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

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

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

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

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

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

Name: Joel Proskewitz

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

Company: The SpineXchange

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

Connect: Website |  LinkedIn 

Top takeaways from this Back Talk Doc episode 

• Having a healthy functioning spine is critical to having a healthy functioning life. Dr. Lakhia’s passion for anatomy led him to osteopathic medicine. He wanted to dive deeper into spine care and understand the science behind a healthy spine so he could contribute to treating dysfunction. In addition, his osteopath older brother inspired him to pursue physical medicine. 
• The modern lifestyle is impacting our health. Dr. Lakhia stresses the importance of reviewing your diaphragm’s ability to expand correctly. The connection between good diaphragmatic movement, posture, and overall health is paramount. Those who disregard the influence of posture on pain are overlooking a crucial component of their health.
• You have to meet people where they are. When meeting patients, Dr. Lakhia...

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

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

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

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

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

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

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

Name: Joseph Cheatle, MD

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

Company: Carolina NeuroSurgery & Spine Associates

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

Connect: Website 

Top takeaways from this Back Talk Doc episode 

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

[04:28] Brushing off an injury: Dr. Cheatle shares how he was involved in a skiing accident that he originally...

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.

Name: John Howard, LAc., Dipl. Ac

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

Company: Battlefield Acupuncture Seminars

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

Connect: Website | LinkedIn

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

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

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

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

🎧 Subscribe in your favorite podcast app.

Back 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

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.

Name: Samantha Schroeder, DPT

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

Company:  Carolina Neurosurgery & Spine

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

Connect: LinkedIn | LSVT BIG® Promotion

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

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

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

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

🎧 Subscribe in your favorite podcast app.

Back 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...

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. 

Name: Dr. Sanjiv Lakhia

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

Company: Carolina NeuroSurgery & Spine Associates

Connect: Website |  LinkedIn 

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

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

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

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

🎧 Subscribe in your favorite podcast app.

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

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. 

Name: Patrick Jowdy, MD

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

Company: Carolina Neurosurgery & Spine Associates

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

Connect: Website | LinkedIn 

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

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

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

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

🎧 Subscribe in your favorite podcast app.

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

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.

Name: Gregory Lutz, MD

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

Company: Regenerative SportsCare Institute

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

Connect: Website | LinkedIn

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

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

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

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

🎧 Subscribe in your favorite podcast app.

Back 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

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.  

Name: Dr. Gerry Stanley 

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

Company: Harvard MedTech 

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

Connect: Website |  LinkedIn

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

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

https://www.drlakhia.com/offers/WanLnrxk

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https://www.drlakhia.com/apply

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

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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. 

Name: Puneet Aggarwal, MD

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

Company: Spine First - Atrium Health

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

Connect: Website

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

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

https://www.drlakhia.com/offers/WanLnrxk

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

https://www.drlakhia.com/apply

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

🎧 Subscribe in your favorite podcast app.

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

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. 

Name: Joseph Stern, MD

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

Company: Carolina Neurosurgery & Spine Associates

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

Connect: Website | LinkedIn | Facebook | Twitter | Instagram  

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

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

🎧 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

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. 

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

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

🎧 Subscribe in your favorite podcast app.

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

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. 

Name: Dave Eichman, MD

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

Company: Carolina Neurosurgery & Spine Associates

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

Connect: Website | LinkedIn

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

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

🎧 Subscribe in your favorite podcast app.

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

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

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

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

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

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

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

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

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

Name: Lindsey Howard, MPAS, PA-C

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

Company: Carolina Neurosurgery and Spine Associates 

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

Connect: Website |  LinkedIn

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

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

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

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

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

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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. 

Name:  Dr. Sanjiv Lakhia

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

Company: Carolina Neurosurgery & Spine Associates

Connect: Website |  LinkedIn 

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

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

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

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

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

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

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

Name: Carolyn McMakin, DC

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

Company: The FSM Clinic and Training Center

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

Connect: Website |  LinkedIn 

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

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

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

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

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

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

Name: Ki S. Jung, MD

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

Company: Carolina NeuroSurgery & Spine Associates

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

Connect: Website 

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

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

🎧 Subscribe in your favorite podcast app.

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

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. 

Name: John Slattery 

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

Company: Desert Tortoise Botanicals

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

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

Connect: Website | Instagram | YouTube

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

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

🎧 Subscribe in your favorite podcast app.

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

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

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

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

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

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

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

Access a 20% coupon to purchase Rezzimax today. 

Name: Sharik Peck

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

Company: Rezzimax 

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

Connect: Website |  LinkedIn 

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

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

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Back Talk Doc is brought to you by Carolina Neurosurgery & Spine Associates, with offices...

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.

Name: Dr. Sanjiv Lakhia 

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

Company: Carolina Neurosurgery & Spine Associates

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

Connect: Website |  LinkedIn 

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

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

🎧 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 carolinaneurosurgery.com.

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. 

Name: David Berceli, PhD

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

Company: TRE® for All, Inc.

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

Connect: LinkedIn

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

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

🎧 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 carolinaneurosurgery.com.

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

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

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

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

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

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

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

Name: Dr. Eric Goodman, DC

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

Company: Foundation Training

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

Connect: LinkedIn | Foundation Training Streaming | Instagram | YouTube

Name: Josh Brigham

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

Company: Adapt CLT

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

Connect: LinkedIn | Instagram

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

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

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

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

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

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

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

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

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

Name: Dr. Peter Bailey

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

Company: Carolina Neurosurgery and Spine Associates

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

Connect: Website |  LinkedIn 

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

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

🎧 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

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

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

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

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

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

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

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



Name: Dr. Stuart McGill, PhD

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

Company: BackFitPro 

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

Connect: Website | Twitter

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

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

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

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

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

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

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

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

Name: Vince Rossi, MD, MBA

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

Company: Carolina Neurosurgery & Spine Associates (CNSA)

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

Connect: LinkedIn

Top takeaways from this Back Talk Doc episode 

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

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

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

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

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

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

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

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

Name: Esther Gokhale

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

Company: Gokhale Method Institute, Inc.

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

Connect: LinkedIn | Book 

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

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

🎧 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...

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

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

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

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

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

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

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

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

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

Name: David Schechter, MD

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

Company: David Schechter, MD (private practice)

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

Connect: LinkedIn

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

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

🎧 Subscribe in your favorite podcast app. 

Back Talk Doc is brought to you by Carolina Neurosurgery & Spine Associates, with...

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

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

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

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

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

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

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

Name: Bryana Gregory, PharmD, RPh

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

Company: Physicians Preference Pharmacy

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

Connect: Website | LinkedIn | Facebook

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

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

🎧 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 carolinaneurosurgery.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 BackTalkDoc.com

Name: Stephanie Plummer, DO

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

Company: Carolina Neurosurgery and Spine

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

Connect: Website

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

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

🎧 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...

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.

Name: Andrew Sumich, MD

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

Company: Carolina Neurosurgery & Spine Associates

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

Connect: LinkedIn

Top takeaways from this Back Talk Doc episode

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

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

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

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

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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.

Name: Jackson Bellis, DPT COMT

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

Company: Carolina Neurosurgery & Spine Associates

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

Connect: LinkedIn ⼁Website

Top takeaways from this Back Talk Doc episode 

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

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

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

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.

Name: Joseph P. Zuhosky, MD

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

Company: Carolina Neurosurgery & Spine Associates

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

Connect: Website

Top takeaways from this Back Talk Doc episode

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

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

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

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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.

Name: Matt Parks

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

Company: One Less CBD

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

Connect: LinkedIn

Top takeaways from this Back Talk Doc episode

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

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

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

Top takeaways...

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

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

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

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

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

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

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

Name: Garrett Salpeter

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

Company: NeuFit

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

Connect: LinkedIn

Top takeaways from this Back Talk Doc episode

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

★    The body’s protective responses to stimuli are necessary, but often an overcorrection. When Garrett and his team identify a defensive neurological reaction to an insult, they are careful not to eliminate it completely, because it serves a purpose.  Yet the response is often too far-reaching. Many times, this has to do with bad habits...

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

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

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

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

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

Name: Marty Kestin

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

Company: Ensoma Bodyworks

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

Connect: LinkedIn

Top takeaways from this Back Talk Doc episode

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

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

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

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

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.

Name: Elizabeth (Betsy) Yurth, MD

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

Company: Boulder Longevity Institute

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

Connect: LinkedIn | Instagram

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

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

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

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

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Back Talk Doc is brought to

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

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

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

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

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

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

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

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

Name: Michael Nido

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

Company: Carolina Neurosurgery and Spine Associates

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

Connect: LinkedIn

Top takeaways from this Back Talk Doc episode 

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

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

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

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

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.

Name: Aaron and Jocelyn Freeman 

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

Company: Meet the Freemans 

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

Connect: LinkedIn | Facebook | Podcast

Top takeaways from this Back Talk Doc episode 

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

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

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.

Name: Dr. Hunter Dyer

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

Company: Carolina Neurosurgery & Spine Associates 

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

Connect: LinkedIn

Top takeaways from this Back Talk Doc episode 

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

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

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

★    Spinal fusion...

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

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

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

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

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

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

View Dr. Osler’s TED Talk.

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

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

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.

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

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

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

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

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

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

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

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

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

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

 More topics discussed on this episode include:

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

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

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

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

1. 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.
2. 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.
3. H-Wave (15:42): H-Wave is a multi-functional electrical stimulation device intended to speed recovery, restore function, and manage chronic, acute, or post-operative pain. The H-Wave delivers a low voltage current that promotes injury recovery and rehabilitation by stimulating muscles and can help prevent disuse atrophy. The H-Wave can provide significant relief, and, like the Alpha-Stim, it appears that the benefits of H-Wave are cumulative and lasting. So, over time, you get better and better results the more you use it. And it's an alternative to the use of prescription pain medication. The typical session lasts around 30 to 60 minutes. H-Wave is available both by prescription and offered as an OTC model.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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.

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. 

Name: Heather Wolcott

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

Company: Heather Wolcott

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

Connect: Website | Instagram

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

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

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

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

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

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

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

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

• 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)

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

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

If you enjoyed this episode of Back Talk Doc, check out our episode

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

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

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

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

·     What is an inversion table? (04:14)

·     Lumbar decompression (5:08)

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

• BlessBackWorldwide.org
• The Nature of Suffering and the Goals of Medicine by Eric Cassell