Herniated Disc Treatment

About Herniated Discs

Intervertebral discs serve as spacers and shock absorbers between the vertebrae of your spine. They prevent bones from rubbing together and provide a space for nerve roots to exit the spinal canal and travel to structures throughout your body.

The discs are made up of a tough rubbery exterior called the annulus, and a soft center called the nucleus. The annulus is composed of fibrous layers of collagen and proteins, while the gel-like nucleus is made up of mostly water and collagen. The discs give your spine its mechanical flexibility and shock-absorbing properties.

A disc can become ruptured, or herniated, when a portion of the nucleus bulges through a crack in the annulus. Most herniated discs occur in the lower back, but they can also arise in the neck. A herniated disc can be asymptomatic if it does not affect a nerve. But when a bulging disc compresses a nerve root where it exits the spinal column, it can cause severe pain and restricted mobility.

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Dr. Lev Kalika
Dr. Lev Kalika

Clinical director & DC RMSK

About Neck and Back Pain
Specialist Dr. Lev Kalika, DC

Dr. Kalika is a foremost practitioner of rehabilitative medicine in NYC. He has dedicated his life’s work to finding innovative solutions for treating pain syndromes and movement disorders. Over the past 20 years, he has successfully restored pain-free functional movement to hundreds of patients. As an expert in diagnostic ultrasonography, Dr. Kalika has published multiple scientific studies that have contributed greatly to the body of knowledge in his field.

The NYDNRehab clinic features some of the most advanced medical technologies available, most of which are rarely found in private clinics. Dr. Kalika’s expertise in extracorporeal shockwave therapy (ESWT), ultrasound guided dry needling and a host of other innovative therapies makes NYDNRehab the clinic of choice for sports medicine, physical therapy and chiropractic care in Midtown Manhattan.

NYDNRehab’s Unique Approach to Herniated Disc Treatment

Conventional doctors and therapists often rely on symptoms alone to arrive at a diagnosis of disc herniation. However, there are numerous other causes of back and neck pain that produce similar symptoms, and getting an accurate diagnosis is the first step toward recovery.

At NYDNRehab, we use the highest resolution diagnostic ultrasound to get crystal-clear images of your spine, discs and surrounding structures in real time. On-site imaging means a speedy diagnosis, with no waiting for lab results.

Once we have a clear picture of what is going on, we design a personalized treatment plan based on your unique diagnostic results and profile. We never take a one-size-fits-all approach to patient care. Our advanced technologies enable us to objectively measure your progress along the way, to ensure your therapy is working.

Our holistic and personalized approach to diagnosis and treatment sets NYDNRehab apart as the clinic of choice for herniated disc treatment in NYC.

Herniated discs are common among adults. In fact, Most people after age 40 have some degree of bulged and herniated discs, and foraminal compressions to the spinal nerve roots. The majority of them are asymptomatic, producing no pain at all, and where pain is present, herniated discs are often not the sole generators of pain.

Pain is often caused by a combination of soft tissue lesions, pelvic /hip misalignment, ligamentous and fascial deterioration, muscular trigger points, and cutaneous nerves entrapment within the toraco-lumbar fascia. Unfortunately, MRI does not show those details, and doctors often focus on disc lesions, unaware of other factors that contribute to disc herniation.

Herniated Disc Symptoms
and Causes

Symptoms

  • Sharp pain in your low back or neck, often on one side
  • Pain that shoots down your buttocks or legs
  • Numbness and/or tingling in the arms or legs
  • Muscle weakness on the affected side
  • Reduced mobility due to pain
  • Herniated discs can sometimes be asymptomatic

Causes

  • Repetitive overuse from sports or exercise
  • Inefficient lifting technique
  • Excessive sitting
  • Excessive use of computers and handheld devices
  • Being sedentary and out of shape
  • Poor diet and dehydration

Accurate Diagnosis Means Fast and Effective Results

Back and neck pain does not always indicate a disc herniation, and a diagnosis based on symptoms alone can result in ineffective treatment that prolongs your pain. In many cases, back pain is non-specific in nature, with no detectable cause appearing on X Ray imaging or MRI. MRI imaging of herniated discs gives us only partial information. Diagnostic ultrasonography completes the picture, and those images together with a proper clinical examination, defines all pain generators and allows the clinician to create a comprehensive approach to herniated disc treatment.

At NYDNRehab, we use high resolution diagnostic ultrasonography to look at the structures affecting the spine in real time. Ultrasound imaging lets us view long bodies like bones, nerves and fascia along their entire path, to pinpoint the true source of pain. Sometimes nerves become entrapped by fascia adhesions or bony structures located away from the spine and the nerve root itself. Pain can also be caused by muscle strains, trigger points, and other factors.

Diagnostic ultrasound ensures that you get an accurate diagnosis on your first visit, without having to leave the clinic or wait for lab results, so your treatment can begin right away.

MRI imaging of herniated discs gives us only partial information. Diagnostic ultrasonography completes the picture, and those images together with a proper clinical examination, defines all pain generators and allows the clinician to create a comprehensive approach to herniated disc treatment.

At NYDNRehab, we use high resolution diagnostic ultrasonography to look at the structures affecting the spine in real time. Ultrasound imaging lets us view long bodies like bones, nerves and fascia along their entire path, to pinpoint the true source of pain. Sometimes nerves become entrapped by fascia adhesions or bony structures located away from the spine and the nerve root itself. Pain can also be caused by muscle strains, trigger points, and other factors.

Diagnostic ultrasound ensures that you get an accurate diagnosis on your first visit, without having to leave the clinic or wait for lab results, so your treatment can begin right away.

Innovative Treatment Options Accelerate Healing

Once we identify a disc herniation as the primary cause of pain, we create a personalized treatment plan based on your unique results. Prior to beginning physical therapy, we pretreat your disc to reduce pain and inflammation.

Pre-treatment may include:

  • Focal cryotherapy to numb painful nerve roots and shrink your bulging disc
  • Extracorporeal shockwave therapy (ESWT) to reduce pain and stimulate healing
  • Ultrasound guided dry needling to release trigger points in surrounding tissues
  • Myofascial release therapy to restore the integrity of densified fascia

Depending on the underlying cause of your pain, your treatment plan may include:

  • Physical therapy for your herniated disc
  • Posture correction therapy to prevent future disc herniation
  • Gait analysis and retraining
  • Gentle chiropractic spinal manipulation
  • Acupuncture
  • Clinical Pilates
  • Vojta Therapy
  • 3D chiropractic care
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Our Regenerative Therapies are Game-Changers for Back and Neck Pain

Your body has its own innate healing mechanisms, but it sometimes needs a nudge to accelerate the healing process. Non-invasive regenerative technologies help to jump-start healing by stimulating tissue repair at the cellular level.

Focused Shockwave Therapy

Focused Extracorporeal Shock Wave Therapy (ESWT)

Focused ESWT technology produces high frequency sound waves to reduce pain and inflammation and stimulate the body’s own reparative mechanisms.


Myofascial Acoustic Compression Therapy (MyACT)

Our new PiezoWave shockwave machine features MyACT, a new type of focused shockwave technology that allows for deeper compression of the focused waves. Its higher frequency allows for precise neuro modulation under ultrasound guidance, with a special linear head for treating myofascial pain.

This innovative shockwave technology transforms the mechanical energy of shockwaves into biochemical signals that precisely target damaged tissues. Its versatile system of controls lets us fine-tune its output levels for precise and personalized patient care. With MyACT, we are able to repair and regenerate damaged tissues by stimulating the body’s own reparative mechanisms.

Myofascial Acoustic Compression Therapy (MyACT)

Extracorporeal Pulse Activation Technology (EPAT)

Extracorporeal Pulse Activation Technology (EPAT)

EPAT, also called radial shock wave therapy, is not a true shockwave, but uses mechanical pressure waves that are much weaker than focused shockwaves. EPAT is most useful in regenerating fascia fibroblasts and eliminating fascia densifications.


Extracorporeal Magnetic Transduction Therapy (EMTT)

EMTT transmits high energy magnetic pulses that synchronize with your body’s own magnetic fields, triggering a regenerative response in tendons, muscles, bones and nerves.

Extracorporeal Magnetic Transduction Therapy (EMTT)

INDIBA Radiofrequency Therapy

INDIBA Radiofrequency Therapy

INDIBA therapy helps to restore the ionic charge of damaged cells, for faster injury healing.


NESA Neuromodulation Therapy

The NESA device generates a biphasic low-frequency electrical current that travels through autonomic neural pathways, to restore optimal neural signaling to the brain.

NESA Neuromodulation Therapy

HIGH ENERGY INDUCTIVE THERAPY (HEIT)

High Energy Inductive Therapy (HEIT)

High Energy Inductive Therapy (HEIT) is a new technology that uses electromagnetic fields to penetrate cells, tissues, organs and bones, to reactivate the electrochemical function of cells and cell membranes. HEIT relieves pain by restoring peripheral nerve function.


Laser Therapy

Laser therapy is a non-invasive approach to treating chronic pain that reduces inflammation, eliminates pain and speeds up tissue healing. The treatment uses light energy to penetrate your skin, muscle, nerve, and connective tissues, stimulating a photochemical reaction that changes the chemical and physical properties of the affected area at the molecular level

Phoenix Theralase Laser Therapy

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Ultrasound Guided Injection
Therapies

Injection therapies use natural/neutral solutions that stimulate cellular repair by either nourishing or irritating the targeted cells. Guidance by ultrasound ensures that the injected substances hit their mark, for maximum effectiveness.

Platelet Rich Plasma (PRP)

PRP therapy uses a sample of the patient’s own whole blood, which is spun in a centrifuge to extract a high concentration of platelets. When injected into damaged tissues, PRP initiates tissue repair by releasing biologically active factors such as growth factors, cytokines, lysosomes and adhesion proteins. The injected solution stimulates the synthesis of new connective tissues and blood vessels. PRP can help to jump-start healing in chronic injuries and accelerate repair in acute injuries.

 

Proliferation Therapy, aka Prolotherapy

Prolotherapy uses a biologically neutral solution, often containing dextrose, saline or lidocaine. The solution irritates the affected connective tissue, stimulating the body’s own natural healing mechanisms to encourage growth of new normal ligament or tendon fibers.

Avoiding Pinched and Herniated Discs

A balanced diet, adequate fluid intake and regular exercise are essential for a healthy spine and discs. Regular exercise promotes the flow of cerebrospinal fluid, enhances bone mineral density in the vertebra, and strengthens the muscles that hold the spine in proper alignment. Sedentary lifestyles and too much sitting can lead to poor spinal alignment and disc degeneration.

Since the inner gel-like nucleus of intervertebral discs is composed of up to 85 percent water, dehydration can profoundly affect disc integrity, causing discs to dry up and collapse. Chronic dehydration is estimated to affect between 40-75 percent of US adults. The elderly are especially prone to dehydration and disc herniation.

Many common medications promote dehydration:

  • Laxatives
  • Meds for Type II diabetes
  • Hypertension medications
  • Medications for heart failure
  • Drugs to treat migraine headaches
  • Cancer drugs

In addition to water, discs are mostly made of collagen, which requires dietary nutrients to build and maintain.

Top collagen-promoting foods include:

  • Bone broth made from bones and connective tissue, especially beef
  • Chicken, including chicken skin and connective tissue
  • Fish, especially salmon and sardines with bones and skin
  • Eggs, especially egg whites

Certain other lifestyle changes can help you avoid herniated discs:

  • Maintain a normal weight for your sex and height
  • Take frequent breaks from sitting
  • Pay attention to posture, especially when using mobile devices
  • Stretch regularly to elongate your spine
  • Do not smoke cigarettesэ
  • Use proper lifting technique
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Get Fast and Effective Herniated Disc Treatment in NYC

Conventional approaches to herniated disc rehab often involve medications, steroid injections and bedrest. When pain becomes chronic and persistent, doctors may recommend surgery to fuse your vertebrae, eliminating the disc altogether. However, these methods all involve substantial risks, with no guarantee of satisfactory outcomes.

At NYDNRehab, our holistic conservative approach gets to the root cause of your condition and corrects it, without drugs or surgery. Our end goal is to help you move freely, without pain or disability. We treat the whole patient, not just their symptoms. Our innovative therapies and advanced technologies help to accelerate healing and restore mobility, so you can quickly get back to doing the things you love.

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    Herniated Disc FAQs

    Will my herniated disc go away on its own?
    Most herniated discs resolve themselves over time. However, absence of pain does not necessarily mean your disc is healed. Moreover, unless you address the underlying cause of your disc herniation, it is likely to recur in the future.
    How many sessions will I need to resolve my herniated disc?
    Every patient has a unique anatomy, health status and causative factors that contribute to herniated disc pain. Our personalized approach ensures that you get as much treatment as necessary to eliminate the cause of your pain.
    Is it safe to exercise with a herniated disc?
    While gentle movement is recommended, you should avoid strenuous exercise until your disc completely heals.
    What can I do at home to help heal my herniated disc?
    Applying ice can help reduce inflammation and numb pain. Gentle stretching can help separate your vertebrae to take pressure off the nerve root.
    What kind of doctor should I see if I think I have a herniated disc?
    Try to find a holistic chiropractor or physical therapist who provides conservative care, without drugs or surgery
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    In this instance, an athlete was originally diagnosed with minor quadriceps muscle strain and was treated for four weeks, with unsatisfactory results. When he came to our clinic, the muscle was not healing, and the patients’ muscle tissue had already begun to atrophy.

    Upon examination using MSUS, we discovered that he had a full muscle thickness tear that had been overlooked by his previous provider. To mitigate damage and promote healing, surgery should have been performed immediately after the injury occurred. Because of misdiagnosis and inappropriate treatment, the patient now has permanent damage that cannot be corrected.

    The most important advantage of Ultrasound over MRI imaging is its ability to zero in on the symptomatic region and obtain imaging, with active participation and feedback from the patient. Using dynamic MSUS, we can see what happens when patients contract their muscles, something that cannot be done with MRI. From a diagnostic perspective, this interaction is invaluable.

    Dynamic ultrasonography examination demonstrating
    the full thickness tear and already occurring muscle atrophy
    due to misdiagnosis and not referring the patient
    to proper diagnostic workup

    Demonstration of how very small muscle defect is made and revealed
    to be a complete tear with muscle contraction
    under diagnostic sonography (not possible with MRI)

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    Complete tear of rectus femoris
    with large hematoma (blood)

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    Separation of muscle ends due to tear elicited
    on dynamic sonography examination

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