Back Talk Doc

In a special edition of Back Talk Doc, Dr. Sanjiv Lakhia switches gears from hosting to guesting. He recently joined Joel Proskewitz on "Interview the Expert" at The SpineXchange, a platform which provides educational materials to people who have gone through back surgery or have back pain in general. In this episode, we bring you the insightful conversation between Dr. Lakhia and Joel. Don't miss this unique opportunity to hear them delve into the various aspects of back care.

In this episode of Back Talk Doc, Dr. Sanjiv Lakhia is joined by friend and colleague, Dr. Joseph Cheatle, one of the neurosurgeons at Carolina Neurosurgery & Spine Associates. Dr. Cheatle shares his story of his own low back challenges resulting from a ski accident.

In this episode of Back Talk Doc, Dr. Sanjiv Lakhia is joined by colleague Lindsay Howard, a physician assistant at Carolina Neurosurgery & Spine Associates. Lindsay shares her unique perspective of having gone through the process of taking care of her back as a scoliosis patient and now being a spine healthcare provider.

In this episode of Back Talk Doc, host Dr. Sanjiv Lakhia discusses cutting edge artificial disc and facet replacement surgical techniques with a rising star in the field of neurosurgery in the Charlotte community, Dr. Vincent Rossi.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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. Subscribe & Contact

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.

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.   

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 Sanjiv Lakhia talks with Dr. McMakin about FSM and her work introducing it to physicians, chiropractors, physical therapists, and practitioners all over the world.  

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 Sanjiv Lakhia is joined by his new partner at the Carolina Surgery and Spine Association, Dr. Ki Jung, MD to discuss neuropathy and its many facets.  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.  

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. 

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.  https://rezzimax.com/discount/CNSA20 (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 https://rezzimax.com/discount/CNSA20 (Rezzimax) today. 

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.

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.   

Sometimes, the greatest struggles can bring forth the greatest innovations.  That is certainly true for Dr. Eric Goodman, DC, the founder of http://foundationtraining.com (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 http://adaptclt.com (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.   

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 https://www.backtalkdoc.com/podcast.html (BackTalkDoc.com).  

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 https://www.backfitpro.com/books/back-mechanic-the-mcgill-method-to-fix-back-pain/ (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 https://www.cnsa.com/providers/john-m-lesher-md-mph (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 https://www.backtalkdoc.com/podcast.html (BackTalkDoc.com). 

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 https://www.backtalkdoc.com/podcast.html (BackTalkDoc.com).  

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 https://www.backtalkdoc.com/podcast.html (BackTalkDoc.com).

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 https://www.backtalkdoc.com/podcast.html (BackTalkDoc.com).

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 https://www.backtalkdoc.com/podcast.html (BackTalkDoc.com)

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.  

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.

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.  

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.

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? https://neu.fit/ (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.  

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 https://ensomabodyworks.com/ (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. 

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 https://www.cnsa.com/ (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.  

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.  

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.  

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 https://qor360.com/ (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 ResourcesTo learn more about Dr. Osler’s mission of educating the community about the benefits of active sitting, visit https://qor360.com/ (QOR360.com) and https://buttonchairs.org/ (ButtOnChairs.org), which promotes active sitting for children. View Dr. Osler’s https://www.ted.com/talks/turner_osler_active_sitting_could_we_give_our_kids_a_future_without_back_pain (TED Talk). https://gokhalemethod.com/ (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 https://backtalkdoc.com/ (BackTalkDoc.com).   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 http://carolinaneurosurgery.com/ (carolinaneurosurgery.com).

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, https://www.cnsa.com/providers/michael-bohl-md (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 https://backtalkdoc.com/ (BackTalkDoc.com).   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.

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 https://www.cnsa.com/providers/scott-m-otis-md (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 https://www.backtalkdoc.com/a-pain-in-the-neck-and-back-how-technology-stress-and-genetics-are-leading-to-aches-and-pains-with-dr-sameer-vemuri---back-talk-doc-podcast-episode-29.html (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 https://www.backtalkdoc.com/ (BackTalkDoc.com).  https://pod.link/1486857278 (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 https://www.cnsa.com/ (carolinaneurosurgery.com).

By the numbers, a solid percentage of you are listening to this 29th 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. 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.

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. https://www.amazon.com/TENS-7000-Digital-Unit-Accessories/dp/B00NCRE4GO (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. https://www.alpha-stim.com/ (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. https://www.h-wave.com/ (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 https://www.backtalkdoc.com/ (BackTalkDoc.com) 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 https://www.cnsa.com/ (carolinaneurosurgery.com).

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 https://www.traditionalmedicinals.com/products/turmeric-with-meadowsweet-ginger/ (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 https://www.amazon.com/dp/B000FZ3F20?ots=1&slotNum=5&imprToken=aebb1f23-bd42-2301-39f&ascsubtag=%5b%5dst%5bp%5dck6l7o2xs00176cy6j4w8yncu%5bi%5dwAYKKW%5bd%5dD%5bz%5dm%5bt%5dw%5br%5dgoogle.com&tag=thestrategistsite-20 (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 https://www.amazon.com/Gimme-10-Massager-Myofascial-Trigger/dp/B07G2ZWLD2/ref=asc_df_B07G2ZWLD2/?tag=hyprod-20&linkCode=df0&hvadid=312130834541&hvpos=&hvnetw=g&hvrand=17198902202841562862&hvpone=&hvptwo=&hvqmt=&hvdev=c&hvdvcmdl=&hvlocint=&hvlocphy=9060246&hvtargid=pla-583753266400&psc=1 (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 https://www.amazon.com/Body-Back-Massager-Handheld-Massage/dp/B005F9F5H4/ref=sr_1_8?dchild=1&keywords=theracane&qid=1607361822&sr=8-8 (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 https://www.backtalkdoc.com/whatrsquos-the-point-acupuncture-vs-dry-needling---back-talk-doc-podcast-episode-18.html (Acupuncture vs. Dry Needling)) https://www.amazon.com/Trigger-Point-Therapy-Workbook-Self-Treatment/dp/1608824942/ref=sr_1_1_sspa?dchild=1&keywords=trigger+point+manual&qid=1607361789&sr=8-1-spons&psc=1&spLa=ZW5jcnlwdGVkUXVhbGlmaWVyPUEyUUdRWEdLQ0tUTEw1JmVuY3J5cHRlZElkPUEwMzgxNDA4MkRaVzVaVDNNTU9aRSZlbmNyeXB0ZWRBZElkPUEwMTUyNzgzMTRIRDQ1VklLQU9RUyZ3aWRnZXROYW1lPXNwX2F0ZiZhY3Rpb249Y2xpY2tSZWRpcmVjdCZkb05vdExvZ0NsaWNrPXRydWU (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...

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: https://qxmd.com/calculate-by-qxmd (Calculate), https://read.qxmd.com/ (Read), and https://qxmd.com/learn-by-qxmd (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 https://qxmd.com/ (qxmd.com), or email contact@qxmd.com. To try QxMD’s apps, download them on your device’s app store or follow these links: https://qxmd.com/calculate-by-qxmd (Calculate by QxMD), https://read.qxmd.com/ (Read by QxMD), https://qxmd.com/learn-by-qxmd (Learn by QxMD). For more information on Dr. Sanjiv Lakhia’s practice, visit https://www.backtalkdoc.com/ (BackTalkDoc.com) 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 https://www.cnsa.com/ (carolinaneurosurgery.com).

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 https://www.cnsa.com/providers/john-m-lesher-md-mph (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:https://read.qxmd.com/read/23140128/prospective-study-of-disc-repair-with-allogeneic-chondrocytes-presented-at-the-2012-joint-spine-section-meeting (Prospective study of disc repair with allogeneic chondrocytes presented at the 2012 Joint Spine Section Meeting) by Coric D, Pettine K, Sumich A, http://valleysportsandspine.com/wp-content/uploads/2015/02/mesoblast.pdf (Mesoblast Study) by Mesoblast the regenerative medicine company  https://www.beckersspine.com/spine/item/34294-cell-based-therapy-for-spinal-disc-regeneration-dr-domagoj-coric-discusses-how-far-it-s-come-how-far-it-has-to-go.html (Cell-based therapy for spinal disc regeneration) by Coric D. https://static1.squarespace.com/static/59d2b1d812abd948b8707a48/t/5c9b9bdde4966b6c30bde84e/1553701858593/ORS+2019+Clinical+Study+Overview.pdf (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, https://bjsm.bmj.com/ (British Journal of Sports Medicine) https://www.outsideonline.com/podcasts (Outside podcast) https://peterattiamd.com/podcast/ (The Peter Attia Drive Podcast)  https://www.wunc.org/programs/peoples-pharmacy (The People's Pharmacy)   For more information on Dr. Sanjiv Lakhia’s practice, visit https://www.backtalkdoc.com/ (BackTalkDoc.com) If you enjoyed this episode of Back Talk Doc, check out our episode https://www.backtalkdoc.com/introduction-to-spinal-artificial-disc-replacement-surgery-with-dr-dom-coric---back-talk-doc-podcast-episode-19.html (Introduction to Spinal Artificial Disc Replacement Surgery with Dr. Dom Coric). 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 atcarolinaneurosurgery.com.