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Spine & Nerve

Brian Joves, M.D.

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We are physicians who practice pain management and physical medicine and rehabilitation, and believe that the main goal of practice is to improve the quality of life of our patients and communities. We will dive deep into the world of modern pain management to help healthcare providers and consumers understand various diagnoses, treatment options, and the changing landscape of pain management. This podcast is meant for educational and entertainment purposes only, and is not medical advice.
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In this episode of the Spine & Nerve podcast, join Brian Joves, MD for an enlightening conversation with Mike Ochoa, DPT, a passionate advocate for fitness in aging populations.Dr. Mike brings valuable insights into the importance of exercise, particularly weightlifting, in promoting longevity and overall well-being as we age. Discover the truth be…
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Episode Summary:Join Dr. Jason Kung and Dr. Brian Joves for an in-depth discussion on the latest in neuromodulation. This episode covers a range of topics from the North American Neuromodulation Society 2024 Annual Meeting highlights to a journal club traversing the topics of spinal cord stimulation, closed-loop technology, and the impact of parasp…
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In this episode of The Spine & Nerve Podcast, Dr. Dr. Jason Kung and Dr. Brian Joves have a reflective and forward-looking discussion as we transition from 2023 into 2024, sharing our podcast's journey, personal insights, biggest happenings in pain medicine, and anticipations for the new year.1. Podcast Journey and Global Reach:Transitioning throug…
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In this episode of the Spine & Nerve Podcast, Dr. Brian Joves has the distinct pleasure to welcome Dr. Andrea Furlan to the show. Dr. Furlan is a pain specialist in Toronto Canada. She is a physiatrist (specialist in Physical Medicine & Rehabilitation). She holds a medical degree from the University of Sao Paulo and a Ph.D. degree from the Universi…
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In this episode of the Spine & Nerve Show, Dr. Robert Bowers joins Dr. Brian Joves to discuss the progression of young athletes in throwing sports, such as baseball. He emphasizes the importance of allowing children to play multiple sports and avoid specializing too early. Dr. Bowers also highlights the risks associated with overuse injuries and th…
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In this episode of the Spine & Nerve podcast, Dr. Jason Kung and Dr. Brian Joves delve into a comprehensive discussion surrounding anticoagulation guidelines and their implications in interventional pain procedures. With over a hundred thousand downloads and over 1,000 YouTube subscribers, we would like to express our sincere gratitude to all the l…
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In this episode, we have a special guest, Dr. Nikhil Verma, who shares his inspiring journey from undergrad to establishing his own medical practice. Dr. Verma opens up about the challenges he faced, the pivotal moments that shaped his career, and the lessons he learned along the way. Join us as we delve into his story of perseverance, passion, and…
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In this week's episode of the Spine & Nerve podcast, we have a return guest! Dr. Hunter Vincent returns to the show to chat with Dr. Brian Joves about health coaches and how they can help your patients to be more successful in their journey with and through chronic pain. In this episode we'll discuss: What is a health coach? Where does this fit int…
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In this week's episode of the Spine & Nerve podcast, Dr. Jason Kung and Dr. Brian Joves try to digest all the recent happenings in the world of neuromodulation.They address:Internal Pulse Generators Artificial Intelligence The Cochran StudyListen as the doctors get excited, frustrated, and try to bring a silver lining to the whirlwind of headlines …
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In this week's episode of the Spine & Nerve Podcast we would like to introduce you all to the newest member of the Spine & Nerve family... Dr. Jason Kung. Jason Kung, MD, is a board-eligible anesthesiologist and interventional pain physician who joined Spine & Nerve last year. Listen in as Brian Joves, MD gets to know Dr. Kung better and explore hi…
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In this week's episode we take a deep dive into lumbar spinal stenosis, discussing the underlying disease process as well as treatment options in the medical literature. The studies referenced in this podcast are given at the end of the podcast. This is meant for education and entertainment only, this is not to be interpreted as medical advice. If …
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In this week's episode of The Spine & Nerve Podcast, Evan Hauger, DPT joins Brian Joves, MD to discuss movement as medicine.Dr. Evan HaugerEvan specializes in sports physical therapy, strength, and conditioning. He knows the ins & outs of injury from years of personal experience. Growing up, he was a multi-sport athlete and went on to play baseball…
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In this week's episode of the Spine & Nerve podcast, Dr. Julie Hastings connects with Dr. Krystyna Holland, PT, DPT to learn about trauma informed care.Trauma informed care has many definitions, including some fantastic work done by the Substance Abuse and Mental Health Services Administration. One definition is a consistent and intentional effort …
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In this week's episode of the Spine & Nerve podcast, Drs. Nicolas Karvelas and Brian Joves discuss infectious spondylodiscitis, a relatively rare inflammatory process involving an intervertebral disc and the adjacent vertebral bodies. Spondylodiscitis has a prevalence of about 4-24 per million, and has been increasing as patients have more risk fac…
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In this week's episode of the Spine & Nerve podcast, Drs. Julie Hastings, Nicolas Karvelas, and Brian Joves present a journal club on interventional management of patients with persistent pelvic pain syndrome.Three different interventions are covered in the articles presented, showing a range on invasiveness and diversity of targets to help moderat…
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In this week's episode of the Spine & Nerve podcast, Dr. Joves welcomes Dr. Raman Gurai back to the show. Dr. Gurai walks us through his journey in medicine and how he took the road less traveled to achieve his goals and dreams!Dr. Gurai's Bio:Dr. Raman Gurai is a board certified Physical Medicine and Rehabilitation physician with a special interes…
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In this week's episode of the Spine & Nerve podcast, Dr. Julie Hastings sits down with Shereen Sairafi, PT, DPT, WCS to discuss all things pelvic physical therapy related. Pelvic floor physical therapists play an integral role in helping patients who have urinary, bowel, or sexual dysfunction, as well as pelvic pain. Dr. Shereen Sairafi graduated f…
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In this week's episode of the Spine & Nerve podcast, Dr. Julie Hastings and Dr. Brian Joves go back to basics and give us an overview of persistent pelvic pain.Persistent pelvic pain is defined as non malignant pain that is present for more than six months. It may or may not be associated with a woman's cycle or related to intercourse. Studies have…
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In this week's episode of the Spine & Nerve podcast, Dr. Nicolas Karvelas and Dr. Brian Joves celebrate the 100th episode and welcome Dr. Julie Hastings to the show! We are so appreciative of the support, and love to hear the feedback from all of you. We never imagined that we would make 100 episodes of the podcast, let alone reach as many listener…
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In this week's episode of the Spine & Nerve podcast Dr. Brian Joves is joined by a very special guest, Dr. Monica Verduzco-Gutierrez, to discuss Long COVID, otherwise known as Post Acute Sequalae of SARS CoV2 (PASC).Long COVID is defined as a condition in which a patient continues with symptoms of COVID-19 more than 2 months after being infected by…
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In this week's episode of the Spine & Nerve podcast Dr. Nicolas Karvelas and Dr. Brian Joves discuss Post Herpetic Neuralgia (PHN), the most common complication of Herpes Zoster (also known as Shingles, which is caused by reactivation of the Varicella Zoster Virus). PHN is defined by pain that is typically burning or electrical, and may be associat…
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In this week's episode of the Spine & Nerve podcast Drs. Nicolas Karvelas and Brian Joves take a look back at basic physiology to try to look into the future. An area of research that has really piqued the interest of Dr. Karvelas in recent years has been the discussion/possibility of selective voltage gated sodium channel (NaV) modulators. NaV are…
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In this week's episode of the Spine & Nerve podcast Drs. Nicolas Karvelas and Brian Joves discuss a clinical case regarding a patient with Persistent Spinal Pain Syndrome (PSPS). To review, PSPS is not a single diagnosis, but rather an encompassing term that includes persistent painful disease with spinal origin. This disease can be linked to the p…
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In this week's episode of the Spine & Nerve podcast, Dr. Nicolas Karvelas and Dr. Brian Joves discuss landmark articles regarding the treatment of patients with Persistent Spinal Pain Syndrome (PSPS). PSPS is a new term that was recently proposed by an expert international committee to describe patients with chronic, severe pain of spinal origin, r…
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In this week's episode of the Spine & Nerve podcast, Dr. Nicolas Karvelas and Dr. Brian Joves go back to Basics with a twist - the doctors discuss Persistent Spinal Pain Syndrome (PSPS). PSPS is a new term that was recently proposed by an expert international committee to describe patients with chronic, severe pain of spinal origin, refractory to t…
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In this week's episode of the Spine & Nerve podcast, Dr. Brian Joves is joined by a very special guest to continue the discussion on Degenerative Cervical Myelopathy (DCM).Dr. Erich Anderer joins the podcast today to give us the surgeon's perspective on DCM. During his day job as the Chief of Neurosurgery at NYU Langone Hospital- Brooklyn, Dr. Ande…
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In this week's episode of the Spine & Nerve podcast Dr. Nicolas Karvelas and Dr. Brian Joves discuss Degenerative Cervical Myelopathy (DCM). DCM, previously called cervical spondylotic myelopathy, is defined as neurologic injury to the cervical spinal cord due to various age-related degenerative conditions of the cervical spine resulting in injury …
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In this week's episode of the Spine & Nerve podcast Dr. Nicolas Karvelas and Dr. Brian Joves present a case of an early 40s female physician who presented with about 1 year of back pain that was progressively impacting her marathon training.Listen as the doctors talk through this case presentation, including the history, physical, workup, conservat…
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In this week's episode of the Spine & Nerve podcast Dr. Nicolas Karvelas and Dr. Brian Joves dive deeper into lumbar discogenic pain and discuss a recent publication reviewing the evidence for regenerative therapies in the management of discogenic pain.Regenerative medicine and orthobiologic therapy utilizes the body's own healing factors to treat …
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In this week's episode of the Spine & Nerve podcast Dr. Nicolas Karvelas and Dr. Brian Joves go back to basics and introduce the topic of lumbar discogenic pain.Lumbar discogenic pain is defined as a painful disease process due to compromise of the lumbar disc and is very common, with most studies documenting that around 40% of low back pain is pre…
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In this week's episode of the Spine & Nerve podcast Dr. Nicolas Karvelas and Dr. Brian Joves present a case of a relatively young patient with lumbar facetogenic pain in the setting of spondylolisthesis with some level of dynamic instability. There is strong evidence for the treatment of lumbar facetogenic pain with lumbar medial branch radiofreque…
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In this week's episode of the Spine & Nerve podcast Dr. Nicolas Karvelas and Dr. Brian Joves continue the discussion on lumbar facetogenic pain with a journal club. Lumbar spondylosis with a primary pain generator of facet joint pain is a common pathology that can have a significant negative impact on a patient’s function and health. There are mult…
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In this week's episode of the Spine & Nerve podcast Dr. Nicolas Karvelas and Dr. Brian Joves introduce the topic of pain coming from the lumbar facet joints - specifically when it is related to the general aging and degeneration of the spine (also known as spondylosis).Lumbar facetogenic pain is defined as pain originating from any structure integr…
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In this week's episode of the Spine & Nerve podcast Dr. Nicolas Karvelas and Dr. Brian Joves wrap up the series on lumbar radiculopathy with a case presentation. This is a case of a young man who presented with a severe acute on chronic lumbar radiculopathy after the holidays. As he was already managed by our office, he presented very acutely (abou…
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In this week's episode of the Spine & Nerve podcast Dr. Nicolas Karvelas and Dr. Brian Joves review a recent meta-analysis of transforaminal epidural steroid injections. This continues off of their conversation about lumbar radiculopathy. Epidural injections to treat pain have been around for over a hundred years. It is one of the most common proce…
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In this week's episode of the Spine & Nerve podcast Dr. Nicolas Karvelas and Dr. Brian Joves review lumbar radiculopathy. Lumbar radiculopathy is a common diagnosis in which there is irritation or compression of one or more nerve roots in the lumbar spine. Because these nerves travel to the hips, buttocks, legs and feet, an injury in the lumbar spi…
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In this week's episode of the Spine & Nerve podcast Drs. Nicolas Karvelas and Brian Joves conclude the discussion regarding Myofascial Pain Syndromes through a case presentation. The doctors present a common clinical scenario where myofascial pain is causing significant negative impact on a patient's function, quality of life, and health. In the pr…
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In this week's episode of the Spine & Nerve podcast Dr. Nicolas Karvelas and Dr. Brian Joves expand on the recent discussion of myofascial pain and discuss a recently published article that explored neuroinflammation. In the prior discussion, it was highlighted how prone chronic myofascial pain processes are to the development of central and periph…
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In this week's episode of the Spine & Nerve Podcast, Drs. Nicolas Karvelas and Brian Joves discuss a very underappreciated component of the chronic pain picture- myofascial pain syndrome.Myofascial pain is pain of the muscle and associated connective tissue. It typically presents as regional pain with associated tension, decreased range of motion, …
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In this week's episode of the Spine & Nerve podcast, Dr. Brian Joves and Dr. Nicolas Karvelas expand on their recent discussion of pain chronification. The doctors discuss a fairly common scenario in which a patient with very chronic pain develops a relatively new pain condition. In this setting, the new onset pain process can be significantly ampl…
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In this week's episode of the Spine & Nerve Podcast, Drs. Nicolas Karvelas and Brian Joves build on last week's episode on pain chronification and discuss a promising therapy for chronic axial low back pain: Peripheral Nerve Stimulation (PNS).PNS is an implanted device (in our discussion, a temporary implant for 60 days) that uses therapeutic elect…
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In this week's episode of the Spine & Nerve podcast Dr. Nicolas Karvelas and Dr. Brian Joves go back to the basics to discuss a fundamental topic: pain chronification.Pain chronification is defined as the process of acute pain progressing into chronic pain. Acute pain is a normal, predicted physiological response to adverse stimuli (chemical, therm…
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In this week's episode of the Spine & Nerve podcast Dr. Nicolas Karvelas and Dr. Brian Joves review a common cause of low back pain, sacroiliac joint (SI) pain. The SI joint is a large complex joint that involves the iliac bone and sacrum. The SI joint is a critical component of the connection between the spine and lower limbs, and one of the prima…
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In this week's episode of the Spine & Nerve podcast, Dr. Nicolas Karvelas and Dr. Brian Joves discuss how pain medicine has been affected by COVID-19. This pandemic has caused so much devastation for our patients, including some who directly experienced COVID-19 infection and those who have had to weigh seeking medical care against risking infectio…
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In this week's episode of the Spine & Nerve podcast Dr. Nicolas Karvelas and Dr. Brian Joves return to their Bay Area roots and mourn with Dub Nation after a devastating injury to Klay Thompson (shooting guard for the Golden State Warriors). Klay Thompson sustained a season ending right Achilles’ tendon tear. Thompson suffered the injury during a w…
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In this week's episode of the Spine & Nerve podcast Dr. Nicolas Karvelas and Dr. Brian Joves highlight a patient centered approach to tapering opioids. Treatment of the chronic pain disease process is challenging, but optimizing patient buy in and creating an active participant in the treatment plan can be very powerful. In many clinical scenarios …
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In this week's episode of the Spine & Nerve podcast Dr. Nicolas Karvelas and Dr. Brian Joves want to stay pink past October- they are continuing breast cancer awareness month and discussing one of the overlapping diagnoses: Post-Mastectomy Pain Syndrome (PMPS). Breast cancer is the most frequently diagnosed life threatening cancer in women. There a…
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In this week's episode of the Spine & Nerve podcast Dr. Nicolas Karvelas and Dr. Brian Joves discuss the recent DTM (Differential Targeted Multiplex) Spinal Cord Stimulation Randomized Controlled Trial with Dr. Michael Fishman. Dr. Fishman was one of the clinical investigators in this ground breaking study and joins our podcast to discuss the 12 mo…
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In this week's episode of the Spine & Nerve podcast Dr. Nicolas Karvelas and Dr. Brian Joves discuss the relationship between diet and chronic pain. Chronic pain including chronic spinal pain is incredibly common and difficult to treat. There are many aspects to a thorough and complete treatment plan including physical modalities, medications, proc…
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In this week's episode of the Spine & Nerve podcast, we sit down with Dr. Kevin Mullins. Dr. Mullins joins the podcast to discuss the journey of becoming a sports medicine physician, specifically focusing on what drove Dr. Mullins into this area of expertise and his tips to the next generation of physiciansListen in as the doctors discuss:- Why phy…
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