About

Alexios G. Carayannopoulos, DO, MPH, DABPMR, FASOMR, FFSMB, is a full professor of neurology and neurosurgery at The Warren Alpert Medical School of Brown University. He serves as chief of Physical Medicine and Rehabilitation at Brown University Health and Brown Health Medical Group, and is an attending physician at the Norman Prince Spine Institute. Dr. Carayannopoulos is board-certified in both physical medicine and rehabilitation as well as in pain medicine. His educational background includes a residency in physical medicine and rehabilitation at Harvard Medical School, a fellowship in pain medicine at Dartmouth Medical School, a master’s degree in public health from Johns Hopkins University, and certification in medical acupuncture from Harvard University. With a diverse background that includes 13 years as a US Navy diver and submarine officer, he is a specialist in undersea medicine and radiation health. He is internationally recognized as a leader in rehabilitation, interventional spine treatment, and pain medicine. Dr. Carayannopoulos holds leadership roles such as president of the American Society of Osteopathic Medical Regulators and the Rhode Island Society of Pain Physicians, and chairs multiple committees within prominent medical societies. He has been awarded Top Doctor in PM&R each year from 2017 through 2025 by Castle Connolly, and actively participates in medical regulation and licensure boards. He is extensively published, frequently speaks at national and international medical meetings, and has been interviewed by the news media on numerous occasions.

Research topics

• Computer Science
• Medicine
• Surgery
• Psychology
• Artificial Intelligence
• Neuroscience
• Physical therapy
• Physical medicine and rehabilitation
• Internal medicine
• Medical education
• Pathology
• Pedagogy
• Cognitive psychology
• Audiology
• Anesthesia

Selected publications

• Perilesional neuromodulation replaces lost sensorimotor function in persons with spinal cord injury

  Nature Biomedical Engineering · 2026-03-11

  article
  PublisherDOI

• Rehabilitation Strategies for Traumatic Brain Injury: Insights and Innovations.

  PubMed · 2025-08-01

  article1st authorCorresponding
  Publisher

• P200 PRECISION REHABILITATION FOLLOWING RESTORATIVE NEUROSTIMULATION IMPLANTATION FOR MULTIFIDUS DYSFUNCTION

  Neuromodulation Technology at the Neural Interface · 2025-01-01

  article1st authorCorresponding
  PublisherDOI

• O052 HIGH FREQUENCY SPINAL CORD STIMULATION IN PATIENTS WHO PREVIOUSLY FAILED TRADITIONAL SCS: A PROSPECTIVE, MULTICENTER, OBSERVATIONAL STUDY

  Neuromodulation Technology at the Neural Interface · 2025-01-01

  articleSenior author
  PublisherDOI

• El Comité de Consenso sobre la Adecuación en Neuroestimulacion (NACC)®: Recomendaciones para la Mitigación de Complicaciones en Neuroestimulacion

  NeuroTarget · 2025-07-22

  articleOpen access

  Introducción: La Sociedad Internacional de Neuromodulación convocó a un grupo de médicos de múltiples especialidades según su experiencia y la representación internacional para establecer directrices basadas en evidencia sobre la mitigación de las complicaciones de la neuromodulación. Este proyecto del Comité de Consenso sobre la Adecuación en la Neuroestimulación (NACC)® tiene la intención de actualizar las directrices basadas en evidencia y ofrecer opiniones de expertos que mejoren la eficacia y la seguridad.Materiales y Métodos: Los autores fueron elegidos en base a su experiencia clínica, familiaridad con la literatura revisada por pares, productividad en investigación y contribuciones a la literatura de neuromodulación. Los líderes de sección supervisaron búsquedas de literatura en MEDLINE, BioMed Central, Current Contents Connect, Embase, International Pharmaceutical Abstracts, Web of Science, Google Scholar y PubMed desde 2017 (cuando NACC publicó por última vez directrices) hasta octubre de 2023. Los estudios identificados fueron clasificados utilizando los criterios del Grupo de Trabajo de Servicios Preventivos de los Estados Unidos para evidencia y certeza de beneficio neto. Las recomendaciones se basan en la solidez de la evidencia o consenso cuando la evidencia era escasa.Resultados: El NACC examinó la literatura publicada y estableció recomendaciones basadas en evidencia y consenso para guiar las mejores prácticas. Se proporcionará orientación adicional a medida que se desarrolle nueva evidencia en futuras versiones de este proceso.Conclusiones: El NACC recomienda las mejores practicas relativas a la mitigación de complicaciones asociadas con la neuroestimulación para mejorar la seguridad y eficacia. Las recomendaciones basadas en la evidencia y el consenso deberían ser usadas como guía para asistir a la toma de decisiones, cuando sea apropiado clínicamente.

  PublisherOA PDFDOI

• Five-Year Longitudinal Follow-Up of Restorative Neurostimulation Shows Durability of Effectiveness in Patients With Refractory Chronic Low Back Pain Associated With Multifidus Muscle Dysfunction

  Neuromodulation Technology at the Neural Interface · 2024-03-12 · 29 citations

  articleOpen access

  BACKGROUND: Adults with refractory, mechanical chronic low back pain associated with impaired neuromuscular control of the lumbar multifidus muscle have few treatment options that provide long-term clinical benefit. This study hypothesized that restorative neurostimulation, a rehabilitative treatment that activates the lumbar multifidus muscles to overcome underlying dysfunction, is safe and provides relevant and durable clinical benefit to patients with this specific etiology. MATERIALS AND METHODS: In this prospective five-year longitudinal follow-up of the ReActiv8-B pivotal trial, participants (N = 204) had activity-limiting, moderate-to-severe, refractory, mechanical chronic low back pain, a positive prone instability test result indicating impaired multifidus muscle control, and no indications for spine surgery. Low back pain intensity (10-cm visual analog scale [VAS]), disability (Oswestry Disability Index), and quality of life (EuroQol's "EQ-5D-5L" index) were compared with baseline and following the intent-to-treat principle, with a supporting mixed-effects model for repeated measures that accounted for missing data. RESULTS: At five years (n = 126), low back pain VAS had improved from 7.3 to 2.4 cm (-4.9; 95% CI, -5.3 to -4.5 cm; p < 0.0001), and 71.8% of participants had a reduction of ≥50%. The Oswestry Disability Index improved from 39.1 to 16.5 (-22.7; 95% CI, -25.4 to -20.8; p < 0.0001), and 61.1% of participants had reduction of ≥20 points. The EQ-5D-5L index improved from 0.585 to 0.807 (0.231; 95% CI, 0.195-0.267; p < 0.0001). Although the mixed-effects model attenuated completed-case results, conclusions and statistical significance were maintained. Of 52 subjects who were on opioids at baseline and had a five-year visit, 46% discontinued, and 23% decreased intake. The safety profile compared favorably with neurostimulator treatments for other types of back pain. No lead migrations were observed. CONCLUSION: Over a five-year period, restorative neurostimulation provided clinically substantial and durable benefits with a favorable safety profile in patients with refractory chronic low back pain associated with multifidus muscle dysfunction. CLINICAL TRIAL REGISTRATION: The Clinicaltrials.gov registration number for the study is NCT02577354; registration date: October 15, 2016; principal investigator: Christopher Gilligan, MD, Brigham and Women's Hospital, Boston, MA, USA. The study was conducted in Australia (Broadmeadow, New South Wales; Noosa Heads, Queensland; Welland, South Australia; Clayton, Victoria), Belgium (Sint-Niklaas; Wilrijk), The Netherlands (Rotterdam), UK (Leeds, London, Middlesbrough), and USA (La Jolla, CA; Santa Monica, CA; Aurora, CO; Carmel, IN; Indianapolis, IN; Kansas City, KS; Boston, MA; Royal Oak, MI; Durham, NC; Winston-Salem, NC; Cleveland, OH; Providence, RI; Spartanburg, SC; Spokane, WA; Charleston, WV).

  PublisherOA PDFDOI

• ID: 325685 Remote Monitoring of Sleep/Physical Activity in Chronic Pain Patients during the Neuromodulation Trial Period

  Neuromodulation Technology at the Neural Interface · 2024-10-01

  article
  PublisherDOI

• The Neurostimulation Appropriateness Consensus Committee (NACC)®: Recommendations for the Mitigation of Complications of Neurostimulation

  Neuromodulation Technology at the Neural Interface · 2024-06-13 · 22 citations

  reviewOpen access
  PublisherOA PDFDOI

• Precision Rehabilitation After Neurostimulation Implantation for Multifidus Dysfunction in Nociceptive Mechanical Chronic Low Back Pain

  Archives of Rehabilitation Research and Clinical Translation · 2024-03-22 · 5 citations

  articleOpen access1st authorCorresponding

  Chronic low back pain (CLBP) is a debilitating, painful, and costly condition. Implantable neuromuscular electrical stimulation targeting the multifidus musculature is growing as a non-pharmacologic option for patients with recalcitrant nociceptive mechanical CLBP who have failed conservative treatments (including medications and physical therapy) and for whom surgery is not indicated. Properly selecting patients who meet specific criteria (based on historical results from randomized controlled trials), who diligently adhere to implant usage and precisely implement neuromuscular rehabilitation, improve success of significant functional recovery, as well as pain medication reductions. Patients with nociceptive mechanical CLBP who underwent implanted multifidus neurostimulation have been treated by physicians and rehabilitation specialists who have honed their experience working with multifidus neurostimulation. They have collaborated on consensus and evidence-driven guidelines to improve quality outcomes and to assist providers when encountering patients with this device. Physicians and physical therapists together provide precision patient-centric medical management with quality neuromuscular rehabilitation to encourage patients to be experts of both their implants and quality spine motion to help override long-standing multifidus dysfunction related to their CLBP.

  PublisherOA PDFDOI

• Impact of Sacroiliac Belt Utilization on Balance in Patients with Low Back Pain

  Orthopedic Reviews · 2024-04-30 · 1 citations

  articleOpen accessSenior author

  Background: Low back pain (LBP) is a common problem which can affect balance and, in turn, increase fall risk. The aim of this investigation was to evaluate the impact of a Sacroiliac Belt (SB) on balance and stability in patients with LBP. Methods: Subjects with LBP and without LBP ("Asymptomatic") were enrolled. Baseline balance was assessed using the Berg Balance Scale. In a counterbalanced crossover design, LBP and Asymptomatic subjects were randomized to one of two groups: 1) start with wearing the SB (Serola Biomechanics, Inc.) followed by not wearing the SB or 2) start without wearing the SB followed by wearing the SB. For subjects in both groups, dynamic balance was then assessed using the Star Excursion Balance Test (SEBT) with each leg planted. Results: Baseline balance was worse in LBP subjects (Berg 51/56) than Asymptomatic subjects (Berg 56/56) (p<0.01). SB significantly improved SEBT performance in LBP subjects regardless of which leg was planted (p<0.01). SB positively impacted Asymptomatic subjects' SEBT performance with the left leg planted (p=0.0002). Conclusion: The Serola Sacroiliac Belt positively impacted dynamic balance for subjects with low back pain. Further research is needed to examine additional interventions and outcomes related to balance in patients with back pain, and to elucidate the mechanisms behind improvements in balance related to sacroiliac belt utilization.

  PublisherOA PDFDOI

Frequent coauthors

• Alex Han

  Methodist Hospital

  26 shared

• Richard Rauck

  24 shared

• Christopher Gilmore

  Center for Clinical Research (United States)

  24 shared

• Edgar L. Ross

  Brigham and Women's Hospital

  24 shared

• Shivanand P. Lad

  Duke University Hospital

  24 shared

• Joanne Borg‐Stein

  Spaulding Rehabilitation Hospital

  24 shared

• James P. Rathmell

  Brigham and Women's Hospital

  24 shared

• Christopher Gilligan

  Brigham and Women's Hospital

  24 shared

Education

• Other

  New York College of Osteopathic Medicine

  1997

• Other

  The Johns Hopkins University

  1995

• B.A.

  Connecticut College

  1992

Awards & honors

• Top Doctor in PM&R (2017-2025) by Castle Connolly