Spine & Nerve

In this episode, Dr. Brian Joves shares a personal journey of confronting cancer and how it reshaped his perspective on nutrition. Despite the fact that most physicians receive only a few hours of formal training in nutrition, diet remains one of the most powerful—and underutilized—tools in medicine.We’ll discuss:Why nutrition education is lacking in medical training.The dangers of the Standard American Diet (SAD) and its role in chronic disease and pain.The science behind ketogenic diets, the Warburg effect, and what emerging research says about cancer and metabolism.How nutrition quality directly impacts chronic spinal pain and recovery.Practical, evidence-based ways patients can improve wellness and resilience—whether managing cancer, chronic pain, or simply aiming for better health.Key Takeaways:Nutrition is foundational—not optional—for long-term health, recovery, and resilience.Cancer and chronic pain share a common thread: both are influenced by inflammation, metabolic health, and lifestyle choices.Medical interventions—whether injections, medications, or surgery—are more effective when paired with better nutrition, movement, rest, and mindset.Patients don’t need to overhaul everything at once. Small, consistent changes—reducing processed foods, improving diet quality, and focusing on whole foods—can be transformative.Want to dive deeper into the link between nutrition and pain? Check out my prior episodes here:Nutrition and Chronic Pain (https://spotifycreators-web.app.link/e/eo3TZcNloWb?utm_source=chatgpt.com)Nutrition, Inflammation, and Pain Medicine (https://open.spotify.com/episode/18CCOiYVIN2yN4wOO2Xuwi?si=DQM3SJgwS5-Nj0Er_4P5Hg&utm_source=chatgpt.com)

In this episode of the Spine & Nerve Podcast, Dr. Brian Joves and Dr. Jason Kung dive into the evolving world of peripheral nerve stimulation (PNS). As the field of pain medicine continues to progress, new studies are offering more insights into advanced therapies for challenging conditions like peripheral neuralgia and chronic pain. This discussion focused on the COMFORT study, which evaluates the efficacy of the Nalu PNS System, and discuss recent data presented at the American Society of Regional Anesthesia and Pain Medicine (ASRA) meeting concerning the SPRINT PNS System. Key Topics Covered: COMFORT Study Insights: The doctors analyze the one-year data from the COMFORT trial, a randomized controlled study assessing the Nalu PNS System combined with conventional treatments versus conventional treatments alone for chronic neuropathic pain. They highlight significant findings, including an 87% responder rate with an average pain reduction of 69% among responders at 12 months. SPRINT PNS System Data: Discussion extends to new data from the SPRINT PNS System, particularly the RESET Clinical Trial, which compares 60-day percutaneous PNS to standard interventional management for chronic low back pain. The trial's primary endpoint results indicate that PNS provided clinically meaningful and statistically superior reductions in pain, as well as improvements in function and quality of life. Clinical Implications and Future Directions: Dr. Joves and Dr. Kung explore the broader implications of these studies for clinical practice, emphasizing the importance of personalized treatment plans and the potential for PNS therapies to offer durable pain relief. They also discuss the evolving landscape of pain management and the need for ongoing research to refine and validate these therapeutic approaches. Resources and Links: https://nalumed.com/clinical-trials/comfort-trial/ https://www.sprtherapeutics.com/2024/11/21/new-sprint-pns-data-for-low-back-shoulder-knee-and-headache-at-23rd-annual-asra-pain-medicine-meeting/ Follow us on LinkedIn: ⁠Jason Kung, MD and Brian Joves, MD⁠ Subscribe to the Spine & Nerve Podcast everywhere podcasts are available Keep striving to provide the best care for your patients and stay informed on the evolving practices in pain management! This podcast is for information and educational purposes only, it is not meant to be medical or career advice. If anything discussed may pertain to you, please seek council with your healthcare provider. The views expressed are those of the individuals expressing them, they may not represent the views of Spine & Nerve.

In this episode of The Spine & Nerve Podcast, Dr. Jason Kung and Dr. Brian Joves break down the new California opioid guidelines with insights that every healthcare provider and pain management specialist should know. Our doctors explore the latest guidelines from the California Medical Board, published in July 2023 and designed to navigate the complexities of prescribing opioids in chronic pain management. Whether you're in California or beyond, this episode is a must-listen to understand the evolving landscape of pain treatment. Understanding the New Guidelines Published in July 2023, these guidelines are a response to the opioid crisis and aim to balance effective pain management with reducing opioid-related risks. Patient-Centered Approach Discover how the new guidelines emphasize a patient-focused approach. From initial evaluations to risk assessments- the guidelines highlight the importance of treating each patient as an individual, tailoring treatments to their specific needs and conditions. The Role of Documentation thorough documentation in pain management is critical. Proper documentation not only supports clinical decisions but also safeguards both the provider and the patient throughout the treatment process. Managing High-Risk Patients Explore strategies for managing patients at high risk of opioid misuse. The guidelines provide tools for assessing and mitigating risks, ensuring that opioid therapy is reserved for those who will benefit most and are least likely to experience adverse outcomes. Opioid Tapering and Legacy Patients The team discusses the sensitive topic of tapering long-term opioid therapy, particularly for legacy patients who have been on high-dose opioids for extended periods. Learn how to approach tapering with caution to minimize patient distress and maximize safety. Telehealth and Pain Management Understand the role of telehealth in pain management as outlined in the new guidelines. While a valuable tool, telehealth requires careful use to ensure that patients receive appropriate examinations and care. Social Media Spotlight: Dr. Kung shares his experience rejoining social media through LinkedIn, offering a glimpse into how pain management professionals stay connected and informed. Breaking Down the Guidelines: A detailed exploration of the California Medical Board’s opioid guidelines, including patient evaluation, risk assessment, and non-opioid treatments. Explore the California Opioid Guidelines: Access the document directly from the show notes to understand the specifics and apply them in your practice. Engage with Us: Subscribe to the Spine & Nerve podcast, share this episode with your colleagues, and join the discussion on LinkedIn and other social media platforms. "Pain relief is important, but it is difficult to measure objectively. Our goal is to maintain or improve function while managing pain effectively." - Dr. Brian Joves Dive into this episode and equip yourself with the knowledge and tools to navigate the complex world of pain management with confidence and compassion. California Opioid Guidelines: Access the full guidelines here Follow us on LinkedIn: Jason Kung, MD and Brian Joves, MD Subscribe to the Spine & Nerve Podcast everywhere podcasts are available Keep striving to provide the best care for your patients and stay informed on the evolving practices in pain management! This podcast is for information and educational purposes only, it is not meant to be medical or career advice. If anything discussed may pertain to you, please seek council with your healthcare provider. The views expressed are those of the individuals expressing them, they may not represent the views of Spine & Nerve.