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We have helped thousands of people get out of pain, often times these people were in so much pain that they were having trouble walking, and going about daily tasks. Stairs can become an excruciatingly painful challenge, a walk to the store or to the subway can seem like a marathon. Eventually this leads to avoiding daily tasks, then social activity and leads a person to shut themselves off from the outside world, just being able to carry on the most basic of activity and spending the majority of their time laying in bed, or on pain medication, instead of going about their daily social activities and hobbies.

The majority of our patients respond extremely well to normal treatment methods, and we have an array of procedures available to employ, which can address most cases and we don't have to prescribe steroidal medication or other pain medication, but what about the patients that we get that are in so much pain they cant even sit or lie down on the examination table?

We are an integrated practice and provide Chiropractic, Physical Therapy, Massage, STIM, Cold Laser, Graston, Active Release Technique, and custom orthotics as well as many other treatment techniques.
We also use epidural and other interventional pain management treatments to help relieve pain. These are powerful medications that provide immediate relief, but also have some side effects, some of them are short term like weakness, and drowsiness so we always make sure that patients are aware of what effects the drugs may have.

All of the injections and procedures are performed by our DO (Doctor of Osteopathic Medicine), who is also board certified in pain management.

Procedures Offered:
Epidural Steroid Injection
The Epidural Injection is probably the most common and well known pain reducing injection. There is a protective coating known as the dural sac which surrounds the spinal cord. It contains that fluid that coats and is responsible for providing nourishment to the spinal cord. The area between the surface of the dural sac and the spinal vertebrae is the epidural space. It is a procedure where anesthetic medicine (causes numbing) and an anti- inflammatory steroidal medicine is injected into the epidural space which reliever pain caused by irritation to the spinal nerves. Epidural injections can be given in the lower back (lumbar), middle back (thoracic), or  neck (cervical).

Facet Block Injection
The goal of the procedure is fairly straightforward and like the name indicated, it is used to "block" the nerve's pain signals. Facet joints, which are about the size of a penny, are located on either side of the vertebrae. They function to provide stability and guide the motion of the spine. The Facet Joint Injection is a simply a procedure used to block or decrease pain caused by problems in the spine.  If the facet joints are inflamed you may experience  back pain but the pain can also radiate to the abdomen, hip, groin and all the way down to the legs since the nerves run through the facet joint openings.

Nerve Block
A nerve block injection is when  a local anesthetic (like Novocain) is injected in a specific area in the area of the body's tissue near where a nerve is located. A block is performed for  pain that may be somatic (muscle or bone pain) or,  neuropathic (nerve pain). Neuropathic pain occur from damage or impingement of a nerve from a chronic condition or a previous surgical  procedure or even cancer. Somatic pain can result from many acute injuries, or chronic conditions, and may even result from  cancer or past surgical procedures.  A Nerve Block injection is used for temporarily blocking or disrupting painful nerve function. It can result in varying degrees of permanent relief. Several blocks can also be performed  and each successive block may allow for a greater degree of sustained pain relief.

We always try to make sure our patients can heal, and get out of pain the best way possible. Often that means chiropractic care, physical therapy, and treatments that come together to create a solid, effective treatment plan that works to treat the cause of pain and not just mask the symptom of pain that indicates an underlying injury of condition. When it is called for we also employ the use of powerful and effective medicine and injections to provide immediate pain relief so we can start working on finding and addressing the underlying problem.

Aches and pain are a part of life right?
Well, no, not all the time. During a particularly hectic or stressful time, yes, you are more susceptible to injury and fatigue and illness, and your hormones and immune system can become deficient from constant strain.

The fact is, that even in old age, you are not supposed to be in constant pain. Its true that young people have an easier time staying pain free due to the rate at which their bodies recover, hormone levels. Along with a higher capacity to do work, combined with a higher max heart rate, and exercise levels and it seems like you are naturally invincible when you are young.

 With age, people generally become smarter and know more about what they can, or cant, sometimes shouldn't, do.  However that doesn't always translate to people's knowlidge of thier bodies and need for fitness and exercise.  People get smarter about money, habits, even diet, but it doesnt seem like they gain much knowlidge about staying active, but injury free.

Lets step away form age for a minute, how about people in their late 20's and even early 30's that are constantly walking around with back pain, knee pain, achillies tendon problems, hamstring pain, carpal tunnel syndrome, forward head posture, and all the resuting pain and trauma resulting from these issues.

 The good news is that all of these aforementioned "injuries" are musculoskeletal, and for the most part, not related to  long term illnesses or developmental issues that can not be helped easily. There are many factors that can turn musculoskeletal imbalances in to chronic injuries, weather its bad habits, a tough and cramped work envoronment, or a simple disdain for exercise. The human body is a very capable system of movement and like the finely tuned race car that it has the ability to be, it must be taken out to the track from time to time.

Exercise:
"Working out" as we like to say, is a loosely defined regimen of running on a treadmill that does little to mimic actual running conditions or goals, followed by a visit to a few machines with little understanding of exercise is actually a great way to compound that stress and muscular imbalances that may be causing you pin in the first place.
Instead of following what everyone else is doing or getting your workouts from fitness magazines that know nothing about your body, your goals or needs, go see a physical therapist and learn about what you NEED to be doing. A physical therapist will diagnose weak, overdeveloped, and tight muscles and will implement a rehabilitation, strengthening and stretching routine, thats made specifically for you. Find a good personal trainer, explain your issues, and discuss your goals. If a trained fails to ask you about your goals before starting any type of trianing regimen with you, run away, fast, and find a better trainer.

Goals:
Many people fail to set a destination for their efforts. You have to pick a general time frame in which to address your injuries. "Ill see a doctor this week" isnt a goal. Set a date, this will make you commit to your decision. Everything after you walk in to a good pain management clinic, like here at Living Well Medical, is  easy. We have a team  of professionals with a huge repertoire of proven treatment methods that will help you recover, fast, and after you have recovered and are able to do so, you can start physical therapy to help make sure the chances of re- injuring yourself are reduced greatly.

Treatment:
This just gets easier. Weather you are suffering from "runners knee" or carpal tunnel syndrome, or have herniated or bulging discs in your back, and painful sciatica, we can help eliminate the pain, and we can do it without pills, needles or surgery. Sometimes people will require prescription pain medication for a short amount of time in order to be mobile enough to work and receive treatment, we also provide that since we have an MD on staff.

For example, you hurt your back lifting a heavy air conditioner, its happens a lot, just this week we have seen 3 people who hurt themselves while trying to open a window. Usually, a Chiropractor and Physical Therapist will talk to you about your injury, and lifestyle and exercise, and fitness habits etc. After a quick chiropractic adjustment, you can probably walk around with a little more ease and less pain. Depending on the treatments required to treat your specific case, you may then receive electric STIM therapy, and physical therapy.

We constantly evaluate out patients and reassess the treatment protocols to best suit their needs and changing physical condition, we employ a variety of cutting edge methods to produce unparalleled results.

Here is a look at what we see every day. From the initial complaint from the patient, to the MRI, and how they are treated and the outcome of the treatment protocol, we track every patient's progress, and constantly review it for the best possible results.

We recently had a patient complaining of pain and discomfort which was constant. The patient described a sharp pain that simply did not change, it just hurt all the time. Pain that emanated from the lower back (lumbar region) and radiated down the leg, resulting in sciatica, which can interfere with the function of the leg, and in severe cases it can even cause the foot to drop and render the patient unable to flex the foot back up. At worst the pain would become almost unbearable along with causing problems with mobility. It affected his life to a point that he's was constantly preoccupied with seeking relief. It had gotten so bad that if he did not lay down and take morphine it would keep him from going about their daily tasks, sometimes requiring help from friends and family to come help take care of him.

After a visit to the ER, like for most people, did not result in any reduction of pain the patient came in to see us at Living Well Medical. This particular patient has had these symptoms in the past and had even sought chiropractic care before. The desire for the commencement of daily activities and a recovery that would even allow for an increase in physical activity was the goal.

The MRI findings went as follows:
Small focal disc herniation at L5-S1 spanning to the right central to right lateral recess locations with potential nerve impingement of the S1 nerve root.  

A focal disc herniation is a herniation towards the back, and to the right of the disc. Just because the herniation is small doesn't meant that it is of little concern. A small focal herniation can impinge the sacral nerve that exits the spinal column and affect motor control of the leg, and can cause a lot of pain.

L5/ S1 simply means that the disc is located between the last spinal vertebrae in the lumbar region of the spine and the first vertebrae in the sacrum. There are 5 vertebrae in the lumbar spine and usually 5, sometimes 4, in the sacral spine.

Course of Treatment:
Adjustments
Chiropractic adjustments were employed to keep proper alignment of the spinal vertebrae and help mobilize soft tissue.
Spinal Decompression
Using the DRX 9000 the patient was put through a series of decompression sessions. The DRX 9000 is a highly specialized machine that used  exact weights and measurements to produce a series of pulls followed by periods of relaxation. This form of linear traction helps "decompress" the intervertebral disc, allowing for pressure to be released and for the the herniated disc material to recede back in to the disc.
Active Release Technique
ART is known by professional athletes all over the word as a method of treatment for sports related pain and injuries that helps them get back on the field fast and also promotes faster recovery between games. IT is an advanced soft tissue treatment method based on massage/ mobility techniques that can help treat almost any musculoskeletal injury.
Cox Technique
One of the most researched and evidence backed treatment methods available today for treating back pain. The Cox technique uses a specially designed table to help treat back pain. The technique allows for the ability to gently increase the space between vertebraes to allow for increased blood flow and speed healing.

Living Well Medical has many more treatment techniques, in addition to the aforementioned methods, that are integrated in to a specialized, individualized treatment program that helps produce unparalleled results.

Physical Therapy is the practice of helping people manage, reduce and, even eliminate pain from injuries, structural imbalances, or diseases. Physical therapists also help people improve their physical ability and help improve the strength and flexibility of muscles, joints, and ligaments and as a result help improve the integrity of the kinetic chain, which results in proper balance, agility and coordination. This can lead to a reduction in pain by taking stress away form an injured or overworked parts of the body. 

 Physical Therapists also employ a wide variety of tools and techniques and often work along side other specialists like, massage therapists or a chiropractor and medical doctors to better serve their patients.

A visit with a Physical Therapist usually starts with a few questions about the nature of your pain/ injury followed by assessments to the joints, and muscles near the site of the pain. Sometimes patients will have to get X-rays or an MRI to better assist the physician in prescribing and implementing a treatment plan. After an assessment the PT will help you better understand whats wrong and then prescribe exercises and stretching routines to help strengthen and mobilize an effected joint or muscle. Usually additional treatment protocols are also used to speed up the recovery process and help lymph drainage if there is swelling present.  

Lisa Corey is a Physical Therapist at Living Well Medical and has been working with many different patients who have been suffering from a wide variety of painful conditions and injuries.

Techniques used to treat patients:

Stretching
Strengthening Exercises
Foam Rolling
Ice/ Heat Therapy
Ice/ Heat and STIM
Kinesio Taping
Graston Technique
Cold Laser Therapy
Exercises using the SpineForce

Here is a quick video of how Kinesio Taping is used to help a patient with a grade 3 hamstring tear.

Dr Shoshany talks about the Cox Technique and why it is one of the best and most effective tools in his practice for treating patients with back pain.