If you don't see a question that you have listed below, please feel free to contact us. We will try and answer any question or address any concern that you have.
I have been having Low-back pain for 15 years. The pain flairs up yearly and is progressively getting worse. What can be done?
- A thorough examination, detailed movement history, as well as imaging need take place to determine the cause of your pain and to rule out any underlying pathology that would contradict conservative treatment.
- 15 years of Low back pain flair ups is an indication that a patient has not been educated as to what initially caused and continually adds to their dysfunction. Chronic, long term low back issues require more than pain control measures. A comprehensive plan is needed to break the chain of pain going forward.
- Our Conservative Care model is designed to address all the contributing factors that started and continue to cause pain and dysfunction.
Is conservative spine care an alternative to standard medical care?
- Conservative care is often thought of as an alternative to traditional medical approaches. However, conservative care should be a complement to traditional medical care.
- Conservative spine care puts the patient first, and what is best for them.
-In conjunction with standard medical approaches, conservative care looks to find the least invasive way to get lasting results. However if medication, injections, or surgery are indicated, the next step would be for us to refer you to the appropriate medical doctor who could co-manage your condition.
- Our conservative care model is designed to work as a standalone approach or as a compliment to traditional medical care.
I have been diagnosed with Sciatica, how should it be treated?
- Sciatica is technically not a diagnosis but rather a symptom of an underlying issue.
- The sciatic nerve can produce symptoms if a herniated disk or other spinal issue irritates the smaller nerve roots that make up the larger Sciatic nerve.
- Treatment for sciatica starts with the determination of what the cause of the sciatic irritation is. An examination and Imaging ,such as an MRI ,would help pinpoint the involved structures and rule out any possible pathology.
- A long term approach would be to also identify the contributing factors that caused the damage to those structures that are irritated.. Our conservative care model teaches patients how to addresses these causes and then guides patients to take control of their health for the long term .
Do you believe in medication, injections, or surgery for the treatment of spinal issues?
- We believe in what is best for the patient long term.
- After we diagnose, and determine why they are in pain, we start with our conservative care model that is designed to pinpoint causes and to teach patients how to correct them.
- During that time, if it is in the best intrest of the patients progression, we will make recommendations and refer them to medical doctors who can co-treat with us.
- The co-treatment involves continuing the conservative care where appropriate so that long term success is improved.
I have tried physical therapy, chiropractic, and acupuncture but still have pain. Is it time for surgery?
- Surgery is required in less than 5% of spinal pain sufferers. . However, why surgery is performed seems to be the greatest predictor of success. Patients who have neurological deficits such as foot drop and bowel and bladder control loss, can have great success with surgery. However, if pain is the only symptom, surgical success rates decrease dramatically. It is for this reason that surgery should be the absolute last option unless otherwise contra-indicated.
- Physical Therapy, Chiropractic care, acupuncture, massage and any other non-invasive approach is only as good as its end goals. Conservative care can be a band aid if symptoms are all that are treated.
-Those treatments, if focused on pain only may have short term success but will ultimately fail the patient long term.
- The goal of care should be identifying causes of the pain, what the contributing factors are within the patients life, correcting for those factors, and then showing patients how to take care of their own health..
- If conservative care that is focused on addressing causes not just symptoms, medication, injections, and time are still not yielding expected results then surgical options can be explored.
I had a micro-discectomy and still have pain. What else can be done?
- Micro-discectomies are often performed to reduce the symptoms of a herniated disk. If the symptom is soley pain, the micro-discectomy on its own may not prevent the pain from returning.
- The damaged disk that was operated on was damaged for a reason. If the causes of the original and progressive damage to the disk are not addressed, then even after surgery the disk will continue to break down and ultimately pain will return.
- Our approach using a conservative care model, is to prevent the need for the surgery and if the surgery was performed, to improve the long term success of the surgery.
Research as well as our experience has indicated that surgical outcomes can be greatly improved if a conservative care model that identifies causes and guides patients to make changes is implemented both before and after the surgery.
I see my Chiropractor for weekly adjustments, but still have Low back pain. Is the adjustment helping or hurting?
- Manipulation of the spine is a modality used by Chiropractors, Physical Therapists, and DO's.
- If done in isolation, it will have no long term positive effect on addressing the causes of a persons pain.
-If done for prolonged periods of time, it may also contribute to the degeneration of a inter-vertebral disk as it induces destructive forces that the disk is not designed to withstand.
- Manipulation has its short term benefit in some spinal issues, but not as a standalone treatment when the goal is to improve stability and address contributing causes of the disk injury.
My Pilates instructor thinks I have Low back pain because my core is weak. Are they right?
- Have you had a formal diagnosis from a doctor that can rule out any underlying pathology that may be causing your low back pain?
- If yes, proceed. If not, that is your first step.
-I can say that the term core stability gets thrown around a lot by doctors, therapists, and fitness professionals with very little regard to what it actually means.
- Spine stability is our greatest focus when it comes to improving a patients long term success.
- Spine stability is dependent on many factors, but building the strength of a few muscles in your core in isolation is not one of them.
- Spine stability success is determined by identifying and addressing the actual physical forces that have damaged the disks. We must find out where in a persons lives those forces are found, often hidden in their activities of daily living. It is then crucial that we teach patients how to identify those forces and then to modify their activities so that those forces are no longer contributing to their chronic issues.
- In the process, the spine stabilizer muscles are re-trained to activate as a collective unit so as to recognize and work in unison to offset external destructive forces. That is true spine stability.
I have a personal trainer who I've been seeing each week for the last few years and I really like them. However, my low back pain is getting worse. What should I do?
- The first step is to have your pain evaluated by a doctor to determine the exact cause of the pain and to rule out any pathology.
- The next step is to evaluate the exercises you are doing and determine if they are appropriate for you given your lifestyle and any underlying limitations in movement you may have.
- You need to learn which activities in your life are contributing to your continued pain. That could be work activities, movements like picking up your child, or the exercises you do with your trainer. More likely though it is multi faceted and includes many activities in your life.
-Identifying these contributing factors in peoples lives that are responsible for their ongoing pain is what our conservative care model was designed to do.
-In conjunction, my involvement in the fitness industry educating fitness professionals, has led to my Clinician Guided Exercise Programs. These personalized programs are designed to educate trainers and instructors so that they can continue to train their clients with less risk of injury.
Do you refer to Orthopedists, Physiatrists, and/or Neurologists?
- As I mentioned, I do what is in the best interest of my patients long term health.
- In the event that our conservative care model is not working, a patient will be referred to the appropriate medical specialist based on their condition and needs.
- If given clearance, we will continue to co-manage the patients condition with the medical doctor.
- In addition, many of our patients are initially referred to us for co-management of their conditions from their medical doctor.
- We maintain an open communication with all of our patients doctors, therapists, and fitness professionals so that the patients care is coordinated and complete.
Why do so many people have such different opinions about the best way to deal with Low back issues?
- Most of the varied opinions are based on anecdotal results that they or someone they know had from an experience.
- Most of these varied opinions are valid in that the person did get pain relief. However, if pain relief is the only goal of care, then the actual underlying causes have not been addressed.
- It is for this reason that so many people may get pain relief from varying forms of treatment, but very few get long term results and often they have flair ups because the causes were not addressed.
- While we do address a patients pain, their long term success is greatly improved because of the conservative care model that we employ that addresses the causes not just the symptoms.
Will I be able to exercise again even though I have several herniated disks?
- Many of our patients come to us with the goal of returning to exercise. Most patients are happy to hear that herniated disks are not the end of their fitness goals. Quite the opposite actually as exercising with proper form may help manage their herniated disks long term.
- Since herniated disks never fully heal, they must be managed so that they do not worsen. Exercise for some people may be what caused their injuries in the first place so identifying the reasons why, will help them return to exercise safely.
- Our conservative care model is designed to teach people how to identify causes and then move safely without fear of re-injury. Coupled with the Clinician Guided Exercise Program, patients can return to their favorite exercise. Whether you train on your own or with an instructor or trainer, we will make sure exercise is helping you and not hurting you.
Why aren't you in Network with insurance companies?
Simple answer: Time=results!
-Many of my patients have been seen by numerous doctors, therapists, and alternative healers prior to seeing me, but yet still have pain and dysfunction. Most of those providers were in network and while most were very qualified to help, the limitations of the insurance networks made it difficult to spend enough time with a patient so that they would get the quality of care they needed.
-I made a decision 24 years ago not to "cheapen" the care I offer by succumbing to the insurance demands of seeing 6 patients an hour. I chose quality of care over volume of patients, and it has helped thousands of chronic pain patients who otherwise were left without hope.
-I see a patient for 45 to 60minutes, with new patients being seen for up to 90minutes. I am the only one who sees them, questions them, uncovers the causes of their pain, and then educates and empowers them to help themselves. In that time, the results that I get far surpass those that I would get in 6 visits in network!
I value my patients time, my time, and I want patients to get better, stay better, and not to waste time, money, and opportunities to live pain-free and dysfunction free lives.
-So, simple answer is, I invest time in patients to get them better. Being in network would not allow that to happen.
- Not everyone needs to see me, and for those people, going in network makes more sense. But for those patients whose quality of life is diminished due to chronic pain and dysfunction, insurance companies make it difficult for them to get better going in network.