Dr. Gerard Jarvis

06/12/2026

There is increasing clinical awareness of the relationship between metabolic health and cognitive function, particularly in older adults and patients with diabetes or insulin resistance.

In many hospital settings, standard meal trays often include refined carbohydrates and simple sugars that can contribute to rapid postprandial glucose elevation and subsequent fluctuations in blood sugar. These glycemic swings are frequently managed reactively with insulin administration, rather than being addressed upstream through nutritional planning.

From a physiologic perspective, the brain is highly sensitive to changes in glucose availability. Acute hyperglycemia and glycemic variability have been associated in the literature with changes in attention, processing speed, and overall cognitive performance, especially in vulnerable populations with pre-existing vascular or metabolic risk factors.

While pharmacologic glucose control remains an essential component of care, nutrition is a primary determinant of glycemic stability and is often underemphasized in acute care planning.

A more integrated approach that includes nutrition as a foundational element of treatment may support not only metabolic outcomes, but also cognitive function and recovery in at-risk patients.



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In people with chronic diabetes, persistently high glucose doesn’t just raise blood sugar levels — it also triggers a biochemical process called glycation. Glycation happens when excess sugar molecules bind to proteins and fats without enzymes, forming what scientists call advanced glycation end products or AGEs. These sticky compounds accumulate inside cells, including neurons, and alter the structure and function of critical proteins. Over time, this “internal sweetening” can stiffen cellular machinery, impair energy metabolism, and create oxidative stress that damages nerve cells. Elevated AGEs have been linked to poorer brain health in people with diabetes and a higher risk of cognitive decline and Alzheimer-like changes.

Inside neurons, AGEs trigger inflammation and reactive oxygen species that interfere with normal signaling and promote structural deterioration, especially in memory-related regions like the hippocampus. Chronic hyperglycemia also disrupts insulin signaling in the brain, which neurons depend on for survival and plasticity. This combination of sugar-driven protein modification, inflammation, and metabolic stress can weaken synaptic connections and slow cognitive processes.

This isn’t a literal caramelization like cooking sugar in a pan, but the metaphor helps describe how persistent high glucose chemically alters brain cells. These changes are part of what researchers call diabetic encephalopathy — a pattern of brain injury associated with long-term diabetes that spans functional decline and structural changes.

Research Paper 📄
DOI: 10.1007/s12035-025-05051-9
PMID: 38539672

06/12/2026

Pain Relief and Healing Are Not Always the Same Thing

When you're living with chronic back pain, it's completely understandable to want relief as quickly as possible. But before undergoing any procedure, patients deserve to understand not only the potential benefits but also the possible long-term consequences.

Lumbar medial branch radiofrequency ablation (RFA) is commonly used to reduce facet-related back pain by burning nerves that transmit pain signals. What many patients are never told is that these same nerves also help supply the multifidus muscle - of the most important stabilizing muscles of the spine.

Research has raised concerns that ablations may contribute to multifidus dysfunction, fatty infiltration, and muscle atrophy. In other words, pain may improve, but important questions remain about what happens to spinal stability and function over time.

This doesn't mean ablations are never appropriate. It does mean patients deserve true informed consent.

Consent is signing a form.

Informed consent is understanding:
• What is being done
• What structures are affected
• What benefits may occur
• What risks exist
• What alternatives are available
• Whether the procedure addresses the cause of the problem or simply the symptom

And perhaps most importantly:
Are you willing to trade today's pain relief for a potentially increased risk of future weakness, instability, and disability?

Another question worth asking is:

What is the long-term plan?
If the procedure needs to be repeated every 10–12 months, what happens after the second, third, or fourth ablation? If progressive muscle loss and spinal instability become part of the equation, what comes next?

For many patients, the answer may ultimately become more procedures, more interventions, or even surgery.

Muscle matters. Stability matters. Function matters.

The goal shouldn't simply be less pain today. The goal should be building and preserving a stronger, more resilient spine for years to come.

Before choosing any treatment, ask yourself:

Is this helping my body heal, or is it simply helping me feel less pain?

Sometimes those are the same thing. Sometimes they're not.

(See the linked study below for more information.)

Background/Objectives: Chronic low back pain (CLBP) is a leading cause of disability worldwide, with lumbar medial branch radiofrequency ablation (LRFA) widely used to manage facet-mediated pain; however, emerging evidence raises concerns regarding ...

06/10/2026

🚨 A fall isn't just a fall.

For many older adults, it's the beginning of a downward spiral that can steal strength, independence, confidence, and quality of life.

The injury itself is only part of the problem.

What happens next may be even more devastating.

Days or weeks of reduced activity, bed rest, medications, and fear of movement can lead to rapid muscle loss, worsening balance, instability, and weakness in the very muscles needed to stay independent.

And the statistics are sobering:
📊 More than 1 in 4 adults over 65 fall each year.
📊 Falls are the leading cause of injury-related death in older adults.
📊 Nearly 3 million older adults visit emergency rooms annually because of falls.
📊 About 1 million are hospitalized each year due to fall-related injuries.
📊 Falls are a leading cause of hip fractures, traumatic brain injuries, loss of independence, and admission to assisted living facilities.

Unfortunately, many seniors are then prescribed medications that may further affect balance, coordination, alertness, and cognitive function-factors that can increase the risk of future falls.

Risk-reducing strategies, including preserving strength and mobility, become increasingly important as we age.

This is why maintaining muscle isn't about appearance.
💪 Muscle is longevity.
💪 Muscle is stability.
💪 Muscle is resilience.
💪 Muscle is independence.

At Tonic Spine & Disc, we're proud to be one of the few clinics in the state offering functional rehabilitation with EMSCULPT NEO.

For individuals recovering from injury, struggling with weakness, or concerned about age-related muscle loss, EMSCULPT NEO can help build muscle and improve strength in key support areas of the body-helping create a stronger foundation for movement, balance, and function.

The goal isn't simply to recover from a fall.

The goal is to become more resilient against the next one.

Because the stronger you are today, the more independent you can remain tomorrow.



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06/08/2026

The Forgotten Food Factor in Health

When people struggle with fatigue, brain fog, chronic pain, mood changes, weight gain, or declining health, the focus is often on symptoms rather than one of the biggest influences on the body: nutrition.

The brain is highly sensitive to metabolic health, and what we eat can affect inflammation, blood sugar, hormones, gut health, and brain function.

Many experts have raised concerns about diets high in:
• Added sugars
• Industrial trans fats
• Ultra-processed foods
• Artificial additives
• MSG and other potential excitotoxins in susceptible individuals

While these ingredients are not the sole cause of disease, research continues to link heavily processed diets to obesity, diabetes, heart disease, inflammation, cognitive decline, and mental health challenges.

Food isn't just fuel-it's information for every cell in the body.

It influences hormones, inflammation, blood sugar regulation, neurotransmitter production, gut health, and brain function.

Before assuming a pill is the only answer, it may be worth looking at what's on the plate.

The body is built from what we consume. The brain is no exception.

06/06/2026

When it comes to helping patients with chronic low back, hip, and knee pain, having more treatment options matters.

Dr. Mohamed Abdulhamid, MD, FAANS, FCNS (Dr. A) recently shared his experience using one of the advanced technologies we offer in our clinic. His perspective reinforces something we've believed for years: better tools often lead to better outcomes.

Today's patients are looking for effective, conservative solutions that help them avoid unnecessary medications, repeated injections, and surgery whenever possible.

That's why we've invested in bringing together multiple best-in-class technologies under one roof.

Our comprehensive approach may include:
• Emsculpt Neo® for muscle strengthening, functional restoration, and core stabilization
• IDD Therapy® for non-surgical spinal decompression and disc-related conditions
• MLS M7® and Summus Medical Laser® for advanced laser therapy and tissue healing
• SoftWave Tissue Regenerative Technologies® to support the body's natural healing and regenerative processes
• Emsella® for pelvic floor rehabilitation and core support
• Additional evidence-informed technologies designed to help patients move better, function better, and hurt less

No single treatment is a magic solution.

However, when advanced technologies are combined with a thorough evaluation, clinical expertise, and an individualized treatment plan, the results can be remarkable.

We're proud to offer innovative conservative care options that help patients regain function, improve quality of life, and get back to doing the activities they enjoy most.

Technology alone doesn't create great outcomes. But when the right technology is paired with the right diagnosis, the right treatment plan, and the right team, patients win.




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06/06/2026

Watching Painkiller is a powerful reminder of what can happen when profits are placed ahead of patients.

One quote from the series that stuck with me was:
"If we park ourselves right in the middle between pain and pleasure, we'll never worry about money again."

It's a chilling statement because it highlights a fundamental truth about addiction and the human brain. Opioids don't just treat pain-they interact with the same reward pathways that influence pleasure, motivation, and dependence. When that balance is manipulated for profit, the consequences are devastating.

The opioid epidemic wasn't just about a drug -it was about a system.

Pharmaceutical companies aggressively marketed opioids while addiction risks were knowingly minimized. Many physicians were paid for speaking engagements and promotional activities tied to these medications.

Pill mills appeared across the country.

Prescriptions skyrocketed. Money flowed.

Meanwhile, families paid the price.

Many people weren't seeking a high-they were seeking relief from pain. They trusted the healthcare system, trusted the research, and trusted that the medications being prescribed were safe.

While many healthcare professionals acted with the best intentions, the opioid crisis exposed how financial incentives can influence healthcare decisions. The result was one of the most devastating public health crises in American history.

Parents lost children. Children lost parents. Communities were torn apart.

The lesson isn't to reject medicine. The lesson is to stay informed, ask questions, understand the risks, and remember that no company, profession, or institution should ever be beyond accountability.

When profits come before people, the consequences are measured not in dollars-but in lives.

Check out the new Painkiller Limited Series Trailer starring Matthew Broderick!► Learn more: https://www.rottentomatoes.com/tv/painkiller/s01?cmp=RTTV_YouTub...

06/05/2026

Fusion Stops Motion at the Treated Levels - What Happens Next?

Have you ever felt like your treatment options for neck or back pain keep following the same frustrating script?

First, you're prescribed medications.

Maybe it's gabapentin, muscle relaxers, NSAIDs, antidepressants, or a combination of several drugs. When the pain persists, you're offered injections. Then more injections. Then nerve burning procedures. Maybe some physical therapy. Eventually, the conversation shifts toward surgery.

For many patients, it can feel like they're becoming increasingly medicated while getting no closer to addressing the actual source of their pain.

The good news is that spine care has evolved dramatically over the last decade.

While spinal fusion remains is a necessary procedure for certain conditions, many spine specialists now recognize that it should NOT always be the first surgical solution. Advances in medicine have led to alternatives such as artificial disc replacement, minimally invasive and endoscopic spine procedures, and innovative conservative treatments designed to help patients avoid surgery whenever possible.

One important consideration with spinal fusion is that it permanently stops motion at the treated levels. When movement is eliminated in one area of the spine, the levels above and below must often absorb additional forces and stress. Over time, this will contribute to what is known as adjacent segment degeneration, a process that may accelerate wear and tear in neighboring spinal segments.

If the goal is to avoid surgery, conservative care should involve more than medications, injections, and outdated rehabilitation approaches.

Today's modern spine care may include targeted spinal decompression with IDD Therapy, regenerative medicine, Class IV laser therapy, neuromodulation, movement-based rehabilitation, ergonomic modifications, nutritional support, and other evidence-informed strategies tailored to the individual patient.

Nonsurgical IDD Therapy treatment is proven to gently and effectively treat the source of pain so you can get back to living life to the fullest. As part of a comprehensive spine care approach, advanced nonsurgical therapies may help appropriate candidates reduce pain, improve function, and potentially avoid more invasive procedures.

Not every case of neck or back pain can be resolved without surgery. Some patients ultimately require operative intervention, and surgery can be life-changing when appropriately indicated.

However, every patient deserves access to the most current, comprehensive, and up-to-date conservative options before considering invasive procedures.

The goal is to ensure that patients have explored the full spectrum of modern spine care and can make informed decisions based on all available options.
Ask questions.

Understand the risks and benefits of every treatment.

Seek multiple opinions when appropriate.

Your spine is too important for anything less.

06/04/2026

That Daily Ibuprofen Might Not Be as Harmless as You Think

Headaches. Neck pain. Back pain. Joint pain.

For many people, the first response is reaching for an NSAID such as ibuprofen (Advil), naproxen (Aleve), or other anti-inflammatory medications. While these drugs can provide short-term relief, chronic use comes with risks that are often underestimated.

Research has estimated that NSAID-related complications contribute to more than 100,000 hospitalizations and over 16,000 deaths annually in the United States due to gastrointestinal bleeding, ulcers, kidney injury, cardiovascular events, and other serious complications.

One of the biggest concerns is that serious complications can occur with little warning. Many patients who develop bleeding ulcers or other severe adverse events report few or no symptoms beforehand. NSAID use has also been associated with increased risks of heart attack, stroke, heart failure, kidney damage, and life-threatening gastrointestinal bleeding.

Pain relievers have a place in healthcare, but relying on them day after day to mask symptoms is not a long-term solution.

The good news is that healthcare continues to advance, providing more options than ever before for those seeking relief from chronic pain. While some healthcare providers remain focused primarily on medications, a growing body of evidence supports the value of comprehensive, non-drug approaches for many musculoskeletal conditions. Rather than simply masking symptoms, these therapies may help address underlying contributors to pain while avoiding many of the systemic risks associated with long-term medication use. Depending on the individual and their condition, treatments such as advanced laser therapy, SoftWave therapy, spinal decompression, targeted rehabilitation, ergonomic modifications, nutritional support, exercise, and other lifestyle changes can play an important role in improving function, reducing pain, and enhancing overall quality of life.

Understanding both the potential benefits and the potential consequences of long-term NSAID use can help you make more informed choices about your health.

Temporary relief is important. Finding and addressing the cause of the pain is even more important.