you know that nutrition plays an important role in contributing to your better quality of health and overall well-being? According to research, about 700,000 deaths and 15% disability cases have a correlation to poor nutrition. It’s not just diseases, but the pain that you’re feeling right now in your back and other parts of the body may be because of high levels of inflammation. And as clinics are not operating at full-capacity with the COVID-19 pandemic still underway, you can make a difference in managing your pain with the food that you eat.

In this episode of Back Talk Doc, Dr. Sanjiv Lakhia dives deep into the anti-inflammatory diet and how it can help with pain. He debunks certain misconceptions about inflammation and the role food plays in exacerbating this condition, and affecting our body. One type of diet he highly recommends is the Mediterranean diet, which is more of a pattern and way of eating rather than specific recipes. It’s one that’s backed up by studies that have shown positive results to one's health.

Dr. Lakhia further breaks down the Mediterranean diet, and the different food groups that you can consume while following it. He further specifies the type of food you can and cannot eat, such as nuts, the type of protein, fats and carbohydrates, to name a few. You can also tweak the Mediterranean diet and make adjustments to your meal plans, for as long as you follow the basic principles it espouses.

Improving your nutrition is a great way to supplement pain management, especially if you’re already taking medicine to lower inflammation levels. If you start providing your body with good nutrition and being consistent with it, then you’re going to see the results and benefits in the long run.

Key moments in the episode

Important statistics 03:56
The truth behind inflammation 04:49
How food contributes to inflammation 05:54
Determine existence of high levels of inflammation in your body 06:53
The Mediterranean diet 08:05
The Mediterranean diet as a pattern of eating 09:44
PREDIMED trial on the Mediterranean diet and cardiovascular disease 11:07
Debunking fats 12:13
On nuts 14:09
On carbohydrates 15:09
On fruits and vegetables 16:57
The importance of spices 19:40
Consumption of alcoholic beverages 20:39
16 top food sources for the anti-inflammatory diet 22:12

Links mentioned in the episode

Back Talk Doc is brought to you by Carolina Neurosurgery & Spine Associates, with offices in North and South Carolina. To learn more about Dr. Lakhia and treatment options for back and spine issues, go to backtalkdoc.com. To schedule an appointment with Carolina Neurosurgery & Spine Associates, you can call us at 1-800-344-6716 or visit our website at carolinaneurosurgery.com.

Top 8 Apps to Help With Pain

Sanjiv Lakhia - Carolina Neurosurgery & Spine Associates — Mon, 06 Apr 2020 03:00:00 -0400

The world has shifted to a new normal due to the Coronavirus pandemic. Everyone is encouraged to stay at home, resulting in the medical community not operating at full capacity. You may not have the same access to your medical practitioner, but you can empower yourself and manage your pain while waiting for the storm to pass.

In this episode of Back Talk Doc, Dr. Sanjiv Lakhia shares 8 apps that can help you deal with pain in your back and in other parts of your body. Although these won’t provide the equivalent relief of a prescription pill or a corticosteroid injection, you can still enjoy the benefits to your overall health and well-being.

Some of these apps help you track your vitamin D intake and measure the quality of your sleep, as vitamin D levels and sleep have direct correlations to pain, particularly chronic pain. He also suggests apps that are in the mind-body medicine realm, such as those that teach guided meditation, journaling and acupuncture.

Additionally, he encourages you to stay physically active, through apps that provide exercise routines, and even workout programs that address specific injuries you have sustained.

Dr. Lakhia believes that the combined effects of these interventions have a positive impact not just on your pain, but on your energy levels and mood, which is a huge help especially as we go through a crisis like today.

Key moments in the episode

Dminder – the importance of Vitamin D 02:58

Sleep Cycle, Sleep++ – correlation of sleep and chronic pain 06:50

Acupressure 08:59

Headspace – the advantages of meditation 12:24

Omvana – using meditation to target specific pain areas 13:25

How meditation works 14:37

7 Minute Workout – how to exercise major muscle groups in a short amount of time 15:38

The Ready State – injury specific workout programs 18:28

Five Minute Journal – how reflection can help you deal with chronic pain 20:53

Links mentioned in the episode:

· Dminder

· Sleep Cycle

· Sleep++

· Acupressure: Heal Yourself

· Headspace

· Omvana

· 7 Minute Workout

· TRS The Ready State

· Five Minute Journal

· Worth a Shot? Spinal Injections with Dr. Andrew Sumich

· Sports and Spine with Jake Beamon PTA

· Glute power with Ryan Klomparens, PT

Back Talk Doc is brought to you by Carolina Neurosurgery & Spine Associates, with offices in North and South Carolina. To learn more about Dr. Lakhia and treatment options for back and spine issues, go to backtalkdoc.com. To schedule an appointment with Carolina Neurosurgery & Spine Associates, you can call us at 1-800-344-6716 or visit our website at carolinaneurosurgery.com.

Understanding the Science of Practice in Neurosurgery and Medicine

Sanjiv Lakhia - Carolina Neurosurgery & Spine Associates — Mon, 23 Mar 2020 03:00:00 -0400

Dr. Tony Asher, who specializes in brain and spine surgery, talks about the science of practice in this episode of Back Talk Doc. He introduces this concept, that’s being done on a national level, in order to accomplish three goals: boosting healthcare, cost efficiency and patient satisfaction. These outcome science programs aim to collect quantitative data based on studies and experience, and analyze that information, leading to better care for patients.

He also shares how physicians can be involved in this initiative, without sacrificing the heart of medicine. There is a risk of devaluing the patient-physician relationship, especially if you only treat their case as part of a data set. This relationship should not be sacrificed for the sake of data.

Dr. Asher stresses the importance of medical practitioners staying up-to-date with the latest knowledge and drawing up from their own experiences to determine the best course of action for them.

Key moments in the episode

Evolution of clinical care in neurosurgery 05:48
Practical aspects of the neurosurgery practice 08:35
How healthcare groups are being measured in terms of performance, quality and outcomes 14:08
How the processes benefit patients 18:30
Efforts done on a national scale 21:23
How to reconcile the art and science of medicine 23:18
Clarifications 28:36
Additional resources for patients who want to be more involved in their care 30:42
Tips to improve your own personal health and wellness 33:14

Links mentioned in the episode

Back Talk Doc is brought to you by Carolina Neurosurgery & Spine Associates, with offices in North and South Carolina. To learn more about Dr. Lakhia and treatment options for back and spine issues, go to backtalkdoc.com. To schedule an appointment with Carolina Neurosurgery & Spine Associates, you can call us at 1-800-344-6716 or visit our website at carolinaneurosurgery.com.

Worth a Shot? Spinal Injections with Dr. Andrew Sumich

Sanjiv Lakhia - Carolina Neurosurgery & Spine Associates — Mon, 02 Mar 2020 03:00:00 -0400

Not to be mistaken with the epidural administered during pregnancy labor and prior to childbirth, injecting medication to the spine has been an option widely considered by patients with low back pain. Whether they experience leg pain or not, or if their inflammation is related to disc herniations, more people are asking for this type of treatment. But did you know that, in particular, epidural steroid injections are not the best course to treat back pain?

This week’s episode features Dr. Andrew Sumich of Carolina Neurosurgery and Spine Associates, whose expertise revolves around musculoskeletal medicine and interventional spine care. He dives deep into the role of spinal injections as it relates to alleviating back pain, particularly steroid injections. In particular, he makes the distinction of an epidural steroid injection, which is better for relieving symptoms and helping the physician make an accurate diagnosis.

Dr. Sumich shares the different techniques used to administer medication to the spine and what they’re typically comprised of. While these procedures are relatively safe, there are still some risks present. However, if the right equipment is used and a skilled doctor is following the processes, then the chances of any serious complications are minimal to none. Though this is the case, he also cautions about having too many injections done frequently. This means that the treatment may not be effective and a minimally-invasive surgical procedure may be a better alternative.

For Dr. Sumich and Dr. Lakhvia, common sense should rule when it comes to using spinal injections for back pain. You should always consult with your doctor to know which option is the best to treat this problem.

Key moments in the episode

Role of spinal injections for back pain 06:12
What is an epidural steroid injection 07:11
Techniques to inject steroids for pain relief 09:30
Risk and complications 11:24
Transforaminal epidural steroid injection vs. selective nerve root block 12:52
Types of medication administered and what happens during the procedure 15:02
Risk for spinal cord injury 16:32
Deciding factors for choosing surgery over epidural steroid injection 21:07
Number of injections usually done 24:38
Other options for back pain 27:51
Research on biologic or regenerative agents for back pain 30:56
Challenges to disc healing 34:29
Personal approach to maintain health and wellness 42:30

Every episode of Back Talk Doc includes a Health Matters segment intended to provide actionable health information you can immediately put into practice in your life. This week, Dr. Lakhia discusses vitamin D, which is not only essential to maintaining good health, but can reduce back pain. This is because this fat-soluble vitamin can control inflammation by lowering levels of C-reactive protein and inflammatory cytokines.

The correlation was seen in a study that showed a strong reduction of pain in patients who were given 3200 international vitamin D supplements every day for 5 weeks. More research is still being done, but the results have so far been positive. So, if you’re planning to consume more vitamin D, consult with your physician first and have your vitamin D levels checked.

Links mentioned in the episode

Back Talk Doc is brought to you by Carolina Neurosurgery & Spine Associates, with offices in North and South Carolina. To learn more about Dr. Lakhia and treatment options for back and spine issues, go to backtalkdoc.com. To schedule an appointment with Carolina Neurosurgery & Spine Associates, you can call us at 1-800-344-6716 or visit our website at carolinaneurosurgery.com.

Back on track: Exercise recovery with Josh Kollman DC and Bridgette Kelly PT

Sanjiv Lakhia - Carolina Neurosurgery & Spine Associates — Mon, 17 Feb 2020 03:00:00 -0400

You don’t need to be a professional athlete to know that it’s important to give your body the rest and recovery it needs after a grueling workout or training session. Some people forget this and push themselves beyond their limit, increasing the risk of sustaining serious injuries. Even those who regularly exercise, no matter the age group, are as susceptible to getting injuries as an elite athlete.

This episode of Back Talk Doc features Dr. Joshua Kollman, chiropractor at Carolina Sports Clinic and physical therapist Bridget Kelly, experts on the topic of recovery from physical exertion. They talk about the different recovery tools and strategies available not only to athletes, but to anyone who is taking up sports casually or exercising regularly. Pain and injuries are typically caused by what you do or don’t do prior to and after a physical activity, rather than the activity itself.

For Dr. Kollman, the best approaches are multidisciplinary and involve not just doing something after a workout, but even before starting. He stresses the importance of doing functional specific warm-up exercises prior and static stretching towards the end of a warm-down. He also talks about what you should do on rest days, which should also involve doing light mobility work.

Both Dr. Kollman and Bridget share the variety of tools and programs that they use in their own practice. These include state-of-the-art machines that conduct cryotherapy and thermogenesis, to simple massage therapies and acupuncture. Additionally, it’s important that you support these tools by giving your body the proper nutrition, hydration and quality sleep it needs.

They also stress the necessity of consulting with an expert team of medical practitioners before trying out any recovery equipment or procedures. Sometimes, they can detect things like movement patterns and behaviors better than any machine could.

Key moments in the episode

Definition of an athlete 10:44
What to do before and after exercise 14:08
What to do on days off 18:35
Fascial stretch therapy or massage therapy 20:09
On cryotherapy and thermogenesis as recovery tools 24:39
Compression therapy 29:36
New technology as an alternative to manual therapy 32:47
The importance of personal medical evaluation 35:11
Using nutritional supplements for recovery 37:27
Supplement recommendations 40:04
Protocol to prevent back pain 45:23
Dr. Kollman's nutrition and exercise strategies 49:00
Bridget's nutrition and exercise strategies 51:29
Recommended apps or books 52:22

Links mentioned in the episode

Back Talk Doc is brought to you by Carolina Neurosurgery & Spine Associates, with offices in North and South Carolina. To learn more about Dr. Lakhia and treatment options for back and spine issues, go to backtalkdoc.com. To schedule an appointment with Carolina Neurosurgery & Spine Associates, you can call us at 1-800-344-6716 or visit our website at carolinaneurosurgery.com.

Sports and Spine with Jake Beamon PTA

Sanjiv Lakhia - Carolina Neurosurgery & Spine Associates — Mon, 03 Feb 2020 03:00:00 -0400

Very often you hear this saying in the fitness world and athletic arena, “No pain, no gain”. It’s as if pain should be expected when you do exercise or undergo training for a sport and if you don’t, whatever you’re doing isn’t going to be effective. This kind of misinformation that exists in this field is one of the main reasons why injuries, particularly on the back, are prevalent among athletes. Because the truth is, the most you should feel while training is a little soreness or muscular discomfort.

Today’s guest on Back Talk Doc is Jake Beamon, a physical therapy assistant at Carolina Neurosurgery & Spine Associates and avid CrossFit enthusiast. He discusses the many causes of back injuries among athletes, with one of the main reasons is a lack of understanding of the importance of core strengthening. Another is muscle asymmetry, which is often in the case in those who play golf, baseball and basketball.

Injuries also occur when there is lack of warm-up or excessive non-essential training. Jake is a believer of adopting functional sports-specific training and working your body out as a whole unit, and not separating certain muscle groups.

Jake also dives into how you can protect your back if you’re into athletics, or even as an ordinary person who’s into fitness programs like CrossFit. Besides strengthening your core and improving mobility, you must maintain functional body movements of hip hinging, squatting and jumping/walking/running regardless of age and fitness level.

Always consult your doctor or expert before embarking on any sport or training regimen. Additionally, putting good nutrition in your body should be of priority as well. The benefits will only be seen when you incorporate a healthy balanced diet in your everyday routine.

Key moments in the episode

Reasons athletes tend to injure their back 06:05
The body's core muscle system 07:56
Pelvic muscles in healthy spinal movements 09:34
Characteristics of a strong core 10:26
Breathing and core stability 11:49
Effects of yoga 14:28
Sports that create the most muscle asymmetry 15:07
Excessive non-essential training 17:34
Kettlebell swings as alternatives to deadlifts 19:17
Weight training for sports 20:18
Increasing muscle bulk from weight training to prevent back injuries 21:49
Ideal exercise program for people with varying levels of fitness 31:41
Back injury prevention for golfers 32:50
How to tell you're physically fit for CrossFit 35:15
Health habits to follow 38:31
Favorite apps, books or other tools 39:20

Every episode of Back Talk Doc includes a Health Matters segment intended to provide actionable health information you can immediately put into practice in your life. This week, Dr. Lakhia talks provides insight into the nutritional content of dairy and other plant-based milk alternatives. While cow’s milk is a great source of calcium, many are unable to consume this due to lactose intolerance or allergy to casein. Almond milk, coconut milk, oat milk, pea mil, rice milk, soy milk and hemp milk or some of his recommended alternatives, which not only provide the calcium you need but are also infused with the right vitamins and minerals that your body needs.

Links mentioned in the episode

Back Talk Doc is brought to you by Carolina Neurosurgery & Spine Associates, with offices in North and South Carolina. To learn more about Dr. Lakhia and treatment options for back and spine issues, go to backtalkdoc.com. To schedule an appointment with Carolina Neurosurgery & Spine Associates, you can call us at 1-800-344-6716 or visit our website at carolinaneurosurgery.com.

Treating Nerve Injuries with Dr. Alan Tillotson

Sanjiv Lakhia - Carolina Neurosurgery & Spine Associates — Mon, 20 Jan 2020 03:00:00 -0400

One of the toughest conditions to treat is nerve injuries, particularly when it’s related to spinal conditions such as sciatic nerve injury. There are a lot of options for treatment when it comes to these conditions, which often involve a lot of pain relief medications, for instance. However, there is growing evidence on the effectiveness of the inclusion of herbal and alternative medicine and systems in treatment plans for patients suffering nerve damage. And a growing number of doctors are considering these types of products too.

This episode of Back Talk Doc features Dr. Alan Tillotson, a registered herbalist and natural medicine specialist, with an expertise in Western and Oriental herbal medicine for over 30 years. He gives insight into the causes of nerve injury, which not only include poor lifestyle choices but exposure to harmful chemicals, trauma and hereditary factors. He also reveals how inflammation of the connective tissues in the nerve system and poor circulation leads to damage in the nerves.

The body has its own healing process and many times, we are prohibiting it by using medicine, like many pain killing medications that only provides temporary relief. He suggests using substances that contain specialized pro-resolving mediators (SPMs) which can provide better pain management without the side effects that most traditional opioids in the market have.

For Dr. Tillotson, treating nerve injuries need to involve a more holistic approach – reduce the inflammation, improve the body’s internal circulation of nutrients and remove harmful toxins. And you can adopt certain practices outside traditional Western medicine, like yoga or meditation, to help supplement the healing process.

Key moments in the episode

Basics of nerve anatomy 09:08
Health risk factors for nerve dysfunction 13:37
Differences of treatment in acute and chronic nerve injuries 14:45
Importance of guidance from a professional clinician before starting on alternative treatments 17:51
Sample treatment models 19:10
Problematic area in healing injuries 20:32
What are specialized pro-resolving mediators 22:31
The problem with pain relief 34:12
The goal of inflammation treatment 35:55
Diet and food plan for healing nerve injury 40:12

Links mentioned in the episode

Back Talk Doc is brought to you by Carolina Neurosurgery & Spine Associates, with offices in North and South Carolina. To learn more about Dr. Lakhia and treatment options for back and spine issues, go to backtalkdoc.com. To schedule an appointment with Carolina Neurosurgery & Spine Associates, you can call us at 1-800-344-6716 or visit our website at carolinaneurosurgery.com.

Cutting Edge Surgery with Dr. Mark Smith

Sanjiv Lakhia - Carolina Neurosurgery & Spine Associates — Mon, 06 Jan 2020 03:00:00 -0400

Correcting structural spinal problems involves techniques that will take years to practice and master for any neurosurgeon. Procedures not only need to effectively fix the issue, but make sure that no additional damage is done to adjacent areas, the skin and to the spine itself! Nowadays, patients are recommended a specific variety of surgery that does the job with lower risks compared to an open spine surgery.

This episode of Back Talk Doc features Dr. Mark Smith, a practitioner who has been with Carolina Neurosurgery & Spine Associates for 17 years, specializing in brain tumors, spine disorders and surgeries. He talks about what exactly Minimally Invasive Spine Surgery (MISS) involves and the many benefits it affords to patients with spinal issues.

While the risks are relatively the same as any open surgery, MISS, when performed correctly can help achieve the desired patient outcome without affecting the nearby areas or the spine overall. This is because prior to a diagnosis, the medical team will locate the specific location of the pathology that has an issue and focusing the treatment only in that spot. Additionally, there are lower pain levels, reduced risk for infection and quicker recovery times post-surgery.

Dr. Smith also explains how a patient can become a candidate for MISS, how soon can they get back to their regular activities after the procedure, and the downsides to this type of surgery. He also discusses the new technologies and techniques being studied today so doctors can improve the effectivity of MISS.

For Dr. Smith, it’s also important that you consult with a clinic that’s able to offer you a comprehensive variety of techniques that can help you have a better patient outcome.

Key moments in the episode

How to stay on top of your game as a neurosurgeon 04:07
Basics of Minimally Invasive Spine Surgery or MISS 13:18
Tools typically used in MISS 16:22
Benefits of MISS versus an open procedure 18:19
Standard recovery times 23:03
MISS for correcting cervical spine issues 25:50
Downsides to MISS 27:05
Use of lasers as standard of care in neurosurgery 28:52
Success rates of standard MISS surgeries 29:41
Possible insurance hurdles 30:51
New technologies 32:58
Using robotics in MISS 34:41
Important factor in deciding to go for MISS 35:44

Every episode of Back Talk Doc includes a Health Matters segment intended to provide actionable health information you can immediately put into practice in your life. This week, Dr. Lakhia dives into how using a far-infrared sauna promotes wellness and offers a range of health benefits that can help you stay active. Using this piece of equipment not only helps improve blood circulation and tissue oxygenation, it also eliminates toxins and cleanses your body, to name a few. 06:52

Links mentioned in the episode

Back Talk Doc is brought to you by Carolina Neurosurgery & Spine Associates, with offices in North and South Carolina. To learn more about Dr. Lakhia and treatment options for back and spine issues, go to backtalkdoc.com. To schedule an appointment with Carolina Neurosurgery & Spine Associates, you can call us at 1-800-344-6716 or visit our website at carolinaneurosurgery.com.

Back Injuries at Work

Sanjiv Lakhia - Carolina Neurosurgery & Spine Associates — Mon, 23 Dec 2019 03:00:00 -0400

The statistics surrounding back injuries among adults is alarming and reflects how grave this problem is in society today. About 80% of adults will experience this type of injury, and at least 1 million of recorded cases are caused by manual labor, with trailer truck drivers as the top type of workers suffering from it. Even employees who sit still at their desks for at least 8 hours in a day can sustain these injuries too. Low back pain, which is the leading cause of disability, is common among office workers.

Dr. Sanjiv Lakhia talks about the prevalence of back injuries among those in the workforce and what people are doing to cause them. He discusses how incorrectly pushing, pulling and lifting objects, as well as bending your back and twisting your waist can lead to serious consequences. If you can’t avoid doing manual labor, especially if your job calls for it, then it’s important to know how you can safely execute your tasks to prevent injury.

Dr. Lakhia also shares practical tips and strategies to keep in mind as you go about your work day. These include checking your posture, stretching and using equipment like footrests. Further, he stresses the importance of being proactive at preventing back injuries from happening in the first place by using common sense and taking care of your health at home.

Key moments in the episode

Top occupations that report cases of back injuries 02:03
Other effects of back injuries at work 03:40
Preventing workplace back injuries 11:35
Questions on ergonomics 14:49
Tips when lifting heavy objects 16:36
Most important strategy in preventing back injuries 16:51
Advice from the physical therapy department 17:08
Things to avoid doing 17:43
Why prevention and personal fitness is important 18:14

Every episode of Back Talk Doc includes a Health Matters segment intended to provide actionable health information you can immediately put into practice in your life. This week, Dr. Lakhia shares Consumer Lab, an online tool that he uses to check the authenticity and true effectivity of nutritional supplements. This independent company conducts its own evaluations and provides results that may have been overlooked by regulating bodies. (05:50)

Links mentioned in the episode

Back Talk Doc is brought to you by Carolina Neurosurgery & Spine Associates, with offices in North and South Carolina. To learn more about Dr. Lakhia and treatment options for back and spine issues, go to backtalkdoc.com. To schedule an appointment with Carolina Neurosurgery & Spine Associates, you can call us at 1-800-344-6716 or visit our website at carolinaneurosurgery.com.

The Narrowed path, Understanding Spinal Stenosis with Joe Cheatle MD

Sanjiv Lakhia - Carolina Neurosurgery & Spine Associates — Fri, 06 Dec 2019 03:00:00 -0400

The things that you do in a single day, no matter how minor you think they may be, is going to have a profound effect on your body soon. Are you feeling sharp pain in your legs, for instance? It may be because you’re putting too much pressure on your spinal cord or your unhealthy habits are already taking a toll on your spine.

In this episode of Back Talk Doc, neurosurgeon Joe Cheatle, MD – whose interests spans brain tumors and degenerative spinal disorders to name a few – dives deep into spinal stenosis. While this illness is pretty common, there’s little knowledge and understanding among patients about what it truly is. Joe then talks about the causes and symptoms to watch out for. There’s no one reason for spinal stenosis, with genetics and lifestyle playing a huge role in acquiring this condition.

Although getting surgery is an option to treat lumbar spinal stenosis, Joe recommends exhausting all nonsurgical treatments and therapies first. Undergoing surgery should be the last resort as even medical professionals like himself want to avoid it if possible. Of course, if the pain is unbearable and changes the way you do your normal activities, then surgery would be the best option. There are different kinds of surgeries that you can take, which have their own risk levels and recovery times too, depending on the patient.

At the end of the day, Joe believes that building habits like avoiding vices, eating right and exercising regularly, and properly is what’s going to keep your spine healthy and strong.

Key moments in the episode

Personal habits to keep spine healthy and strong, promote wellness 04:28
What is stenosis 06:47
Common symptoms of lumbar spinal stenosis 07:55
Factors that contribute to the development of lumbar stenosis 11:52
Is spinal stenosis preventable 15:03
Percentage of patients who need to spinal surgery 16:41
Pain as an indication for surgery 17:46
Treating spinal stenosis symptoms to avoid surgery 26:02
Reasonable time frame for nonsurgical care 27:13
Indications for when surgery is needed 28:57
Common neurosurgical approaches 31:01
Recovery and rehab time for surgeries 36:14
New innovative surgical techniques for treating spinal stenosis 38:02

Every episode of Back Talk Doc includes a Health Matters segment intended to provide actionable health information you can immediately put into practice in your life. This week, Dr. Lakhia talks about gratitude and how having an attitude of gratitude can make a difference in a person’s overall physical and mental well-being. He provides scientific research that shows how doing activities such as journaling reduce physical ailments and mental stress. (18:19)

Links mentioned in the episode

· Joe Cheatle, MD

· Lumbar spine anatomy video

· The Grateful Brain by Dr. Alex Korb

· Article on neural biology of gratitude

· Five Minute Journal App

· 6-Phase Meditation

Back Talk Doc is brought to you by Carolina Neurosurgery & Spine Associates, with offices in North and South Carolina. To learn more about Dr. Lakhia and treatment options for back and spine issues, go to backtalkdoc.com. To schedule an appointment with Carolina Neurosurgery & Spine Associates, you can call us at 1-800-344-6716 or visit our website at carolinaneurosurgery.com.

Glute power with Ryan Klomparens, PT

Sanjiv Lakhia - Carolina Neurosurgery & Spine Associates — Mon, 25 Nov 2019 03:00:00 -0400

Have you ever heard of gluteal amnesia or dead butt syndrome? Did you know that this can happen when you sit for long periods of time without standing or moving around? Many of us are in this same situation every day, our backs hunched over the computer finishing tasks and projects at work. And if your glutes are weak, chances are you’re experiencing pain in your lower back.

In this episode of Back Talk Doc, Ryan Klomparens – who is a Physical Therapist at the Carolina Neurosurgery and Spine Associates – discusses why it’s important to keep your gluteal muscles strong and functioning correctly, while also promoting flexibility. He reveals how we need to have a comprehensive look at our body’s muscle groups as having weakness in one can affect how the other performs.

The glutes, in particular, help keep the pelvis level to reduce stress on the lumbar spine and decrease the pressure put on the back muscles. Forgetting to strengthen these in your exercise routine will have detrimental effects on your knees, feet and ankles too. Ryan also specifically talks about runners and CrossFit athletes, and how strong gluteal muscles can reduce the risk of injuries when doing this sport. He also provides tips and basic exercises you can do at home for your gluteal muscles, which include pelvic bridging, step-ups, reverse lunges and goblet squats, while carrying hand weights or kettlebells.

For Ryan, we should focus on working to make our bodies healthy and keeping our joints strong, by minimizing the workload we put on them on a daily basis.

Key moments in the episode

What are the gluteal muscles? 05:20
Having strong hips reduces back pain 07:20
Effects of prolonged sitting on the back and hips 09:26
Self-correcting sitting posture 10:56
The importance of strong gluteal muscles for runners 12:28
How the glutes affect the knees, hips and ankles 21:33
Balancing strengthening muscles and promoting proper flexibility 24:00
Basic exercises for the gluteal muscles 25:49
Lowering the risk of injury when doing deadlifts and squats 27:54
Recommended exercise apps and online programs 30:19
Ryan’s personal exercise routines 31:44

Every episode of Back Talk Doc includes a Health Matters segment intended to provide actionable health information you can immediately put into practice in your life. This week, Dr. Lakhia explores organic vegetables and fruits, and how it’s necessary for us to nourish our bodies with only clean food. He mentions the Environmental Working Group’s 2019 Shopper's Guide to Pesticides in Produce. (14:44)

Links mentioned in the episode

Ryan’s recommended apps:

Ryan’s recommended gluteal and back strengthening exercises

Back Talk Doc is brought to you by Carolina Neurosurgery & Spine Associates, with offices in North and South Carolina. To learn more about Dr. Lakhia and treatment options for back and spine issues, go to backtalkdoc.com. To schedule an appointment with Carolina Neurosurgery & Spine Associates, you can call us at 1-800-344-6716 or visit our website at carolinaneurosurgery.com.

Top 10 Back Pain Myths

Sanjiv Lakhia - Carolina Neurosurgery & Spine Associates — Mon, 11 Nov 2019 05:00:00 -0400

Carolina Neurosurgery & Spine Associates welcome you to Back Talk Doc, a podcast dedicated to empowering you to take control of your back pain and enhance your quality of life. On this inaugural episode, we introduce our host, Dr. Sanjiv Lakhia, a board certified physiatrist and specialist in physical medicine and rehabilitation at Carolina Neurosurgery & Spine Associates.

Dr. Lakhia is passionate about educating patients on how to care for their back by combining the best of holistic and conventional medicine approaches. He is the author of the patient education booklet, Back Talk, that addresses common questions you may encounter when searching for back and spine care options.

On this episode, Dr. Lakhia provides a straightforward approach to treating and preventing back and spine issues. Additionally, he addresses health and wellness issues, navigating the healthcare system, and safe and effective treatment options for back problems.

Future episodes of Back Talk Doc will feature interviews with prominent neurosurgeons, physiatrist, physical therapists, nutritionists, and other experts in the field of spine care and wellness.

Top 10 Back Pain Myths

Myth #1: Most patients with low back pain need surgery. 3:09
Myth #2: All herniated lumbar discs need surgery. 4:31
Myth #3: Sit-ups are good for your low back. 6:20
Myth #4: All back injuries need x-rays and MRI studies. 7:46
Myth #5: Only overweight individuals have low back pain. 9:04
Myth #6: If you hurt your back, bed rest is critical. 11:05
Myth #7: Over-the-counter drugs are totally safe for treating back pain. 16:59
Myth #8: Muscle relaxers, relax muscles. 19:19
Myth #9: Exercise causes back injuries. 20:54
Myth #10: Back braces help low back pain. 22:22

Every episode of Back Talk Doc includes a Health Matters segment intended to provide actionable health information you can put into practice in your life immediately. This week Dr. Lakhia discusses the importance of sleep. He details the overall benefits of sleep and the strong correlation in medical research between sleep and pain. (11:50)

Links Discussed in Today’s Episode

· Why We Sleep by Matthew Walker

· Back Talk by Sanjiv Lakhia

Back Talk Doc is brought to you by Carolina Neurosurgery & Spine Associates, with offices in North and South Carolina. To learn more about Dr. Lakhia and treatment options for back and spine issues, go to backtalkdoc.com. To schedule an appointment with Carolina Neurosurgery & Spine Associates, you can call us at 1-800-344-6716 or visit our website at carolinaneurosurgery.com.

Welcome to Back Talk Doc

Sanjiv Lakhia - Carolina Neurosurgery & Spine Associates — Mon, 21 Oct 2019 03:00:00 -0400

Here on Back Talk Doc you’ll find answers to some of the most common questions about back pain and spine health. Brought to you by Carolina Neurosurgery & Spine Associates, where providing personalized, highly-skilled, and compassionate spine care has been our specialty for over 75 years. And now, it’s time to understand the cause of back pain and learn about options to get you back on track!

If you'd like to learn more about Dr. Lakhia and treatment options for back issues, go to BackTalkDoc.com. We look forward to having you join us for more insights about back pain and spine health on the next episode of Back Talk Doc. Additional information is also available at: CarolinaNeuroSurgery.com.

New Episodes Coming Soon!