TPMG Unveils New Spine Center



Terri Reedy


TPMG Unveils New Spine Center

Newport News, VA, October 12, 2020 – Tidewater Physicians Multispecialty Group provides the full spectrum of spine care with the new TPMG Comprehensive Spine Center (CSC), a dedicated spine center designed to improve the efficiency, speed, and quality of treatment for patients suffering from spine pain. With two locations in Williamsburg and Newport News, the team is able to provide access to patients from New Kent and West Point, Gloucester and Matthews all the way down to the Hampton Roads tunnel.

The CSC is a collaboration between orthopedic specialists, Drs. Shane McGowan, Jeffrey Moore, Lara Quinlan, and Michael Potter and pain management specialists, Drs. Christopher Dawson and Mark Newman. The partnership developed after recognizing the need in Hampton Roads to improve speed and quality of care for spine pain patients. Patients will be able to receive a full continuum of spine care from diagnosis, education, and treatment to pain management, physical therapy, and non-surgical and surgical interventions.

“With the prevalence of spinal disorders in the Hampton Roads community and the length of time it can take a patient to receive appropriate treatment we knew it was imperative to form the CSC,” said TPMG Orthopedic Spine Surgeon, Shane McGowan, MD. “TPMG is the only group in the area with the resources and combined expertise to provide essential treatment for any spinal disorder.”

“I provide an alternative to opioids – pain reducing procedures that take minutes to perform in my office and require no downtime and no restrictions afterwards,” said TPMG Interventional Pain Treatment Specialist, Christopher A. Dawson, MD. “Our spine specialists at the TPMG CSC work together to enhance the function of the spine pain patient, decrease suffering and improve quality of life – all in a timely fashion.”

The goals of the TPMG Comprehensive Spine Center are to provide state-of-the-art treatment for all Hampton Roads spine pain patients, improve the efficiency and ease of referrals from doctors in the Tidewater region, and improve feedback to the referring physicians about the status of their spine pain patient. The CSC specialists have the convenience of on-site physical therapy locations in both Newport News and Williamsburg.

The Comprehensive Spine Center (CSC) provides care for the following conditions:

• Back Pain
• Neck Pain
• Sciatica
• Disc Bulges
• Disc Herniations
• Spinal Stenosis
• Back/Neck arthritis (facet arthritis)
• Degenerative disc disease
• Scoliosis (both adult and pediatric)
• Sacroiliac Joint Pain
• Spinal Tumors
• Spinal Deformity
• Vertebral Compression Fracture

The team works in close collaboration to develop a customized plan of care that suits the needs of each patient. Drs. Jeffrey Moore, Christopher Dawson, and Mark Newman are highly trained in non-surgical spinal procedures including epidural steroid injections, nerve blocks, sacroiliac joint injections, and radiofrequency ablation. In addition, following an extensive career as a spine surgeon, Dr. Moore currently focuses on non-operative spine care which provides a unique perspective from a surgeons viewpoint. Dr. Shane McGowan will continue to focus on the surgical intervention of patients when absolutely required opting for minimally invasive techniques when appropriate and larger surgeries when necessary.

If you have back pain, neck pain, pinched nerves or sciatica call the TPMG Comprehensive Spine Center (CSC) today to be evaluated promptly and receive treatment to eliminate your spine pain. To learn more visit TPMG Comprehensive Spine Center or call the office at (757) 327-0657.


Founded in 1992, Tidewater Physicians Multispecialty Group (TPMG) includes more than 220 primary care, specialty physicians and advanced practice clinicians in more than 85 locations throughout southeastern Virginia. TPMG’s mission is to provide superior healthcare that is responsible, physician-directed, and dedicated to keeping patients best interest foremost. The TPMG medical team includes expert physicians, nurse practitioners, physician assistants, nurses, medical assistants, diagnostic staff, and non-clinical staff all working together to provide consistent, compassionate, high-quality medical care. Learn more at

Carpal Tunnel Syndrome

By: Madison Bambini
Published: October 12, 2020

With the dreaded summer heat behind us, many of us are spending more time outdoors sprucing up the home. One effective way of ridding our area of debris is by power washing. Although a great cleaning tool, your prolonged grasp and the consistent vibration of the machine can make your hand numb and tingly. This combination may cause the flare-up of carpal tunnel syndrome.

What is Carpal Tunnel Syndrome?

Carpal tunnel occurs when the largest nerve (median nerve) in the wrist is compressed. This compression can cause numbness, tingling, and

 even weakness. In some cases, pain may radiate from the fingers into the hand and arm. 

The median nerve provides feeling and movement to the thumb side of the hand. The area where your palm and wrist connect is the carpal tunnel and is also where the median nerve sits. If swelling builds in the tunnel, the pressure pushes on the nerve and affects its function. 

Symptoms of Carpal Tunnel Syndrome

The symptoms of carpal tunnel syndrome include sensory and motor dysfunction. Numbness or tingling most often occurs in the thumb, index, middle, and ring fingers and is frequently noticed at night. However, symptoms may develop during daily activities such as power washing, driving, or reading a newspaper. Sometimes, a weaker grip may develop with a tendency to drop objects. In more severe cases, sensation may be permanently lost and the muscles at the base of the thumb slowly shrink, resulting in a difficulty to pinch objects.

The diagnosis of carpal tunnel syndrome remains a clinical diagnosis. The clinical criteria for the diagnosis includes numbness and tingling in the median nerve distribution; nighttime numbness; weakness and/or atrophy of the thumb muscles; Tinel’s sign (tapping over nerve results in “pins and needles” in fingers); Phalen’s test (forced wrist flexion results in “pins and needles” in fingers); and loss of 2-point discrimination. If clinical testing is positive and surgery is being considered, a hand surgeon may perform an electrodiagnostic test to confirm carpal tunnel syndrome and check for other possibilities of nerve problems.

How to Treat Carpal Tunnel Syndrome

Non-Operative Treatments

When treating carpal tunnel, it’s important to exhaust all non-operative treatments first. Wrist splints can be used to help reduce pressure on the nerve and relieve symptoms, especially at night. Another non-operative option is the use of steroid injections to reduce swelling around the nerve to relieve symptoms.  Oral steroids, mobilization exercises, and ultrasound are other options to provide relief.  

Operative Treatments

When symptoms are too severe or do not improve, surgery should be considered. Surgery helps to make more room for the nerve by releasing the tension in the tunnel. Following surgery, numbness and tingling may disappear quickly or slowly depending on the patient. The strength of the hand and wrist may take several months to return with the help of a hand therapist. In some cases, the symptoms of carpal tunnel syndrome may not completely go away, especially in the more severe instances. Overall, after carpal tunnel surgery, patients are satisfied by the improvement in their symptoms and can return to functional abilities again.

Getting Back to Normal

If you do suffer from carpal tunnel, it’s important to remember the different ways you can minimize symptoms when performing everyday activities. Reduce your grip in instances like vacuuming or mowing the lawn, take frequent breaks, stretch, and in cooler months, stay warm by wearing gloves. When you are not busy performing housework or at the office, try to maintain a neutral wrist position by wearing a brace. By making simple modifications to performing everyday tasks you can help alleviate flare-ups and reduce the reoccurrence of symptoms. Remember, a hand specialist can help you find the best path to recovery. 


About Nicolas A. Smerlis, MD, FAAOS, CAQSH

Nicholas Smerlis, MDBoard certified Orthopedic hand surgeon, Nicholas A. Smerlis, MD, FAAOS, CAQSH has over a decade of experience specializing in the surgical and non-surgical treatment of the hand, wrist, and elbow. Although he specializes in surgery of the hand, not all problems need surgery. Dr. Smerlis often uses non-operative treatments such as medications, splints, injections, and hand therapy to restore function to the hand and wrist. Dr. Smerlis joined TPMG Orthopedics in June 2019 and sees patients in the Newport News and Williamsburg offices.

Post-Inflammatory Hyperpigmentation

By: Meg Irish
Posted: September 11, 2020

The color of human skin is partly determined by specialized cells in the skin called melanocytes. One important job of melanocytes is to make a brown pigment called melanin. The amount of melanin produced by melanocytes varies across individuals with lighter and darker skin color. Conditions that result in either darkening or lightening of the skin are known as pigmentary disorders.

Pigmentary disorders are a common concern, particularly for persons with skin of color.  In fact, numerous studies have showed that disorders of pigmentation are amongst the most common reason for visiting a dermatologist. Read more

Dr Coleman and the InterStim Micro

TPMG Center for Colorectal Surgery Is One of First to Offer New Medical Technology from Medtronic to Treat People Suffering from Incontinence

Melanoma – Tips to Spot this Aggressive Form of Skin Cancer

By: Max Warren
Posted: August 24, 2020

There are three major types of skin cancer: basal cell carcinoma, squamous cell carcinoma, and melanoma. Melanoma is the least common and most aggressive form. Of the over 3 million skin cancer diagnoses reported by the American Academy of Dermatology, approximately 200,000 cases will be diagnosed as melanoma. Melanoma can occur anywhere on the skin, but is more commonly found on the legs of women and the chest or back of men. Research indicates that UV light from the sun and indoor tanning causes melanoma*. (*Source: American Academy of Dermatology) Risk factors that increase the odds of developing melanoma include excessive sun exposure, a weakened immune system, fair skin, personal skin cancer history, and a family history of skin cancer. Read more

Foot and Ankle

Five Common Conditions that Cause Foot and Ankle Pain

By: Benjamin R. Proto, DPM, FACFAS
Published: August 11, 2020

Getting around to do daily tasks is highly dependent on the performance of your feet and ankles for many people. When something goes wrong, simply going for a walk could be taxing if pain emerges. Symptoms, risk factors, and treatment for five common conditions are explained below.

Foot and Ankle

Plantar Fasciitis

What are the Causes and Risk Factors for Plantar Fasciitis?

This condition is recognized by a sharp stabbing pain which is caused by inflammation of the ligament that supports the bottom of the foot, connecting the heel to the toes.  The inflammation can occur anywhere in the foot but is usually felt in the heel or arch of the foot. People who have plantar fasciitis commonly notice the pain when they first get out of bed in the morning that may subside or be felt throughout the day.
Read more

Older woman safely gardening to avoid a flare-up in her arthritis

Arthritis in the Hand: Being Mindful During Home DIYs

By: Nicholas A. Smerlis, MD, FAAOS, CAQSH
Published: May 22, 2020

With more time at home during quarantine, now is a great time to tackle that home to-do list. Working in flower beds, power-washing the driveway, or even finally taking the time to build a new piece of furniture are all great activities to start. But be careful, the possibility of an arthritic flare-up lurks for some projects. 

Be Mindful of Arthritic Flare-Ups

Older woman safely gardening to avoid a flare-up in her arthritis

As spring blooms, we spend time preparing flower beds, weeding, and pruning. Together, these activities can create the perfect opportunity for arthritis in the hand and wrist to flare, leading to swollen joints and painful movements. Read more

Woman suffering from stomach condition like IBS, clutching her stomach.

IBS: What is it?

By: Madison Bambini
Published: April 24, 2020

Suffering from stomach issues can be exhausting. If you find yourself with consistent abdominal cramping, bloating, and irregular bowel movements, you’re not alone. According to the International Foundation for Gastrointestinal Disorders, 10-15% of the population worldwide suffers from IBS. Irritable bowel syndrome, or IBS, is a condition that affects the large intestine and can present itself in a variety of ways. Read more

pain in knee

What is Prolotherapy and How Does it Work?

By: James Thompson, DO
Published: March 3, 2020

A non-invasive regenerative medicine therapy practiced for nearly a century by doctors, prolotherapy has the potential to aid in the healing of numerous ailments including common sports injuries and arthritic joints.   

What is Prolotherapy?

Prolotherapy, short for proliferation therapy, is a non-invasive treatment that involves the injection of a solution into a weak or damaged area of the body in order to regenerate and repair tissue. More specifically, a small amount of solution, often dextrose (sugar), lidocaine (a commonly used local anesthetic), and sterile water mixture, is injected near painful or damaged ligaments, tendons, or joints to induce an inflammatory response. Once injected into these areas, these seemingly benign substances promote healing, which is initiated by the body. Read more

Kidney stones passing in the right kidney, showing where pain originates.

Two Williamsburg Urologists Change the Way Kidney Stones are Treated

By: Madison Bambini
Published on: February 21, 2020

Small Stones That Cause Big Problems

For those who suffer from kidney stones, finding relief as soon as possible is crucial. When you’re starting to experience symptoms, a trip to the Emergency Room (ER) may only give you slight relief before the pain returns. Two Williamsburg urologists, Geoffrey B. Kostiner, MD, and Joseph R. Habibi, MD, offer a unique approach aimed at helping patients avoid a repeat trip to the ER.

What is a Kidney Stone? How do I Know if I Have One?

Kidney stones (nephrolithiasis) are mineral deposits that form when the solutes, or the chemistry of urine, is imbalanced. These alterations allow the deposits to clump together, forming a kidney stone.


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