BACK PAIN PHYSICAL THERAPY

About Back Pain

Back pain is a common complaint among adults around the world, and it accounts for the majority of doctor visits in the United States. Yet most back pain is non-specific in nature, meaning that no specific mechanical or pathological cause can be identified. There is a growing consensus that back pain is multifactorial, meaning that each case of back pain may have more than a single cause. For that reason, accurate diagnosis is key to effective back pain treatment.

Dr. Lev Kalika

Clinical director & DC RMSK

About Back Pain Specialist Dr. Lev Kalika

Dr. Lev Kalika, clinical director of NYDNRehab, is the author of multiple medical publications and research, and an international expert in the fields of rehabilitative sonography, ultrasound guided dry needling and sports medicine. Dr. Kalika works with athletes, runners, dancers and mainstream clients to relieve pain, rehabilitate injuries, enhance performance and minimize the risk of injuries. His clinic features some of the most technologically advanced equipment in the world, rarely found in a private clinic.

Why Physical Therapy Alone May Not Resolve Your Condition

Physical therapy is a valuable and effective approach to resolving musculoskeletal pain and dysfunction, but in many cases, physical therapy does not provide a stand-alone solution. Prior to beginning physical therapy, patients often need to address underlying issues that contribute to their pain and disability.

Unfortunately, mainstream physical therapy clinics are often not adequately equipped or experienced to identify and treat complications that undermine the effectiveness of physical therapy. They often rely on one-size-fits-all treatment protocols that overlook the unique characteristics of the individual condition, opting to treat the symptoms and not the patient.

Issues that should be addressed prior to beginning physical therapy include:

Scar tissue and fascia adhesions
Neurogenic inflammation
Joint edema
Inflamed soft tissues

Myofascial trigger points
Compressed or entrapped nerves
Tendons that have degenerated and lost their elastic properties
Compensation patterns developed post-injury

Holistic Non-Invasive Diagnosis and Regenerative Therapy

Identifying and treating underlying issues prior to beginning physical therapy is key to getting fast and effective results. Failure to do so can completely undermine your treatment protocol, and in some cases, your condition may even worsen.

At NYDNRehab, we use a broad range of advanced technologies and innovative therapeutic approaches to resolve issues that can potentially undermine the success of physical therapy.

Our talented staff is certified in a diverse array of treatment methodologies, rarely found in run-of-the-mill physical therapy clinics. Our one-on-one sessions are personalized, based on the patient’s unique diagnostic profile.

Obstacles to physical therapy success include:

Scar tissue and fascia adhesions
Neurogenic inflammation
Joint edema
Inflamed soft tissues
Myofascial trigger points
Compressed or entrapped nerves
Tendons that have degenerated and lost their elastic properties
Compensation patterns developed post-injury

Why Back Pain Physical Therapy at NYDNRehab is Better than Conventional Back Pain Treatment

The human body is made up of interconnected structures designed to work together in coordinated patterns to produce movement. Because the spine is involved in every aspect of human movement, back pain often originates from weakness, tightness or imbalances of muscles and connective tissues located far from the locus of pain.

Conventional medicine often focuses on pain management, treating generalized back pain with opioids, steroid injections and anti inflammatory medications without addressing its underlying causes. This often leads to recurring episodes of back pain that are never fully resolved, causing chronic pain and disability.

Excessive use of MRI and surgical interventions have proven to be no more effective than conservative care for improving patient outcomes, and excessive use of prescription pain medications appears to be fueling the current global opioid epidemic.

Many people stop moving when they are in pain, but with back pain, active treatments are more likely to be successful than passive treatments. Any back pain treatment should involve active care, where the patient is an active participant in their recovery. Active care includes exercise, modifying thoughts and beliefs about back pain, and learning more about behaviors that cause back pain.

Types of Back Pain

Non-specific back pain

Has no identifiable root. The patient experiences pain, yet no mechanical cause can be determined by medical practitioners.

Myo-fascial back pain

Has its origins in the fascia, the thin tough sheath of connective tissue that encases and compartmentalizes muscles. Myofascial pain often stems from trigger points, tiny knots in fascia that sensitize nerves in local muscles or connective tissue.

Mechanical back pain

Originates from excessive stress on muscles surrounding the vertebral column. Mechanical pain is often caused by daily habits such as poor posture, poorly-designed workstation ergonomics, or faulty lifting techniques.

Nociplastic back pain

Arises from heightened activation of peripheral sensory nerves, despite no clear evidence of tissue damage.

Neuropathic back pain

Is caused by disease or damage that affects the somatosensory nervous system.

Nociceptive back pain

Is the most common type of back pain. It arises from physical damage to the body due to trauma or surgery.

Symptoms, Causes and Risk Factors of Back Pain

Symptoms

Dull or achy pain in the spinal region
Burning pain that runs from the low back to the legs (sciatica)
Muscle spasms and tightness
Pain that gets worse after long periods of sitting or standing
Pain and stiffness when trying to stand up straight
Pain when walking
Pain when moving from standing to sitting

Causes

Lifting objects with poor technique
Poor workspace ergonomics
Poor posture when sitting or standing
Weakened deep spinal muscles and core musculature
Neuromuscular dysfunction
Faulty gait mechanics
Motor deficits in the lumbopelvic region

Risk Factors

Sedentary lifestyle with excessive sitting
Smoking
Obesity
Metabolic disease
Physically demanding work
Poor sleep habits
Overuse from exercise or occupation

Accurate Diagnosis Means Successful Back Pain Treatment

Our initial back pain diagnosis begins with a clinical exam. Radiology rarely adds useful information unless conservative care fails to resolve back pain. In such cases, epidural steroid injections or surgery may be considered as a last resort. However, the first line of defense for back pain treatment is always conservative care, making imaging with MRI or Xray unnecessary.

Diagnostic ultrasonography can be useful for identifying soft tissue damage or inflammation, and it can be used to provide a differential diagnosis for disc bulges or spinal canal stenosis. Ultrasound can also be used to guide pain-blocking injections and dry needling procedures.

Accurate Diagnosis Means Successful Back Pain Treatment

We Use High-Tech Equipment for Optimal Results

At NYDNRehab, we go beyond treating back pain symptoms to finding the underlying causes of back pain and eliminating them. To optimize results, we use advanced technologies that are rarely found in a private clinical setting.

We approach back pain with a variety of manual and therapeutic exercise techniques, spinal stability strengthening, gait retraining, ultrasound guided dry needling and exercises to correct motor dysfunction and improve neural communication between the muscles and the central nervous system.

Our treatment toolbox includes:

Dynamic neuromuscular stabilization (DNS) to restore innate motor patterns

Ultrasound guided dry needling, to eradicate trigger points

Therapeutic massage

Neuromodulation

Chiropractic spinal manipulation

Gait analysis and retraining

Deep core stabilization exercises with C.A.R.E.N, our computer assisted rehabilitation environment

Postural retoration

Redcord Neurac therapy

Extracorporeal shock wave therapy (ESWT)

Electromagnetic transduction therapy (EMTT)

Myofascial manipulation

McKenzie therapy

Regenerative Technologies for Back
Pain Physical Therapy

At NYDNRehab, we use a combination of treatment approaches for back pain, based on the specific needs of the individual patient. The human body has its own innate healing mechanisms, but it sometimes needs a nudge to accelerate the healing process. Regenerative technologies help to jump-start healing by stimulating tissue repair at the cellular level. Our outpatient regenerative therapies expedite recovery with minimal discomfort for the patient.

We combine regenerative shock wave therapy, electromagnetic transduction therapy and other regenerative approaches to relieve pain and stimulate healing. Our regenerative technologies and innovative therapeutic approaches make NYDNRehab the premier clinic for back pain treatment in New York.

Focused Shockwave Therapy

Focused Extracorporeal Shock Wave Therapy (ESWT)

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.

Extracorporeal Magnetic Transduction Therapy (EMTT)

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.

Electromagnetic Transduction Therapy (EMTT)

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.

High Energy Inductive Therapy (HEIT)

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.

HIGH ENERGY INDUCTIVE THERAPY (HEIT)

INDIBA CT9 Radiofrequency Device

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.

Ultrasound Guided Dry Needling

Myofascial trigger points often contribute to lower back pain. Dry needling is an outpatient procedure that inserts non-medicated needles into the trigger point to evoke a twitch response, releasing the trigger point and immediately relieving pain. Ultrasound guidance eliminates the need for multiple insertions, reducing pain and discomfort for the patient.

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.