Dry needling is a procedure where non-medicated needles are inserted into painful tissues, with the goal of releasing trigger points, mini muscle spasms that can cause pain and limit functional range of motion. Because of the shoulder’s complex architecture and its multi-planar movement, trigger points often arise in the rotator cuff muscles and in connective tissues involved in shoulder movement. When performed under ultrasound guidance, dry needling for shoulder pain can bring fast relief and quickly restore functional shoulder range of motion.
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Clinical director & DC RMSK
Our clinical director Dr. Lev Kalika is a highly respected specialist in ultrasound imaging and dry needling, with multiple scientific studies and publications to his credit. Dr. Kalika has trained under some of the world’s most renowned specialists in the field of rehabilitative medicine, and he never stops learning.
Dr. Kalika is quick to embrace new technologies and innovative therapies that help patients resolve their pain syndromes and movement disorders. The NYDNRehab Manhattan clinic features some of the most advanced technologies in the world, rarely available to patients in a private clinical setting.
Conventional treatment for shoulder pain often involves steroid injections, anti-inflammatory medications and pain pills. Dry needling offers an alternative shoulder treatment that pinpoints the source of shoulder pain and delivers fast relief, without drugs. Needles are inserted “dry,” meaning they do not deliver any sort of medication. Instead, the goal of dry needling is to evoke a twitch response in trigger points, to get tight fibers to release and relax.
At NYDNRehab, we use high resolution diagnostic ultrasound to guide our needling procedures. Ultrasound imaging takes place in real time, with the patient in motion, to ensure accurate and effective treatment. Ultrasound gives us a clear image of dysfunctional tissues during needling procedures, enabling us to precisely hit our target and to immediately confirm our results.
Dry needling requires expertise on the part of the practitioner, but without ultrasound guidance, needling procedures are hit-or-miss. Even the most skilled dry needling specialist can miss the mark if needling is done “blind.” Blind needling procedures are performed based on the assumption that the patient’s shoulder complex conforms to the standard anatomical model, but human anatomy varies widely from one patient to the next.
At NYDNRehab, we treat the patient, not the condition. We recognize that every patient has a unique anatomical architecture, and that needles inserted blindly can potentially hit neural bodies and do more harm than good.
Due to the complexity of shoulder architecture, shoulder pain and dysfunction can stem from many causes. Diagnosis based on symptoms alone is not likely to get to the root of the problem, and even MRI imaging can overlook changes in damaged tissues that cause shoulder pain.
At NYDNRehab, we use high-resolution diagnostic ultrasonography to view the shoulder complex in real time. Ultrasound imaging lets us examine the shoulder from multiple angles, with the patient in motion and providing verbal feedback.
Because diagnostic ultrasound is performed on-site in our clinic, we can quickly get to work on a treatment plan, often in the same session — no waiting for images to come back from the lab.
Conventional shoulder pain treatment with drugs and steroids often fails to improve the patient’s condition, and when all else fails, surgery becomes the next step. But conservative treatment of shoulder pain often leads to better patient outcomes, at a fraction of the cost, with much lower risk, and faster recovery.
In addition to dry needling, other alternative shoulder treatments include:
Physical therapy
Manual therapy
Dynamic neuromuscular stabilization (DNS)
Posture correction therapy
Regenerative therapies
With a vast array of non-invasive or minimally invasive tools at our disposal for treating shoulder pain, we are able to help patients quickly restore pain-free functional movement without drugs or surgery.
Regenerative therapies work by tapping into the body’s own innate healing mechanisms, to jump-start the healing process. Some tissues are slow to heal due to low vascularity that limits blood flow to the cells. Blood carries with it oxygen and nutrients that are essential to the healing process. Regenerative therapies work by a variety of mechanisms to increase blood flow and stimulate cellular repair.
Focused ESWT is used as a regenerative treatment for damaged tendon, muscle and bone tissue. This technology produces high frequency sound waves to stimulate the body’s own reparative mechanisms. It is especially effective for chronic degenerative tendon disorders and myofascial pain syndrome.
EMTT is a fairly new technology that transmits high energy magnetic pulses to targeted tissues. The magnetic waves synchronize with the body’s own magnetic fields, causing a disturbance that triggers a regenerative response. EMTT waves can penetrate deep tissues up to 18 cm beneath the skin’s surface, to target difficult-to-reach tendons, muscles, bones and nerves.
Extracorporeal Pulse Activation Technology (EPAT)
EPAT, also known as defocused shock wave therapy, uses acoustic pressure waves to enhance blood circulation to targeted tissues. This speeds up the delivery of oxygen and nutrients to damaged tissues and stimulates cellular metabolism, to accelerate the healing process.
HEIT uses electromagnetic fields to penetrate cells, tissues, organs and bones, to reactivate the electrochemical function of cells and cell membranes. HEIT generates a magnetic field 600 times stronger than the field of a normal magnet, to stimulate healing of nerves, muscles and blood vessels.
Our INDIBA Tecar therapy machine converts electrical current into a stable radio frequency current of 448 kHz, designed to increase and stabilize the exchange of ions in damaged cells, evoking a regenerative response that accelerates healing. INDIBA can be used to successfully treat joint and muscle disorders, low-back pain, sports injuries, surgical incisions and various pain syndromes. Another therapeutic effect of INDIBA is extreme and prolonged cellular hyperthermia. Due to this effect, INDIBA therapy combined with manual therapy and soft tissue tissue manipulation enables instantaneous release to occur, significantly shortening the number and duration of physical therapy sessions. What is normally accomplished in two months of physical therapy can be accomplished in 3-4 sessions with INDIBA.
Prolozone therapy is a new regenerative needling procedure that takes Prolotherapy to the next level. With prolozone therapy, a combination of procaine, anti-inflammatory medications, vitamins, minerals, and a mixture of ozone/oxygen gas is injected into joints or tissues that have been injured or have degenerated. When performed under ultrasound guidance, Prolozone therapy quickly reduces pain and inflammation while jump-starting the healing process.
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.
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.
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.
Shoulder pain can be debilitating, limiting your range of motion and keeping you in constant pain. Drugs may mask the symptoms for a little while, but they cannot resolve the problem in the long run.
The shoulder pain specialists at NYDNRehab have a growing array of tools and technologies to treat shoulder pain and dysfunction. Our track record of success makes NYDNRehab the premier shoulder clinic in NYC.
You don’t have to live with shoulder pain, and there are highly effective alternatives to shoulder surgery. Contact NYDNRehab today, and get rid of your shoulder pain for good so you can get back to doing the things you love!